European Society for Medical Oncology The finding that breast tumours can evolve to express low HER2 potentially widens the number of patients who can benefit from new investigational agents, typically novel antibody-drug conjugate therapies, that are currently in clinical trials for HER2-low tumours. The first study of its kind exploring how breast cancers change from the primary to the recurrent tumour has revealed that nearly 30% of breast cancer patients convert from, or to, human epidermal growth factor receptor (HER)2-low status. Specifically, the study found that 14% of triple-negative breast cancers with HER2-negative expression (also referred to as HER2-0) in the primary tumour converted to HER2-low expression in the recurrent tumour possibly offering an option to such hard-to-treat tumours.