August 10, 2021

Clinical trial offers new treatment, hope for 13-year survivor of metastatic breast cancer

Clinical Trial Journeys

Reagan Smoker has been approached by more than a few people with "sad dog eyes," as she likes to call them.

After 13 years of being in and out of treatment for metastatic breast cancer, the Philadelphia native is used to well-meaning friends and family members giving her that look of despair when they talk to her.

“I look and them and I’m like, ‘Hi, I’m still here,' " she said with a laugh. But the many years of fighting cancer have given her a certain perspective, sincerity and understanding that often only comes with a life-changing health condition.

“It’s all about compassion and empathy,” she said. “I’ve been told more times than I can remember that I’m a very strong person, and I turn to these people and say, 'So are you.' Because you truly don’t know what others might be going through.”

At the age of 29, Smoker was diagnosed with HER2-positive breast cancer. With no family history of the disease, and no evidence of having the so-called breast cancer gene, the diagnosis came out of left field.

“There was shock and awe,” she said.

She later underwent chemotherapy, radiation and had a double mastectomy, a procedure which caused its own complications and required nearly a dozen additional surgeries. It took a physical toll on her body, but the treatment got her cancer to a manageable place.

Several years later, Smoker visited a doctor to have a cough checked out. She thought she was possibly experiencing asthma or even allergies, but an x-ray discovered that the cancer had metastasized to her lung. With additional treatment, doctors were able to once again get the spread under control.

But last year, she discovered that her tumor was once again beginning to grow. For metastatic cancer patients, this isn’t an uncommon experience. Over time, the effectiveness of cancer-management drugs can begin to wane, and other types of treatments may not always be available or feasible.

Now living in Door County in Wisconsin, she knew she wanted to be treated at an academic medical center, which is how she found herself at the UW Carbone Cancer Center under the care of Kari Wisinski, MD.

“She explained to me that we have to trick the cancer again, and there were some new exciting drugs out there for people like me who have already run the gamut with the existing treatment options,” Smoker said.

Through a partnership with the Academic Breast Cancer Consortium, Smoker was able to enroll in a phase 2 clinical trial at UW Carbone that met her unique criteria, and gave her a new treatment option. The study, overseen by Wisinski, is testing the effectiveness of combining two separate breast cancer drugs – palbociclib and T-DM1 – in treating patients with metastatic HER2 positive breast cancer.

Now, every three weeks, Smoker makes the six-hour round trip from Door County for treatment and observation in Madison. She doesn’t mind the drive, and said it gives her a chance to clear her head and catch her breath, especially during the hectic summer season. Because when she’s not busy managing her cancer, she’s busy managing a restaurant, bar, inn and bakery in Sturgeon Bay.

While she’s grateful for the treatment, and the opportunity it presents, Smoker said she’s happiest about being part of something to benefit the next generation of breast cancer patients.

“Everybody that went before me, who went through clinical trials and tested the drugs I’ve already taken, they did it for me,” she said. “As much as it’s mentally difficult, because you’re in this stage IV cancer diagnosis, you realize that the work you’re doing with the team you have is truly helping other people. The most important thing that you can do with science, I think, is to truly help those who might be coming along behind you.”

As the study has progressed, Smoker said she’s experienced a few side effects. And she’s still waiting to see if this treatment will be the one to bring her a more permanent and positive outcome. But regardless of what happens, one thing is for sure: If you see Smoker out and about, you certainly won’t see her with any sad dog eyes.

“You do the best you can every day,” she said. “You get up and you continue and life isn’t always perfect by any means, but you meet a lot of wonderful people along the way.”