Dawn Varrati: Staying Positive and Paying It Forward After a Diagnosis of Cholangiocarcinoma

At 63 years old, Dawn Varrati was navigating life after loss. A longtime Ohio resident, she got married at 37 and spent two joyful decades with her husband before he passed away. She stayed active, surrounded by close friends, some dating back decades, enjoying music, concerts, and lively outings. Life was good, not perfect, but fulfilling and she was looking forward to ongoing adventures with her friends.

Then, one day in July 2021, while grocery shopping with a neighbor, Dawn felt short of breath. “My lips were turning blue,” she remembered. “They called the ambulance, and I remember hearing the sirens, I was holding on, waiting for them to come.” Moments later, she collapsed. “I died right there,” she said.

At the hospital, doctors initially attributed her condition to a previously diagnosed heart valve issue. But while preparing for valve replacement surgery at the Cleveland Clinic, routine preoperative scans found something unexpected on her liver. Further testing confirmed cholangiocarcinoma, also known as bile duct cancer.

Dawn’s first reaction was dread. “You hear the word cancer, and everything else goes blank,” she said. “I thought, ‘This is it, I have to start saying goodbye.’” But her oncologist refused to let her spiral. “It’s not like it used to be,” he told her. “We have options now. We’re going to fight this as aggressively as it’s coming for you.”

Dawn was ready to do what it took to beat the cancer.

“I told him, we’re going to kick cancer’s butt—and he liked that attitude,” she said.

Her initial treatment began with a liver resection—surgeons removed 70 percent of the right lobe. Because the remaining cancer in the left lobe couldn’t be surgically removed without causing liver failure, she underwent targeted radiation therapy. Later, she began several cycles of capecitabine, an oral chemotherapy that left her ill but temporarily cleared the disease.

But her cancer returned.

For the next few years, Dawn cycled through a wide range of treatments—radiation, multiple chemotherapies, and a form of targeted therapy, the latter based on a specific gene mutation. The targeted therapy kept her cancer stable for 11 months before, once again, the disease began to progress.

This time, the outlook was more sobering. Nonetheless, her doctor researched potential options for Dawn. There was an investigational targeted therapy, zanidatamab-hrii, being evaluated in a clinical trial that appeared to be her best, and only, option. “My doctor said, ‘If you don’t have this mutation, there may not be anything left for us to try,’” Dawn recalled.

“He told me I might only have 3 or 4 months. And that was the one time I cried. I thought, ‘This is it.’”

However, Dawn had the biomarker that made her an eligible candidate for the treatment. In the meantime, zanidatamab- hrii (Ziihera) emerged from clinical trials and received FDA approval. Dawn heard back from her physician. “He said, ‘I’ve already checked—your insurance approved it, and I think you’d be a perfect candidate,’” Dawn remembered.

Dawn became one of the first patients in the United States to receive the newly approved therapy outside of clinical trials. “Everyone was watching me during that first infusion,” she said. “I joked, ‘Am I the guinea pig?’ and they said, ‘No—you’re the pioneer.’”

Dawn began treatment in early December 2024. Since then, she’s experienced virtually no side effects beyond a
manageable steroid-induced glucose spike, which is controlled through her endocrinologist. Her bimonthly infusions take just an hour. “I go in, get it, and feel great,” she said.

Follow-up scans show that her tumors are shrinking. “All I look for now is no new masses and stable disease,” she laughed. “If it says that, I’m good.”

Dawn is deeply religious and credits her faith—and her doctor’s relentless optimism—for keeping her alive. “He said, ‘You never gave up, so I never will either,’” she recalled.

Now 67, Dawn is committed to paying it forward. She serves as a mentor in Cleveland Clinic’s 4th Angel Mentoring Program, supporting other patients with cholangiocarcinoma. “They call me when someone needs help—some people talk to you once, some every day,” she said. “They ask about test results, about how I felt, what I went through. It’s a privilege to be there for them.”

She’s also a powerful advocate for federal investment in cancer research. “Every single option I have had was
because of clinical trials,” she said. “We cannot do any of this without funding. People need hope. And that only comes from research.”

To policymakers, she is direct: “We need the money. Period. You want to change the cancer story for millions of people? Fund the science. Fund the trials. Give us something to hold onto.”

You want to change the cancer story for millions of people? Fund the science. Fund the trials.