Standing Up to Stage 4 Breast Cancer

LOS ANGELES — (Aug. 3, 2022) — Holly Hammond faced one of the toughest-imaginable breast cancer scenarios. Her cancer was already advanced and had spread to her liver and lymph nodes when she discovered a tumor on her right breast. The tumor was negative for all of the markers that respond to targeted therapies for cancer treatment. She was also positive for the genes that mark her as especially prone to breast cancer.

Three years later, Holly has no detectable cancer in her body. Inspired by Holly’s upbeat attitude, her care team at Cedars-Sinai Cancer in Tarzana problem-solved its way through Holly’s harrowing cancer journey. In doing so, notes oncologist Dr. Natasha Banerjee, “We may have cured what’s considered an incurable breast cancer.”

“Hey, so I have something to tell you. I have breast cancer,” she wrote. “My first surgery is tomorrow, and I’ll know more after that. As I sit here waiting for surgery and preparing for next steps, I just want to remind you to check your breasts, have your annual OB-GYN exams and get anything weird checked.”

Those four sentences encapsulate Holly’s essence. Sugarcoating and self-pity aren’t her thing. Holly defaults to caring about the wellbeing of others, even when her own wellbeing is at the mercy of stage 4 triple-negative breast cancer (TNBC) and the grim statistical reality that patients with this relentless disease generally survive for only 13 months

Holly doesn’t put much stock in statistics. 

“I can’t rely on statistics because all of the statistics for stage 4 TNBC say I died two years ago,” explains Holly. “The joke is on them. Stage 4 simply isn’t enough to take me down.”

Immunotherapy increases the immune system’s ability to attack cancer cells. In Holly’s case, aggressive chemotherapy was combined with pembrolizumab (brand name: Keytruda), an immunotherapy medicine that helps the immune system hunt down hidden cancer cells.

The immunotherapy-chemotherapy combination is a new addition to the limited therapeutic arsenal available to TNBC patients. In November 2020, the U.S. Food and Drug Administration (FDA) approved the combination of immunotherapy and single-agent chemotherapy for metastatic TNBC. In July 2021, the FDA approved an intensive regimen of four chemotherapy drugs plus pembrolizumab for stage 2 and stage 3 TNBC patients. When Holly was diagnosed with breast cancer, she already was at stage 4, which generally is considered incurable.“The spread of her cancer was limited to her liver and lymph nodes, so we decided to go with an intensive chemotherapy regimen that included immunotherapy, which was a treatment strategy that had not yet been fully approved for stage 4 patients and thus was not covered by insurance,” Dr. Banerjee explains.

“I wanted to treat Holly very aggressively and with full curative intent. Fortunately, we were able to obtain pembrolizumab free of charge from the manufacturer through its compassionate use program.”

Holly also feels fortunate to have had Dr. Banerjee as her oncologist. “I was so lucky to be treated at Cedars-Sinai by an oncologist who knew that chemotherapy and immunotherapy were options for TNBC,” Holly says.Holly completed six months of chemotherapy combined with immunotherapy and then continued immunotherapy alone for two more years. Holly also had 31 sessions of radiation on her right breast and the lymph nodes in that area. 

“If there’s some residual cancer, it’s going to grow and show itself within a couple of months,” says Dr. Banerjee. “The fact that nothing has come back after two years actually means there’s a very good chance Holly’s cancer won’t return.”

Moving forward, Dr. Banerjee plans to see Holly every two to three months for blood work and to keep an eye out for signs of recurrence.

Dr. Banerjee recalls that when Holly was having chemotherapy, she would go out of her way to encourage other patients at the infusion center. So much so that personnel at the infusion center started asking Holly if she would reach out to specific patients, which she did happily.

“Holly’s a very special person,” observes Dr. Banerjee. “Everyone who meets her feels that way.”