“How did I beat lung cancer for eight years? Targeted therapy”

Christine Wu is a lung cancer patient and a member of the MOHCCN Patient Working Group. You can follow Christine's cancer journey on YouTube or X/Twitter.

My name is Christine Wu and I have been a survivor of advanced lung cancer for over eight and a half years. Today, I want to share how I managed to defy all odds and beat this cancer for so long. I also want to tell you about the challenges that I and other cancer patients face in our access to precision oncology in Canada.

Let’s start at the beginning. I still remember when the doctor told me that I had lung cancer and that it had already metastasized to my brain. I was in the Emergency Room and my mind went blank. This blankness lasted about three years. Part of it was due to shock: I didn’t have any symptoms of lung cancer, like shortness of breath and coughing, but my brain metastasis had already started to mess me up. Because the tumours I had were in the language and motion control centres of my brain, I had begun to stutter and couldn’t speak a complete sentence. Meanwhile, my right arm and leg were seriously weakened. While some of these issues have been resolved due to treatments, I still deal with some of them to this day.

At the time of diagnosis, my oncologist told me and my husband that there was a new drug that might work for me, but there was no guarantee. If I wanted to try this new drug, he could send my biopsy to the United States for biomarker testing. As these things sadly go for so many cancer patients in Canada, my medical insurer told me they would not cover the cost of the testing, which was $5,000 USD at the time. We are amongst the lucky ones that could afford to pay out of pocket. I’m glad we had the possibility to do that, because a few weeks later, we found out that I had a ROS1+ gene mutation. At the time, I didn’t realize how this test – and the knowledge that came from it – would change my life. 

Before the biomarker testing results came back, I had started chemotherapy, which is standard of care treatment for lung cancer patients. But within three months, the chemo had stopped working. Luckily, right at the time that this happened, my tests came back, and the FDA approved a drug for ROS1+ lung cancer patients. That’s when I was introduced to the concept of precision medicine. It’s been eight years of using that targeted therapy drug, and knock on wood, it is still working: my lung cancer is not cured, but it is under control. 

So, when someone asks me how I beat lung cancer for eight years, I have one answer—targeted therapy. Without it, I would have died shortly after my chemotherapy stopped working.

As I write this and look back at my story, I can’t help but wonder: why was I so lucky? And how can I help other patients survive as long as I have?

To do this, I must outline the two challenges that I think must be addressed so that precision medicine becomes a reality for more Canadian patients with lung cancer. These are: the depth of biomarker testing and the availability and coverage of targeted drugs that have been FDA approved. 

In terms of the first point, here’s what I have to say. While there are nine biomarkers in lung cancer that have FDA-approved targeted therapies, not all patients in Canada are tested for all these biomarkers. This means that if a patient has an actionable mutation that isn't being tested for, they may not receive a targeted therapy. If we expanded the depth of biomarker testing, these patients would have access to targeted therapies.

The second challenge concerns the availability of targeted therapy drugs for patients. Canada’s Drug and Health Technology Agency (CADTH) is responsible for approving the targeted drugs in Canada and negotiating the drug prices with big pharma. It is then up to the provinces and territories to pay for the drugs. The challenge our patients face is that provincial and territorial governments don’t all pay for the same targeted therapy drugs. I know a patient in one province, for example, who had to fundraise to pay $8,000 CAD a month for the same ROS1+ drug that I was getting for free in my province.

Luckily, things are changing, at least in part due to patient advocacy. I have personally worked with 15 other ROS1+ lung cancer patients campaigning provincial governments through letters and meetings to get them to start paying for these drugs. Due to our persistence and hard work, all Canadian provinces now pay for the ROS1+ drug, which broadens access to precision medicine for these patients. Patients are also working to expand biomarker testing.

This has led me to see that patients and their family members have a big voice, and that we should be helping to shape cancer research and care in Canada, because, in the end, we are the ones who will most benefit from it. That is why I’m so excited to be a part of the MOHCCN Patient Working Group. I see that the more integrated this group becomes in the Network, the better our chances are of making a real change. It is clear that if we are to succeed, then the doctors, researchers, cancer patients and caregivers must work together – along with government – to make changes that will help more people access better treatments, improving outcomes and quality of life for all cancer patients.

Watch Christine's videos on the Patient Working Group event in Halifax