This case study used weekly Paclitaxel in combination with Trastuzumab and Pertuzumab in a patient with recurrent breast cancer and acute liver failure, but in contrast to this patient, who had AST 351 UI/L and ALT 144 UI/L, our patient had AST 635 UI/L and ALT 309 UI/L. The gene discussed is GPT; the disease is breast carcinoma.