The FDA approved Gilead’s Trodelvy for first-line treatment of triple-negative breast cancer (TNBC), adding a second authorization for Trodelvy shortly after the agency cleared a rival breast cancer therapy from Daiichi Sankyo and AstraZeneca. Trodelvy is an antibody-drug conjugate (ADC), and the approval underscores the FDA’s willingness to shift ADCs earlier in the treatment sequence when randomized data support improved outcomes versus standard chemotherapy. For Gilead, the move expands Trodelvy’s positioning in a large, highly competitive TNBC market where ADC differentiation is increasingly defined by line-of-therapy placement, safety profile management, and companion diagnostic or biomarker strategy. Clinicians will now balance sequencing decisions against existing SOC options as payer coverage and clinical guideline updates roll out following the new first-line label.