The FDA approved Arvinas and Pfizer’s Veppanu (formerly vepdegestrant), a proteolysis-targeting chimera (PROTAC), for a biomarker-defined subgroup of adults with metastatic estrogen receptor–positive, HER2-negative breast cancer that has progressed after at least one endocrine therapy. The label is restricted to patients with ESR1 mutations, aligning the drug’s clinical development strategy with the biology of endocrine resistance. The agency’s decision followed data from the VERITAC-2 trial showing Veppanu improved progression-free survival by nearly three months versus fulvestrant. Arvinas said the approval supports targeted protein degradation as a strategy that can translate into clinically meaningful benefit, particularly for patients with limited second-line options. The approval arrives alongside a competitive crowded field of oral endocrine-disrupting therapies, but the ESR1 mutation focus narrows the addressable population and helps frame how the product may be positioned clinically and commercially going forward.