A recent study assessing the impact of the TIME on the efficacy of T-Dxd in gastric cancer found that T-DXd treatment increased tumour-infiltrating CD8+ and PD1+CD8+ T-cells and upregulated cytotoxic and helper T-cell gene signatures, while downregulating hypoxia, MYC, collagen, and IL-10 pathways, suggesting that both the baseline HER2 levels and the TIME influence therapeutic efficacy, and that T-DXd may actively modulate the TIME [73]. The gene discussed is ERBB2; the disease is gastric cancer.