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Article History

Received: 31 July 2025

Accepted: 14 February 2026

First Online: 5 March 2026

Competing interests

: Alba Llop-Guevara, Violeta Serra and Judith Balmana are co-authors of a patent related to this work (WO2019122411A1, pending). Alba Llop-Guevara and Violeta Serra are current employees of AstraZeneca. Benedetta Pellegrino reports advisory board from Daiichi-Sankyo, other support from Lilly, Pfizer, Novartis and Gilead; and personal fees from MSD outside the submitted work. Isabel Pimentel reports advisory board functions from AstraZeneca and received honoraria and/or travel support from MSD, Novartis, Pfizer, AstraZeneca and Gilead. Judith Balmana received honoraria from MSD and AstraZeneca. Laura Cortesi reports honoraria from Astra Zeneca, Pfizer, MSD, Novartis, Gilead, Roche and Diichi-Sankyo. Laura Cortesi reports a relationship with AstraZeneca, Merck, Daiichi Sankyo and Pfizer that includes board membership and consulting or advisory. Cinzia Solinas reports travel grants from Lilly and Ipsen, and speaker honoraria from Bayer. Guillermo Villacampa received a speaker’s fee from Pfizer, MSD, GSK and Pierre Fabrer, and held an advisory role with AstraZeneca and received consultant fees from Reveal Genomics. Gabriele Zoppoli reports honoraria from Menarini Stemline, travel grants from Menarini Stemline and Novartis. Cristina Cruz reports honoraria and/or travel support from Novartis, Daichi Sanchyo, Roche, Lilly and Gilead. Cristina Saura reports consulting fees, honoraria or meeting/travel support from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eisai, Genentech,Gilead, Lilly, MediTech, Menarini, MSD Spain, Novartis, Pfizer, Philips Healthcare, Pharmalex, Pierre Fabre, Puma Biotechnology, Roche, Seagen, Synthon and Zymeworks. Matteo Lambertini reports advisory role for Roche, Lilly, Novartis, AstraZeneca, Pfizer, Seagen, Gilead, MSD, Pierre Fabre, Menarini and Exact Sciences; receiving speaker honoraria from Roche, Lilly, Novartis, Pfizer, Sandoz, Libbs, Daiichi Sankyo, Takeda, Ipsen, Menarini and AstraZeneca; receiving travel grants from Gilead, Roche, and Daiichi Sankyo; receiving research funding (to his institution) from Gilead; and having nonfinancial interests as a member of the national council of the Italian Association of Medical Oncology (AIOM). Maria Vittoria Dieci reports personal fees and/or advisory board functions from Novartis, Lilly, Seagen, Exact Science, Pfizer, Daiichi Sankyo, Gilead, Roche, MSD, AstraZeneca. She also reports travel/accommodation support from Roche and Gilead, licensing Fees, listed as co-inventor in patent applications for HER2 DX. Research Grant from Roche. Antonino Musolino reports Consulting or Advisory Role from Lilly, Eisai Europe, Daiichi Sankyo, Astra Zeneca, Novartis. Research Funding from Lilly and travel support from Pfizer. Sara Torres-Esquius, Nicoletta Campanini, Sara Simonetti, Chiara Tommasi, Olga Serra, Matilde Corianò, Daniela Boggiani, Maria Michiara, Roberta Minari, Beatrice Bortesi, Elena Rapacchi, Alessio Schirone, Chiara Casarini, Elisabetta Cretella, Enrico Maria Silini, Karen Willard-Gallo and Anais Boisson have no conflicts of interest to declare related to this work.