.Attribute Medicine, Released online: 13 September 2024 doi:10.1038/ s41591-024-03261-7In the non-randomized period 3b/4 DESTINY-Breast12 study, trastuzumab deruxtecan (T-DXd) therapy of patients along with HER2+ sophisticated breast cancer as well as energetic or even stable brain metastases showed regular intracranial activity and systemic efficacy of T-DXd.