Double antiHER2 blockage with trastuzumab and pertuzumab had been studied in the APHINITY trial [41]; 4805 patients with node-positive or high-risk node-negative HER2-positive, operable breast cancer were randomly assigned to receive either pertuzumab or placebo added to standard adjuvant chemotherapy plus 1 year of treatment with trastuzumab; 63% had node-positive disease and 36% were hormone receptor negative. This evidence concerns the gene NR4A1 and breast carcinoma.