Tori Geib travels the country advocating for people with metastatic breast cancer. "I also have every intention of having a beer with Dr. Stover when he retires. My goal is to be at his retirement party," she says.
In March 2016, Tori Geib was working as a chef at Ohio State University’s James Cancer Hospital and living with undiagnosed Stage 4 breast cancer. Hundreds of miles away, Dr. Daniel Stover was completing his training as a research fellow in cell biology at Harvard Medical School and had recently joined the faculty at Dana-Farber Cancer Institute in Boston.
Three years later, their paths led them both back to The James at Ohio State, and Stover became Geib’s oncologist.
It was the week of her 30th birthday when Geib learned she had metastatic, estrogen-positive cancer that had spread to her liver, lung and bones. Her back pain, which had been misdiagnosed earlier, turned out to be a vertebra that was 70 percent crushed.
Her disease is terminal. When she passed the three-year mark since diagnosis this year, Geib outlived most patients with metastatic cancer, who succumb to the disease about two years after being diagnosed.
Geib, who is BRCA2 positive, responded to treatment for two years, but her disease began to progress again. When her oncologist at the time decided to leave her practice, Geib was devastated. “As a cancer patient, that relationship is one of the biggest bonds you have,” she says. In searching for a new physician, she knew she wanted someone with both clinical experience and a passion for research. She began following Stover’s work while he was at Dana-Farber.
Geib became Stover’s patient when he moved to back to his hometown and joined the translational therapeutics program at Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
Stover and Geib are unwilling to accept that cancers like hers must be terminal. Their aim is to turn these diseases into chronic conditions, not life-ending ones. “To have more time with family and friends is everything,” Geib says. “Moms want to see their babies grow up, not die when they are 3 years old.”
Geib, who lives in Bellefontaine, is honorary chair of the 2019 Komen Columbus Race for the Cure. Despite her illness, she has been a tireless advocate for those with metastatic breast cancer, traveling across the country to educate and inform legislators and others who can make an impact. “I’m OK right now, I can speak for this community. I also have every intention of having a beer with Dr. Stover when he retires. My goal is to be at his retirement party.”
Stover is 38. With $450,000 from Susan G. Komen Columbus, he and his team are studying another of the worst cancers -- triple-negative breast cancer -- and why patients develop resistance to the drugs used to treat TNBC, which accounts for about 15 percent of all breast cancers. It is most common in younger women, African-American women and those with the BrCa1 gene mutation. It’s also the most difficult to treat. “We’re focusing on the most aggressive cases. We’re trying to tackle the worst of the worst,” he says.
The research focus is computational oncology, using “big data” to characterize the genetic changes leading to drug resistance. His lab’s mission is to more accurately forecast a patient’s likelihood of developing resistance and target therapy accordingly. Ultimately, researchers hope to identify high-risk patients at the time of diagnosis.
Tumor DNA is obtained from blood samples, or “liquid biopsies” that are easier to acquire than conventional biopsies and enable physicians to take samples more frequently. Improved genetic algorithms also being studied provide a closer look at mutations in a tumor.
Not far from his lab, Stover sees patients at OSU’s Stefanie Spielman Comprehensive Breast Center. Being both scientist and physician gives him valuable insight, he says. “The patients I see inform the questions I ask and identify the areas where I feel like we need to do more. Feedback from my patients was one of the things that drove me to pursue the liquid biopsy,” which causes less anxiety and pain than a conventional biopsy. At the same time, patient samples make research timelier and more relevant.
Stover first experienced this connection when he was a 15-year-old lab volunteer at The James. Because of the hospital’s configuration at the time, the Upper Arlington High School student rode the elevators alongside patients receiving treatment. “That had a very striking impact,” he says.
Researchers and clinicians all want the same outcome, Stover says. “I worry about my patients. I go to bed thinking about TNBC, and I wake up thinking about TNBC.”
He says the last two years have seen an acceleration in potential new treatments and hope is on the horizon for one or two additional drugs becoming available in the near future. Earlier this year, the FDA approved an immune therapy protocol for metastatic TNBC. “At this point it looks like a combination of chemo and immunotherapy may be the key,” he says.
Julie McMahon, director of mission and strategy for Komen Columbus, says Stover’s research and Geib’s voice reflect the organization’s shift in focus. A goal of reducing the U.S. death rate from breast cancer by half by 2026 means more attention to aggressive, late-stage and resistant cancers and finding therapies for those who don’t now have options.
“We want to keep the pipeline full of new drugs, and we don’t want to waste time using drugs that aren’t working,” McMahon says. “There is a sense of urgency.”
Even the language Komen uses reflects a change in perspective, McMahon says. At this year’s race, the Survivor Celebration Tent is now Hope Village. Race participants with metastatic disease can opt to wear a shirt that doesn’t emphasize the survivor element.
For patients like Geib, those changes provide hope and a feeling of being recognized and less isolated from the larger group of breast cancer patients. “Some people ring a bell at the end of their treatment,” she says, “and that’s something a metastatic patient never gets to do. When I was diagnosed, I thought this would be a year, and then I could go on with my life. For many, life doesn’t go on.”
Geib connects with the drive to reduce cancer deaths by honing in on cancers like hers. “We’re the worst-case scenario. If you cure the worst, you save everybody. Without the research, we’re not going to be here.”