Inetetamab Plus Rapamycin and Chemotherapy for HER2+ Metastatic Breast Cancer With Abnormal Activation of PAM Pathway

Inclusion Criteria: 1. Female, Aged \> 18; 2. HER2-positive breast cancer are defined as immunohistochemical (IHC) testing as +++, or IHC++ with FISH testing of positive; 3. Histologically or cytologically confirmed invasive breast carcinoma with locally recurrent or radiological evidence of metastatic disease. 4. Patients with HER2-positive metastatic breast cancer who have progressed disease after trastuzumab treatment include the following four types of patients (Note: The following patients are in a parallel relationship): 1. Patients with HER2-positive breast cancer who have progressed during adjuvant trastuzumab treatment after surgery; or 2. Patients with HER2-positive breast cancer who have relapsed or metastasized after receiving adjuvant trastuzumab therapy; or 3. HER2-positive recurrent or metastatic BC patients who have progressed after receiving at least 4 weeks of trastuzumab as first-line treatment ; or 4. HER2-positive metastatic BC patients who have never been treated have progressed after receiving at least 4 weeks of trastuzumab as first-line treatment. 5. Genetic testing shows that the PI3K/Akt/mTOR pathway related genes are mutated; 6. ECOG PS score ≤2, estimated survival time ≥6 months, and can be followed-up; 7. Patients with measurable disease as per RECIST 1.1 criteria; 8. Cardiopulmonary function is basically normal, LVEF≥50% within 4 weeks before starting treatment; 9. An adequate liver function with the following definition: 1. Total bilirubin ≤ 1.5 times the upper limit of normal value. Patients with known Gibert's disease can be included in the group if combined bilirubin ≤ 1.5 times the upper limit of normal value; 2. AST and ALT ≤2.5 times the upper limit of the normal value; if there is liver metastasis, ≤5 times the upper limit of the normal value (the normal value is the normal value specified by this clinical trial center); 10. Have sufficient baseline hematology parameters, defined as follows: 1. ANC≥1.5 x 10\^3 /μL; 2. Platelet count ≥100 x 10\^3/μL, if it is 75-100 x 10\^3/μL, it may be included in the group, as long as the doctors believe it can be included; 3. Hemoglobin ≥9 g/dL. 11. Coagulation Indicators: International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤ 1.5 times the upper limit of normal, unless drugs known to change INR and aPTT are used; 12. No history of serious heart, kidney and other important organs and endocrine disease; 13. Female patients of childbearing age have a negative pregnancy test and voluntarily take effective and reliable contraceptive measures; 14. The patients voluntarily signed an informed consent form. Exclusion Criteria: Anyone who has one of the following conditions cannot be selected for this trial: 1. Participated in other clinical trials within 4 weeks; 2. Have used mTOR inhibitors in the past; 3. Previous use of Pyrotinib in first-line treatment stage; previous use of lapatinib is allowed; 4. Accompanied by immunosuppressant or chronic corticosteroid medication, or more than 25% bone marrow radiotherapy within 4 weeks; 5. Symptomatic CNS metastases or evidence of leptomeningeal disease; 6. Gastrointestinal dysfunction or gastrointestinal diseases (including active ulcers); 7. Hepatitis B or hepatitis C carriers, or other known chronic liver diseases; HIV positive; 8. Known hypersensitivity to any study medication 9. Women during pregnancy or lactation; 10. Left ventricular ejection fraction \<50%; clinical manifestations of patients with obvious arrhythmia, myocardial ischemia, severe atrioventricular block, cardiac insufficiency, and severe valvular disease; 11. Any malignancy within 5 years prior to randomization, with the exception of adequately treated in-situ carcinoma of the cervix uteri, basal or squamous cell carcinoma; 12. The researchers decide that any other medical, social or psychological conditions which are inappropriate to participate in this trial.