Food and Drug Administration (FDA) approvals include alpelisib for postmenopausal women and men with HR+, human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic, PIK3CA-mutated breast cancer, elacestrant for postmenopausal women or adult men with estrogen receptor positive (ER+), HER2-, advanced or metastatic, ESR1-mutated breast cancer, and capivasertib for patients with HR+, HER2-, locally advanced or metastatic breast cancer harboring one or more PIK3CA, AKT1, or PTEN alterations [7–9]. The gene discussed is ESR1; the disease is breast cancer.