In HER2-positive breast cancer patients, the HER2-directed therapy in a neoadjuvant setting has been escalated by adding pertuzumab to trastuzumab, but there is some evidence that we can de-escalate the chemotherapy portion of the neoadjuvant therapy and it may be possible to omit carboplatin +/− taxane chemotherapy from the combination of docetaxel, carboplatin, trastuzumab and pertuzumab (TCHP) that is currently the standard neoadjuvant regimen and to maintain the high pCR rate [20,21]. The gene discussed is ERBB2; the disease is breast cancer.