In the 500 mg Sacibertinib plus exemestane cohort (N = 12), ORR was 25.0%(3/12), DCR was 100.0%(12/12), CBR was 50.0%(6/12), and median PFS was 9.0 months. Sacibertinib plus endocrine therapy had a favorable safety profile and antitumor activity in patients with ER+/ HER2+ MBC, 400-500mg daily showed more efficacy, supporting further assessment in randomized studies.