Tiffany A. Traina, MD, FASCO; Melissa Rikal, MSN, FNP-BC, AOCNP, and Marissa Marti-Smith, DNP, APRN, AGNP-C, AOCNP discuss how emerging treatment strategies and molecular profiling are transforming the management of metastatic hormone receptor-positive, HER2-negative breast cancer, with a specific focus on ESR one mutations and the potential of new targeted therapies like L-acstrin.