you are not going to like this--first evidence based guidelines 4 brain met treatment

[Lani]

Steph--what annoyed me is that by aiming one's treatment against the primary, you may be treating the brain met completely wrong. 40% of mets have a different ER,PR or her2 status than the primary. Without biopsying the brain or having a spect MRI, special PET(both still works in progress and theoretical) or other study which might identify
the brain met as being her2 positive or not how will we improve things.

It is easy to say that chemo is not effective --but if it is because it is the wrong chemo/targetted agent because it is aimed against the wrong culprit
than this "evidence" based medicine is only keeping us from learning how to improve treatment.