The FDA approved Arvinas and Pfizer’s PROTAC breast cancer therapy Veppanu (formerly vepdegestrant) for a defined subgroup of adults with metastatic estrogen receptor-positive, HER2-negative breast cancer that has progressed after at least one endocrine therapy, with ESR1 mutations identified by companion diagnostics. The decision was based on data from the VERITAC-2 trial. The approval underscores the regulatory momentum behind protein-degradation mechanisms, with Veppanu designed to eliminate estrogen receptors rather than inhibit them. Arvinas said the treatment adds an option for patients with limited second-line choices once standard therapies fail. Clinically, the label is tightly constrained to an ESR1-mutated population, reflecting evidence that drove efficacy signals in that subset, and setting a clear bar for payers and clinicians to test for ESR1 before prescribing.