I'm a bit confused. How closely monitored was the last year on Tykerb/Xeloda? it strikes me a need to try a different treatment might have been realized earlier.
Anyways...
Not sure where you are in terms of health systems. But aside from TDM-1, now might be a time for an up to date biopsy/pathology and
chemosensitivity testing to see what would have the best chance of working. There have reportedly been folks at the end of their rope who bounced back after an informed chemo decision.
Otherwise, here are some
chemo combos that might help.
Reusing previously "failed" drugs in lower/more frequent i.e.
metronomic dose might help.
A new biopsy might also reveal opportunities for hormonal therapies.