Tears started to roll down her cheeks when Elisa Leaf Sneider got the call, the one that said the cancer was back.
The new mother had been in remission prior to getting pregnant, but she wanted to become a mom and discontinued her hormonal treatment. Now she feared she may lose her son — or rather, he may lose her.
“I was devastated,” Sneider said. “All I could think of was how selfish I was. I only thought about my desires to be a mom. But I don’t think you can think like a mom until you are one.”
It was a phase III clinical trial that saved her the first time, and it would be an auspiciously timed clinical trial that would her get through the second time — despite the odds being heavily stacked against her.
She first found the lump in her breast prior to her wedding. She had a doctor look at the tissue, but no alarms were sounded.
Four months later, she started to feel pain in her underarm. She sought out a new doctor, who ordered an ultrasound and a biopsy. She was diagnosed with locally advanced stage III breast cancer in 2003.
The treatment included surgery, where a lemon-sized tumor was removed, as well as chemotherapy and radiation.
Elisa Leaf Sneider with her son, Will.
At the time, the medical field was testing Herceptin, a drug that targets HER2 receptors found on the surface of cells, blocking the growth signals that tell the cells to multiply. Sneider enrolled, and was randomized into the investigational drug group.
“We kind of all credit that for me being alive,” she said.
Herceptin had received approval from the Food and Drug Administration in 1998, but its permitted use was limited. Sneider’s trial studied expanded use of the drug, gaining approval in 2006.
“It was through enrollment in clinical trials that this drug became approved,” said Dr. Diana Medgyesy, an oncologist with UCHealth Cancer Care and Hematology in Fort Collins.
Things were looking good for Sneider. She’d gone into remission. As a newly married woman in her early 30s, she really wanted to have a child.
“I was already wanting to have a baby when we got married and I just really didn’t want to hold off any further,” Sneider said.
She gave birth to her son, Will, in October 2005.
Four months later she got the call.
The severity of the situation revealed itself over several months. She had tumors in her brain and liver. The cancer had spread to her lungs, spine, pelvis and one adrenal gland.
She went into a tailspin and began to panic. Medgyesy carved out a path forward.
“Dr. Medgyesy is an unbelievable oncologist, not only for her knowledge but because of her compassion,” Sneider said. “She’s very real, but optimistic.”
It felt as if it was one step forward, two steps back. But Sneider didn’t give up.
“She was a fighter,” Medgyesy said. “She never gave up because she had a child she wanted to raise.”
Another phase III clinical trial had started, similar to the first, but this time the Herceptin was “loaded” with the chemotherapy drug emtansine, Medgyesy explained. Sneider enrolled in the EMILIA trial comparing this new drug with a combination of previously approved drugs for patients with HER2-positive metastatic disease.
Again, the trial placed patients into groups at random, sorting only half into the group that would receive the drug. This particular study wasn’t blind, so once the patients were placed, they’d know their course of treatment. They know if they weren’t selected, Sneider said.
“You know that going into it,” she said. “You’re still receiving the standard of care, but you have your hopes set on getting this new novel drug that’s showing benefit.”
Sneider was randomized into the investigational drug group. She stayed on the treatment for two years, a process that required a CT scan every six weeks, and she achieved complete remission.
The FDA approved the treatment in 2013.
“I think the credit goes to those women who take the chance on a phase I or phase II trial,” Sneider said. “With all the trials that I’ve been aware of, whether they pertain to me or not, it’s amazing because you realize how many people are working and researching to end this disease. That really brings me comfort.”
Having stabilized, she transitioned off the loaded Herceptin onto the plain version three years ago. She goes in every three weeks for treatment, something she considers a lifelong commitment.
Her son, Will, comes along, she said. He has since the beginning.
“He doesn’t mind. The nurses are sweet to him and there’s candy,” Sneider laughed. “I’ve been very honest with him since the start. He’s a very smart kiddo and I thought it would create more fear for him if he thought we weren’t telling him the truth.
“It just became normal to him growing up,” she said. “It’s what he’s gown up with. It’s what he knows.”
It’s also what has kept them together.
Visit uchealth.org to learn more about clinical trials near you.