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"In 2003, I was a busy 42-year-old wife and Mom of three. Although I had been to the doctor numerous times expressing concern over a growing mass in my breast, the mass did not show up on a mammogram or sonogram. The tumor continued to grow and eventually I was diagnosed with ER/PR-positive, stage IIIC, invasive lobular breast cancer. My prognosis was poor. I received neoadjuvant chemotherapy to shrink the mass. Next, I had a double mastectomy. Pathology testing revealed there was a great deal of residual cancer. Therefore, my oncologist recommended additional chemo followed by radiation. After the additional treatment, I had my ovaries removed and began therapy with Aromasin.

"From 2005 to 2015, I remained on Aromasin and was cancer free. In early 2016, a routine oncology appointment showed that my CA 27.29 was elevated to 245. A PET scan revealed several enlarged retroperitoneal lymph nodes. There was some conflicting data regarding the ER status of my cancer, so I began taking Ibrance with the hope I was still ER-positive. Soon additional testing confirmed that this stage IV lobular cancer was triple-negative and very aggressive. Within three months of my stage IV recurrence, I was suffering from the symptoms of a bowel obstruction. I did my best to manage the symptoms while GI tests were performed. I was finding it increasingly difficult to eat without debilitating pain. By October of 2016, I weighed just over 100 pounds and my tumor marker soared to over 1300. Things looked terribly bleak.

"In retrospect, I see that that God was using the bowel obstruction to bring me to a place of healing. You see, my UCSD GI surgeon, Dr. Jason Sicklick, serves as the principle investigator of a clinical trial designed to test a new approach to treating cancer. The objective of this trial is to determine if patient outcome is better with 'individualized therapy' or 'standard of care' therapy. The trial uses genomic data from each individual patient's tumor to create an individualized treatment plan. When I was accepted into this clinical trial, I had failed six lines of therapy and been referred for hospice care. Were it not for the I-PREDICT clinical trial, that created a custom treatment plan based on the genomic profile of my individual cancer, I would most likely have continued to fail the standard breast cancer treatment options available to me.

"From the Foundation One genomic report, the clinical trial team noted a very high Tumor Mutation Burden (TMB) as well as a high PD-1 pathway in my tumor sample. After a careful review of my case, they selected the drug, Opdivo, for my treatment. Unfortunately, Opdivo was denied by my insurance provider because immunotherapy is not standard of care for breast cancer. Thankfully, the clinical trial team coordinated with the Bristol-Meyers Squibb Patient Assistance Foundation (BMSPAF) to obtain the drug for free on my behalf. I cannot imagine any other therapy being more effective.

"My response to Opdivo was immediate and dramatic. After just two infusions, my tumor markers dropped by 75% to 84%. By mid-June of 2017, all of my tumor markers were in the normal range. My first CT scan after eight weeks in the trial suggested a potential complete response to therapy. A PET scan on 6/16/17 revealed that previously seen metabolically active retroperitoneal and midline pelvic lymph nodes were no longer present. On 1/9/18 ileostomy take down surgery was performed and there was no evidence of disease.

"While I have no way of knowing how my cancer will behave in the future, I feel incredibly blessed to be alive today. Sometimes I wake up long before daylight with the same excitement and joy a child feels on Christmas morning. Like the little child, I force myself to remain in bed until the first light of day. Then I jump out of bed confident that this new day will overflow with gifts - including the priceless gift of more time with my husband and three children.

"I daily pray that God will illuminate the mystery of this disease. I think there are significant advances being made. We are 'fearfully and wonderfully made'! Each person is unique and as our cancers are treated with that in mind, we will see people with stage IV cancer living much, much longer.

"Thank you for reading my story. I pray God surrounds you with the love of those you hold dear and give you strength, hope, and perseverance as you seek healing."

-- HealingHope, diagnosed metastatic in early 2016

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