While planning her annual breast cancer fundraiser in Hull, Mass., Ellie Destito’s friends learned some surprising news. For the first time, their friend revealed that she was living with breast cancer herself.
“They had no idea,” recalls Destito, who was first diagnosed with breast cancer back in 2008. Through the years, she was treated with chemotherapy, radiation, surgery, and a series of hormone therapies.
Destito never let it slow her down. She is a fixture in her community: a regular at the weekly bluegrass night in town, a Marilyn Monroe impersonator at Hull’s annual vintage car show—a fundraiser for veterans and pediatric cancers—and a 46-year resident of a bright pink home that matches her vivacious personality.
“You’ve got to have a positive attitude,” she says. “Because cancer is afraid of anyone with a positive attitude.”
A new drug gives hope
It was with a positive attitude that she met the news in November 2023 that her cancer was progressing again, and her current medication was no longer working. She had run out of the established treatment options.
But hope was not lost. Destito was referred to Antonio Giordano, MD, PhD, breast oncologist and clinical director of phase 1 clinical trials at Dana-Farber. An expert in novel therapeutics and breast oncology, Giordano is uniquely positioned to treat those with breast cancer seeking cutting edge options.
Destito immediately felt reassured. “At that first visit, it was almost like Dr. Giordano and I had known each other for forever,” she recalls. “He was amazing.”
When he met Destito, Giordano was investigating a new therapy that did not even have a name yet, just a code: PF07220060. The infant drug was the result of Giordano’s long history of work with a relatively new type of drug called CDK4/6 inhibitors. This targeted therapy interrupts the process of producing a protein that encourages the growth of cells in cancer. As Giordano studied how this therapy interacted with cancers, it became clear that CDK4 played a more prominent role than CDK6. In animal testing, researchers found that it could be more effective at treating cancer while introducing less toxicity. As Giordano explains it, this allows for a higher dose of the drug and “more powerful anti-cancer activity.”
The resulting CDK4 drug, PF07220060, was in a phase 1 trial when Destito came to Giordano. This phase is designed to determine the efficacy and safety of a new cancer therapy. Researchers evaluate how a new medication should be given (orally, intravenously, or by injection), how often, and at what dosage. At this stage, medications have already been rigorously studied in laboratory testing, and the research team at Dana-Farber is trained to closely monitor patients and address any safety concerns immediately.
It’s not guaranteed that a phase 1 trial drug will be effective, but clinical trials are an important part of pushing forward the field of oncology. Nearly all cancer drugs in use today were tested and made available to patients through clinical trials. And fortunately for Destito and people like her, the drug was an astounding success.
“Her response was remarkable,” Giordano says.
At 73, Destito has felt few side effects while maintaining a life full of friendship and celebration. There’s never a dull moment.
Her most recent Marilyn Monroe appearance had a special audience. “My son loves cars,” Giordano explains, and when Destito invited him to Hull’s car parade, he decided to make it a family trip.
“I’ll never forget how she looked up in the parade,” Giordano recalls. “She is such colorful personality.”
Destito didn’t see him in the crowd, but when the two crossed paths after the parade, she burst into tears.
“That’s the man keeping me alive,” she remembers telling her friends.
Destito is not the only person who has benefited from Giordano’s trial. It was so successful that today, the drug has moved into phase 3 clinical trials: large-scale, long-duration surveys used to determine whether the drug is effective for a broader population of people. Giordano is running several of those trials investigating it in the first-line metastatic setting for patients with hormone receptor-positive breast cancer and exploring the drug’s effect before surgery. Sometimes called a “window of opportunity” study, this trial will help Giordano and his team determine how the drug interacts with a tumor.
“With a biopsy before and then after the drug, we’ll be able to find out exactly how it is affecting the tumor. It’s possible that this can help people as their first option, not just their last.”
About the Medical Reviewer
Dr. Giordano completed his medical school and oncology fellowship at University of Naples Federico II in Italy in 2004 and 2009, respectively. The passion for research was the motivation behind his pursuit of starting a PhD Program in medical oncology and immunology at the Second University of Naples and participating in the exchange program with The University of Texas MD Anderson Cancer Center. During the four years spent as faculty at MD Anderson, he consolidated his solid foundation in breast clinical oncology, transitional and basic science research, and has made tremendous contributions to the field of breast cancer biology and circulating biomarkers. He subsequently worked as faculty at MUSC in Charleston SC from 2016 to 2020. In 2020, Dr. Giordano joined the staff of Brigham and Women's Hospital and Dana-Farber Cancer Institute, where he is a medical oncologist and clinical investigator in the Breast Oncology Center.
Thank you for sharing the trail of this remarkable journey. We are blessed to have Ellie as an integral part of the Hull community, neighbor and treasured friend.