Fig. 1: Cohort selection and study design.

a Selection of patients with HR+/HER2- BC in the CGDB. b Attrition of the eBC cohorts in our study. c Attrition of the 1L cohorts in our study and split into pre- and post-1L groups based on the line of treatment and timing of the sample collection for CGP testing. d Patients are selected based on their 1L regimen and are divided into subgroups based on the timing of their CGP. The effect of treatment on gene alterations is estimated by comparing alteration prevalence in tumors profiled prior to the 1L versus tumors profiled after 1L. Stratified analyses are based on a stratum of patients defined by clinical variables (e.g. de novo vs. recurrent disease) or sample characteristics. eBC/mBC stands for early/metastatic breast cancer, HR+/HER2- for hormone-receptor positive HER2-negative, CGP for comprehensive genomic profiling, 1L for first-line treatment, ETR for endocrine treatment resistance, CGDB for clinico-genomic database, AI for aromatase inhibitor, Fulv for fulvestrant.