About 10 % of the cases will be diagnosed as metastatic disease and the 5-year overall survival (OS) in these patients achieves 20 % (historical median survival range 16–29 months), of which 2–5 % are long-term survivors [1, 2] On the other hand HER2 espression identifies patients who may benefit from anti-HER2 targeted therapies [3–11]. The gene discussed is ERBB2; the disease is metastatic neoplasm.