Jamie L. Carroll, APRN, CNP, MSN, of the Mayo Clinic, discussed the evolving second-line treatment landscape for HR-positive, HER2-negative metastatic breast cancer, emphasizing the importance of clinician education and patient advocacy. Many community cancer centers use palbociclib (Ibrance), the first CDK4/6 inhibitor approved for this condition. For patients with ESR1 mutations, the FDA approved elacestrant (Orserdu), highlighting the need for testing upon disease progression on a CDK4/6 inhibitor. Nurses and APPs play a crucial role in advocating for the best treatment options based on individual patient needs.