It was a hot day on the links in New Hampshire in July 2014. Carol MacKenzie recalls that her neck was strangely sore. By the end of the round of golf, she had a fever.
Soon after, MacKenzie met with an oncologist. In 1996, she had been diagnosed with early-stage triple-negative breast cancer and successfully treated. Eighteen years later, she learned that it had come back and spread to the lymph nodes in her neck.
The news was a shock. MacKenzie had retired two months earlier and had also recently lost two close friends to cancer. She thought, “Can this really be happening?”
Now, nearly twelve years after that day, MacKenzie is 74, living in Waltham, Massachusetts, and thriving – though it wasn’t always this way. During those years, she and her oncologist, Nancy Lin, MD, director of the Metastatic Breast Cancer Program at Dana-Farber, tried treatment after treatment. Time after time, her cancer eventually evaded the medicine.
Then, in 2020, she started on a recently approved type of medicine called an antibody-drug conjugate (ADC). ADCs didn’t exist in 1996, but when they did emerge, pioneering investigators such as Dana-Farber’s Sara Tolaney, MD, MPH, chief of Breast Oncology, led pivotal, phase 3 clinical trials that revealed their benefits across all major subtypes of breast cancer. Because of those trials, several ADCs are now approved for use by patients across the country, including MacKenzie.
“Carol is experiencing an incredible response,” says Lin. “It is amazing to see.”
Finding Dana-Farber
In 1996, MacKenzie’s breast cancer was caught early. She was treated at Newton-Wellesley Hospital with a lumpectomy, radiation, and chemotherapy by Caroline Block, MD, who is now clinical director of Breast Oncology at Dana-Farber.
In 2014, a biopsy confirmed that MacKenzie’s cancer had returned and spread to her lymph nodes. She received more chemotherapy, but after six months, the cancer began to grow again.
In May of 2015, Block, still at Newton-Wellesley, referred MacKenzie to Dana-Farber where she would potentially have access to clinical trials of innovative medicines for metastatic triple-negative breast cancer.
“I love Dr. Block and she linked me up with Dr. Lin, and I love her, too,” says MacKenzie. “I’ve been so fortunate to have the best doctors in the whole world.”
One treatment after another
Once at Dana-Farber, Lin offered MacKenzie treatment after treatment, some standard and some investigational. All told, MacKenzie received seven distinct treatments from 2015 to 2020.
One of those therapies was a combination of alpelisib, a PI3K inhibitor, and olaparib, a PARP-inhibitor, being tested in a clinical trial. It was an unusual combination that pre-clinical research at Dana-Farber suggested might be beneficial.
For about ten months, MacKenzie’s cancer responded to the treatment, giving her an opportunity to venture to Ireland with her sister and cousin.
“I was pretty beat from side effects, but I was determined I was going to live,” she says. “We took our family to Disney the year before, as well. All of this care has given me the chance to enjoy time with my grandchildren and to make special memories.”
Later, MacKenzie joined a clinical trial of an off-the-shelf cancer vaccine combined with pembrolizumab, an immune checkpoint inhibitor. The experimental vaccine aimed to train her immune system to recognize triple-negative breast cancer, and pembrolizumab works to enhance the immune response. After receiving the treatment, MacKenzie’s cancer was kept at bay for about nine months.
Neither of these clinical trials advanced into phase 3 trials or became part of standard of care. But they both worked temporarily for MacKenzie. That time she gained – nearly two years – turned out to be essential.
Finding stability
After the vaccine, MacKenzie needed additional treatment, including radiation therapy, while she waited for new options to emerge. Then, towards the end of April 2020, the U.S. Food and Drug Administration granted accelerated approval to sacituzumab govitecan for patients with metastatic triple negative breast cancer.
“I started her on the medication in June 2020, very, very soon after that approval,” recalls Lin. “She’s been on it ever since.”
MacKenzie reports feeling great and experiencing very few side effects. Her cancer is not detectable on scans. She still loves traveling and recently enjoyed a river boat cruise in France and is planning a road trip to Florida this spring.
“The support from my family, especially my husband, who has been there for me every step of the way, has been a crucial part of my journey,” MacKenzie says.
She also enjoys her regular trips to Dana-Farber for infusions.
“I don’t know how to explain it to people, because it isn’t just going for treatment. The nurses at Dana-Farber make it so wonderful,” she says. “Over more than ten years of going in, I’ve seen them get married and have babies. It’s so amazing. They are very special people.”
Stories like this make my heart swell. As an ovarian cancer survivor treated at Dana-Farber decades ago – I know I would not be here if not for the innovative treatment and the extraordinary Dana Farber care teams!
This gives me hope and I am so happy for Carol.
As someone currently undergoing treatment for mTNBC, stories like this give me such hope! I’m so fortunate to be receiving care at DF, where they have access to innovative treatment and trial opportunities. Also, I know just what Carol means about enjoying infusion visits – you build relationships with your care team! Thank you for sharing this story!
Amazing! As a bilateral triple negative breast cancer patient this story is very uplifting to me and gives me hope for my own future. Thank you for telling your story for all to share in your happiness, and to celebrate your successful fight.