The trial aims to demonstrate that T-DXd-based regimens are superior to standard treatments by reducing toxicities and improving outcomes.47 Similarly, the ADAPT-HER2-trial (NCT05704829) evaluates de-escalation of neoadjuvant therapy in the low-intermediate risk group, testing T-DXd therapy vs standard chemotherapy + trastuzumab + pertuzumab in HER2-positive, low-intermediate risk, node-negative patients with cT1-2 tumors.48 Of note, the SHAMROCK trial (NCT05710666) is enrolling patients with HER2-positive early-stage breast cancer to receive six cycles of neoadjuvant T-DXd monotherapy. Here, ERBB2 is linked to breast cancer.