I’ve met many people who’ve been diagnosed since my own cancer “event” in 1997, but my friend Leigh was the first person I had met who shared the same diagnosis I had received 10 years earlier. When we met for lunch to discuss, she was understandably distraught.
“Look,” I said, “we have the exact same diagnosis. They’re recommending the same treatment plan that I was given, and I’m still here, aren’t I? You’re young, you’re strong, and you’re going to beat this!” Leigh left our lunch feeling more hopeful and began chemotherapy a few days later.
Leigh caught her breast cancer early, before it had spread to any lymph nodes. Like mine, her cancer was “triple-negative.” To best describe what triple-negative breast cancer (TNBC) is, it’s easiest to describe what it isn’t. It isn’t driven by estrogen or progesterone, and it doesn’t have high levels of HER2 protein. Of all the targeted therapies available, this type of breast cancer didn’t seem to have any targets.
To make matters worse, it affects younger women, is more aggressive, and offers a poorer prognosis, primarily because of delayed diagnoses and limited treatment options. It tends to strike more Black and Hispanic women, and those with a BRCA1 mutation. Approximately 15 percent of breast cancer cases are “triple-negative.”
BRCA1 and BRCA2 are the first two genes found to be associated with inherited forms of breast cancer. People with mutations in either gene have a much higher risk for developing breast cancer than those without mutations.
After six months of treatment, Leigh was declared “cancer free.” Just a few months later, Leigh called to tell me that she was experiencing a nagging pain in her rib. It’s common to worry about every ache and pain for months (sometimes years) after treatment, but I told her that she should call her doctor. Her healthcare team assured her that it was probably nothing but recommended that she come in. To everyone’s horror, her cancer was not only back, it was everywhere. Leigh passed away just a few months later.
What I’ve learned since her death is that our cancers weren’t the same, which is the fundamental premise of personalized medicine. Today, we know that the individual characteristics of a person’s cancer make each one unique. We’re moving away from the one-size-fits-all treatment approach to personalized therapies that have been proven to interact with genetic biomarkers that either protect us from or promote cancer’s growth.
In 2020, the U.S. Food and Drug Administration approved Trodelvy (sacituzumab govitecan-hziy), the first personalized medicine for people with TNBC. Although this development arrives too late for Leigh, it could not be more welcome for the tens of thousands of people who are diagnosed with triple-negative breast cancer each year.
Susan McClure is a two-time breast cancer survivor and CEO of Genome Creative.
