A 43-year-old’s pleural effusion has been drained ten times, HER2-zero on every cytology yet her primary tumor was HER2-low a decade ago. One expert hesitates, fearing the T-DXd will flop; the other would “give her the benefit of the doubt” and infuse anyway, citing sampling error and intratumoral patchiness. The dialogue captures precision oncology’s grayest zone: when historical positivity collides with current negativity, do you trust the old slide or the latest fluid?
The 11th Tap: Betting against HER2 Data
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