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How would you approach a patient with metastatic ER/PR+,HER2- breast cancer with linear leptomeningeal enhancement on MRI but negative CSF protein and cytology?  

She had disease progression on palbociclib and letrozole. She also has a PIK3CA mutation however did not tolerate alpelisib due to Grade 3 hyperglycemia and depression. 



Answer from: Medical Oncologist at Academic Institution
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