G Grazia, Rodrigo Sánchez-Bayona, Casals-Pascual Climent, Tomás Pascual, Daniele Generali, Alessandra Gennari, Paolo Vigneri, Nadia Harbeck, Javier Cortés, A. Prat, F. Schettini
Hormone receptor-positive/HER2-negative breast cancer evolves in response to therapy, demanding smarter, adaptive biomarker-based treatment strategies. We review emerging dynamic biomarkers to guide therapeutic decision-making, spanning tissue and liquid biopsies, metabolic imaging, and microbiome profiling, that capture tumor or host-related changes over time. By contrasting Academic and Industry approaches, we advocate for a cultural shift in clinical trial design and implementation, aiming to move from reactive to proactive Oncology.