Antibody-drug conjugates beyond HER2: Translating evidence into practice for HR+ HER2-negative and triple-negative metastatic breast cancer.

Antibody-drug conjugates (ADCs) have redefined therapeutic paradigms in metastatic breast cancer, offering unprecedented efficacy across hormone receptor-positive/HER2-negative and triple-negative subtypes. Trastuzumab deruxtecan, sacituzumab govitecan, datopotamab deruxtecan, and sacituzumab tirumotecan are expanding treatment options beyond traditional chemotherapy. As their clinical integration advances, optimizing the prevention and management of ADC-related toxicities, determining optimal sequencing strategies, and refining biomarker characterization have become central challenges. Ongoing research into ADC combinations, earlier-line use, and precision biomarker selection is expected to further reshape the therapeutic landscape and personalize care for patients with advanced breast cancer.