For the first time, a drug targeting a protein that drives breast cancer growth has been shown to work against tumours with very low levels of the protein.

It’s not a cure. But this latest gain for targeted cancer therapy could open new treatment possibilities to thousands of patients with advanced breast cancer.

Until now, breast cancers have been categorised as either HER2-positive — the cancer cells have more of the protein than normal — or HER2-negative. Doctors reporting the advance Sunday said it will make “HER2-low” a new category for guiding breast cancer treatment.

About half of patients with late-stage breast cancer formerly categorised as HER2-negative may actually be HER2-low and eligible for the drug.

The drug is Enhertu, an antibody-chemotherapy combo given by IV. It finds and blocks the HER2 protein on cancer cells, while also unloading a powerful cancer-killing chemical inside those cells. It belongs to a relatively new class of drugs called antibody-drug conjugates.

The drug was already approved for HER2-positive breast cancer, and in April the Food and Drug Administration granted it breakthrough status for this new group of patients.

In the new study, the drug lengthened the time patients lived without their cancer progressing and improved survival compared with patients given standard chemotherapy.

The study compared Enhertu to standard chemo in about 500 patients with HER2-low breast cancer that had spread or could not be treated with surgery. The drug stopped the progress of cancer for about 10 months compared with about 5 1/2 months in the group getting regular care. The drug improved survival by about six months (from 17.5 months to 23.9 months).

The drug, which costs about $14,000 a month, can have severe complications. Three patients in the study died of a lung disease that’s a known hazard of the drug. Doctors need to make sure patients report breathing problems right away so the drug can be stopped and patients treated with steroids.

“A lot of people, including a lot of patients, will not have heard of HER2-low breast cancer before,” said the study’s lead author, Dr. Shanu Modi of Memorial Sloan Kettering Cancer Center in New York.

“We finally have a HER2-targeted drug that for the first time can target that low level of HER2 expression,” Modi said. “This drug actually helps to define HER2-low breast cancer. It makes it, for the first time, a targetable population.”