The broad applicability of DESTINY-PanTumor02 provided a compelling clinical rationale for using T-DXd for our patient, who presented with a metastatic HER2-high (3+) positive tumor, and for whom the alternative chemotherapy regimen (cisplatin/ifosfamide/paclitaxel) would have mandated inpatient administration and monitoring for ifosfamide-related neurotoxicity and hemorrhagic cystitis. The gene discussed is ERBB2; the disease is neoplasm.