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I think one of the possible reasons for oncs to be reluctant to give an additional treatment(such as Tykerb) to someone who is NED from an other drug (such as Herceptin) is first it won't provide any measurable better outcome but it can introduce either new side effects that worsen QOL or even more importantly it may cause early resistance which would make the new treatment not usable when you realy need it if & when the remission ends.
An other reason is the lack of approval of the combo regimen. Doctors are allowed to use approved drugs off label as they wish but they fear lawsuits & loosing their licence to practice if their prescription leads to an unexpected fiasco for the patient.
This said, it is certainly still frustrating since other risks may not be taken care of (such as brain mets) until new symptoms appear.
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