As adults, it’s not every day we make a new friendship that we know will last the rest of our lives. As Rachel Leppert sat in a room at MUSC Hollings Cancer Center facing a brand-new breast cancer diagnosis in May of 2021, it was the last thing she expected.
But in walked Alexandria Green.
“Something about your presence – it made me feel like I could breathe for a minute,” recalled Leppert through tears, thinking back on the moment they met. “Your kindness that day meant so much to me.”
Green, a senior program coordinator for clinical trials at Hollings, reached out and grabbed Leppert’s hand as she explained feeling a similar connection. The day they met, which was shortly after Leppert received her diagnosis, Green visited to pitch her a simple clinical trial. The trial would record a first-time patient’s surgical consult to help future patients to prepare themselves better for the information they were going to receive. Leppert signed on without hesitation.
“I walked into the room because Rachel was a candidate for the recording trial and then I fell in love with such a sweet person,” said Green. “I love all my patients, but you get those patients sometimes that just embed themselves in your heart and she is definitely my girl forever. Whether we’re on a clinical trial or not, she can always call me, and I will always come running for her.”
Green now vows that someday when she gets married, Leppert will be there to watch her walk down the aisle. She’s not even engaged.
Putting her health on the back burner
Months earlier, Leppert thought she felt a lump in her breast but ignored it at first. “I kind of pushed it to the back burner because I’m always healthy,” she said. “Nothing goes wrong.”
It was after her first granddaughter was born that she realized something was wrong. One day, while the baby was laying in her lap kicking her legs, she kicked Leppert in the chest.
“It was honestly the worst pain I’ve ever felt in my life,” said Leppert. “It had gotten so big, so fast.”
That moment was what made Leppert go to the doctor and what led to a HER2 positive breast cancer diagnosis. HER2 positive means that the breast cancer cells have higher levels of a protein, called HER2, that causes them to grow quickly. These cancers tend to grow and spread faster but are much more likely to respond to treatment with drugs that target the HER2 protein.
“It’s crazy how quickly things happened,” said Leppert. “It was just appointment after appointment after appointment. And then you just start chemo. I don’t think people realize you don’t even have time to process what is happening to you.”
A new trial
Leppert embarked on six rounds of TCHP chemotherapy, which is a combination regimen for early-stage breast cancer that targets the HER2 receptor. She then had a double mastectomy. It was after surgery that Green reappeared in her life.
“I was happy that her name came across my desk again after surgery,” said Green. “It had qualified her for this new clinical trial.”
Leppert had qualified for the Compare HER2 clinical trial. All patients enrolled in this trial start on 14 cycles of TDM1, which is a standard of care treatment for HER2 positive breast cancer. In addition, some patients will receive a drug called tucatinib. Researchers believe, and this trial is working to confirm, that adding tucatinib helps keep the cancer in remission.
“It’s randomized, so we don’t actually know if Rachel is on tucatinib or a placebo,” said Green. “But Rachel did really well, and that makes us very happy.”
The long-term goal of this trial, which is still active and enrolling, is to confirm that the addition of tucatinib is beneficial to patients and keeping their cancer in remission. If successful, it could become part of a new standard of care treatment for patients like Leppert and she’s thrilled to be playing a part in something that could help others who haven’t even been diagnosed yet.
“I think about with HER2 – the targeting drugs were a big deal. That’s what keeps the cancer from coming back. And I remember Dr. Brescia saying that 15 to 20 years ago, we’d be having a different conversation,” Leppert explained, referring to Frank Brescia, M.D., a medical oncologist. “I thought about all the women who did the trials for that targeting drug that saved my life and I knew as soon as Alex asked me, I wanted to do it – because someone else did it for me.”
“I thought about all the women who did the trials for that targeting drug that saved my life and I knew as soon as Alex asked me, I wanted to do it – because someone else did it for me.”
breast cancer survivor
clinical trials participant
Leppert finished the 14 weeks of treatment and underwent radiation. In late September this year, she was given the news that she was in remission.
Her friendship with Green, who was by her side thorough it all, has grown.
“Just you being there every time for those cycles – it meant so much to me. Seeing your smile really lifted me,” Leppert gratefully told her friend. “You are so perfect for your job. I know this clinical part is important, but the way you make us feel is just as important and I appreciate that.”
Green admits that she originally took her position for the opportunity to move up in her career and make more money. She now realizes that the real opportunity is to bring hope to patients fighting the biggest battle of their lives.
“Clinical trials are an extra chance,” said Green. “They bring hope. It’s another opportunity to strive to overcome this scary thing – the scariest time in someone’s life.”
She admits that the work is not always easy. The outcomes are not always good. She sometimes loses a patient she has made a connection with. “It hurts my heart,” said Green glancing at Leppert. “But I get tears of joy when I think about you – because we made it!”
Made it they have. Two clinical trials, two lives changed, two hearts connected by a shared experienced. For Leppert, the scariest time in her life has been lightened by not only the added hope of a clinical trial but by a friendship she treasures.
“You’re my heart forever and ever,” said Green still gripping Leppert’s hand.
“And I love you for that,” Leppert replied, holding back tears.
“I love you too,” said Green.