Without knowing your treatment history, here are some thoughts. And of course I'm not a doctor so not qualified to recommend anything, so I'm responding based on what I would consider doing myself
First, as far as I know, TDM-1 is only available as an infused drug - are you sure about the description of this study? Maybe you could post the trial #, or recheck what it is.
It looks more like the BOLERO trial which is Herceptin/Navelbine and Everolimus (Affinitor), the latter being an agent that targets the MTOR pathway. That is a trial I would personally consider (coming off TDM1 and in decision mode myself right now!).
http://clinicaltrials.gov/ct2/show/N...rceptin&rank=4
I haven't had Navelbine (yet!) but know many women who have done very well on it - both efficacy and tolerability. If you are feeling that the Tykerb/Herceptin hasn't quite been able to keep things under control, maybe it is time to try a stronger option. Herceptin/Navelbine is a good combo, even without the everolimus.
TDM1 is a great drug - it drove me to NED and kept me there for 3 years. I think that would also be a good option and should be in your arsenal - if not now, then for later. As I think you know (from your other post), Genentech is working on a protocol change for the EAP which would allow patients in an EAP trial, after they get started, to get some treatments at home. Getting this protocol amendment through and approved will probably take a bit of time. Keep in mind, if you are fatigued, TDM1 is a slightly tougher road than vanilla herceptin - and particularly so if you have to travel to get it.
Interesting how the options present...and how doors and windows open and close without us knowing why, for us, they are doing that at just that specific time.
Sounds like you have good options, and you will make the right choice for you, whatever that is.