Study aid only. Verify against current guidelines, primary literature, staging manuals, and prescribing information before clinical use.

← All algorithms  ·  Related notes →

HR+ / HER2− Advanced Breast Cancer — Systemic Therapy

First-line Second-line Later-line SECOND-LINE THIRD-LINE / LATER HR+ / HER2− advanced breast cancer Endocrine-sensitive ESR1 mutation PIK3CA / AKT / PTEN PIK3CA mutation gBRCA1/2 Endocrine-resistant ADC by HER2 status Frontline CDK4/6 inhibitor + ET MONALEESA / PALOMA ↗ Oral SERD Elacestrant EMERALD ↗ AKT pathway Capivasertib + fulvestrant CAPItello-291 ↗ PI3K Alpelisib + fulvestrant SOLAR-1 ↗ PARP Olaparib / talazoparib OlympiAD ↗ PIK3CA Palbo + fulvestrant + inavolisib INAVO120 ↗ No driver Everolimus + AI / fulvestrant BOLERO-2 ↗ HER2-low Trastuzumab deruxtecan DESTINY-Breast04 ↗ TROP2 Datopotamab deruxtecan TROPION-Breast01 ↗ TROP2 Sacituzumab govitecan TROPiCS-02 ↗