Trial flow chart. Flow chart summarizing the multi step process from initial patient contact until the inclusion of properly screened patient into the trial. Once diagnosis of pancreatic cancer stage IVb was established patients were screened for inclusion criteria. If patients met all inclusion criteria and no exclusion criteria prohibited participation in the study an informed consent was signed. All patients underwent histological confirmation and HER2 grading in the centralized reference pathology. Patients with HER2 grade 3 and patients with HER2 grade 2 plus proven HER2 gene amplification in FISH analyses were eligible for study inclusion. All other patients with HER2 grade 0, 1, or 2 without gene amplification were excluded from this study.