Living Proof (2008) and the Herceptin Trials

A Lifetime television film adapted from Robert Bazell's book about the making of Herceptin. It follows Dr Dennis Slamon at UCLA from 1988 to 1996 as he pursues an antibody against the HER2 protein. When his pharmaceutical partner stops funding the work, philanthropy keeps the lab alive: Lilly Tartikoff and Ronald Perelman raise money through Revlon and the Fire and Ice Ball. Animal work precedes three human trials. Nicole, a young mother with stage four disease, is the first woman to receive the drug, but she does not meet the entry criteria for the later trials and is excluded despite her mother's pleading. The women in the first trial become a group, coping through humour or alternative therapy. Barbara Bradfield, a retired art teacher, and Ellie, a designer, are followed through treatment and recovery. Some trial participants die. The film closes with the drug on course to change breast cancer treatment; every patient except Bradfield is a composite.

Spoilers throughout. Discussing the cancer storyline means discussing how this ends.

The research strand is the accurate part. It shows how funding decides which science happens, how a company can shelve a promising molecule for commercial reasons, and how philanthropy and organised patient advocacy pushed a stalled programme forward. Fran Visco and the National Breast Cancer Coalition appear, which is a rare acknowledgement that activists shaped drug development. Nicole's exclusion is the film's most honest scene: eligibility criteria genuinely do keep the sickest and most desperate patients out of trials, and clinicians genuinely cannot bend them. The film also gets right that a drug can be transformative for one biological subgroup and useless for everyone else, and that a cohort of women bonds tightly and does not all survive.

Compression and heroics. Eight years become a brisk narrative driven by one determined man, when trastuzumab emerged from Genentech science as well as UCLA and hundreds of people ran the trials. Patients are composites, so timelines and responses are shaped for effect, and several remain glamorous and lucid deep into metastatic illness. Toxicity is underplayed, notably the cardiac effects that shadow trastuzumab. The story also stops before the September 1998 approval and before the later adjuvant trials in early-stage disease, which is where the drug's largest benefit eventually showed up.

HER2-positive breast cancer causes the same symptoms as any breast cancer: a new lump or thickening in the breast or armpit, a change in size or shape, skin dimpling, a nipple turning inward, nipple discharge, redness or scaling, or persistent pain. HER2 status is not something a woman can feel or a scan can show, and there is no screening test for it. It is determined after a biopsy, by testing tumour tissue with immunohistochemistry and, when the result is borderline, in-situ hybridisation such as FISH. That test result is what decides whether HER2-targeted treatment is offered. Screening for breast cancer itself does exist: the USPSTF recommends mammography every two years for women aged 40 to 74, and NCI notes that screening mammography reduces breast cancer deaths, most clearly between 50 and 69. Trastuzumab was approved by the FDA in September 1998, initially for metastatic HER2-positive disease. The practical point for viewers is that a breast change needs clinical assessment and, if indicated, a biopsy, because treatment now depends entirely on what the tissue testing shows.

A film is not a diagnosis, and a dramatised illness is not a guide to your own. What a story like this is genuinely good for is lowering the barrier to a conversation you might otherwise put off.

If something in your body has changed and stayed changed for a few weeks, that is worth raising with a doctor — not because it is likely to be cancer, but because most of the time it will not be, and finding that out is the point. Where screening exists for a cancer, it is the one thing you can do before anything is wrong at all. See screening and possible warning signs.

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Living Proof is worth watching as a film. It is not a guide to the disease it portrays. The gap between the two is what this page is for — and the thing worth carrying away is that a change which persists is worth a conversation, whatever a story led you to expect.

This page describes a work of film or television for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].