Translational analyses in the INTEGA trial confirmed substantial molecular heterogeneity, with baseline tumor tissue and cfDNA profiling revealing frequent driver and resistance-associated mutations—most commonly in TP53, ERBB2, and PIK3CA—and an early increase in cfDNA levels (>20% after one cycle), strongly predicting shorter PFS and OS, regardless of treatment arm. This evidence concerns the gene ERBB2 and neoplasm.