What Patient-Centered Research Looks Like, From a Nurse Who Became the Patient | Janice Cowden

This episode is sponsored by Gilead Sciences. Gilead had no involvement or input in the podcast content. Gilead is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.Recorded on location at the San Antonio Breast Cancer Symposium, December 2025.Metastatic triple-negative breast cancer remains the breast cancer subtype with the fewest targetable biomarkers and the shortest treatment algorithm. When a trial reports a double-digit progression-free survival in the first-line setting, it is worth understanding what that actually changes and how the trial was designed with patient outcomes at the center.This episode was recorded in December 2025, before regulatory action. On June 24, 2026, the FDA approved sacituzumab govitecan-hziy for two first-line indications in triple-negative breast cancer: as a single agent for adults with unresectable locally advanced or metastatic TNBC who are not candidates for PD-1 or PD-L1 inhibitor-based therapy supported by ASCENT-0, and in combination with pembrolizumab for adults whose tumors express PD-L1 with a CPS of 10 or greater supported by ASCENT-04. Janice's speculation in this episode about how PD-L1 status might factor into the guidelines has since been answered by the label.ASCENT-04/KEYNOTE-D19 NCT05382286 was a phase 3, open-label, randomized trial of 443 patients with previously untreated locally advanced unresectable or metastatic TNBC whose tumors expressed PD-L1 at a CPS of 10 or greater by the 22C3 assay. Participants were randomized 1:1 to sacituzumab govitecan plus pembrolizumab or to physician's choice of chemotherapy plus pembrolizumab. Patients in the control arm with centrally confirmed progression were offered crossover to sacituzumab govitecan.0:00 Live from the San Antonio Breast Cancer Symposium0:30 The METAvivor ribbon and what the pink ribbon leaves out1:35 Diagnosed in 2016 with a median overall survival of 9 to 15 months2:26 Nine years later3:20 From pediatric nursing to research advocacy4:30 What has changed since 2017, and what has not5:26 2011: when chemotherapy was the only option5:55 On not knowing a relevant clinical trial existed6:47 Why metastatic TNBC still has no maintenance therapy7:25 What first-line treatment looks like today8:25 Inside ASCENT-049:09 Progression-free survival, defined9:59 Why a double-digit PFS is notable in this subtype11:20 Why each subsequent line of treatment works for less time11:52 How many patients never reach second line12:50 The case for a stronger first-line option13:21 Crossover design, and why it matters to patients14:33 What crossover means in a randomized trial15:56 Patient advocates in clinical trial design18:59 Quality of life versus quantity of life21:48 Rapid fire: metastatic breast cancer and metastatic TNBC23:06 Rapid fire: first line, second line, progression-free survival24:00 Rapid fire: immunotherapy and antibody-drug conjugates24:59 Advice for the newly diagnosed26:04 What she wants next: a biomarker26:52 On ADCs, tolerability, and the need for novel targetsJanice Cowden, RN is a research patient advocate living with metastatic triple-negative breast cancer. She practiced as a registered nurse for approximately 22 years, primarily in pediatrics, and later worked as a pharmaceutical sales representative. She was diagnosed with stage I triple-negative breast cancer in 2011 and with metastatic disease in 2016, and completed the Living Beyond Breast Cancer advocacy training program in 2017.This podcast is intended for educational and informational purposes only and should not be considered medical advice.