Zanidatamab is showing early promise in a pre-surgical setting for HER2-positive breast cancer, with results from the NeoZanHER phase 2 trial reported in Nature Communications. The study evaluates the next-generation HER2 antibody in early-stage disease, targeting patients before surgery to assess tumor response and translational biomarkers. The trial was led by the study group cited in the report and designed around the concept that neoadjuvant therapy can reveal efficacy signals faster than a purely post-surgical approach. The Nature Communications publication focuses on clinical activity in the neoadjuvant window rather than late endpoints. For HER2-directed development, the key operational takeaway is the continued expansion of bispecific-leaning HER2 formats into earlier lines and earlier decision points, including trials where response rates can guide whether programs move toward larger confirmatory studies. As with other neoadjuvant antibody strategies, the regulatory and commercial implications hinge on pathologic response measures, duration of activity, and safety in a population that may also be receiving standard chemotherapy and anti-HER2 backbone therapies.