ESR1 and breast carcinoma: Palbociclib is a cytostatic drug, and its effects decrease PIK3CA-mutant ctDNA, indicating that ctDNA PIK3CA mutations may be useful as an early predictor of response, as was observed in the PALOMA-3 trial of ER-positive/HER2-negative advanced breast cancer patients who had previously progressed to endocrine therapy [69,77].