In the ESME cohort, a large national observational database, patients of the HER2+ subgroup had a median age of 57 years at diagnosis of metastatic disease, 83% had performance status 0–1, 21.5% had ≥3 metastatic sites and 11.3% had brain metastases.7 This evidence concerns the gene ERBB2 and metastatic neoplasm.