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ER-negative subset were HER2 enriched by intrinsic subtyping, and there were no luminal-A/B subtypes [5]. The greater likelihood of biological dependency on HER2-driven signaling in HER2-positive and ER-negative breast cancer may explain why longer trastuzumab therapy may have a differentially superior effect in ER-negative disease than in ER-positive disease. Our findings suggest that it may be possible to identify a subset of patients who would benefit from longer or shorter course of trastuzumab therapy based on the ER status. For a resource constrained setting, it may be possible to shorten the duration of trastuzumab therapy in patients with ER-positive status. An individual patient-level data meta-analysis of these three trials will provide greater power to conduct subgroup analysis. We recommend that the investigators of all the adjuvant trastuzumab duration trials contribute their trial data for a pooled analysis. It will benefit thousands of patients with HER2-positive breast cancer, especially women in the developing regions of the world.

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Lung adenocarcinomas with gene rearrangement in the receptor tyrosine kinase ROS1 have emerged as a rare molecular subtype. Although these lung adenocarcinomas respond to ROS1tyrosine kinase inhibitors, many patients ultimately acquire resistance. ROS1gene rearrangement is generally mutually exclusive with other driver genomic alterations, such as those in EGFR, KRAS, or ALK, thus multiple genomic alterations are extremely rare. Herein, we report a case of a 42‐year‐old man diagnosed with lung adenocarcinoma positive for a SDC4‐ROS1 fusion, who was treated with crizotinib followed by three cycles of chemotherapy. A biopsy acquired after disease progression revealed the original SDC4‐ROS1 fusion along with a KRAS point mutation (p.G12D).We reviewed the related literature to determine the frequency of gene mutations in non‐small cell lung cancer patients. A better understanding of the molecular biology of non‐small cell lung cancer with multiple driver genomic aberrations will assist in determining optimal treatment.