What would you recommend as next line treatment for a man with metastatic ER+ PR+ HER2 1+ PIK3CA mutated breast cancer with mets to bone, who was diagnosed with advanced disease while on AI + GnRH agonist, and has subsequently progressed through CDK4/6 inhibitor + fulvestrant, PIK3CA + fulvestrant, and capecitabine?   

What would you recommend as next line treatment for a man with metastatic ER+ PR+ HER2 1+ breast cancer with mets to bone, PIK3CA+ who was diagnosed with advanced disease while on AI + GnRH agonist, and has subsequently progressed through CDK4/6 inhibitor + fulvestrant, PIK3CA + fulvestrant, and capecitabine?