A New Treatment Option for HER2-Positive Early Breast Cancer – Allison Fields [transcript] [audio]

Guests: Dr. Denise Yardley & Allison Fields

Presenter: Neal Howard

Guest Bio:

Dr. Denise Yardley joined Sarah Cannon in 2000 as a senior investigator of the breast cancer research program. In this role, she serves as principal investigator on numerous breast cancer clinical trials. Dr. Yardley received her undergraduate degree from Columbus State University in 1983 and her medical degree from the Medical College of Georgia in 1988. She completed her residency and fellowship training at the University of Texas Southwestern Medical Center in Dallas. A diplomate of the American Board of Internal Medicine, Medical Oncology and Hematology, she is also a recipient of the American Cancer Society Clinical Oncology Career Development Award.

Allison Fields – With both her mother and grandmother having breast cancer, 47-year-old Allison knew she wanted to do everything she could to fight her disease. When diagnosed with an aggressive form of early breast cancer, Allison decided to participate in a clinical study that was investigating how women with HER2-positive breast cancer responded to receiving treatment after surgery. While clinical studies remain a mystery to many people, as a medical professional Allison knew that she may personally benefit and saw it as an opportunity to potentially help others. Now, four years later, she remains a passionate veterinarian and enjoys traveling with her husband. In fact, they traveled to Iceland most recently to view the Northern Lights.

Segment Overview: Dr. Denise Yardley and Allison fields talk about how each year in the US, 255-thousand women will learn that they have breast cancer and may not realize that breast cancer is not just one single disease, but that there are many different types. As many as 20% of women have the more aggressive form of the disease, called HER2-Positive breast cancer.


Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neil Howard. Thank you for joining us today. Each year in this country, 255,000 women will learn that they have breast cancer. Now until that diagnosis, they may not realize that breast cancer is not just one single disease but there are many different types as many as 20% of these women have the more aggressive form of the disease. It’s called HER2-Positive Breast Cancer. And here to explain what’s being done to treat it and hopefully keep it from coming back are Dr. Denise Yardley, Senior Investigator Breast Cancer Research Program at Sarah Cannon and breast cancer survivor, Allison Fields. Welcome both of you to Health Professional Radio.

Dr. Denise Yardley: Thank you.

Allison Fields: Thank you.

N: Now Dr. Yardley, how many types of breast cancer are there and why is it so important that women be diagnosed early?

Y: I think we recognize now three main groups of breast cancer. We call them the Hormone Receptor Positive Breast Cancer, the Triple Negative Breast Cancer and the HER2-Positive breast cancer. It’s important to establish which subtype a particular breast cancer is so that we make the appropriate treatment recommendations of the drugs that are most likely to help that particular subtype of breast cancer. I think we look at early detection is being pivotal in the treatment of patient with breast cancer because we know it’s earlier diagnosis from early detection leads to diagnosis of early stage breast cancer. And that is to say that we have the greatest chance of improving outcomes for patients, increasing the cure rate and decreasing the lives lost to breast cancer.

N: Now Allison as a patient, talk about what it was like to be diagnosed and how are you managing your life today?

A: Well, I’m managing my life the exact same way that I was then and all through treatment which is working as a full time veterinarian. I’m doing great today. Thank you for asking. But when I was diagnosed, it was not a surprise. My mom and my grandmother both had breast cancer, so I was a little suspicious that I might be getting it. So when I was diagnosed, my goal and my focus was to find out what type of breast cancer I had and what the best treatment options were for me.

N: And you discovered that you had this HER2-Positive.

A: I did and then Dr. Yardley got me set up on the clinical trial for early stage breast cancer that is also HER2-Positive.

N: Dr. Yardley, specifically talk about HER2-Positive. How is it different from some of the other forms of breast cancer and how is it treated?

Y: HER2-Positive really refers to a very specific feature of that 15-20% of breast cancers and this the appearance of a protein on the surface or the outside of that breast cancer cell that’s called “HER2-Positive” and we can test for it in the lab. The pathologists do it from an original biopsy. The importance of establishing whether this protein is on the surface of any individual that’s facing a diagnosis of breast cancer is that we’ve been able to develop very specific treatments that attack that protein on the surface of that breast cancer cell. And so we’re here today on behalf of Genentech to talk about the latest approval for HER2-Positive early stage breast cancer and that’s namely a drug called “PERJETA.” That was approved by the FDA in December for the treatment of early-stage HER2-Positive breast cancer in combination with Herceptin that comes with side effects of rash and diarrhea. But in the appropriate patient facing the HER2 early stage breast cancer diagnosis, this may be an appropriate treatment that stands to increase the survivability and outcomes for that particular patient.

N: What was it that made Allison an appropriate patient?

Y: At the time that Allison came for treatment recommendations, we already knew a lot about HER2 breast cancer and we’ve had established already Herceptin as an effective treatment for the HER2-Positive early stage breast cancer patients. We had just seen the benefit of PERJETA in our advanced patients in the clinical trial unfolded to now establish the combination of PERJETA with Herceptin in early stage breast cancer patients that were HER2-Positive. And so when Allison had the diagnosis of HER2-Positive early stage breast cancer, I offered to her the consideration of participating in that trial and getting a chance in a blinded fashion, both I was blinded and Allison to what the treatment was, but she was getting standard treatment with the chance of receiving PERJETA which was already FDA-approved for advanced patients in the early stage setting.

N: Now Alison, talk briefly about deciding to join this study and give some advice to other women who may be facing the same type of diagnosis.

A: Well joining the study, I feel like was just kind of an obvious choice. This drug had already been FDA-approved for late stage breast cancer which means that it has already gone through a lot of trials and obviously, wasn’t hurting anybody. And if I wanted to try to get it which the only way I could was joining the study, so I could have not gotten it or I could have gotten it. But if I didn’t do the study, I didn’t have a chance to get it. So I decided to do study for A, me and B, the more people that were joining that study, the more women that had HER2-Positive breast cancer and were candidates for that study. The more of us that completed the study gave more ammunition to the doctors and researchers to get it passed by the FDA so that now, every woman who has HER2-Positive breast cancer if their doctor thinks that this is an appropriate drug choice for them has the ability to get it.

N: Was there a support system that you took advantage of outside your relationship with Dr. Yardley?

A: Yes, she was not bringing me dinner on a regular basis. I have some very good friends, and a husband, and family and co-workers that definitely helped me get through those rough days after chemo. And then there was a large amount of the time that during all of my treatments that I felt it was fine, I still worked all through chemo and radiation. I tried to keep my life as normal as I could. So I was really tired but keeping life as normal as you can is really helpful.

N: Absolutely. And doctor in wrapping up, talk about where we can go and learn some more about HER2-Positive and about breast cancer in general, raising awareness and possibly getting involved or just getting the word out?

Y: I always suggest that the patient diagnosed with breast cancer really have an open dialogue with their physician and really explore opportunities of what specifically is recommended for their type of breast cancer because I think the physician really has an understanding of the stage of the disease and what the appropriate treatments may be for that individual and that subtype of breast cancer. I think for patients, family members, viewers alike, there are many other websites (like living beyond breast cancer org), that’s lbbc.org. My own institution, for questions, we have a great website asksarahnow.com. There’s a registered nurse that can actually get on a chat line if they have specific questions. But both of those talk about breast cancer, talk about the clinical trials that may be available and other resources for the patient or viewers who’d like to explore.

N: I thank both of you for coming in and speaking with us Dr. Denise Yardley, Senior Investigator of Breast Cancer Research Programs at Sarah Cannon and breast cancer survivor, Allison Fields.

Y: Thank you.

A: Thank you very much.

N: You’ve been listening to Health Professional Radio. Transcripts and audio of the program are available at healthprofessionalradio.com.au and also at hpr.fm. You can subscribe to this podcast on iTunes, listen in and download at SoundCloud and be sure and visit our affiliates page at hpr.fm.

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