To provide more recent data on this topic and to motivate a discussion around the activation process of phase III trials across the globe, we aimed to study if geographic location and income classification would influence the activation timelines of the phase III APHINITY trial (NCT01358877), which investigated the addition of pertuzumab to chemotherapy and Trastuzumab as adjuvant therapy for patients with HER2-positive early breast cancer. The gene discussed is ERBB2; the disease is breast cancer.