Too soon to die - a case for Kadcyla

Tracey Eising knows that the medicine she is taking to stop her cancer spreading will soon stop working. The only medicine left with a chance of extending her life is Kadcyla, a drug that is currently unfunded in New Zealand. At a cost of $100,000 per year of treatment, Tracey, like most New Zealanders cannot afford it. 

The 48-year-old Blenheim mother of four has been living with metastatic (advanced) breast cancer since November 2009 when she learned the cancer had spread to her liver, lungs and bones. Tracey was first diagnosed with early stage ER+ breast cancer in 2004 and later found out she was also HER2+.

After her cancer advanced Tracey was given docetaxel chemotherapy and Herceptin. Six months later she was happy to be diagnosed as NED (No evidence of Disease). For the next three years she continued to take Tamoxifen and Herceptin which successfully prevented the cancer from returning. 

However, in November 2012 she discovered the cancer had spread to her ovaries. In addition to taking Herceptin, Tracey was also given Capecitibine which she took until late 2014. “I took a treatment break for a few weeks as I was so tired of taking medicines.” She is now taking a taxane (Paclitaxel) and says there has been shrinkage of the tumours in her liver but doctors have recently told her it will soon stop working.

“The only option left for me is Kadcyla,” says Tracey. Kadcyla is recognised as a breakthrough medicine and was approved for funding this month (July) in Australia. Would she consider moving to Australia to receive the treatment to allow her to live longer? “I would, but I can’t leave my Mum here. I’m all she’s got and she has been such a lovely Mum to me.”

Kadcyla is a new generation cancer drug that targets a powerful chemotherapy agent to HER2+ cancer cells, with minimal side effects. Results of a large international clinical trial, ‘Emilia’, recently revealed its effectiveness as a ‘second line’ treatment for patients with metastatic HER2+ breast cancer whose breast cancer had advanced after treatment with Herceptin and a taxane. While the trial showed Kadcyla extended the life of these patients by an average of 5.8 months some patients can live much longer. The trial revealed that 64.7% of patients taking Kadcyla were alive at two years compared with 51.8% of patients who did not receive Kadcyla. In New Zealand, a few patients on the Marianne study taking Kadcyla have been on treatment for 3.5 years and are still responding well. 

It has been a long breast cancer journey for Tracey from her first breast cancer diagnosis in 2004 and her metastatic diagnosis five and a half years ago. “I’ve done well but I can’t accept that I’m at the end of the road. I am dying too early and unnecessarily.” Tracey’s third grandchild is due to be born in December. “I want to see my son become a Dad.”

Tracey finds the biggest battlefield of living with metastatic breast cancer is in the mind. “Every day I look in the mirror I am reminded of my cancer. It’s constantly in the background.” She is grateful for the “marvellous support” she receives from her oncology nurses in Blenheim and she is also a member of a website called www.inspire.com for people with metastatic breast cancer. “It keeps me abreast of what’s going on with treatments in the US and it is a very vocal space which I find very refreshing.”  Tracey is also a member of Metavivors NZ, a Facebook group for New Zealanders with metastatic breast cancer.

But, most of all, Tracey, like metastatic breast cancer patients everywhere, does not want to die. “I am afraid to die and I am afraid of being separated from my family. Having those important new drugs like Kadcyla and Perjeta could add many valuable years to people’s lives and who doesn’t want that?”

23 July 2015

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