Finally, presence of FGFR1 alterations in baseline plasma tumor DNA was associated with a shorter progression free survival in the large randomized MONALEESA-2 trial of letrozole ± ribociclib, suggesting aberrant FGFR signaling is a potential mechanism of escape from endocrine therapy plus CDK4/6 inhibitors, a current standard of care in advanced ER+ breast cancer. The gene discussed is CDK4; the disease is breast cancer.