Reporting Dr. Maria Simbra
PITTSBURGH (KDKA) — Grandmother, wife and artist Joan Esposito has breast cancer — a specific kind called “HER-2 positive.”
Only 20 to 25 percent of people with breast cancer have this kind.
“When I was diagnosed in ’03, the fear was unbelievable. I never really thought I’d be sitting here today,” she admits.
It showed up as tumor in her liver and her neck. She was treated, but it came back in her spine. After more treatment, it came back again in her liver.
“Then they did a scan and there was a suspicious looking area,” she recalls. “They did a biopsy, and confirmed it had reoccurred.”
Every three weeks, along with the breast cancer drug, Herceptin, she gets a new drug, also for breast cancer, called pertuzimab, brand name, Perjeta. It was initially developed for breast cancer that has spread. These drugs work by blocking signals that make the cancer more aggressive.
“With this being the third bout of the disease, fighting the disease, I’m willing to take anything that comes along,” says Joan.
Clinical trials with Perjeta are so encouraging, the Food and Drug Administration is speeding up the approval process. In some cases, the drug has removed all traces of breast cancer, even before surgery.
“It predicts for a longer survival,” says Dr. Jane Raymond, a breast cancer specialist at Allegheny General Hospital.
The FDA is reviewing a study of 417 women with HER-2 positive breast cancer: half got Perjeta, Herceptin, and standard chemotherapy. Half got only Herceptin and chemo.
Of those getting Perjeta, 39 percent had undetectable cancer levels. Of those who didn’t get Perjeta, only 21 percent got that result with the standard drugs.
If the FDA approves this, it will be approved for use before surgery. This is a different approach. Usually surgery to remove the tumor would be the first step.
The downside? It’s expensive — $160,000 a year.
“You can get a very good response with just Herceptin,” says Dr. Raymond. “Adding may help, but it’s a huge cost.”
Joan relies on her husband’s health insurance. He works as a schoolteacher.
“They have great insurance. And that’s one thing why he’s still working. This is his 45th year teaching,” she says.
Covering this for potentially tens of thousands of women is something insurance companies will be watching closely.
“I feel for the people who either can’t afford to have it, or don’t have good insurance. Because you have enough strain on your body just trying to fight the disease,” says Joan.
Joan hopes she never loses her husband’s coverage.
“I pray that doesn’t happen,” she said. “I’ve been very, very fortunate through the whole experience. It’s been 10 years. and I’ve never been in the hospital. It’s been a journey, but it has opened so many doors for me that I would not have traveled otherwise. I feel I’ve come out a better person.”