Fulvestrant, Ipatasertib and CDK4/6 Inhibition in Metastatic ER+/HER2- Breast Cancer Patients Without ctDNA Suppression

This study is testing whether combining fulvestrant (a hormone-blocking injection), ipatasertib (a targeted therapy), and a standard CDK4/6 inhibitor can better suppress breast cancer in patients whose cancer DNA is still detectable in the blood despite current hormone therapy. **You may be eligible if:** - You have advanced (metastatic or locally advanced) ER-positive, HER2-negative breast cancer - You have already received at least one hormone therapy for advanced disease and your cancer has progressed - You have received no more than one prior line of chemotherapy for advanced disease - You are eligible for fulvestrant combined with a CDK4/6 inhibitor as standard care - You have measurable disease on imaging or assessable bone disease **You may NOT be eligible if:** - You have progressed on more than one chemotherapy regimen for advanced disease - You do not have measurable or assessable disease - You are pregnant or breastfeeding - Your organ function (heart, liver, kidneys) does not meet the required thresholds Talk to your doctor to see if this trial is right for you.