When Two Drugs Are Better Than One in Fighting Breast Cancer
Two drugs targeting the same molecule in a fast-growing type of breast cancer are better than one, even in women with earlier stage disease.
The international APHINITY study, published in the Journal of Clinical Oncology in 2024, involved more than 4,800 people with HER-2-receptor positive breast cancer, which accounts for about one in five cases of breast cancer.
The study investigators – including researchers from Breast Cancer Trials in Australia – were asking whether using two drugs to target the HER2 receptor could improve survival in women with early-stage disease.
When the study launched, there was already evidence that treating advanced HER2-receptor-positive breast cancer with two different drugs targeting the HER2 receptor – trastuzumab (Herceptin) and pertuzumab (Perjeta) – in combination with chemotherapy made a big difference to survival.
The APHINITY study looked at whether those same benefits would occur in women with earlier stage disease, before the cancer had spread.
Half the participants were randomised to get the two HER2-receptor-targeting drugs plus chemotherapy, and the other half received trastuzumab only plus chemotherapy and a placebo infusion.
The study found that the combination of the two HER2-receptor-targeting drugs did improve survival in earlier stage disease, but only in women whose tumour had spread to their lymph nodes.
In those participants, the combination of trastuzumab and pertuzumab was linked to a nearly 5% greater likelihood of having no recurrence of their cancer at eight years after starting treatment, compared to the participants only treated with trastuzumab.
This translates to nearly five fewer women in every 100 with this type of cancer would have their disease return in the eight years after treatment
But in the people whose cancer hadn’t spread to their lymph nodes, adding pertuzumab to trastuzumab didn’t make a significant difference to their disease-free survival rates.
“I would describe APHINITY as a bridge between when the standard was just chemotherapy and trastuzumab, by saying that adding pertuzumab is a little bit better, at least in more advanced disease,” said Associate Professor Nicholas Wilcken, the Breast Cancer Trials study chair of APHINITY.
It has also paved the way for this combination treatment to be used before surgery, which, for some patients, can mean less extensive surgery. “Now there’s an emphasis on giving the chemotherapy before the surgery, not after the surgery,” Prof Wilcken said. “It does two things: one is it shrinks the tumour; and, the other is it gives you a test run to see how well your treatment works. We now know that if there’s still some residual tumour at surgery after the two targeted drugs, a change in drug treatment leads to better survival.”
Publication
Loibl, S et al. (2024) Adjuvant Pertuzumab and Trastuzumab in Early Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in the APHINITY Trial: Third Interim Overall Survival Analysis With Efficacy Update. Journal of Clinical Oncology, 42 (31), P **-**. https://doi.org/10.1200/JCO.23.02505
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Clarifying the Role of HER2-Low in Early Breast Cancer
A new study supported by Breast Cancer Trials is helping doctors better understand how to personalise treatment for people with early-stage breast cancer.
The human epidermal growth factor receptor 2, or HER2, protein is a well-established drug target in some breast cancers where it promotes cancer cells to grow. Cancers with high levels of HER2 are treated with targeted therapies designed to block this growth. More recently, new drugs also work in cancers with lower levels of the HER2 protein. These therapies – known as antibody-drug conjugates, which deliver chemotherapy directly to cancer cells – have expanded treatment options and created a newly defined category called ‘HER2-low breast cancer’, which is now used to help determine who would benefit from these newer drugs.
But what does HER2-low really mean for people with early stage, hormone receptor-positive breast cancer – the most common breast cancer subtype? And is it truly different enough from other types of breast cancer to justify its own treatment approach?
To explore this, a team led by Dr Stephen Luen from the Peter MacCallum Cancer Centre and the University of Melbourne, analysed tumour samples from about 1,800 women who participated in two large international clinical trials: BIG 1-98 and SOFT. These years-long trials collected detailed clinical and biological data, providing a rich resource to explore questions of tumour behaviour and treatment response. All participants had breast cancers that tested negative for high HER2 levels, but were grouped by the researchers as either HER2-low or HER2-zero, based on the amount of HER2 protein present in the tumour.
The researchers compared outcomes between the two groups, including how the cancers behaved over time and how likely they were to return. They also examined tumour characteristics and patterns of gene mutations. The findings showed no meaningful differences. HER2-low tumours did show slightly more expression of the HER2 gene, but this difference was small and unlikely to influence how the cancer responds to treatment.
“Our findings suggest that the HER2-low category isn’t a discrete type of breast cancer in its early stages,” said Dr Luen. “That matters because it raises questions about how we currently use HER2 test results to make treatment decisions.”
This research suggests that HER2 expression exists on a spectrum, rather than in fixed categories. It highlights the need for better tools to identify who will benefit most from HER2-targeted therapies, so that treatment decisions are based on meaningful differences, not on arbitrary thresholds.
Publication
Luen, S. J., Brown, L. C., van Geelen, C. T., Savas, P., Kammler, R., Dell’Orto, P., Biasi, O., Coates, A. S., Gelber, R. D., Thürlimann, B., Colleoni, M., Fleming, G. F., Francis, P. A., Regan, M. M., Viale, G., Loi, S. (2025). Genomic characterization and prognostic significance of human epidermal growth factor receptor 2–low, hormone receptor–positive, early breast cancers from the BIG 1-98 and SOFT clinical trials. JCO Precision Oncology, 9, e2400599. https://doi.org/10.1200/PO-24-00599
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Early Diagnosis and Better Treatments Improve Breast Cancer Outcomes
Since 2000, women diagnosed with breast cancer are about 20 percent less likely to have their tumour come back or spread, compared to those diagnosed in the 1990s.
A study published in the Lancet in 2024 analysed data from a massive database of 151 clinical breast cancer trials involving more than 155,000 people with early-stage breast cancer. The aim was to determine how the risk of breast cancer spreading, or metastasizing, had changed over time.
Women with breast cancer that is sensitive to oestrogen are known to have an increased risk of their disease returning for at least 20 to 30 years after treatment, even with use of therapies that block hormones. But less is known about the long-term recurrence rate in women with breast cancer that isn’t sensitive to hormones.
Given the many recent advances in treatment of both oestrogen receptor-positive and oestrogen receptor-negative, researchers in the Early Breast Cancer Trialists’ Collaborative Group were interested in how that recurrence rate in both cancer types might have changed over time.
They did what’s called a ‘pooled analysis’ of all the relevant clinical trial data from their database, which enabled them to analyse all the participants in those studies as one enormous group, to see how the risk of recurrence had changed between 1990 and 2009, and what factors might have played a role in those changes.
Overall, they found that the recurrence rates for both types of breast cancer had gone down over time. This was due not only of improved treatments, but also to improved diagnostic technology and screening programs, which meant cancer was being detected and treated earlier which increased the likelihood of survival and a cure.
There have also been advancements in tailoring treatments to an individual cancer.
One of the trials included in the analysis was the TailorX study, which tried to work out whether hormone-sensitive breast cancers that had an intermediate risk of recurrence – based on genetic analysis – would benefit from more intensive treatment with chemotherapy on top of hormone-blocking therapy.
Associate Professor Nicholas Wilcken was a member of the Breast Cancer Trials Scientific Advisory Committee when the TailorX trial was running.
“TailorX essentially showed that, at least for post-menopausal women, the chemotherapy did not make any difference, so you were just as well off having only hormone-blockers alone,” Prof Wilcken says. That finding was significant because it meant many women could avoid chemotherapy and its side-effects, which not only improved outcomes but also quality of life, without increasing their risk of the cancer coming back.
Publication
Early Breast Cancer Trialists’ Collaborative Group (2024). Reductions in recurrence in women with early breast cancer entering clinical trials between 1990 and 2009: a pooled analysis of 155 746 women in 151 trials, Lancet 404: 1407-18. doi: 10.1016/S0140-6736(24)01745-8
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Genetic Test Sheds Light on Which Breast Cancers Respond Better to Ovarian Suppression
Suppressing the production of oestrogen from the ovaries can significantly improve survival in some premenopausal women with breast cancer that is sensitive to estrogen. But, ovarian-function suppression is associated with some unpleasant side effects.
A study published in JAMA Oncology in 2024 found a way to identify which premenopausal women were most likely to benefit from ovarian-function suppression as part of their cancer treatment, and who was unlikely to benefit and should avoid that treatment.
Researchers used tumour samples from 1,687 premenopausal people with breast cancer, which were collected as part of the original Suppression of Ovarian Function Trial (SOFT), and applied a genetic test called the Breast Cancer Index (BCI) that looked at the activity levels of 11 genes known to play important roles in hormone-sensitive breast cancer.
professor prue francis is the breast cancer trials study chair of the soft clinical trial.
Their theory was that those women with a cancer that exhibited a high score on this test would be more likely to benefit from the addition of hormone-suppressing therapy than to the standard treatment options of either tamoxifen or exemestane.
Surprisingly, they found the opposite: those with a lower score on the genetics test were the ones who benefited the most in terms of freedom from breast cancer recurrence during the 12 years of follow-up.
“It may be that those patients with a BCI low score have more sensitivity to the maximum endocrine blockade, and therefore that high endocrine sensitivity leads to them getting more of a benefit from getting rid of all of the estrogen,” said Dr Nicholas Zdenkowski, a medical advisor with Breast Cancer Trials and medical oncologist at Hunter Valley Oncology.
The difference was significant. Participants with a low BCI score who were treated with ovarian suppression and exemestane had about half the risk of their breast cancer returning, and those given ovarian suppression and tamoxifen had a 31% lower risk, compared to those treated with tamoxifen alone.
In contrast, those in the trial with a high BCI score had no benefits from the additional ovarian-suppressing treatment.
The original SOFT trial, which demonstrated the additional benefit of ovarian suppression, was practice-changing, as it led to the standard use of ovarian suppression in premenopausal women with hormone-sensitive breast cancer, and saw those drugs listed on the Pharmaceutical Benefits Scheme in Australia.
While the BCI test isn’t routinely available, Dr Zdenkowski said it could also have an impact on clinical practice if it becomes more widely used.
“If we had access to this test, then we could use it to help refine our decision-making about who specifically might get most benefit from ovarian suppression,” he said.
Publication
O’Regan RM, Zhang Y, Fleming GF, Francis PA, Kammler R, Viale G, Dell’Orto P, Lang I, Bellet M, Bonnefoi HR, Tondini C, Villa F, Bernardo A, Ciruelos EM, Neven P, Karlsson P, Muller B, Jochm W, Zaman K, Marino S, Geyer CE, Jerzak KJ, Davidson NE, Coleman RI, Ingle JN, van Mackelenbergh MR, Loi S, Colleoni M, Schnabel CA. Breast cancer index in premenopausal women with early-stage hormone receptor-positive breast cancer. JAMA Oncology. 2024; epub 15 August 2024; doi:10.1001/jamaoncol.2024.3044
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The Global Study Helping Breast Cancer Patients Live Longer
One of the largest, and longest, worldwide studies into breast cancer, the ALTTO trial, is continuing to reap benefits. The trial was designed to test the effectiveness of different treatment strategies on those with HER2-positive breast cancer. More than 8,000 women from 44 countries participated.
Dr Janine Lombard is a medical oncology specialist at Calvary Mater in Newcastle and Breast Cancer Trials researcher, and has been involved in ALTTO for 18 years. She says the trial has not only greatly increased our understanding of ideal treatments for the roughly 20% of breast cancer tumours that overexpress the HER2 (human epidermal growth factor receptor 2) protein, but it has also created a rich biobank of tumours.
“This is one of the biggest studies ever done in breast cancer and it was done across the entire world, so it has this absolutely unique collection of tumours,” Dr Lombard says. “It has helped advance a lot of understanding about HER2-positive breast cancers.”
Dr Lombard was the principal investigator in the ALTTO trial for Australia and New Zealand, where 223 women participated. “There was a good representation of Oceania, which at the time was often underrepresented in international studies.”
The latest publication from the trial was a 10-year comparison of 6,281 patients who had HER2-positive breast cancer. Too much HER2 protein is thought to cause cancer cells to grow and divide quicker.
“The study was designed with the premise that hopefully a combination of two drugs [trastuzumab and lapatinib] would improve outcomes,” Dr Lombard says. Because the two drugs work differently, it was hoped – based on previous evidence – that a combination would prevent the cancer from returning and possibly spreading to the brain. “However, the 10-year data supports an earlier publication that showed that was not to be the case,” she says.
Standard therapy is now trastuzamab alone, or in combination with another drug that has been developed since the study started, pertuzumab.
But far from being a ‘negative’ study, Dr Lombard says the ALTTO trial provides many grounds for optimism. “The thing we’ve understood in this decade and a half is that with treatment, outcomes for individuals with HER2-positive breast cancer are excellent,” she says. “Ten-year survival rates are close to 90% and that’s a huge improvement compared to before we had these anti-HER2 drugs. Because the survival rates are so good, it encourages us to think, as clinicians, ‘is there a group of women who we can give less chemotherapy to?’”
Dr Lombard says the breast cancer treatment landscape has changed a lot since the ALTTO trial started. Along with the development of next-generation drugs, treatment protocols now often recommend chemotherapy before surgery, whereas all the patients in the trial had surgery before chemotherapy.
Publication
Final analysis of the ALTTO trial: adjuvant trastuzumab in sequence or in combination with lapatinib in patients with HER2-positive early breast cancer [BIG 2-06/NCCTG N063D (Alliance)] de Azambuja, E. et al. ESMO Open, Volume 9, Issue 11, 103938. https://doi.org/10.1016/j.esmoop.2024.103938
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New Immunotherapy Approach Offers Hope for Aggressive Breast Cancer Patients
A shorter, smarter treatment could bring new hope to people with early stage, triple-negative breast cancer (TNBC). Driven by the need to limit toxic side effects, researchers from Breast Cancer Trials designed the Neo-N study to see if combining a powerful immunotherapy drug with a shorter, focused course of chemotherapy before surgery could control tumours as effectively as longer treatments.
TNBC lacks the hormone and HER2 receptors that many targeted therapies attack. It often grows faster, spreads sooner, and strikes younger women more severely, leaving few treatment options. While standard chemotherapy can shrink tumours, its high doses and long schedules can lead to fatigue, nerve damage, and even heart problems years later.
In Neo-N, 108 women at 14 hospitals in Australia, New Zealand, and Italy received 12 weeks of pre‑surgery treatment combining nivolumab – a therapy that awakens the immune system – with two common chemotherapy drugs. The trial deliberately omitted a class of medicines called anthracyclines, which are linked to lasting heart risks and other side effects.
To test timing, participants were split into two groups. One began nivolumab alone for two weeks, then added chemotherapy. The other started all drugs together. After 12 weeks, each woman had surgery to remove the treated tumour and nearby lymph nodes.
The results were striking. 57 of 108 women (53%) had no detectable cancer at surgery – a ‘complete response’ matching rates seen with much longer, more intensive regimens. “This 12‑week chemo‑immunotherapy treatment combination is a promising new treatment option that has been very effective at eradicating the cancer in those patients,” says Professor Sherene Loi, medical oncologist at the Peter MacCallum Cancer Centre, who led the study.
Neo-N also highlighted two simple lab tests that predicted who would benefit most. Women whose tumours contained at least 30% immune cells saw a 67% complete-response rate, while those whose tumours displayed the PD‑L1 protein reached 71%. These markers could help doctors tailor treatment to each patient’s tumour biology.
Importantly, the shorter plan proved generally well tolerated. Serious side effects affected 65% of women – mainly low white-blood cells, anaemia and mild liver changes – but these were managed promptly with standard supportive medications, and did not force most participants to stop treatment. No one died from therapy, and the vast majority completed the full course.
Researchers stress that larger phase 3 trials are now needed – and Neo-N participants will remain under observation for up to three years to track any recurrence, long‑term survival, and late effects.
By pairing immunotherapy with a shorter, heart-safer chemotherapy regimen, Neo-N points toward a future where some people can beat early-stage TNBC with fewer treatments, less toxicity, and a better quality of life.
Publication
Zdenkowski N, Kuper‑Hommel MJJ, Niman SM, et al. Timing of nivolumab with neoadjuvant carboplatin and paclitaxel for early triple-negative breast cancer (BCT1902/IBCSG 61–20; Neo-N). Lancet Oncol. 2025;26(3):367–77. doi:10.1016/S1470-2045(24)00092-4
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THE VILLAGE EFFECT: WHY COMMUNITY MATTERS DURING BREAST CANCER TREATMENT
We spoke with Sarah about balancing treatment with motherhood, and the support systems that helped her through her diagnosis.
For Sarah, motherhood was already a full-time job. Between Nippers, football, and everything in between. When she was diagnosed with breast cancer, she found herself navigating treatment while parenting young children and holding her family through the uncertainty of her diagnosis.
In this episode, we spoke with Sarah about balancing treatment with motherhood, and the support systems that helped her through her diagnosis.
“My children keep me extremely busy. All I am at the moment is a professional Uber driver. The children in summer are all in Nippers and surf lifesaving, so that takes up every second of our time. And in winter, it’s football. So, we live, eat, and breathe football. My husband is an ex-rugby league player, and all three of our children play. It’s even on the TV at every moment. Our life is all about football training, footy boots, washing jerseys etc.”
“It’s exciting that Women’s Magic round is in Newcastle. My family and I went to the very first one up in Brisbane, so it’ll be very exciting. We’d like to see the Knights win. They haven’t been doing so well in the men’s team, but it’s just very exciting. My daughter started playing, so it’s great to see it gain some traction.”
2025 marks the inaugural year of the NRLW Magic Round, which is being played in our backyard here in Newcastle, and we are proud to be part of it! The NRLW Magic Round will be taking place over the weekend of August 2–3 at McDonald Jones Stadium in Newcastle. The event will showcase 12 NRLW teams in one location, creating a vibrant, festival-style experience for fans.
Breast Cancer Trials (BCT) is proud to be the match day charity partner for day one of the NRLW Magic Round on 2 August, and we’re shining a spotlight on the power of teamwork in breast cancer research. Play your part and help #tacklebreastcancer, click here to find out more.
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We spoke with Sarah about balancing treatment with motherhood, and the support systems that helped her through her diagnosis.
Can you share with us a bit about your diagnosis and what was happening in the lead up?
“I was diagnosed in June 2021. It was a complete shock. I had a small lump on my breast, which took me to the doctor’s, which turned out to be shingles. My doctor, who I saw for the first time, thought he would just send me to get a mammogram and ultrasound just to be safe. And unbeknownst they found a tumour, which was not related at all to the lump that initially took me to the doctors.”
“It was complete shell shock and then it was full steam ahead from there. I saw a specialist and within the next week I was operated on and had multiple surgeries, chemotherapy, and then ended up with a double mastectomy five years later.”
“I don’t think I even cried until days later. It was just a shock. We’re in the middle of COVID as well, so it was just a very, very strange time. I look back now, and I think I just blocked a lot of it out. It was just crazy. I honestly can’t explain how I felt. Even looking back, I have blocked a lot of it out. It’s just a bad dream really, hopefully I’m on the other side.”
“I had an initial lumpectomy and my tumour was encapsulated, but there were still some margins left. So, they went back in, and they removed the further margins. My lymph nodes were clear, which was lucky. So, my treatment was straightforward from there on. I had four rounds of extensive chemotherapy, which was not fun. And I opted to have a mastectomy instead of going ahead with radiation. It was pretty final, it was a big decision, but in the end, I just went ahead with it.”
“That initial fear of thinking that I may die from this disease. That was probably the worst of it. But once I was told my lymph nodes were clear and that my prognosis could be OK, I was ready to fight and do everything I could.”
Who were your biggest supporters during this time?
“My family and my friends were incredible. I’m going to get emotional. My girlfriends raised $35,000 in the ‘Sarah’s Walking Warriors’ fundraiser that they set up. That sort of kept me going. It made me stand up and be accountable. The army of people around me were amazing for my children because they were only quite young.”
“My community was insane; there were flowers at the door, my husband was trying to tile the front door and kept getting flower deliveries. He was getting quite annoyed, it was pretty funny, but everyone was just incredible.”
“The worst part was telling my parents. I kept it from them for a little while. So, it was a bit of a secret. I was hiding flowers in the bathroom and linen closets, and they started asking what was going on? And then telling them was probably the worst. I think because I’ve probably always been the brave one. I’m an only child; I’m an endangered species in their eyes. But they’ve been amazing since.”
Did breast cancer cross your mind at all in the lead up to your diagnosis?
“No, when I was diagnosed with the shingles, I just thought that was it. And if I hadn’t gone and got those mammograms and ultrasounds on my doctor’s orders, just to be sure, I probably would not be sitting here today. Because by taking the antivirals, the lump that I had thought was a lump of concern went away, it was nothing. But the bad lump was found with investigation. So, I was sent for a fine-needle biopsy, and I didn’t think I could have cancer. It didn’t even enter my mind.”
“Then I got the phone call, and I was just in shock. You just think it’s never going to happen to you. And I’m sure everyone says that. I couldn’t get in for an ultrasound or mammogram for three months in Newcastle. So, I drove to Tuggerah to have that done. So again, I could have so easily not done it, and it just would’ve been a whole different story.”
“The tumour I had was quite aggressive but was caught very early. If there had been lymph node involvement, it would’ve been a whole different story. When I saw the specialist, he told me it was triple negative breast cancer, and I thought that it was a good thing. I thought three times negative, and I learned very quickly that it was not.”
“When he said that I had a very good chance of survival, all I heard from that was that I could die. I may not survive. So, things went pretty pear shaped quite quickly from hearing that. But then everything was full steam ahead from that day. I was operated on the following week, but I don’t have any ongoing treatment now. I just had my chemotherapy in the chair. It was a five-hour process, not nice on the days leading into it, and for the five days after, were not pretty. Thank goodness it was during COVID, and no one had to see me.”
“I see my oncologist and my surgeon once a year each, but with both I see them six monthly. So, I’m continually seeing someone. Next year I’ll be five years post-diagnosis and hopefully that will be the end, and I get to break up with them.”
Did you have a family history of breast cancer before you were diagnosed?
“Funnily enough, it was not a thing at all. But I met, who is now a very dear friend of mine, probably 12 months prior. I met her when my small child kept going to her caravan. And she was at the time going through treatment. And so that made me become aware of breast cancer. But prior to that, no.”
“If it wasn’t for her, I wouldn’t have been so vigilant with getting my shingle bump checked. So, it’s strange, the events that sort of led to my diagnosis. I think maybe if I had not met her, I would’ve been a bit more dismissive. We’re friends for life now after that, I always say that I caught it off her.”
How did you find out about Breast Cancer Trials?
“I found out about Breast Cancer Trials through a social media fundraiser. I saw the Big Bold Swim challenge pop up and just because I basically live at swimming pools with my children, I thought I would join the swimming fundraiser and see if I could raise some much-needed funds. So, I did it and I raised $3,000 and here I am now. But I think Breast Cancer Trials are amazing. But yes, going forward, I’d like to do more if everyone wants to donate and support me.”
Why do you think breast cancer research is so important?
“Having a daughter and my girlfriends with young children, the girls going forward are potentially going to be faced with this, and if there are much less invasive treatments would be ideal. Better screening, more availability and access to treatments would all be beneficial. Also, I was lucky that I had Private Health Insurance. I think that’s why I was dealt with so quickly, but not everyone is as lucky – they’re waiting for their results, and the waiting is what does a lot of damage.”
“I think breast cancer research means that breast cancer doesn’t have to be a death sentence, there’s more of a chance. There’s more hope going forward.”
What are your hopes for the future?
“My hope for the future is that I never, ever have to deal with anything like this again. No breast cancer recurrence, as well as those around me, my daughter, that she never has to go through this. With Breast Cancer Trials research, and through everyone donating I hope that we can find a better way forward.”
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ROUTINE, RESILIENCE AND RESEARCH: ONE MUM’S CANCER STORY
We spoke with Emily about navigating breast cancer with a young family, the role routine and swimming played in helping her cope, and why she believes breast cancer clinical trials research is so vital.
2025 marks the inaugural year of the NRLW Magic Round, which is being played in our backyard here in Newcastle, and we are proud to be part of it! Breast Cancer Trials (BCT) is proud to be the match day charity partner for day one of the NRLW Magic Round on 2 August, and we’re shining a spotlight on the power of teamwork in breast cancer research.
What happens when your life plans are suddenly redrawn by a breast cancer diagnosis? Emily, her husband and their two children had moved from the UK to Australia in 2012 and were busy building a future for their family when Emily found herself on a very different path.
In this episode we spoke with Emily about navigating breast cancer with a young family, the role routine and swimming played in helping her cope, and why she believes breast cancer clinical trials research is so vital.
“I was just doing a self-exam in bed one night and I found a lump and I wasn’t too sure what it was as I do have naturally lumpy, quite cystic type breasts anyway. But I did go and see my GP. She didn’t think there was anything to worry about at the time, but she did send me for a mammogram and an ultrasound, and it was picked up on the ultrasound and I knew pretty quickly that it was malignant. It was kind of a whirlwind from there really. That was in February 2022.”
“I was in complete shock, and disbelief. The doctor was convinced there was nothing to worry about. I was super fit and healthy and had an active lifestyle. You just don’t think it’s going to happen to you.”
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We spoke with Emily about navigating breast cancer with a young family, the role routine and swimming played in helping her cope, and why she believes breast cancer clinical trials research is so vital.
Before your diagnosis, did you know much about breast cancer or did you have any family history of cancer?
“Not really, I didn’t know that much about it. I wasn’t aware of any family history at the time. It was only after my diagnosis, when I investigated a bit further into my family history that I did find out there was quite an extensive family history of breast cancer and that was on both sides of the family.”
“But I only found out about that after we started asking around, because my family weren’t particularly forthcoming with that type of medical history in the first place.”
“So, my husband, was great. When I initially got diagnosed, I went by myself. I didn’t take anybody with me because I wanted to be able to process it myself before I told the rest of the family. It’s only me and my husband out here in Australia. Everybody else is in the UK. So, I only told my husband and then, with the kids we told them that mummy was sick.”
“We didn’t use the term ‘cancer’, because we didn’t want to terrify them. But everything just carried on as normal. We got the kids to shave my head, which they thought was good fun. And they enjoyed giving mummy a bald cut. But we just tried to keep everything as normal as possible. They knew that mommy was a bit sick and she was having medicine to make her better and life carried on as normal.”
“You just realise how short and precious life really is. Nobody is indestructible. Cancer can hit anybody at any age. It doesn’t discriminate. You think you’re fit and healthy and you’re doing everything right and you still get breast cancer. So, it’s just made me realise life is worth living and you have to live every day like it’s your last because you just do not know what’s around the corner.”
What kind of treatment did you have?
“Initially I had a lumpectomy in March 2022. And then I had the 12 weeks of Paclitaxel chemotherapy, and that was in combination with immunotherapy. So, I had Herceptin every three weeks for a year, and then I also had radiation. I had three weeks of daily radiation after the chemotherapy had finished. So, all in all, my active treatment was just over a year.”
What are some of the biggest challenges you think that breast cancer research needs to address?
“Just being able to find a cure for this horrible disease. The thought of my daughter having to go through this or anybody else I know, I wouldn’t wish this on anybody. And I think, with the medical advances that we’re making, I hope that cancer one day won’t be a term that we need to have in our vocabulary. Hopefully we can find a way for it to disappear completely.”
What would you say to someone who was thinking about participating in a clinical trial?
“If you can get onto a clinical trial, it’s well worth doing because you just advance the treatment for yourself and for the rest of the population as well. Without clinical trials, you don’t find these new medications that work, and we don’t improve treatments.”
“I think clinical trials are vital to bringing advances in treatment and medicines all across the board. Breast Cancer Trials coordinated the HERA trial, which brought about the Herceptin, which has saved countless women with HER2-positive breast cancer.”
How did you find the Big Bold Swim Fundraiser coordinated by Breast Cancer Trials?
“It was good fun; I really enjoyed it. The online community, specifically the Facebook community, was really good fun and just really championed everybody. I saw so many people that said they hadn’t swum before and they were back in the pool to support Breast Cancer Trials, and people that were still undergoing treatment got back in the pool to support this campaign.”
“I thought that was great. Really positive to see. It was a good month of swimming, and it just raises awareness for Breast Cancer Trials. It gets people active as well, and I think that’s really important when you’re going through treatment. Keeping active and keeping a positive mindset.”
What would be your dream outcome for the next generation of breast cancer patients?
“My dream outcome would be that breast cancer doesn’t exist anymore. I know we’re ways off that yet, but with the advances we’ve got and the research that Breast Cancer Trials are doing, we’re one step closer. I just want to be able to see my kids grow up and just be here. That’s it really in a nutshell. I just want to see my kids succeed.”
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HOLDING IT TOGETHER: BREAST CANCER AND THE BUSY MUM LIFE
We spoke with Belinda about navigating a breast cancer diagnosis while raising a young family, the value in having a community around you to offer support during this time and the importance of breast cancer clinical trials research.
2025 marks the inaugural year of the NRLW Magic Round, which is being played in our backyard here in Newcastle, and we are proud to be part of it! Breast Cancer Trials (BCT) is proud to be the match day charity partner for day one of the NRLW Magic Round on 2 August, and we’re shining a spotlight on the power of teamwork in breast cancer research.
When you’re a mum of two young boys, life is full of chaos. And for Belinda, it also became a time of deep uncertainty when in 2019 she was diagnosed with triple negative breast cancer. In this episode, we spoke with Belinda about navigating a breast cancer diagnosis while raising a young family, the value in having a community around you to offer support during this time and the importance of breast cancer clinical trials research.
“I was diagnosed with triple negative breast cancer in June 2019. I found the lump myself during a self-examination. I was just doing a bit of a check and found a lump on my right breast. I immediately knew that it was abnormal. I called out to Kale and said, quick, quick, quick, come here. Can you have a look at this? And he said, yes, there’s something there.”
“The next morning, after a very sleepless night, I went down to see my doctor and she agreed with me that it was abnormal. Fortunately, she ran over to Hunter Imaging at the Women’s Health Center in Gateshead and they told her to send me over straight away.”
“So, I was so lucky. I went over for my mammogram, and something showed up and I was then sent in for ultrasound with a friend, which was fortunate that she was the radiographer. She at the time knew that it looked abnormal, but didn’t share that with me fortunately. And walked around the back and spoke with the doctor. She said, this is a friend of mine, she’s got a lump. Is there any chance we could biopsy it?”
“I was lucky given that it was a Wednesday, because that’s the only day that the doctors are there. So I popped up on the table and they performed the biopsy to take some samples and 15 minutes later they came back and said, you have breast cancer.”
“I was speechless. I didn’t know what to think. I remember Gabby, who performed the ultrasound said, do you want me to drive you home? Do you want me to ring Kale? And I said, no, no, no, I’ll be fine, what do I do now? And they said we’ll contact your GP so you need to make your way there with your husband.”
“So, I made my way to the car. I don’t remember driving around the lake. I called Kale and said, I have breast cancer. You need to meet me at the doctors. So, I got to the doctors at about 4:30 PM and he was waiting for me, and he was quite frank and said, you have breast cancer. I need to make some calls now and arrange some appointments for you.”
“So, he did all of that. He called over to the breast center and they were expecting his call. During that time Gabby walked around and spoke to them, which I’m grateful for. And they said you’ll see Dr David Clark tomorrow morning at 7:00 AM. So, my head was spinning, within 24 hours I’d gone from not knowing a thing to being told I had breast cancer.”
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We spoke with Belinda about navigating a breast cancer diagnosis while raising a young family, the value in having a community around you to offer support during this time and the importance of breast cancer clinical trials research.
Before your diagnosis, did you know much about breast cancer or did you have any family history of cancer?
“To be honest, I was like the normal person who thought breast cancer was breast cancer. I had no idea of all the subtypes of breast cancer. I was clueless in that regard. There was no family history of breast cancer in my family whatsoever, so I thought breast cancer was just one type of cancer.”
“In terms of my treatment, I had surgery a week after detection. And then I went back into the doctors the following week, and that’s when I was told it was triple negative breast cancer. Originally, I thought I was facing surgery and some radiation, and I would be on my way.”
“But unfortunately, chemotherapy was the only answer for my type of breast cancer because of how aggressive it was, and it wasn’t respondent to hormone therapy or immunotherapy. So, I had six rounds of dense dose chemotherapy once every three weeks at Gateshead. So that took me 18 weeks, so to speak, and then a few weeks break, and then I had five weeks straight of radiation and finished just before Christmas.”
What are some of the biggest challenges, in your opinion, that breast cancer research needs to address?
“I guess the biggest one for me is obviously prevention, but a huge stumbling block is the funds that go towards breast cancer research. There’s a lot of research out there for different types of cancer, and I know that breast cancer does have some funding, but without the required funds to pave the way for these scientists to continue with the trials, they’re not going to happen.”
“But also, prevention is huge for me. Have a conversation with your girlfriends. Talk about getting checked, be vigilant, get checked every year. If you think there’s something there, go and get it checked because that alone may stop you from having to go through what I went through and what other women go through.”
“And we may get to the stage with all this research that there’ll be something quite simple for early-stage breast cancer, and that will come out of a trial or many trials that are happening or going to happen.”
“I can honestly say that prior to being diagnosed, I had no idea about breast cancer research. For me, I was fortunate in that my medical oncologist, Dr Nick, is one of the gurus involved with Breast Cancer Trials and Nick spoke to me in figures with survival rates and whatnot, and I had so many questions for him, and he would just shake his head.”
At what point in your cancer journey did you start to become interested in what’s happening within Breast Cancer Trials research?
“My oncologist, Dr Nick said to me, you need to listen to some of the research through Breast Cancer Trials, and I said who are Breast cancer trials? And told me that he was one of the chief medical scientists on their Scientific Advisory Committee, and that Breast Cancer Trials conduct trials across the world on women that are early-stage, late-stage terminal and whatnot.”
“So, I literally jumped on board and listened to Nick talk. And from that point forward I went, OK, this is going to be my source of truth. I will listen to this, and I’d met women that were on active trials, and I listened to various podcasts, so I learned pretty early on about what Breast Cancer Trials actually does for women and men, because men get breast cancer too, in relation to breast cancer research.”
How has breast cancer influenced your outlook on life?
“Breast cancer totally changed my life, and obviously the life of my family, my children were young, and it blind-sided my husband and I. From the get-go, we made a very conscious decision that we would tackle this head on, that we wouldn’t back down from it, and we would do whatever we had to do to beat this, because I was determined to be a mum to my kids for many, many years to come.”
“I think cancer is as much a medical game as it is a mindset, and my mindset was, I will beat this full stop. My hope for the future, for me personally, is to live a long and healthy life with my husband and kids, but I also hope that we are able to find a cure for breast cancer to stop women and men dying every day from a disease that hopefully can be eradicated, or at least prevented, so that patients are subjected to a much less severe treatment regime.”
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ASCO 2025: BREAST CANCER RESEARCH SUMMARY
A summary of the key breast cancer research presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting.
Highlights from the 2025 ASCO Annual Meeting
The American Society of Clinical Oncology (ASCO) Annual Meeting is one of the most important events in the global cancer calendar, where researchers and clinicians gather to share the latest advances in cancer care. This year’s conference, held in Chicago, featured exciting developments in breast cancer research — many of which are expected to change treatment options and improve outcomes for women diagnosed with the disease.
Here are some of the key highlights from ASCO 2025, summarised for our community.
A Promising New First-Line Treatment for HER2-Positive Breast Cancer
A major focus of this year’s meeting was the DESTINY-Breast09 trial, which compared two treatment combinations for women with HER2-positive metastatic breast cancer. The new combination of trastuzumab deruxtecan (T-DXd) and pertuzumab significantly extended the time patients lived without their cancer getting worse — to over 40 months on average, compared to the current standard treatment.
This breakthrough offers new hope for many women, especially as not all patients are able to move on to second-line treatments. While some side effects were reported (including lung inflammation in a small number of patients), this new approach is likely to set a new standard in care.
Reducing Treatment Side Effects Without Sacrificing Effectiveness
The NeoCARHP trial looked at whether a less intensive chemotherapy combination could still be effective for women with HER2-positive early breast cancer. The results showed that dropping one of the drugs (carboplatin) didn’t reduce the treatment’s success, and side effects like low blood counts, nausea, and kidney issues were lower with less chemotherapy.
This could mean a gentler option for some women — particularly those with stage I–II disease — while still achieving excellent outcomes.
Hormonal Therapy Side Effects: A New Non-Hormonal Option for Hot Flushes
Many women who take hormonal therapy for breast cancer experience distressing side effects like hot flushes and insomnia. A new drug called elinzanetant, taken as a daily pill, showed promising results in reducing both the frequency and severity of these symptoms.
What’s exciting is that it works in a non-hormonal way and most women in the trial chose to keep taking it long-term.
Understanding When to Use Targeted Drugs: The FINER and VERITAC-2 Trials
Two trials provided new insights into targeted therapies for women with ER-positive, HER2-negative metastatic breast cancer who had already received standard treatments:
FINER looked at adding a drug called ipatasertib to hormonal therapy. It helped slow the disease down even in women without the expected genetic changes — showing it may work for a broader group than previously thought. The FINER trial was conducted by Breast Cancer Trials in partnership with the Canadian Cancer Trials Group. Find out more about the FINER clinical trial results.
VERITAC-2 explored a new class of targeted therapy (called PROTACs) with a drug named vepdegestrant. Women whose cancers had developed a particular mutation (ESR1) saw the most benefit. This highlights the growing importance of genetic testing to guide treatment.
Associate Professor Andrew Redfern is the Study Chair of the FINER clinical trial.
Detecting Cancer Progression Sooner Using Blood Tests
The SERENA-6 trial focused on using blood tests (ctDNA) to detect signs of cancer returning before symptoms or scans show anything. Women who had a particular mutation (ESR1) found in their blood were switched early to a different hormonal therapy (camizestrant) — and this helped delay the cancer’s return.
This “early warning” approach could become an important tool in the future, although more research is needed to understand its impact on overall survival and quality of life.
Good News for Younger Women: Long-Term Results from the SOFT/TEXT Trial
Fifteen-year follow-up results from the SOFT and TEXT trials — run in Australia by Breast Cancer Trials — continue to show strong benefits for premenopausal women with early ER-positive breast cancer. Women under 40, or with more aggressive tumours, gained the most from combining ovarian suppression with exemestane.
These long-term data reassures us that treatment decisions made early can continue to make a difference many years later.
New Hope for Women with Triple Negative Breast Cancer
Triple negative breast cancer (TNBC) is one of the hardest types to treat. The ASCENT-04 trial showed that a new combination of sacituzumab govitecan (a targeted therapy) with immunotherapy (pembrolizumab) helped women with advanced TNBC live longer before their cancer worsened.
This could offer a more effective first-line treatment for women with PD-L1 positive TNBC, giving them the best possible chance upfront.
Ribociclib Benefits Hold Strong Across Ages and Menopausal Status
The NATALEE clinical trial is exploring a treatment called ribociclib used alongside an aromatase inhibitor for people with early-stage, hormone receptor-positive breast cancer that carries an intermediate to high risk of returning.
The results so far have been promising: the combination significantly reduces the chance of cancer coming back. Importantly, this benefit continues even after completing the full three-year course of ribociclib. This is reassuring news for people with both stage II and stage III breast cancer.
One of the big questions was whether age or menopausal status affected how well the treatment worked. This latest analysis showed that ribociclib works consistently well across all age groups and regardless of whether someone is pre- or postmenopausal. Younger people were slightly more likely to stick with the treatment—possibly because they were more motivated to do everything they could to reduce their risk—but everyone appeared to benefit similarly.
Using a standard quality-of-life questionnaire, researchers found that patients across all age groups and menopause statuses reported similar experiences—suggesting that the treatment is tolerable and manageable for most people.
Targeted therapy for difficult to treat metastatic breast cancer
The INAVO 120 trial added a targeted drug, invaolisib, to standard treatment of palbociclib and fulvestrant, in first line therapy for metastatic ER+/HER2 negative breast cancer with a PIK3CA mutation. Inavolisib, a highly specific inhibitor of PI3K, prolonged patients’ survival from 27 months with standard treatment, to 34 months with the three drug combination. This drug also led to a 2 year longer time interval until chemotherapy was needed for patients.
These results support the use of this medication in the clinic as an effective, specific approach for the 40% of patients whose cancers harbour the targetable mutation.
Can Patients Be Safely Re-Treated After Side Effects?
Finally, a study looking at women who had experienced lung side effects from T-DXd found that many were able to restart the drug safely after recovery, and continue benefiting from it. This may help doctors make more confident decisions about restarting treatment when appropriate.
What This Means for You
Many of the updates shared at ASCO 2025 could lead to new treatment options and better outcomes — especially in tailoring therapies to a woman’s type of breast cancer and individual circumstances. Medications in Australia need to be approved by regulatory bodies and then funded by the PBS before becoming routinely available.
If you would like to stay up to date with research news, sign up to our monthly research newsletter (linked below).
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VIRTUAL REALITY MEETS RADIATION: A NEW ERA IN PATIENT COACHING
Kathleene Dower is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to explore whether virtual reality (VR) coaching and education can help patients learn the Deep Inspiration Breath Hold technique more effectively.
Kathleene Dower is a radiation therapist and 2025 clinical fellow with breast cancer trials. Her project is about piloting virtual reality (VR) coaching and education for Deep Inspiration Breath Hold; a breathing technique used during radiation therapy to move the heart away from radiation and protect it from damage.
This study will explore whether VR coaching and education can help patients learn this technique more effectively. We spoke with Kathleene about the importance of this research and what it means for patients.
“When we had some new technology implemented within this department, basically what we saw with a lot of our breast cancer patients, who are left sided breast cancer patients, was that if deep inspiration breath hold is of benefit for their outcomes from treatment, our radiation oncologists will ask them to take a deep breath in and hold their breath for their treatment.”
“Now these are sustained breaths, so basically, they’ll take a deep breath for at least 20 seconds and then go into normal breathing, then a deep breath again, and then normal breathing after that.”
“And what we found with a lot of our patients is that they could not do a deep inspiration breath hold. Some of our patients became quite frustrated and upset that they couldn’t do it because they knew that there was a higher risk of them getting late cardiac events after their treatment.”
“So, we wanted them to have, a very robust education of what deep inspiration breath hold was. We also saw that the patients were quite anxious as well. They had a fear of the unknown, and they didn’t know what to expect. So, we invested in virtual reality education, and the reason why we invested in virtual reality education was because when people were immersed in the virtual reality experience, they’re completely focused in on whatever you were trying to educate them about.”
“We also have noise canceling headphones as well for them. So, they are completely immersed in that experience, and that’s the feedback that we have received from patients as well, that they were focused in, they knew exactly what they needed to do for their treatment and that it took away one unknown for them, which is exactly what we wanted to do.”
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Kathleene Dower is a 2025 clinical fellow with Breast Cancer Trials, and her project is looking to explore whether virtual reality (VR) coaching and education can help patients learn the Deep Inspiration Breath Hold technique more effectively.
Why is the Deep Inspiration Breath Hold technique important and what challenges do patients typically face with this technique?
“So, it is particularly important for left breast cancer patients who are lying on their back for treatment. So, what happens when patients take a deep breath in and hold their heart moves away from their breast, so that means is that basically the topographical movement away or displacement away from their breasts, means that we are delivering a lower dose of radiation to the heart.”
“There are other ways that we can get the heart dose down, but that is just one extra added measure as well. And it means that we are giving patients the best treatment that we can offer them, so that’s particularly important.”
“It also means as well that their lungs are more inflated. So, as a volume, we’re treating less lung volume too, and because the patient is in a static position we are targeting their breast cancer a lot more than if they were to be free breathing. When they’re free breathing, their breast is moving in and out of the beam a little bit. That’s another reason why deep inspiration breath hold is important for left breast cancer patients.”
“The challenges that we’ve seen are that patients were afraid of the unknown. They had a fear of the unknown. They were anxious about whether they would be able to do deep inspiration, breath hold or not. When we gave them that education and the coaching, they were able to practice before they came in for their mapping or simulation session.”
“If patients couldn’t do a deep inspiration breath hold at their at their mapping session, they won’t be offered a deep inspiration breath hold for their free breathing treatment.”
“It’s important that we maximise the opportunities for patients to do it at their mapping session. We want to give them as best a chance as possible that they can do it. So, you put on the headset first and you’ll watch a 20 second animation of a patient’s chest free breathing, and then the patient taking a deep breath in and holding their breath, and a radiation beam coming on.”
“And it basically says, your radiation doctor has asked you to take a deep breath in and hold for your treatment. By taking a deep breath in, your heart moves away from the radiation beam. So that explains why we want them to do deep inspiration breath hold.”
“When I interviewed patients beforehand, a lot of them said that they wanted to know why they needed to do it. When you talk to patients about it, or you give them written information, they don’t really understand why. Now adults learn best with what we call the VARK acronym. So, its visual, audio, readability, and kinesiology.”
“With the virtual reality they had that visual component, they had the audio, and when they were doing the breath hold exercises as well, they had the kinesiology. So that touch and that feel through doing the movement, and with the readability component we would give them information as well so that they could read through it. So, we were maximising the education that they received, and we made it palatable for patients too.”
“It was really about health literacy too and making sure they could understand what do to from that education, especially receiving it in the form of virtual reality. And the feedback that we received back from patients was that they found it very easy to understand.”
What factors will you be measuring to determine whether it is effective?
“It’s the feedback that we receive from patients. Also in our pilot study, we ask them to do standardised anxiety questionnaires as well. And so, we’re looking at raised anxiety versus normal anxiety. We asked them to do these anxiety questionnaires at certain time points. Before the intervention, and then after the intervention, then a couple more times after that.”
“A lot of patients said that it just took away the factor of the unknown, and it reduced their anxiety. I can’t exactly give you the data now because it hasn’t been run through SPSS, but basically what I have looked at is pre intervention patients had raised anxiety and then post virtual reality education, they had lower anxiety levels after that.”
“So, as I said before, to maximise their ability to do deep inspiration breath hold and give them the best chance possible of them doing that for their treatment, which can affect them late term as well. Patients did feel a sense of accomplishment once they finished it, and some patients also said they liked being in control too.”
“You know, all the way through their pathway. Basically, they’ve been told that they have breast cancer, they get surgery, they might have chemotherapy and then radiation after that. And from some patients they felt like they weren’t in control at all, but doing the deep inspiration breath hold, because when they do the deep inspiration breath hold, they’re controlling the machine.”
“Our treatment machine only activates when they’re in that deep inspiration breath hold mode, and so they felt that they got a little bit of control back during their treatment, which was important too, and it was very empowering for some of our patients.”
“From a research perspective, I’m hoping to do a randomised control trial with other departments as well. So, we’re looking at filming with Tamworth Cancer Center and other rural hospitals, so we can hopefully open this up to other departments as well. And I think that virtual reality education, especially with radiation therapy, is so important, because in general patients only have radiation therapy once, so there’s nothing tangible that they can know or relate their experience to, so that’s why they have that fear of the unknown.”
“But with virtual reality education, they can get immersed in the experience, so they have something tangible to basically base their knowledge of. So, I think for radiation therapy, it will become very much part of our education piece for patients.”
“Unfortunately, some patients cannot do deep inspiration breath hold, but we will aim as much as possible to get their heart dose to as low as what we possibly can through other measures as well.”
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FROM IVF TO BREAST CANCER: NAVIGATING A DIAGNOSIS IN EARLY MOTHERHOOD
We spoke with mum of two, Rebecca Pickering about her breast cancer diagnosis, navigating breast cancer and her participation on the OLIO clinical trial.
“I’ve had a lot of IVF in the last couple of years, from 2020 to 2022. And then we had Dottie, and we also had Daphne through that time as well. So, after I had Dottie things started to change for me physically, which I stupidly overlooked and decided it was just hormone related from so much IVF.”
“Leading up to the diagnosis, we were just finally medical free, like from IVF and everything, and I was working full time. The kids were happy, and I felt like we were coming into our boring 10 years of just raising a family and getting on with things. And I went to the doctors just to finally get my breast checked out and was diagnosed with breast cancer.”
“That first month that I was diagnosed where you are going through all the process of getting MRIs, biopsies, and trying to figure out what kind of cancer it is and if it had spread, it was pretty dark. It was emotional for me. I just shut down when, especially in a high-pressure situation like that.”
“So, I was concerned for me, and for my kids. It was hard because I wanted to be here to raise my kids. I wanted to see them grow up and I didn’t know if it had spread or not. Cancer is prevalent in our family, so I had hope. My mom had it 14 years ago and she’s still here and healthy and happy, so that was a good example.”
“But until you know that it hasn’t spread and it’s just a standard breast cancer, it’s not like your terminal or anything like that, just so much craziness goes in your head of what’s going to happen, how are you going to handle this, and everything like that.”
“And answers don’t come quick enough, but you know, everything has a process. So, you do have to just wait. So, each week we’d get another little piece of the puzzle for about four weeks until we did the PET scan, and I got the confirmation that it hadn’t spread. And around that time we got confirmation that it was only stage two. So very lucky, considering I felt like I’d probably had an issue for nearly a year.”
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We spoke with mum of two, Rebecca Pickering about her breast cancer diagnosis, navigating breast cancer with a young family, and her participation on the OLIO clinical trial.
How did your family react when you told them about your breast cancer diagnosis?
“So, my parents were away at the time, they were overseas. They didn’t know that I was going through the tests and everything. It was good timing. My mum and I are very close, so she would’ve been onto it if she hadn’t been here. So, it was nice that I just got to kind of process it in the lead up.”
“As soon as I had the mammogram, and the ultrasound, I knew something was wrong. Living in a small local town, the man that did my ultrasound had done all my ultrasounds. Not that I believe he remembered me or anything, but he immediately said to me ‘make sure you follow up with your doctor’. And it’s not something that he normally would say in that way.”
“So, my doctor has been my doctor for 14 years, and you just get a rapport with someone in that kind of relationship. The way my doctor rang, I immediately knew. The results weren’t just over the phone like they normally would be if it was nothing.”
“When I saw him, he was nearly distraught that he had to tell me, because he was the one that told my mum as well, when she was diagnosed. My dad’s mum died of breast cancer when she was 38. So, he was quite like me, he just shut down and was essentially like ‘yep, let’s get on with this’, whereas my mum obviously broke down because she’s been through it and knew what I was about to head into.”
“My husband, Matt, was fine. He’s the same as me. Just a deer in headlights in this situation. Like, we’re just going to have to work through it. And obviously a lot of my family and friends were just devastated for me.”
“I have two daughters and six nieces, and now that I know I have the BRCA gene in our family, you know my brother has it, so his daughter possibly has it. My daughters possibly have it. Any research towards the OLIO trial will benefit them in future years, I’m certain of that.”
What has your treatment been like so far?
“There are great local people in Mildura, but my doctor had felt that the Peter MacCallum Cancer Centre had never failed him. So, he referred me there, and my mum also went through the Peter MacCallum Centre, so it was where I wanted to be. I had my first appointment with oncologist around the end of October or start of November 2024.”
“Immediately she knew that I might be interested in a clinical trial, because within five minutes of our first appointment, she mentioned the OLIO trial. So, I felt that the team thought I was a good candidate to be screened for the trial. Going back when I was diagnosed, I had promised myself I’ll do anything to fill my body full of whatever it needs, to get rid of cancer.”
“So, when my oncologist told me about the OLIO trial, I was all for it, as long as I got the same protocol. Because I didn’t know about trials. So how it works is, you get the same protocol as what everyone else gets and then some add-ons. So, we were keen straight away to get it done.”
“For participation in the trial, you had to get genetic testing for the BRCA gene. So, we did that, and I had to get a few blood tests to make sure my bloods were okay. That was a bit of an uphill battle. Some of my bloods weren’t coming back quite right at the end when we were so close to going on the trial. So, I just had to work on some blood tests and things like that, so we did all of that and I made the trial, which was good and the trial team are amazing.”
Why did you decide to participate in the OLIO clinical trial?
“When my mum had breast cancer 14 years ago, there was no mention of the BRCA gene. So, in 14 years we’ve come so far already that they’ve been able to recognise that this gene is a problem for young women. So, when I went in to see Dr Sophie, I went into that appointment ready to have a mastectomy because I thought that’s what everyone around me was getting done.”
“But for this trial, we needed to do chemotherapy first. So, the plan was to start chemotherapy, and I did four rounds of that and then 12 rounds of paclitaxel as well as, as part of the OLIO trial. It is a chemotherapy tablet. And I also got immunotherapy as well. So, we’re just coming to the end of that phase now, and I booked in for a mastectomy in May.”
“I feel lucky to be on the OLIO trial. The coordination behind the scenes from the team is great. It’s something I don’t have to think of. When I initially signed up for it, Dr Stephen Luen said to me that my life would now be organised by the ladies in the research team. And he was correct. Anything I needed, I would just go to that team, and they would organise it for me.”
“Especially appointment changes, because I live remotely, we’ve had to shuffle some appointments around, so I don’t have to come down to Melbourne as often. I asked the doctors the last time I was there if the OLIO trial and remote monitoring is open available through the Peter MacCallum Cancer Centre, or is it available everywhere? And they did say that it’ll hopefully start to be screened everywhere so that everyone will have the opportunity to be on this trial.”
“I’ve known a few people with breast cancer that are going through it, or at the end of it now, and we discuss our different experiences, and I nearly don’t discuss some of the things that I’m doing as part of my treatment, because I do feel like you get a heightened level of care being on a trial, which is great for me, but everyone deserves it, if they can be on a trial.”
“I have struggled so much with the side effects of chemotherapy, of the fatigue, the lack of motivation, the brain not functioning like it would normally do. I can normally make decisions very quickly. So anything to do with trials that are around treatment plans that may be improved, is so beneficial to anyone going through it.”
Why do you think ongoing research into breast cancer is important?
“So, I have a few reasons, which is that the survival rates are so much better now. When I talk to my oncologist team here, they say that the number of young women coming through is baffling and they’ve just noticed that trend that a lot of young women seem to be getting breast cancer.”
“So, for me, the trials are so important for the statistical rate, but also, it’s about the treatment plans for people. Anything where you don’t have to have chemotherapy or you don’t have to have the invasion of radiation or surgery is so good.”
There is a trial out at the moment, where they may not need chemotherapy (find out more about the OPTIMA clinical trial). So, to me that was important because chemotherapy has ruined me in a way that I never thought it would. I don’t know how people work with chemotherapy. I don’t know how they get through their life. I’ve worked full time and long hours for the last 10 years and I stopped working in December and honestly just lay on the couch most days.”
What are your plans for the future?
“In my mind I’ve got September as when I’m going to be clear of all this. I don’t know why it’s September. I have my surgery in May, and I don’t know if I’m having radiation yet. That’ll be decided after surgery. So, by September this year I hope to be finished with this. I know life will never go back to normal, like it used to be.”
“I think there’s always going to be that cloud over you, and that concern about breast cancer coming back. But what I’m looking forward to is being cleared, and what I fear is it coming back somewhere else, because I don’t want chemotherapy again. I’ll do it, but it’s tough.”
“What concerns me the most each day as I’ve been going through this, is my girls. Daphne is four. So, she knows something’s wrong. I’ve been in and out of hospital, I’m away getting treatment. I’m not working, which was a big part of our life was me working. She took a couple weeks to get used to me being home and then wanted to be home with me. She said to me yesterday that she hopes I’m sick forever because I’m home.”
“So, I do feel going forward, I need to be home more. It’s been something that’s played on my mind the whole time. You know, what do I want to learn from this and moving forward, how is our life going to look? And I do believe in time I’ll look at cutting back in my job and possibly seeing what else is around, in that avenue. So yes, it’s just been my family really.”
