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Ironically, presuming the successful completion of the RTOG 0848 trial, if radiation improves local control, but not survival, we may have to revisit the radiation therapy question when better systemic control is finally achieved.
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One hypothesis, originating from studies among patients receiving paclitaxel and trastuzumab, is that the central nervous system is an important sanctuary site and that the higher risk of brain metastases among younger patients is associated with better systemic control of extracerebral metastases and a prolonged survival [ 11, 12].
Although this benefit is likely due to better systemic control, 1 study reported a trend toward longer time to CNS progression, suggesting a possible direct CNS effect, although this remains controversial [ 34].
Command and control is better at that.
Moderate control is generally better.
More control is always better.
My muscle control is so much better.
Our understanding of these phenomena is that trastuzumab alone or in combination with chemotherapy seems to have an indirect, preventive or delaying effect on CNS involvement, which is caused by better systemic extracranial control with the addition of trastuzumab.
"Control was much better today," Verlander said.
Better pollution control technology is available.
We conclude that better systemic and innovation oriented foresight is needed to enhance inclusive development.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com