Two competing antibody-drug conjugates—AstraZeneca/Daiichi Sankyo’s Datroway and Gilead’s Trodelvy—posted Phase 3 results at ESMO that both improved outcomes in first‑line metastatic triple‑negative breast cancer (TNBC) patients who could not receive checkpoint inhibitors. The near-simultaneous presentations set up a direct clinical and commercial comparison that will influence treatment sequencing. Discussants and trial panels compared hazard ratios, safety profiles and patient subsets to help clinicians choose between agents. With both drugs showing benefit, payers and guideline committees will need head‑to‑head interpretation and real‑world data to determine differentiation, while oncologists will weigh toxicity patterns and convenience when selecting therapy.