Breast cancer treatment continues to become more personalized. In 2026, doctors have more ways to match treatment to the specific features of a patient's cancer, including hormone receptor status, HER2 status, stage, genetic mutations, and biomarkers.
Several important breast cancer treatments received new U.S. Food and Drug Administration (FDA) approvals in 2026, including antibody-drug conjugates for triple-negative and HER2-positive breast cancer and a new pathway inhibitor for HR-positive, HER2-negative advanced breast cancer.
Other treatments, including hormone therapy, CDK4/6 inhibitors, oral selective estrogen receptor degraders, immunotherapy, and targeted therapies, continue to play important roles.
What are the main breast cancer treatments in 2026?
Breast cancer treatment may include:
Surgery
Radiation therapy
Chemotherapy
Hormone or endocrine therapy
HER2-targeted therapy
Antibody-drug conjugates
CDK4/6 inhibitors
PI3K, AKT, and mTOR pathway inhibitors
Immunotherapy
PARP inhibitors
Other biomarker-directed targeted therapies
The right treatment depends heavily on the type and stage of breast cancer. For example, treatment for hormone receptor-positive, HER2-negative breast cancer is different from treatment for HER2-positive breast cancer or triple-negative breast cancer.
New and important breast cancer treatments in 2026
Several treatments have expanded the options available to patients in 2026.
Datroway (datopotamab deruxtecan-dlnk)
Datroway, also called datopotamab deruxtecan or Dato-DXd, is a targeted treatment called an antibody-drug conjugate, or ADC.
An ADC combines an antibody that recognizes a protein on cancer cells with a cancer-killing drug. This helps deliver treatment to cancer cells that express the target.
Datroway targets a protein called TROP2, which is found on many breast cancer cells.
Who can receive Datroway?
Datroway has FDA approvals for certain adults with advanced breast cancer. In January 2025, the FDA approved Datroway for adults with unresectable or metastatic hormone receptor-positive, HER2-negative breast cancer who had previously received endocrine therapy and chemotherapy for advanced disease. In May 2026, the FDA expanded its use to adults with unresectable or metastatic triple-negative breast cancer who are not candidates for PD-1 or PD-L1 inhibitor immunotherapy.
Datroway is given as an intravenous, or IV, infusion once every three weeks.
How does Datroway work?
The antibody portion of Datroway attaches to TROP2 on a cancer cell. The ADC is taken into the cell, where it releases a topoisomerase I inhibitor called a DXd payload. The drug damages the cancer cell's DNA and can cause the cell to die.
Revtorpyk (gedatolisib)
Gedatolisib, sold under the brand name Revtorpyk, is a targeted treatment for certain people with hormone receptor-positive, HER2-negative advanced breast cancer. The FDA approved gedatolisib on July 14, 2026.
Who can receive gedatolisib?
It is approved in combination with fulvestrant, with or without palbociclib, for adults with:
HR-positive breast cancer
HER2-negative breast cancer
Locally advanced or metastatic disease
No detected PIK3CA mutation
Cancer that progressed during or after at least one endocrine therapy in the metastatic setting
This gives patients without a PIK3CA mutation another targeted treatment option after endocrine therapy stops controlling the cancer.
How does gedatolisib work?
Gedatolisib targets the PI3K/AKT/mTOR pathway, sometimes shortened to the PAM pathway. Cancer cells can use this signaling pathway to grow and survive. Activation of this pathway can also contribute to resistance to hormone therapy. Gedatolisib inhibits all four class I PI3K isoforms as well as mTORC1 and mTORC2, interfering with several signals that breast cancer cells may use to survive. It is given by IV infusion on days 1, 8, and 15 of a 28-day treatment cycle.
Enhertu (fam-trastuzumab deruxtecan-nxki)
Enhertu, also known as trastuzumab deruxtecan or T-DXd, is a HER2-directed antibody-drug conjugate. It has become an important treatment across several types and stages of HER2-expressing breast cancer.
Who can receive Enhertu?
Enhertu is used for certain patients with:
HER2-positive advanced or metastatic breast cancer
HER2-low metastatic breast cancer
HER2-ultralow metastatic breast cancer in certain settings
HER2-positive early-stage breast cancer
In May 2026, the FDA approved two important new uses for Enhertu in HER2-positive early-stage breast cancer. For treatment before surgery, Enhertu followed by a taxane, trastuzumab, and pertuzumab can be used in adults with stage II or stage III HER2-positive breast cancer. Enhertu was also approved after surgery for adults with HER2-positive breast cancer who still have residual invasive disease after receiving HER2-targeted and taxane-based treatment before surgery. These approvals brought Enhertu into the curative-intent early-stage breast cancer setting.
How does Enhertu work?
Enhertu combines a HER2-targeted antibody with a powerful topoisomerase I inhibitor. The antibody attaches to HER2 on the surface of the cancer cell. After the treatment enters the cell, it releases the chemotherapy payload. Enhertu is usually given by IV infusion once every three weeks.
One important potential side effect is interstitial lung disease or pneumonitis, which can become serious. Patients should report new or worsening cough, shortness of breath, fever, or other breathing symptoms promptly.
Trodelvy (sacituzumab govitecan-hziy)
Trodelvy is another TROP2-directed antibody-drug conjugate. It has been used for previously treated metastatic triple-negative breast cancer and certain HR-positive, HER2-negative cancers. In June 2026, the FDA significantly expanded its use in triple-negative breast cancer.
Who can receive Trodelvy?
As of June 2026, Trodelvy can be used as a first-line treatment for adults with unresectable locally advanced or metastatic triple-negative breast cancer. For patients who are not candidates for PD-1 or PD-L1 immunotherapy, Trodelvy can be given alone.
For patients whose tumors have PD-L1 combined positive score, or CPS, of 10 or higher, Trodelvy can be combined with pembrolizumab.
Trodelvy also remains an option in later treatment settings for metastatic triple-negative breast cancer and certain previously treated HR-positive, HER2-negative metastatic breast cancers.
How does Trodelvy work?
Trodelvy attaches to TROP2 on breast cancer cells. It then delivers SN-38, the active metabolite of the chemotherapy drug irinotecan, into and around cancer cells. SN-38 blocks topoisomerase I, interfering with DNA replication and leading to cancer cell death.
Trodelvy is administered by IV infusion on days 1 and 8 of a 21-day treatment cycle.
Important Trodelvy side effects
Trodelvy carries boxed warnings for:
Severe neutropenia. A dangerous decrease in infection-fighting white blood cells
Severe diarrhea. Diarrhea can become serious and may require medication, fluids, dose interruption, or other treatment
Blood counts are monitored regularly during treatment.
Hormone therapy for HR-positive breast cancer
Hormone receptor-positive breast cancer uses estrogen and/or progesterone signals to help cancer cells grow. Endocrine therapy works by either lowering estrogen levels or preventing estrogen from activating cancer cells.
Common hormone treatments include:
Tamoxifen
Aromatase inhibitors such as anastrozole, letrozole, and exemestane
Fulvestrant
Oral selective estrogen receptor degraders, or SERDs
Ovarian suppression in certain premenopausal patients
Hormone therapy may be used for both early-stage and advanced HR-positive breast cancer.
Oral SERDs for breast cancer
Selective estrogen receptor degraders, or SERDs, attach to estrogen receptors, block their activity, and promote destruction of the receptor. Oral SERDs are particularly important in advanced HR-positive, HER2-negative breast cancer because tumors can develop ESR1 mutations that make certain older endocrine treatments less effective.
Elacestrant (Orserdu)
Elacestrant was the first oral SERD approved specifically for advanced breast cancer. It is FDA approved for certain postmenopausal women and adult men with ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer after progression on endocrine therapy.
Imlunestrant (Inluriyo)
Imlunestrant is another oral estrogen receptor antagonist and SERD. The FDA approved Inluriyo in September 2025 for adults with ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer that progressed after at least one line of endocrine therapy. It is taken orally once daily.
What about camizestrant and giredestrant?
Several additional oral SERDs are moving through clinical trials and regulatory review. Camizestrant is being studied for HR-positive, HER2-negative breast cancer with an emerging ESR1 mutation. Its FDA application remains under review as of August 2026.
Giredestrant is also investigational in the United States. The FDA has granted Priority Review to an application for giredestrant as adjuvant treatment for ER-positive, HER2-negative stage I through III breast cancer. An FDA decision is expected by November 30, 2026.
These drugs should not yet be described as FDA-approved breast cancer treatments.
Itovebi (inavolisib)
Inavolisib, sold under the brand name Itovebi, is a targeted therapy for certain PIK3CA-mutated breast cancers. It targets the PI3K pathway, which can become abnormally activated when breast cancer cells have a PIK3CA mutation.
Inavolisib is used with palbociclib and fulvestrant for certain adults with endocrine-resistant, PIK3CA-mutated, HR-positive, HER2-negative locally advanced or metastatic breast cancer. This is one reason biomarker testing can be particularly important for people with advanced HR-positive breast cancer.
A PIK3CA mutation can directly affect which targeted treatment options may be available.
CDK4/6 inhibitors for breast cancer
CDK4/6 inhibitors are targeted therapies that have transformed treatment for HR-positive, HER2-negative breast cancer. Cancer cells use proteins called cyclin-dependent kinases 4 and 6 to move through the cell cycle and divide. CDK4/6 inhibitors block these proteins, slowing or stopping cancer cell division. They are commonly combined with endocrine therapy.
Ibrance (palbociclib)
Palbociclib is commonly taken once daily for 21 days followed by seven days off, creating a 28-day treatment cycle. It is used with endocrine therapy for certain patients with HR-positive, HER2-negative advanced or metastatic breast cancer.
Kisqali (ribociclib)
Ribociclib is also generally taken for 21 days followed by seven days off during each 28-day cycle. It is used with endocrine therapy for advanced or metastatic HR-positive, HER2-negative breast cancer. It is also approved with endocrine therapy for certain patients with HR-positive, HER2-negative early-stage breast cancer at high risk of recurrence.
Verzenio (abemaciclib)
Abemaciclib is generally taken continuously rather than using the three-weeks-on, one-week-off schedule used with palbociclib and ribociclib. It is used in HR-positive, HER2-negative advanced breast cancer and, with endocrine therapy, in certain patients with node-positive, high-risk early breast cancer.
Why biomarker testing matters in breast cancer treatment
One of the biggest changes in modern breast cancer care is that doctors increasingly choose treatment based on the biology of the tumor, not just where the cancer began. Important breast cancer biomarkers can include:
Estrogen receptor, or ER
Progesterone receptor, or PR
HER2
PD-L1
PIK3CA
ESR1
BRCA1 and BRCA2
Other inherited and tumor-specific genetic changes
For people with metastatic breast cancer, broader molecular testing may identify additional targeted treatment or clinical trial options.
Ask your oncologist which biomarkers have been tested and whether additional tumor or blood-based testing could change your treatment options.
Which breast cancer treatment is right for me?
There is no single best breast cancer treatment for every patient. Your oncologist considers factors such as:
Whether the cancer is early-stage, locally advanced, or metastatic
Hormone receptor status
HER2 status
Triple-negative status
Genetic mutations and biomarkers
Previous treatments
Whether the cancer has become resistant to hormone therapy
Other health conditions
Treatment side effects
Your preferences and goals
For example, a patient with HR-positive, HER2-negative metastatic breast cancer and a PIK3CA mutation may have different options from someone with the same breast cancer subtype but no PIK3CA mutation. Likewise, treatment for HER2-positive breast cancer differs significantly from treatment for triple-negative breast cancer.
What is new in breast cancer treatment in 2026?
Several developments are changing breast cancer treatment in 2026. Antibody-drug conjugates are moving earlier in treatment. Datroway and Trodelvy now have first-line roles for certain patients with advanced triple-negative breast cancer, while Enhertu has moved into treatment of HER2-positive early-stage disease.
Treatment for HR-positive, HER2-negative breast cancer is also becoming increasingly biomarker-driven. ESR1 and PIK3CA testing can identify patients who may benefit from specific endocrine or targeted therapies, while new treatments such as gedatolisib provide additional options after endocrine therapy stops working.
The overall direction of breast cancer treatment is clear: more treatment decisions are being based on the specific biology of each patient's tumor.
Questions to ask your doctor about breast cancer treatment
Consider asking your oncology team:
What type of breast cancer do I have?
Is my cancer ER-positive, PR-positive, HER2-positive, HER2-low, HER2-ultralow, or triple-negative?
What stage is my breast cancer?
Have I had biomarker or genomic testing?
Should my cancer be tested for PIK3CA or ESR1 mutations?
Do I need inherited genetic testing for BRCA1, BRCA2, or other cancer genes?
Am I eligible for an antibody-drug conjugate?
Is immunotherapy an option?
Would a targeted therapy be appropriate?
What is the goal of my treatment?
What side effects should I expect?
Are there clinical trials I should consider before starting my next treatment?
Staying informed about breast cancer treatment
Breast cancer treatment in 2026 offers more personalized options than ever before. New antibody-drug conjugates, targeted therapies, endocrine treatments, immunotherapies, and biomarker-guided approaches continue to expand the choices available to patients. These advances also make understanding your breast cancer subtype and biomarker results increasingly important. Talk with your oncology team about the characteristics of your cancer and which treatments are appropriate for your specific diagnosis.
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