About my diagnosis

I first found out I had bowel cancer August 2021. I was 33 years old and 32 weeks pregnant with our fourth child. 

As my pregnancy had progressed, I had been increasingly tired, I also started experiencing pain in my upper right abdomen. Being a busy mum of three little kids (6, 4 and 22mo) I pushed it to the back of my mind, passing it off as pregnancy related. I think deep down however I knew something wasn’t quite right, but I had previously had three uncomplicated pregnancies. 

The pain under my ribs kept increasing, it went from being mildly uncomfortable to 10/10 pain and I presented to ED. 

Initially my small rural hospital diagnosed it as pneumonia, I had a chest X-ray and was sent home. But within 3 days I was back in ED with unmanageable pain, they sent me to a larger rural hospital with suspected gall bladder. It was there I had an abdominal ultrasound, where they found multiple lesions on my liver. 

I was then transferred to Monash Clayton. After ultrasounds, blood tests, an MRI and a liver biopsy a week after arriving at Monash I was diagnosed with Metastatic Adenocarcinoma, Stage 4. One primary tumour in my bowel with 12 liver metastases. The largest tumour in my liver measuring 14cm. I was given a prognosis of two years.

Finding out about my HER2 biomarker

After my initial diagnosis, I commenced chemotherapy at 33 weeks pregnant, and was able to go home for 2 weeks to get further along in my pregnancy. At 35 weeks pregnant, I was induced and gave birth to a beautiful baby boy. On day 3, before leaving hospital I was given my second round of chemo. 

I initially commenced on Folfox 6 and had several rounds before my oncologist told me about a trial for patients with HER2 over expression advanced colorectal cancer, and that I was eligible to apply. This was the first time I had heard about my HER2 biomarker. The testing had been done when I had my liver biopsy and was ordered routinely through Monash as part of their molecular testing.

How my HER2 biomarker impacted my treatment

Because my tumour overexpressed HER2, I was offered participation in an experimental trial. To confirm my eligibility, the tissue from my biopsy was sent overseas to the Trial Sponsor’s mandated central lab for confirmation of HER2 status. I was then accepted into the Destiny CRC02 trial, a phase 2 study investigating the safety and effectiveness of targeted therapy drug, Trastuzumab Deruxtecan (T-DXd) in the treatment of HER2 positive colorectal cancer. 

T-DXd is an antibody drug conjugate, which means it is made up of 2 parts; a drug and an antibody. The antibody part binds to cancer cells that have the HER2 receptor and delivers the drug into the cancer cell. 

T- DXd has been approved in the USA and Japan for the treatment of patients with HER2-positive breast and gastric cancer in certain patient populations but has not been approved in any country for advanced colorectal cancer. 

Being able to participate in this trial, has given me an alternative to the treatment options normally available. I have been on the trial now for over 18 months and in that time, my tumours have been slowly reducing in size and currently being called “stable disease”. I have passed the two year prognosis, and now I am hopefully looking at a five year prognosis. None of this would have been possible without knowing about my HER2 biomarker.