Would you change treatment for denovo stage IV breast cancer Her 2 positive, ER positive in remission now with isolated brain metastasis?  

I would not change systemic treatment for such a patient if they have stable disease outside the brain. The intracranial disease should be treated with SRS or WBRT or surgery, as the case may be. With the various anti Her-2 treatment options in this setting, namely trastuzumab, pertuzumab, T-DM1 and...

The TBCRC 022 phase II did have an impressive composite CNS ORR 49% in the cohort "3" with Neratinib and Xeloda as recently highlighted in JCO. The NALA trial will be presented in a few weeks at ASCO but in the 3rd Line HER2+ MBC setting. Unfortunately, the although isolated brain met is likely a ha...

I agree with @Milana V. Dolezal's approach. There is a risk of progression outside CNS in this case given new brain mets, One could continue same systemic therapy but considering small molecule inhibitors like Lapatinib or Neratinib concurrent with SRS could give better CNS control. These agents sho...