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President Jimmy Carter, Immunotherapy, and the Promise of New Cancer Drugs

22 December 2015

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Former President Jimmy Carter made headlines recently when he announced that a revolutionary cancer treatment, called immunotherapy, had erased his advanced melanoma. A few months prior, Carter announced that he had been diagnosed with the melanoma that had spread from his liver to his brain.

Even just a few years ago, this diagnosis would likely mean a death sentence, especially for someone who, like Carter, is 91 years old. In many cases, the bodies of the elderly cannot tolerate traditional chemotherapy, which comes with strong side effects as it attacks not just cancer cells but a body’s healthy cells as well. Back then, doctors might have advised against any treatment at all due to Carter’s advanced age.

At the time of his announcement he thought he had only weeks to live. “I’m perfectly at ease with whatever comes,” he said then. “I’m ready for anything. I’m looking forward to a new adventure.”

However, his doctors decided he was a good candidate for immunotherapy. In this treatment, patients are infused with a drug (the most prominent drug is called Keytruda) that is delivered intravenously every few weeks. The idea behind immunotherapy is to use the body’s own defenses in fighting the cancer cells. Shripal Bhavsar, M.D., who is a radiation oncologist at the INTEGRIS Cancer Institute, explains what this means.

“It takes the brakes off the immune system,” he says. “Cancer cells are sneaky and can disguise themselves so that our immune system doesn’t recognize them as harmful foreign invaders and won’t attack them. But drugs like this help the immune system recognize the cancer cells so it can destroy them."

Bhavsar goes on to say that he believes immunotherapy is one of the latest and most exciting oncology developments in the treatment of cancer. “I don’t want to overhype one type of treatment, and it’s important to point out that Carter didn’t rely solely on immunotherapy [he also received very targeted radiation therapy for the small lesions in his brain, and surgery to remove the tumor in his liver] but this latest advancement seems to be well tolerated by many and provides substantial benefit. I believe it’s the next frontier in cancer treatment,” he says.

Currently, drugs like Keytruda are being used to treat people with advanced melanoma and some types of advanced lung cancer. But there is evidence that it could work with bladder, colon, kidney and other cancers, too. According to Richard Justik, PharmD, DPh, who is the pharmacy manager at INTEGRIS Cancer Institute, “Immunotherapy continues to be studied in other forms of cancer as well. In the future, it will be interesting to see how immunotherapy will guide cancer treatments," he says. According to a recent Today Show segment on immunotherapy, there are currently 30 types of cancer that are in clinical trials using these exciting new drugs.

One note: the drugs aren’t cheap. According to the Melanoma Research Foundation, the drugs can cost $150,000 a year for multiple infusions. But when looking at melanoma treatment over the years, immunotherapy is one of the biggest advancements made in several decades, according to Louise Perkins, who is the chief science officer of the Melanoma Research Alliance. If a patient is taking the drug for an FDA-approved use, it is likely that insurance will cover many costs associated with administering the drug.

Although experts say it is too soon to say if Carter’s advanced melanoma is “erased,” as he claimed, it is currently undetectable. Thanks to immunotherapy, his prognosis is much more promising than it would have been just a few years ago.