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Editor’s note: The role of trastuzumab in the treatment of patients with metastatic breast cancer known to be HER2-positive was clearly established by Denis Slamon’s study with paclitaxel (N Engl J Med 2001;344:783–92) and Michel Marty’s study with docetaxel (J Clin Oncol 2005;23:4265–74). Provocative data from Hal Burstein showed excellent response rates with vinorelbine and trastuzumab, but having established the role of trastuzumab in metastatic disease, randomized studies of vinorelbine, with or without trastuzumab, were unlikely to be conducted (J Clin Oncol 2003;21:2889–95). This Scandinavian study provides extremely reassuring data that the use of vinorelbine/trastuzumab is likely to be as effective as a taxoid/trastuzumab combination and certainly more tolerable.