Nature Communications, Published online: 31 August 2026; doi:10.1038/s41467-026-77041-x Anti-HER2 antibody-drug conjugates (ADCs) have been approved for patients with Hormone Receptor positive (HR + ), HER2-low metastatic breast cancer. Here, the authors present a phase II interventional clinical trial evaluating the anti-HER2 ADC SHR-A1811 as neoadjuvant monotherapy in patients with HR + HER2-low breast cancer (HELEN-015).