Most metastatic breast cancers arise months or years after the initial diagnosis and treatment. I鈥橯uasia Russell, however, was among the 6 to 10 percent of people for whom metastatic disease was their first cancer diagnosis. Russell has been treated by Sylvia Adams, MD, director of the Breast Cancer Center at 嘿嘿视频 Health鈥檚 Perlmutter Cancer Center, since her diagnosis in March 2016.
鈥淚鈥橯uasia has done extremely well over the last several years,鈥 said Dr. Adams, who also is a professor in the at NYU Grossman School of Medicine. 鈥淚mportantly, she has been able to fulfill her dream and go back to school for her nursing degree, while working full-time and being a mother of two. It takes an amazing amount of strength for a person to go through this, and I鈥橯uasia has shown that strength. She鈥檚 a fierce fighter.鈥
鈥淲orking in the medical field and knowing the different problems that arise with metastatic breast cancer, you know what you鈥檙e going to have to deal with if you try a treatment and then it doesn鈥檛 take as well as you expected it to take,鈥 Russell said. 鈥淪o now you鈥檙e trying another treatment and now you鈥檙e like, what if this doesn鈥檛 work? Am I going to run out of treatment options to where it鈥檚 just I have to deal with what鈥檚 next?鈥
During the course of her treatment, Russell benefited from several new drug approvals that serendipitously occurred just as she needed something new to treat the cancer.
Russell was initially treated with chemotherapy and the HER2 inhibitor trastuzumab (Herceptin). As the cancer progressed in her liver, she started a newly approved antibody鈥揹rug conjugate called trastuzumab emtansine (Kadcyla). After Kadcyla stopped working, she received a PARP inhibitor, a newly approved drug for certain breast cancers with a deficiency in DNA repair. Months later, after the cancer progressed, Dr. Adams said that Russell was in a great deal of pain from the metastatic disease in her liver. Around that time, another antibody鈥揹rug conjugate, fam-trastuzumab-deruxtecan-nxki (Enhertu), was approved for HER2-positive breast cancer.
鈥淓nhertu is a very powerful drug,鈥 Dr. Adams said. 鈥淚鈥橯uasia had a very rapid improvement in her symptoms and her pain subsided within a week. The benefit of that drug lasted for two years, which is incredible with prior pretreated breast cancer.鈥
When the cancer metastasized to Russell鈥檚 brain, she had stereotactic radiosurgery with Douglas Kondziolka, MD, the Gray Family Professor of Neurosurgery in the and a professor in the at NYU Grossman School of Medicine and director of the Gamma Knife Program at Perlmutter Cancer Center. Russell鈥檚 brain scans have been clear since. When the cancer in the liver began to grow again, she benefited from the approval of ribociclib (Kisqali) and palbociclib (Ibrance), members of a new class of cancer drugs for metastatic breast cancer called CDK4/6 inhibitors. She is monitored every three months with brain MRIs and visits with her treatment team monthly.
鈥淚鈥橯uasia is doing very well and she looks great,鈥 Dr. Adams said. 鈥淥ur goal when we meet with women who have metastatic disease is to provide hope. We encourage them to think about metastatic breast cancer as a chronic illness where they receive treatment like they would for blood pressure or diabetes. The treatment goals for metastatic breast cancer are designed to maintain a good quality of life and extend survival. I鈥橯uasia has definitely had extended survival from the treatments.鈥