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Running For More…

The personal blog and website of Kristen Cincotta

Posts Tagged ‘TDM-1’

Gone, But Never Forgotten

Friday, April 5th, 2013

I know that I still owe everyone a recap on my first half marathon and an update on the results of my Running for the ROC fundraiser. Those posts will be coming, soon. But tonight, I wanted to talk for a minute about Bridget Spence.

Bridget, featured in an ad for Komen for the Cure

Bridget was a member of my pink family. I never had the privilege of meeting Bridget, but as part of the extended 3 Day family, I felt like I knew her. I think a lot of us felt that way. She was so open and honest in her blog, My Big Girl Pants, it was hard not to feel like she was an old friend. Today, we all received word that after a long battle with breast cancer, Bridget passed away last night surrounded by those who truly did know and love her best.

Bridget’s cancer was similar to my mom’s. As similar as a cancer can be, I guess, when it strikes a woman in her early 60s and a young lady in her early 20s. Both of their cancers were/are HER2+, a protein marker that we didn’t even know was a thing until the last two decades. The discovery of HER2+ cancers quickly led to the development of Herceptin, the drug that both my mom and Bridget credited with extending their lives far beyond what used to be expected for Stage IV metastatic breast cancer.

Herceptin is a different kind of drug. The HER2 gene causes cells to express extremely high levels of cell surface receptors that promote improper, aggressive cell division. Herceptin is an antibody that gloms onto those receptors, effectively blocking them from promoting cell division. Unlike other chemo drugs, which interrupt universal cell division processes (and therefore target ALL dividing cells in the body, leading to those side effects that are commonly associated with cancer treatments), Herceptin only affects the cancer cells that are over-expressing these receptors. As a result, it is tolerable for far longer than most chemo drugs. My mom was on Herceptin for the entire first 18 months she was being treated and has been on it continuously since her cancer came back in early 2010. From what she wrote, Bridget was on it for most of her 6+ years of treatment. Herceptin is not a cure in and of itself. Instead, Herceptin keeps the cancer at bay so that individuals like Mom and Bridget can live their lives. Herceptin turns metastatic breast cancer into a chronic condition rather than an immediate death sentence.

Herceptin first gained FDA approval 15 years ago. That’s not that long ago, as far as biomedical breakthroughs go. But scientists aren’t generally the sort to be contented with one breakthrough. Herceptin isn’t perfect. So scientists and the organizations that fund them started asking “What’s next?”. And what was next is TDM-1. TDM-1 is a new drug that is a hybrid of two cancer drugs that we already had: Herceptin plus a super potent molecule of traditional chemotherapy. On its own, that chemo molecule is too damaging to be used in medical care, even for metastatic cancer. It just wouldn’t be tolerable at the doses you’d need to give to get full coverage of a cancer that has spread throughout the body. But! Stick that molecule of super chemo onto a Herceptin molecule, and it’s the equivalent of adding a honing device to missile. Suddenly, the chemo bomb is delivered directly to the cancer cells. That means that far less of the chemo needs to be given to have the same anti-cancer effect. All of the potency, relatively minimal cellular collateral damage. This is what a I truly believe is the future of chemotherapy. And because of Herceptin, HER2+ breast cancer is the first one to have a specific antibody-chemo conjugate that targets it.

TDM-1 was approved for use by the FDA on February 22nd, 2013, when it was rechristened “Kadcyla”. It was in clinical trials last summer when my mom was told that the current treatment she was on might be the last one available to her once her cancer outsmarted it. These last few months have been stressful, wondering what would happen first: would Mom’s cancer would wisen up to the taxotere she was taking and become resistant or would TDM-1 get approved? Thankfully, the clinical trials were successful and the FDA, recognizing the potential in TDM-1, expedited the approval just in time. Mom’s cancer hasn’t yet outsmarted the taxotere. But a few weeks ago, the taxotere outsmarted her lungs and caused significant fluid accumulation, making it unsustainable as a cancer treatment.

Mom will start Kadcyla in a few weeks, if not sooner. And because of Bridget, my mom knows what to expect of this brand new drug. That’s because brave, strong Bridget was in the clinical trials for TDM-1.

When your parent is diagnosed with cancer and you are told that it will be okay, because there are treatments available, you are relieved. You probably don’t give much thought to the people who came before you, who tried all of those experimental drugs and surgeries before we knew what they would do. When you’re told there may not be any more treatments available, it is terrifying. You are obsessed with the clinical trials: who’s in them, what are they experiencing, is it going to work???

You almost never get answers to those questions. Because of Bridget and her honesty, I did. And more importantly, my mom did. That kept Mom fighting so that she would be here for the day that TDM-1 became a reality for her. That’s why Mom is still here, feeling strong and optimistic about this next phase of treatment.

Bridget gave me the greatest gift I have, and probably will ever receive: more time with my mom. That is a priceless gift. In her final blog post back in December, Bridget asked that we not forget her. I know that I absolutely never will.

When I Ran for the ROC at the Publix Half Marathon in March, I dedicated one of my miles to Bridget, knowing that she had made the courageous decision to end her treatments. Tomorrow morning, I will run the Northwestern Mutual Road to the Final Four 5K benefitting the American Cancer Society’s Coaches vs Cancer program in Bridget’s name. It is the very least I can do to honor someone who has given me so much.