How do you manage new brain metastases in patients on trastuzumab emtansine (TDM-1) who has controlled extracranial disease?

This is an increasingly common clinical scenario, because systemic control with antibodies is quite good, but HER2+ disease still has a strong predilection for the brain. There is a third treatment option here, which may have lower toxicity than either whole brain or SRS.

Particularly where larger vo...