Two late‑stage ADCs targeting metastatic triple‑negative breast cancer (TNBC) produced compelling Phase 3 data presented back‑to‑back at ESMO. AstraZeneca/Daiichi Sankyo’s Datroway and Gilead’s sacituzumab govitecan (Trodelvy) both demonstrated efficacy versus chemotherapy in patients ineligible for immune checkpoint inhibitors, setting up a direct clinical choice for clinicians. The studies — discussed in STAT and conference sessions — tested ADCs as first‑line options where checkpoint inhibitors aren’t appropriate. Trial designs, target expression and safety profiles were compared by session discussants to parse which agent might be preferable in specific patient subgroups. The head‑to‑head nature of the data will force payers and providers to weigh differential toxicity profiles, biomarker definitions and durability of response when selecting therapy for TNBC patients.