{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:13:23Z","timestamp":1794276803131,"version":"4.9.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Cancer"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    More effective therapies are required for advanced breast cancer. We report results from 58 women with locally advanced unresectable or metastatic hormone-receptor (HR)-negative, human epidermal growth factor receptor 2 (HER2)-low breast cancer enrolled in arm 6 of the multicenter, open-label phase 1b\/2 BEGONIA platform trial, who received durvalumab (1,120\u2009mg) plus trastuzumab deruxtecan (T-DXd; 5.4\u2009mg\u2009kg\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) intravenously every 3\u2009weeks as first-line treatment. Objective response rate (ORR) and safety were primary endpoints; duration of response (DoR), progression-free survival (PFS) and overall survival (OS) were secondary endpoints. Median follow-up was 20.6\u2009months (range: 1\u201337). ORR was 62.1% (95% confidence interval (CI): 48.4\u201374.5), which did not meet the protocol-specified objective of 38\/57 (66.6%) responses. Median DoR was 15.2\u2009months (95% CI: 8.44\u2013not calculable), PFS was 12.6\u2009months (95% CI: 8.4\u201316.3) and OS was 30.3\u2009months (95% CI: 18.8\u2013not calculable). The safety profile of the combination treatment was consistent with those of the individual therapies. Adjudicated, drug-related interstitial lung disease or pneumonitis occurred in 20.7% of participants (grades 1 and 2, 19.0%; grade 5, 1.7%). Durvalumab plus T-DXd demonstrated clinically relevant efficacy for first-line treatment of metastatic HR-negative, HER2-low breast cancer, with no unexpected toxicities observed. ClinicalTrials.gov identifier:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03742102\" ext-link-type=\"uri\">NCT03742102<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1038\/s43018-026-01181-8","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T09:08:09Z","timestamp":1780909689000},"page":"983-992","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["First-line durvalumab in combination with trastuzumab deruxtecan in women with locally advanced unresectable or metastatic, hormone-receptor-negative, HER2-low breast cancer: multicenter, open-label, phase 1b\/2 BEGONIA platform trial"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9817-5228","authenticated-orcid":false,"given":"Peter","family":"Schmid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5396-6533","authenticated-orcid":false,"given":"Seock-Ah","family":"Im","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Nowecki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4003-5278","authenticated-orcid":false,"given":"Piotr J.","family":"Wysocki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-6747","authenticated-orcid":false,"given":"Jacek","family":"Jassem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-7224","authenticated-orcid":false,"given":"Kyung Hae","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7946-5609","authenticated-orcid":false,"given":"Simon","family":"Lord","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Vukovi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelima","family":"Denduluri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Hee","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"1181_CR1","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1158\/2159-8290.CD-18-1177","volume":"9","author":"AC Garrido-Castro","year":"2019","unstructured":"Garrido-Castro, A. C., Lin, N. U. & Polyak, K. Insights into molecular classifications of triple-negative breast cancer: improving patient selection for treatment. Cancer Discov. 9, 176\u2013198 (2019).","journal-title":"Cancer Discov."},{"key":"1181_CR2","doi-asserted-by":"publisher","first-page":"15584","DOI":"10.18632\/oncotarget.14698","volume":"8","author":"H Mori","year":"2017","unstructured":"Mori, H. et al. The combination of PD-L1 expression and decreased tumor-infiltrating lymphocytes is associated with a poor prognosis in triple-negative breast cancer. Oncotarget 8, 15584\u201315592 (2017).","journal-title":"Oncotarget"},{"key":"1181_CR3","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1158\/2326-6066.CIR-13-0127","volume":"2","author":"EA Mittendorf","year":"2014","unstructured":"Mittendorf, E. A. et al. PD-L1 expression in triple-negative breast cancer. Cancer Immunol. Res. 2, 361\u2013370 (2014).","journal-title":"Cancer Immunol. Res."},{"key":"1181_CR4","doi-asserted-by":"publisher","DOI":"10.1200\/GO.23.00285","volume":"10","author":"S Al Sukhun","year":"2024","unstructured":"Al Sukhun, S. et al. Systemic treatment of patients with metastatic breast cancer: ASCO Resource-Stratified Guideline. JCO Glob. Oncol. 10, e2300285 (2024).","journal-title":"JCO Glob. Oncol."},{"key":"1181_CR5","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s10549-022-06547-x","volume":"193","author":"PE Hall","year":"2022","unstructured":"Hall, P. E. & Schmid, P. Emerging strategies for TNBC with early clinical data: new chemoimmunotherapy strategies. Breast Cancer Res. Treat. 193, 21\u201335 (2022).","journal-title":"Breast Cancer Res. Treat."},{"key":"1181_CR6","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/S1470-2045(19)30689-8","volume":"21","author":"P Schmid","year":"2020","unstructured":"Schmid, P. et al. Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 21, 44\u201359 (2020).","journal-title":"Lancet Oncol."},{"key":"1181_CR7","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1056\/NEJMoa2202809","volume":"387","author":"J Cortes","year":"2022","unstructured":"Cortes, J. et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N. Engl. J. Med. 387, 217\u2013226 (2022).","journal-title":"N. Engl. J. Med."},{"key":"1181_CR8","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1016\/j.annonc.2021.05.801","volume":"32","author":"D Miles","year":"2021","unstructured":"Miles, D. et al. Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced\/metastatic triple-negative breast cancer. Ann. Oncol. 32, 994\u20131004 (2021).","journal-title":"Ann. Oncol."},{"key":"1181_CR9","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1016\/j.annonc.2020.08.2098","volume":"31","author":"JK Litton","year":"2020","unstructured":"Litton, J. K. et al. Talazoparib versus chemotherapy in patients with germline BRCA1\/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial. Ann. Oncol. 31, 1526\u20131535 (2020).","journal-title":"Ann. Oncol."},{"key":"1181_CR10","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-020-00208-2","volume":"7","author":"F Schettini","year":"2021","unstructured":"Schettini, F. et al. Clinical, pathological, and PAM50 gene expression features of HER2-low breast cancer. NPJ Breast Cancer 7, 1 (2021).","journal-title":"NPJ Breast Cancer"},{"key":"1181_CR11","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1200\/JCO.19.02318","volume":"38","author":"S Modi","year":"2020","unstructured":"Modi, S. et al. Antitumor activity and safety of trastuzumab deruxtecan in patients with HER2-low-expressing advanced breast cancer: results from a phase 1b study. J. Clin. Oncol. 38, 1887\u20131896 (2020).","journal-title":"J. Clin. Oncol."},{"key":"1181_CR12","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1056\/NEJMoa1914510","volume":"382","author":"S Modi","year":"2020","unstructured":"Modi, S. et al. Trastuzumab deruxtecan in previously treated HER2-positive breast cancer. N. Engl. J. Med. 382, 610\u2013621 (2020).","journal-title":"N. Engl. J. Med."},{"key":"1181_CR13","doi-asserted-by":"publisher","first-page":"5097","DOI":"10.1158\/1078-0432.CCR-15-2822","volume":"22","author":"Y Ogitani","year":"2016","unstructured":"Ogitani, Y. et al. DS-8201a, a novel HER2-targeting ADC with a novel DNA topoisomerase I inhibitor, demonstrates a promising antitumor efficacy with differentiation from T-DM1. Clin. Cancer Res. 22, 5097\u20135108 (2016).","journal-title":"Clin. Cancer Res."},{"key":"1181_CR14","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1111\/cas.12966","volume":"107","author":"Y Ogitani","year":"2016","unstructured":"Ogitani, Y., Hagihara, K., Oitate, M., Naito, H. & Agatsuma, T. Bystander killing effect of DS-8201a, a novel anti-human epidermal growth factor receptor 2 antibody\u2013drug conjugate, in tumors with human epidermal growth factor receptor 2 heterogeneity. Cancer Sci. 107, 1039\u20131046 (2016).","journal-title":"Cancer Sci."},{"key":"1181_CR15","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1248\/cpb.c18-00744","volume":"67","author":"T Nakada","year":"2019","unstructured":"Nakada, T., Sugihara, K., Jikoh, T., Abe, Y. & Agatsuma, T. The latest research and development into the antibody\u2013drug conjugate, [fam-] trastuzumab deruxtecan (DS-8201a), for HER2 cancer therapy. Chem. Pharm. Bull. 67, 173\u2013185 (2019).","journal-title":"Chem. Pharm. Bull."},{"key":"1181_CR16","unstructured":"ENHERTU\u00ae (fam-trastuzumab deruxtecan-nxki) Prescribing Information (Daiichi Sankyo, 2026); https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2026\/761139s039lbl.pdf"},{"key":"1181_CR17","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1056\/NEJMoa2203690","volume":"387","author":"S Modi","year":"2022","unstructured":"Modi, S. et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N. Engl. J. Med. 387, 9\u201320 (2022).","journal-title":"N. Engl. J. Med."},{"key":"1181_CR18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.17_suppl.LBA1000","volume":"42","author":"G Curigliano","year":"2024","unstructured":"Curigliano, G. et al. Trastuzumab deruxtecan (T-DXd) vs physician\u2019s choice of chemotherapy (TPC) in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-low or HER2-ultralow metastatic breast cancer (mBC) with prior endocrine therapy (ET): primary results from DESTINY-Breast06 (DB-06). J. Clin. Oncol. 42, LBA1000 (2024).","journal-title":"J. Clin. Oncol."},{"key":"1181_CR19","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1158\/1535-7163.MCT-17-0749","volume":"17","author":"TN Iwata","year":"2018","unstructured":"Iwata, T. N. et al. A HER2-targeting antibody-drug conjugate, trastuzumab deruxtecan (DS-8201a), enhances antitumor immunity in a mouse model. Mol. Cancer Ther. 17, 1494\u20131503 (2018).","journal-title":"Mol. Cancer Ther."},{"key":"1181_CR20","unstructured":"IMFINZI\u00ae (durvalumab) Prescribing Information (AstraZeneca, 2025); https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/761069s052lbl.pdf"},{"key":"1181_CR21","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1038\/s41591-020-01189-2","volume":"27","author":"T Bachelot","year":"2021","unstructured":"Bachelot, T. et al. Durvalumab compared to maintenance chemotherapy in metastatic breast cancer: the randomized phase II SAFIR02-BREAST IMMUNO trial. Nat. Med. 27, 250\u2013255 (2021).","journal-title":"Nat. Med."},{"key":"1181_CR22","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.annonc.2022.07.1940","volume":"33","author":"S Loibl","year":"2022","unstructured":"Loibl, S. et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann. Oncol. 33, 1149\u20131158 (2022).","journal-title":"Ann. Oncol."},{"key":"1181_CR23","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2024-011140","volume":"13","author":"C Morgan","year":"2025","unstructured":"Morgan, C. et al. Differential safety profiles of durvalumab monotherapy and durvalumab in combination with tremelimumab in adult patients with advanced cancers. J. Immunother. Cancer 13, e011140 (2025).","journal-title":"J. Immunother. Cancer"},{"key":"1181_CR24","doi-asserted-by":"publisher","first-page":"2108","DOI":"10.1056\/NEJMoa1809615","volume":"379","author":"P Schmid","year":"2018","unstructured":"Schmid, P. et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer. N. Engl. J. Med. 379, 2108\u20132121 (2018).","journal-title":"N. Engl. J. Med."},{"key":"1181_CR25","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1016\/S0140-6736(20)32531-9","volume":"396","author":"J Cortes","year":"2020","unstructured":"Cortes, J. et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. Lancet 396, 1817\u20131828 (2020).","journal-title":"Lancet"},{"key":"1181_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2021.102286","volume":"100","author":"E Hamilton","year":"2021","unstructured":"Hamilton, E., Shastry, M., Shiller, S. M. & Ren, R. Targeting HER2 heterogeneity in breast cancer. Cancer Treat. Rev. 100, 102286 (2021).","journal-title":"Cancer Treat. Rev."},{"key":"1181_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2022.100009","volume":"36","author":"X Baez-Navarro","year":"2023","unstructured":"Baez-Navarro, X. et al. Interobserver variation in the assessment of immunohistochemistry expression levels in HER2-negative breast cancer: Can we improve the identification of low levels of HER2 expression by adjusting the criteria? An international interobserver study. Mod. Pathol. 36, 100009 (2023).","journal-title":"Mod. Pathol."},{"key":"1181_CR28","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s13058-024-01783-z","volume":"26","author":"X Baez-Navarro","year":"2024","unstructured":"Baez-Navarro, X. et al. HER2-low and tumor infiltrating lymphocytes in triple-negative breast cancer: are they connected? Breast Cancer Res. 26, 41 (2024).","journal-title":"Breast Cancer Res."},{"key":"1181_CR29","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1001\/jamaoncol.2021.7239","volume":"8","author":"AI Fernandez","year":"2022","unstructured":"Fernandez, A. I. et al. Examination of low ERBB2 protein expression in breast cancer tissue. JAMA Oncol. 8, 607\u2013610 (2022).","journal-title":"JAMA Oncol."},{"key":"1181_CR30","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1038\/s41591-023-02478-2","volume":"29","author":"F Mosele","year":"2023","unstructured":"Mosele, F. et al. Trastuzumab deruxtecan in metastatic breast cancer with variable HER2 expression: the phase 2 DAISY trial. Nat. Med. 29, 2110\u20132120 (2023).","journal-title":"Nat. Med."},{"key":"1181_CR31","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1056\/NEJMoa2407086","volume":"391","author":"A Bardia","year":"2024","unstructured":"Bardia, A. et al. Trastuzumab deruxtecan after endocrine therapy in metastatic breast cancer. N. Engl. J. Med. 391, 2110\u20132122 (2024).","journal-title":"N. Engl. J. Med."},{"key":"1181_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpi.2023.100343","volume":"15","author":"M Brevet","year":"2024","unstructured":"Brevet, M., Li, Z. & Parwani, A. Computational pathology in the identification of HER2-low breast cancer: opportunities and challenges. J. Pathol. Inform. 15, 100343 (2024).","journal-title":"J. Pathol. Inform."},{"key":"1181_CR33","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2022.100054","volume":"36","author":"S Wu","year":"2023","unstructured":"Wu, S. et al. The role of artificial intelligence in accurate interpretation of HER2 immunohistochemical scores 0 and 1+ in breast cancer. Mod. Pathol. 36, 100054 (2023).","journal-title":"Mod. Pathol."},{"key":"1181_CR34","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/S0140-6736(22)02420-5","volume":"401","author":"SA Hurvitz","year":"2023","unstructured":"Hurvitz, S. A. et al. Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: updated results from DESTINY-Breast03, a randomised, open-label, phase 3 trial. Lancet 401, 105\u2013117 (2023).","journal-title":"Lancet"},{"key":"1181_CR35","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.1016\/S0140-6736(23)00725-0","volume":"401","author":"F Andre","year":"2023","unstructured":"Andre, F. et al. Trastuzumab deruxtecan versus treatment of physician\u2019s choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): a randomised, open-label, multicentre, phase 3 trial. Lancet 401, 1773\u20131785 (2023).","journal-title":"Lancet"},{"key":"1181_CR36","unstructured":"Schmid, P. et al. 555MO datopotamab deruxtecan (Dato-DXd)\u2009+\u2009durvalumab (D) as first-line (1L) treatment (tx) for unresectable locally advanced\/metastatic triple-negative breast cancer (a\/mTNBC): final results from the phase Ib\/II BEGONIA study. Ann. Oncol. (in the press)."},{"key":"1181_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/17588359241248336","volume":"16","author":"A Bardia","year":"2024","unstructured":"Bardia, A. et al. TROPION-Breast03: a randomized phase III global trial of datopotamab deruxtecan\u2009\u00b1\u2009durvalumab in patients with triple-negative breast cancer and residual invasive disease at surgical resection after neoadjuvant therapy. Ther. Adv. Med. Oncol. 16, 1\u201314 (2024).","journal-title":"Ther. Adv. Med. Oncol."},{"key":"1181_CR38","doi-asserted-by":"publisher","DOI":"10.1177\/17588359251316176","volume":"17","author":"HL McArthur","year":"2025","unstructured":"McArthur, H. L. et al. TROPION-Breast04: a randomized phase III study of neoadjuvant datopotamab deruxtecan (Dato-DXd) plus durvalumab followed by adjuvant durvalumab versus standard of care in patients with treatment-naive early-stage triple negative or HR-low\/HER2\u2212 breast cancer. Ther. Adv. Med. Oncol. 17, 17588359251316176 (2025).","journal-title":"Ther. Adv. Med. Oncol."},{"key":"1181_CR39","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.17_suppl.LBA109","volume":"43","author":"SM Tolaney","year":"2025","unstructured":"Tolaney, S. M. et al. Sacituzumab govitecan (SG)\u2009+\u2009pembrolizumab (pembro) vs chemotherapy (chemo)\u2009+\u2009pembro in previously untreated PD-L1-positive advanced triple-negative breast cancer (TNBC): primary results from the randomized phase 3 ASCENT-04\/KEYNOTE-D19 study. J. Clin. Oncol. 43, LBA109 (2025).","journal-title":"J. Clin. Oncol"},{"key":"1181_CR40","doi-asserted-by":"publisher","first-page":"S402","DOI":"10.1016\/j.annonc.2024.08.380","volume":"35","author":"SM Tolaney","year":"2024","unstructured":"Tolaney, S. M., D\u2019Amico, P., Jia, L., Hirshfield, K. M. & Cardoso, F. 433TiP phase III, randomized, open-label TroFuse-010 Study of sacituzumab tirumotecan (sac-TMT) alone and with pembrolizumab vs treatment of physician\u2019s choice chemotherapy (TPC) in patients with HR+\/HER2\u2212 unresectable locally advanced or metastatic breast cancer (mBC). Ann. Oncol. 35, S402 (2024).","journal-title":"Ann. Oncol."},{"key":"1181_CR41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c332","volume":"340","author":"KF Schulz","year":"2010","unstructured":"Schulz, K. F., Altman, D. G. & Moher, D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 340, c332 (2010).","journal-title":"BMJ"},{"key":"1181_CR42","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.5858\/134.7.e48","volume":"134","author":"ME Hammond","year":"2010","unstructured":"Hammond, M. E. et al. American Society of Clinical Oncology\/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch. Pathol. Lab. Med. 134, e48\u2013e72 (2010).","journal-title":"Arch. Pathol. Lab. Med."},{"key":"1181_CR43","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.5858\/arpa.2018-0902-SA","volume":"142","author":"AC Wolff","year":"2018","unstructured":"Wolff, A. C. et al. Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology\/College of American Pathologists clinical practice guideline focused update. Arch. Pathol. Lab. Med. 142, 1364\u20131382 (2018).","journal-title":"Arch. Pathol. Lab. Med."}],"container-title":["Nature Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s43018-026-01181-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43018-026-01181-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43018-026-01181-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:03:40Z","timestamp":1782482620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s43018-026-01181-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":43,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["1181"],"URL":"https:\/\/doi.org\/10.1038\/s43018-026-01181-8","relation":{},"ISSN":["2662-1347"],"issn-type":[{"value":"2662-1347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"23 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"P.S. has received research grants from Astellas Pharma (institution), AstraZeneca (institution), Roche\/Genentech, Medivation (institution), Novartis and OncoGenex Pharmaceuticals (institution), consultant fees from AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Eisai, Roche, Merck, Novartis, Pfizer and Puma Biotechnology and data and safety monitoring fees from Novartis. S.-A.I. has received research grants from AstraZeneca (institution), Boryung Corporation (institution), Daewoong Pharmaceutical Company (institution), Daiichi Sankyo Company (institution), Eisai Korea (institution), F. Hoffmann-La Roche (institution) and Pfizer (institution) and consultant fees from AstraZeneca, Bertis, Daiichi Sankyo Company, Eisai, Eli Lilly and Company, F. Hoffmann-La Roche, GlaxoSmithKline, Hanmi Pharmaceutical Co., Idience Co. Ltd Consultant, MSD Korea, Novartis and Pfizer. Z.N. has received travel expenses from Roche and research grants from Roche (institution). P.J.W. has received consulting fees from, Bristol-Myers Squibb, MSD, Novartis, Pierre Fabre, Immunicom, Merck, Astellas, Janssen and Ipsen, honoraria from Bristol-Myers Squibb, MSD, Novartis, Pierre Fabre, Immunicom, Pfizer, Merck, Astellas, Janssen and Ipsen and travel expenses from Bristol-Myers Squibb, AstraZeneca and Pierre Fabre. J.J. has received consultant fees from AstraZeneca, Pfizer, MSD and Bristol-Myers Squibb, honoraria from AstraZeneca, Roche (not compensated) and Pfizer and travel expenses from AstraZeneca, Roche and Pfizer. K.H.J. has received consultant fees from AstraZeneca, BIXINK, Celgene, Daiichi Sankyo, Eisai, Everest Medicines, Gilead Sciences, MSD, Novartis, Pfizer, Roche and Takeda Pharmaceuticals. S.L. has received research funding from CRUK (institution and personal), Boehringer Ingelheim (institution), Piqur Therapeutics (institution), AstraZeneca (institution), Carrick Therapeutics (institution), Sanofi (institution), Merck KGaA (institution), Synthon (institution), Roche (institution), NIHR (institution and personal), Against Breast Cancer (institution and personal) and Pathios Therapeutics (institution and personal), consultant fees from Sanofi, GLG consulting, Rejuversen, Oxford Biodynamics and Exscientia, honoraria from Eisai, Prosigna, Roche, Pfizer, Novartis and Sanofi, travel expenses from Pfizer, Roche, Synthon and Piqur Therapeutics and advisory board fees from Shionogi, Sanofi and Exscientia and has stock or stock options in Mitox Therapeutics. J.A. has stock or stock options and employment with AstraZeneca. R.S. has stock or stock options and employment with AstraZeneca. P.V. has stock or stock options and employment with AstraZeneca. N.D. has stock or stock options and employment with AstraZeneca. Y.H.P. has received research grants from AstraZeneca (institution), Merck (institution) and Pfizer (institution) and consultant fees from Daiichi Sankyo, Eisai, Lilly, Menarini, Helsinn, Novartis and Pfizer.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}