Abstract The combination of the antibody–drug conjugate ado-trastuzumab emtansine, or T-DM1, plus pertuzumab given prior to surgery outperformed standard therapy in women with HER2-positive breast cancer enrolled in the I-SPY 2 trial. The results, reported at the American Association for Cancer Research Annual Meeting 2016, suggest that the drug combination would be successful in a phase III trial, potentially leading to an effective, less toxic treatment option for women at risk for metastatic disease.