October 12, 2018 | by Maxine Nunes
It was just a cough. And a backache.
A local doctor ordered a scan for back pain. They did blood tests. Everything looked just fine.
Linda Collins should have been relieved. Although she was a breast cancer survivor, her recent mammogram was clear, and she’d just hit that five-year mark, the point many patients finally exhale and stop worrying about a recurrence.
Still, she just hadn’t been feeling right and insisted on another scan. When the results came back, her doctor saw what he suspected was lung cancer. He was wrong. Further tests showed that her breast cancer had returned. It was now Stage 4 and had metastasized to lymph nodes in her chest area.
“I was in shock. I didn’t know what to say,” she said. “The oncologist did a treatment plan for chemotherapy, and when you don’t have medical knowledge, you just take your doctor’s advice.”
But oh, how she dreaded it. The first time she had chemo — a mixture so potent it’s sometimes called the “red devil” — she lost 60 pounds. All of her hair fell out, even her eyelashes. Her nails fell off, and she developed neuropathy in her feet.
Then she talked to her niece, a nurse practitioner, who knew there were new targeted therapies for certain types breast cancer. She suggested Collins go to City of Hope for a second opinion.
There she met oncologist and breast cancer expert Yuan Yuan, M.D., Ph.D. — and it was eye-opening.
For one thing, Collins’s oncologist had just assumed her cancer was the same ER positive breast cancer she’d had before. It wasn’t.
Yuan ran a whole new battery of tests and learned that Collins now had triple-negative breast cancer. It seemed like the worst possible news, because it meant she wasn’t a candidate for a targeted therapy.
“Triple-negative is the most difficult to treat of all breast cancers because there are no estrogen, progesterone or HER2 receptors to target,” Yuan explained. “And the latest data show that the overall survival rate is between 12 and 18 months.”
But one slim ray of hope did turn up with Yuan’s testing.
Collins was positive for androgen receptors. There was a drug for prostate cancer that targeted androgen, and it had been tried with triple-negative breast cancer — but with only limited efficacy. Still, this glimmer of possibility had inspired Yuan to design the study she enrolled Collins in.
“The idea behind our trial is, can we do better by combining androgen targeting with state-of-the-art immunotherapy,” Yuan explained.
Trial subjects are receiving the drug pembrolizumab to boost the immune system, along with drug enobosarm, which targets the cancer’s androgen receptors. Patients, including Collins who had suffered so severely with chemotherapy, have experienced few side effects with this treatment.
What’s more, for Collins, who has been in the trial for a year, the combination therapy has been so successful her cancer is now undetectable.
“I really can’t grasp it. I’m completely overwhelmed actually,” she said.
Her husband and three kids couldn’t be happier.
“My daughters are so funny — they say 'Yuan Yuan for president!'” she said. “They love her and I do, too. She’s a real powerhouse, a real innovator, and somebody who really wants to find a cure.”
The trial has now expanded, and in addition to City of Hope it has begun enrolling subjects at University of California Davis, University of Utah, University of Kansas and Ohio State University.
As a wife, a mother and an elementary school teacher, Collins is a woman who gives a lot and gets plenty of love in return. She’s now thrilled that by taking part in this trial she is also helping others.
What are the odds of little old me in Hemet getting to participate in this trial, instead of going back on chemo like so many other women,” she said. “If this is successful, look at all the people it could help. I feel so fortunate, so blessed, but more than that, I’m just so humbled.”