Trials and papersHR-positive / HER2-negative breast cancer

TROP2 is not a fixed property of a breast cancer; treatment can move it. A test of TROP2 taken at diagnosis may not describe what is left later.

Methylation in blood can say whether advanced breast cancer still carries the oestrogen receptor. Subtyping still needs percent-level tumour content.

NCCN is the source of the category grades on the triple-negative breast cancer page and the first major guideline to place an antibody-drug conjugate first line for the disease.

Surveillance blood tests in hormone-receptor-positive breast cancer find relapse, but often too late to act on it before scans show it. The randomised question, whether treating at molecular relapse helps, has not yet reported.

Answers the two questions that hung over adjuvant olaparib, durability and late leukaemia, in its favour; the remaining question is whether carriers who also received pembrolizumab or capecitabine, whom the trial did not study, get the same benefit.

Acting on a resistant subclone found in blood keeps its benefit into the next line of treatment. It works where the clone carries a mutation that both marks it and chooses the drug.

Chinese patients in the trial saw the same pattern as the global population: a clear progression-free survival gain, no proven survival gain, and a different rather than heavier side-effect burden, with mouth and eye toxicity in nearly half. It supports use of datopotamab deruxtecan in this setting in China but does not resolve the global trial's missing survival benefit.

Platinum and immunotherapy are now consensus for early triple-negative disease; the open votes have moved to who can safely receive less.