What systemic therapy would you recommend for a patient with metastatic triple negative breast cancer (HER2 1+) who has progression of brain mets after WBRT and while receiving first line chemotherapy?

What is your preferred treatment for a patient with metastatic TNBC (HER2 1+), receiving first line chemotherapy, with progression of brain mets after WBRT?

• Local treatment (Surgery/SRS) followed by alternate chemotherapy +/- IO
• Local treatment (Surgery/SRS) followed by TROP2 ADC (eg. sacituzumab, datopotamab-dxd)
• Local treatment (Surgery/SRS) followed by HER2 ADC (eg. T-Dxd)
• Local treatment (Surgery/SRS) followed by other HER2 targeting rx (eg. trastuzumab/tucatinib)
• Systemic therapy alone with alternate chemotherapy +/- IO
• Systemic therapy alone with TROP2 ADC (eg. sacituzumab govitecan, datopotamab deruxtecan)
• Systemic therapy alone with HER2 ADC (eg. T-Dxd)
• Systemic therapy alone with other HER2 targeting rx (eg. trastuzumab/tucatinib)
• Other