When 51-year-old Rhonda Stranz felt three lumps under her armpit, she didn't call her doctor — she drove straight to her doctor's office. As a breast cancer survivor, Stranz said when she felt those lumps, she wanted to see her oncologist that same day.
A biopsy confirmed the news Stranz dreaded: Her cancer was back. Stranz had been cancer-free for only about a month. She previously had been through surgery and chemotherapy, and her care team thought they had "got it all," she says.
But it was back, Stranz says, "and it was back with a vengeance."
Her doctor at the time told her nothing could be done; this was unlike anything they had seen before. "I was given the estimate that I had a year to live," she says. "And it was devastating."
Instead of giving up, Stranz held onto hope. "There wasn't anything to help me in Washington — even in Seattle," she says. "But OHSU had this clinical trial and took me on, thank goodness."
Understanding the cancer's biology
The new tumors were causing severe pain, swelling and skin changes. Stranz's local oncologist in Vancouver, Washington, referred her to OHSU in May 2023 for recurrent breast cancer.
When Stranz first saw her OHSU oncologist, Shivaani Kummar, M.D., FACP, her arm was so swollen she could hardly move it. She had red welts, swollen fingers, and the skin on her chest wall and arm was breaking down. Her advanced cancer had spread from the original location in her breast to the lymph nodes in the axilla, also known as the armpit.
Kummar says the OHSU team considered radiation therapy to help treat the new axilla tumors, but they were concerned it would cause even more damage to her skin. After the team reviewed
Stranz's genomic testing report, they learned she had a relatively uncommon mutation, or change, in a gene. Kummar says they were encouraged that OHSU had a clinical trial available to study a new experimental drug to target her exact mutation: TP53 Y220C.
"Following discussion with Rhonda, the decision was to try this experimental study drug targeting her unique mutation in the clinical trial, and if it didn't help, then we'd move on to radiation therapy," says Kummar, head of the Division of Hematology and Medical Oncology in the OHSU School of Medicine, and co-deputy director of the OHSU Knight Cancer Institute.
After officially enrolling in the trial, sponsored by PMV Pharmaceuticals, in June 2023, Stranz began taking the experimental study drug, called PC14586*, every day. She started coming to OHSU once a week for testing and monitoring.
"Within the first week of treatment on the clinical trial, Rhonda started to feel better, her pain went down, and her skin was healing," Kummar says. "Over the next month, her arm mobility improved dramatically."
Today, she only comes to OHSU once every three weeks. Stranz says it's much easier for her to travel to Portland less frequently. And the best part? "My tumors have shrunk and sores on my skin have healed," she says.
"I'm quite excited about this drug and others being developed for specific mutations in genes found in tumors," Kummar says. "We know the TP53 pathway is important and gets altered in cancer. And now we are testing drugs that specifically target one of these alterations."
Understanding early-phase clinical trials
As co-director of the OHSU Knight Cancer Institute's Center for Experimental Therapeutics, Kummar says the key to Rhonda's treatment was understanding that her tumor has a rare genomic mutation and having access to a clinical trial that is testing a new experimental drug to target the mutation.
"As our understanding of cancer biology increases, we can better identify and develop drugs to target abnormalities that drive cancer growth," she says.
Phase I clinical trials are typically done to find a safe dose, to find the best way to give a treatment, or to see how a treatment affects the body or fights cancer.
"I'd like to see the field — patients and physicians alike — start thinking about early-phase trials as an option for patients whose tumors have progressed on available treatments," Kummar says.
Kummar emphasizes that the entire early-phase clinical trial team was critical to Stranz's treatment. Nurse practitioner Sandra Youngworth, D.N.P., and clinical research coordinator Vicki Abtin "played key roles in Rhonda's treatment journey."
"Dr. Kummar is wonderful; she's amazing," Stranz says. "I just can't say enough about her and her amazing team. She definitely has her work cut out for her to make sure this is working for me."
'So much to look forward to'
Now that she's been on the trial for more than four months and is encouraged by the results, Stranz says she has "so much to look forward to."
"I have faith that I'm going to see my daughter graduate high school in 2026," she says. "She's been my rock, and she has taken care of me through thick and thin. When they said I had less than year to live, I was feeling pretty sick. I have hope again."
Stranz has advice for patients considering whether to participate in a clinical trial: "Talk with your doctor about clinical trials. If a clinical trial is recommended to you, consider participating in it," she says. "Trials are the future, in my opinion."
* PC14586 has not been approved by the Food and Drug Administration for safety and effectiveness and is undergoing early clinical study to verify its safety and effectiveness.
Funding for the study was supported by PMV Pharmaceuticals.
