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The goal of avoiding chemotherapy and its attendant adverse effects is attractive to breast cancer patients and clinicians. In appropriate patients with estrogen receptor (ER)-positive breast cancer, the strategy of exhausting endocrine therapy options has been used to delay time to chemotherapy and help maintain quality of life. A similar strategy has been considered in select patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Previous reports have shown that combining anti-HER2 agents with endocrine agents in ER-positive and HER2-positive metastatic breast cancer is more effective than endocrine therapy alone.
More recently, a clinical trial involving women with HER2-positive disease compared various comb…