Targeted Drugs Offer New Treatment Strategy for Advanced Breast Cancer
With an estimated one in eight women expected to experience a breast cancer diagnosis in their lifetime, experts stress the importance of recognizing the warning signs and knowing the risk factors. The disease takes many forms and impacts women of all ages.
Screening mammograms are recommended starting at age 40 for early detection, but for some women, the disease occurs at a younger age — before screening is even part of the conversation.
In November 2013, Heather Cramer, then 34, of Maria Stein, Ohio, was diagnosed with a complex form of breast cancer (estrogen and progesterone receptor-positive and HER2-negative breast cancer) that placed her life on a sudden detour.
Her disease required immediate and aggressive treatment: 16 rounds of a combination chemotherapy, a bilateral mastectomy and five weeks of targeted radiation therapy, which she had at The Ohio State University Comprehensive Cancer – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
“Like many people, I struggled to understand why this happened to me; I was a healthy person. I exercised, I wasn’t overweight, I breast-fed my boys, breast cancer did not run in my family … I didn’t have any of the ‘normal’ risk factors. I had to embrace a mindset of living right now, leaning into my faith and my family for support,” says Heather.
She completed treatment and went on with life, managing follow-up care through her oncologists at the OSUCCC – James. In December 2018, however, she noticed mosquito bite-like bumps on her breast that didn’t go away. Concerned, she had them checked by her surgical oncologist, William Farrar, MD, at the OSUCCC – James.
Two biopsies and several imaging tests later, she learned that she had developed triple-negative breast cancer (TNBC) — an entirely different form of the disease — and that it had spread to her lungs and eventually to her bones and brain.
“I was essentially starting all over. It was very upsetting. I knew then that living with cancer as a chronic disease was my new normal. However, many women — young women — are still dying from this disease, which is very disheartening,” recalls Heather.
She decided to consult with OSUCCC – James medical oncologist Sagar Sardesai, MBBS, about treatment options, including potential clinical trial therapies. After several therapy options had failed for his patient, Sardesai suggested she begin taking a novel targeted therapy drug called sacituzumab govitecan. It is part of a class of drugs called antibody-drug-conjugates (ADC). These drugs provide enhanced and targeted drug delivery specifically to cancer cells while minimizing generalized side effects that can be seen with chemotherapy.
In April 2020, sacituzumab became the first ADC approved by the U.S. Food and Drug Administration for the treatment of previously treated metastatic TNBC and shows improved survival compared to standard chemotherapy in this patient setting. Heather began receiving the therapy in May.
She travels to Columbus, Ohio, for treatment three times a month at the OSUCCC – James.
“I’m doing everything I can to stay strong and give myself the best chance to continue treatment as necessary and continue to live. It is easy to sink into a mindset of limitations — being sad about what I can’t do because of my disease or fear about the ‘what ifs’ — but staying focused on living keeps me living,” says Heather, now 41, who maintains a busy life as a mom of boys ages 13, 10 and 8, and works full-time as a treasurer for her local school district.
Heather says some days are really bad. Living with cancer as a chronic disease is hard: “It helps me to stay grounded in showing my boys we can all be strong and still do hard things. This gives me the strength to fight and the gift of being present right now, for which I am grateful.”