[Nguyen]

I am surprise not seeing Lapatinib (tykerb) in your regimen, particularly before T-DM1. You might want to discuss Lapatinib and SYD985 (need to be in clinical trial for this one).

So I believe these meds should be discussed with your oncologist: Lapatinib, Enhertu, Margetuximab, Neratinib, and SYD985. Perhaps a discussion to use circulating tumor cells to recheck ER/PR status which would open up more regimens. When you have to use drug that causes hair loss, perhaps consider cold caps or scalp cooling to reduce hair loss.

Best wishes.