CURESPONSE
2026 Commercial
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DESTINY-Breast06 moved T-DXd ahead of chemotherapy for HER2-low and HER2-ultralow disease once endocrine options are exhausted, which covers most HR+ patients. Some oncologists give capecitabine first and T-DXd second; either way, the open decision now sits after T-DXd. Every remaining option was trialled in T-DXd-naive patients, and real-world data show a second topoisomerase-I ADC delivering about 3 months of PFS, with chemotherapy not clearly better. No preferred sequence exists. cResponse™ ranks the remaining chemotherapies and ADCs on the patient’s own post-T-DXd tissue.

DESTINY-Breast09 (FDA approval, December 2025) moved T-DXd with pertuzumab into first line. The post-T-DXd decision now arrives at TL2 for patients treated with first-line T-DXd, and at TL3 for those who started on taxane, trastuzumab and pertuzumab. Post-T-DXd, real-world median PFS on the next regimen is 4.6 months, and options that performed well earlier in the sequence, like the tucatinib triplet, show weaker activity once given after T-DXd. There is no established preferred sequence. cResponse™ ranks the remaining options on patient tissue rather than on pre-T-DXd-era trial data that may not transfer to this setting.

NCCN now lists sacituzumab govitecan as category 1 preferred first-line therapy: with pembrolizumab for PD-L1 CPS ≥10, and alone for CPS <10. The FDA approved both regimens in June 2026, and Dato-DXd for patients not eligible for immunotherapy in May 2026. The open decision is therefore at progression after first-line ADC. Every option here was trialled in ADC-naive patients, and real-world data link prior sacituzumab with weaker benefit from T-DXd. With little time for a second attempt, cResponse™ ranks the options on post-ADC tissue to select the most potent responder upfront.

ORR consistently below 50%; some regimens as low as 10%. Median PFS 4–8 months — a wrong choice leads to rapid clinical decline and lost subsequent treatment windows. cResponse™ ranks on patient tissue to identify the best responder upfront.

RAS-mutated tumors are more aggressive with fewer targeted options. PFS often <6 months. cResponse™ ranks on patient tissue to find the most potent biologic + chemo synergy, extending time on active therapy.

All ORR below 50%; 60–80% non-response risk. Grade 3+ neutropenia, anemia, and 5–10% ILD/pneumonitis risk. Post-osimertinib PFS <4–6 months — a wrong choice risks rapid decline without time for a second attempt.

ORR consistently below 50%; over 60% face non-response risk. Docetaxel causes Grade 3+ neutropenia in 30–50%. PFS <7 months post-first-line. cResponse™ selects the most potent responder upfront.

This is the critical first opportunity after platinum resistance emerges (progression within 6 months). ORR below 50% and highly toxic treatments — choosing wrong risks fast clinical decline before additional lines are possible.

Post-ARPI, most patients face non-response risk >70% with Grade 3+ neutropenia (30–50%) and fatigue. mCRPC survival at this stage is 12–18 months — wrong choice risks exhausting treatment windows entirely.

ORR below 50%; over 60% will not respond. Standard regimens are notoriously toxic — Grade 3+ side effects in 50–80%. Untreated PFS <6 months. A single wrong choice leads to rapid clinical decline.

Complex adjuvant decisions in curative setting. NCCN recommends CDK4/6i addition in high-risk HR+/HER2- disease, but benefit varies and toxicity (2–3 years of treatment) is substantial. cResponse™ on resected tissue identifies dominant tumor biology to optimize curative therapy.

NCCN recommends oxaliplatin-based therapy for Stage III, but IDEA supports 3-month duration in many cases. Significant variation in benefit and long-term neuropathy risk makes this ideal for functional guidance on resected tissue.

NCCN strongly recommends adjuvant chemotherapy post-resection. High toxicity (Gr3+ in 50–75%) and variable benefit make this ideal for functional guidance — determining whether full mFOLFIRINOX or a gentler backbone is appropriate.

Multiple HER2-directed strategies with complex risk-stratification, but decisions on dual blockade, chemo intensity, and extended neratinib involve significant toxicity trade-offs. cResponse™ on resected tumor provides direct functional insight.

NCCN highlights shared decision-making due to modest absolute benefit of adjuvant chemo in high-risk Stage II pMMR/MSS. cResponse™ helps quantify benefit vs harm on resected tissue — supporting observation or treatment with functional evidence.

NCCN recommends adjuvant chemotherapy ± radiation for high-risk/pMMR endometrial cancer with substantial toxicity. cResponse™ on resected tissue helps personalize intensity — whether full chemo-radiation, chemo alone, radiation alone, or observation is appropriate.

NCCN recommends adjuvant chemo for Stage II–III NSCLC with strong addition of osimertinib for EGFR-mutated patients. Decisions around chemotherapy necessity and targeted therapy benefit vary significantly by biology. cResponse™ on resected tissue personalizes the decision.

Many patients are cisplatin-ineligible due to renal impairment. High toxicity and variable benefit make this ideal for functional guidance — especially to support observation vs treatment decisions in a post-major-surgery setting.

BILCAP established capecitabine as standard but benefit is modest with significant toxicity trade-offs. Ideal for resected tissue testing — especially for determining doublet vs monotherapy vs observation in an indication with limited data.

NCCN recommends adjuvant chemotherapy for high-grade, large soft tissue sarcomas, but benefit is variable and toxicity (cardiotoxicity, myelosuppression) is substantial. cResponse™ determines which patients truly benefit from intensive regimens vs observation.

NCCN recommends neoadjuvant chemo for borderline resectable PDAC. Suboptimal choice frequently results in failure to downstage — shifting patients to metastatic lines with dismal prognosis. Response rates are low and highly variable across tumor biologies.

Significant toxicity trade-offs with dual blockade and full chemotherapy backbone. cResponse™ on pre-treatment biopsy determines whether dual HER2 blockade is truly necessary or safe de-escalation to single blockade is appropriate.

NCCN recommends neoadjuvant cisplatin-based chemotherapy for eligible patients. Significant toxicity and variable pCR make this excellent for functional guidance on pre-treatment TURBT tissue — particularly for cisplatin-ineligible patients who need an alternative strategy.

Response rates are highly variable across sarcoma subtypes. Suboptimal regimen risks progression to unresectable disease or metastatic spread — making upfront selection critical to preserve the surgical window.

Downstaging to resectability is the only curative path in locally advanced HCC. An unsuccessful choice may delay or eliminate the surgical window entirely. cResponse™ functional testing identifies the most effective downstaging strategy upfront.