EGFR – Precision Medicine: Deb is surviving with stage IV cancer.

When Deb Smith sought care from Dana-Farber/Brigham and Women’s Lowe Center for Thoracic Oncology for stage IV lung cancer three years ago, she was in the right place at the right time. Today, she is a beneficiary of Dana-Farber research on targeted, gene-specific therapies. For more details about this discovery, download the Whitepaper.

“As someone who never smoked cigarettes, I did not think about lung cancer happening to me,” she recalls. “At first my doctors thought my cough was due to asthma and the pain in my hip was caused by arthritis. When I learned I had a tumor the size of an orange in my lung, cancer in my lymph nodes, and a cancer-related lesion on my hip, I never dreamed I’d be alive three years later.”

Diagnosed at age 58, Smith is among the 15-20 percent of women whose lung cancer is not related to smoking.  She was found to have a mutation in the epidermal growth factor receptor (EGFR). Dana-Farber scientists discovered this mutation’s role in lung cancer treatment.

“After my diagnosis at a local hospital in New Hampshire I came to Dana-Farber because I wanted the most advanced treatment,” she says. “At the beginning, I was in shock and didn’t fully comprehend what targeted therapy meant when my doctor recommended it.” Smith participated in a clinical trial with the drug erlotinib (Tarceva), and overall her tumor shrank by 80 percent. “After a few months I began feeling and breathing better.” However, her doctor did warn her that eventually the cancer stops responding to the drug. “Sure enough, my tumor began to grow again,” says Smith. “I joined another clinical trial and tried two other drugs that were not effective and had a lot of side effects.”

Once more, serendipity changed the course of her life. Dana-Farber was beginning a clinical trial for patients with an EGFR mutation who had become resistant to first-line therapy, and Smith joined the first group of patients to be placed on an experimental AstraZeneca drug called AZD9291. The results of the study, led by Dana-Farber scientists, showed that this drug – which is expected to be filed for Food and Drug Administration approval in 2015 – was effective and caused fewer side effects. For Smith, the new drug has both lengthened her life and improved its quality. “I hope my experience inspires other cancer patients to choose a cancer center like Dana-Farber and join clinical trials.”

A retired special needs teacher, Smith is honest with her son, Dylan, about the reality of her illness. But for now, she says, “I feel pretty good most of the time. I can do most of the things I want to do as long as I pace myself. Dylan and I have been traveling to create some good memories, and every birthday since my diagnosis has been a cause for celebration.”

Video produced in partnership with the American Association for Cancer Research