Hi, I’m Dennis Watson, VP of Business Development at Travera. I’m here today with Janice Cowden. She spent over 20 years serving as a pediatric nurse before becoming a pharmaceutical sales representative with Eli Lilly. Janice loves to travel and is very proud of her 43-year marriage, 2 children, and 3 amazing grandchildren.
Nearly a year ago, Janice was honored to join the Board of Directors for METAvivor, a charitable foundation focused on supporting patients and funding research solely on women and men diagnosed with Metastatic Breast Cancer. Janice was diagnosed with Metastatic Breast Cancer in 2016, and this experience has driven her to a deep passion for patient advocacy.
Travera recently partnered with METAvivor for an educational webinar, and we had the privilege of catching up with Janice following that event. Here is what Janice had to say.
Let’s start with an important question: What drives you, Janice?
I am passionate about patient advocacy in research and peer support, helping those diagnosed with metastatic breast cancer. I love attending scientific conferences (ASCO, AACR, SABCS, MBCRC, etc.). As a lifelong learner who loves learning about science, research, drug development, & clinical trials.
How did you first become involved with METAvivor?
I’ve been a supporter of METAvivor since my MBC diagnosis in 2016 – via personal fundraising through programs like, BCAM awareness about MBC campaigns, “This Is MBC” campaign, and as an “Annual Stampede” participant. In 2018, I participated in METAvivor’s Peer-to-Peer volunteer training; after3 years later was approached about joining the Board of METAvivor, and was elected as a BOD member in February, 2022.
What does this kind of advocacy work mean to you?
Because of my healthcare background, passion for research, and desire to create public awareness & education about MBC, METAvivor checks all of those boxes, and it’s been a great experience. In addition to research & peer support, I’ve also learned a great deal about legislative advocacy from METAvivor.
Can you share about your personal diagnosis?
I was initially diagnosed in 2011 with Stage I triple-negative breast cancer (TNBC). My treatment at that time consisted of a lumpectomy and radiation, followed by Taxotere and Cytoxan-based chemotherapy. In 2016 I learned that I had distant nodes with limited metastases, and this is when my journey with metastatic breast began. I had a complete response to the first line of treatment (Adriamycin/Cytoxan chemotherapy), followed by external beam radiation. Have remained NED (no evidence of disease) & on no systemic treatment for six years now, since 11/17/2016.
What has been your biggest learning in this experience?
Learning about Stage IV metastatic breast cancer has been a real education, but despite the poor prognosis of metastatic triple-negative breast cancer, I’ve learned that this is not an immediate death sentence. I’ve learned a great deal about gratitude and hope in this journey.
What has the hardest part of your own personal journey thus far?
While learning of my diagnosis and telling my family members was extremely difficult initially, the most challenging part of living with MBC has been the loss and grief I’ve experienced along the way. I’ve seen so many losses in the MBC community. So many friends have died in the past six years, and while I’m grateful to be alive, those losses are devastating. Survivor’s guilt is something I deal with every day.
What is one thing you wish you could tell your newly diagnosed self?
To be hopeful, to connect with others who are living with this disease earlier, and that I would live long beyond my “expiration date,” according to statistics.
What would you share with others facing this diagnosis?
I am always sharing my story with those who are newly diagnosed with the intent of offering a measure of hope for them. I encourage everyone to focus on living life each day and not to use their energy focused on dying.
What procedures and tests have you done through your journey that you felt were the most impactful for your care?
Although I’ve had genetic/genomic testing, the value wasn’t significant as I had no actionable targets. Since my diagnosis, the most impactful thing I’ve done was to seek a 2nd opinion from a Breast Medical Oncologist at a comprehensive cancer center. I got 4 of them at four major cancer centers in the US. I continue to see one of the 2nd opinion doctors at MD Anderson, along with my local Oncologist in Tampa, Florida. I wish I had known more about NGS testing when mine was ordered, as I would have requested a different platform. My goal now is to find a tumor-agnostic ctDNA/CTC/cfDNA testing platform to utilize in conjunction with imaging scans for prognostic/predictive information.
METAvivor recently partnered with Travera to make our Rapid Therapy Guidance test available to METAvivor’s patients through a special program. You were immediately enthusiastic about this partnership. Can you tell us why?
I am excited about Travera’s testing for several reasons, including the fact that it’s novel. There’s nothing on the market to compare it with right now. It’s immediately helpful for patients with malignant fluids, like a pleural effusion. Once tissue is a viable specimen for Travera testing, I believe it will be able to help even more patients. This test may prove very helpful as we move towards more personalized precision-based practice with more evolving targeted therapies in drug development. Because most with MBC are on treatment for life, we need to find effective therapies that will benefit patients with less exposure to toxicities of treatments that are unlikely to work. We need to focus our energy on finding the right treatment for the right patient at the right time, and I think Travera’s test provides real promise.
The data for this test is still developing and hasn’t yet been proven in large trials. As someone living with MBC, how do you feel this early data might apply to patients with metastatic breast cancer?
As someone who collaborates with basic researchers, I realize the value of pre-clinical research and the steps & time needed to validate tools that will be useful for patients. While your current 80% accuracy is good, I hope to see an improvement in that number with larger studies. Hopefully, we will learn from the technology to further develop a tool that will lead to less utilization of therapies that are unlikely to benefit patients. We have a limited number of treatments for MBC, and because of the increase in drug resistance, we have less time to waste on treatments that do not work. That makes it worth the risk to me.
From your perspective, what problem does the Travera test potentially solve for you and other patients diagnosed with metastatic disease?
I think it’s beneficial because of the quick turnaround time from test to results, which means less delay in access to effective treatments for patients. As patients, we often feel that the approach to a treatment plan is much like a game of whack-a-mole – it’s an Oncologist’s best guess as to which treatment is likely to provide longer progression-free survival and longevity of life. When we use other valuable resources, patients are often delayed in starting treatment awaiting NGS/genomic/genetic testing – and studies have proven that a delay in initiation of treatment leads to lower median overall survival. With Travera’s quick turnaround time for results, patients are less likely to be prescribed a treatment that will not benefit them, and they can initiate their treatment regimen quicker. It’s a win-win situation for Oncologists and patients alike.
In my case, the test will offer promise if/when I have progression. I currently have no evidence of disease, so I will not personally benefit at this time. This will be of great value in determining a personalized treatment plan for newly diagnosed and those who have had multiple lines of treatments fail. This is important because metastatic breast cancer is an incurable, terminal disease in 2022. With a median overall life expectancy of around three years, this could mean fewer exposures to ineffective treatments and fewer toxicities as a result, which in turn improves the quality of life and potentially saves time that would have been wasted on ineffective therapies. Time is something we don’t have an abundance of with MBC.
If you wanted this test for your journey, how would you bring it up to your doctor?
I would gather as much information on the test methodology and data that has been collected to date and suggest that this is an important test that I am choosing to have done. Many patients run into challenges bringing new ideas to their oncologists, and without sufficient data, many physicians are reluctant to order testing, in particular, any novel test that they’re unfamiliar with. I understand that perspective, but I would approach my oncologist and plead that I have nothing to lose by having Travera testing, but I may have a lot to gain. With that in mind, all decisions about our care should be shared decisions with our oncology team and us as patients. I would offer to connect my oncologist with someone at Travera to discuss further if he/she was still reluctant.
What advice would you give other patients that are considering this test?
To understand that this novel test is in the early stages of development in the MBC community and that by having the test done, you are essentially participating in research that may benefit a large number of patients, in addition to possibly shedding new insight on your own case. As with all research, we need patient participation in order to continually move the needle forward and this is what Travera is focused on doing. Moving the needle forward.
The team here at Travera cannot thank Janice Cowden enough for her honest feedback. We have more to learn in this exciting science and partnerships with organizations like METAvivor and Janice to educate patients, engage doctors and researchers, and learn from each other will help the entire community to, in Janice’s words: “Move the needle forward!” We are humbled to engage with passionate people and advocates like Janice and METAvivor.
If you’d like to learn more about Travera’s testing in the recent educational webinar with METAvivor, you find it below.