T-DXd and Cycling

Community oncologists are floating eight or nine cycles of T-DXd, and pausing until recurrence before reinducing. The logic is simple but seductive: by stopping before toxicity or resistance develops, you can preserve both patient tolerance and drug potency, turning T‑DXd into a renewable frontline weapon rather than a one‑and‑done sledgehammer. Drs, Mouabbi and Rimawi weigh the pharmacologic sense of giving the body a breather from the topoisomerase‑I payload against the risk of letting residual tumor biology regroup.