It has also been approved for use in patients with residual HER2-amplified breast cancer after neoadjuvant HER2-directed therapy and chemotherapy, where it has been shown to improve invasive disease-free survival by 50% compared to adjuvant trastuzumab (HR 0.50, 95% CI 0.39 to 0.64; p < 0.001) [65]. This evidence concerns the gene ERBB2 and breast carcinoma.