Former president Jimmy Carter announced at a press conference yesterday that he is being treated for metastatic melanoma, the most deadly form of skin cancer. In addition to surgery and radiation, Carter will receive an immunotherapy called pembrolizumab (Keytruda®), one member of a promising class of immune-modulating drugs called checkpoint inhibitors.
These drugs—which have been hailed as “game-changers” in the field of cancer treatment—work by blocking molecules that act like brakes on the immune system. By “releasing the brakes,” checkpoint inhibitors allow a stronger immune attack against cancer. The particular braking molecule blocked by pembrolizumab is called PD-1. Pembrolizumab was approved by the FDA for melanoma less than a year ago.
Carter’s cancer was detected recently in his brain, in four small spots. These spots will be treated with a targeted form of radiation called stereotactic radiosurgery. Carter already had surgery to remove a tumor from his liver.
At 90 years old, Carter is on the older end of the spectrum of patients being treated for metastatic melanoma. But given his otherwise good health, doctors are planning to treat him with curative intent.
Just a few years ago, Carter’s prognosis would have been dire—and it still is obviously quite serious. But immunotherapies are radically changing the treatment odds for patients with metastatic melanoma, including for patients with brain metastases. Many patients with very advanced cancers have seen their tumors melt completely away with immunotherapy, and have remained cancer-free for many years afterward.
Some evidence even suggests that the combination of radiation and immunotherapy may empower the immune system to mount an even more robust and effective attack on the cancer hiding in the body. (Doctors call this the abscopal effect.)
Carter is one of many high-profile figures whose cancer treatment is drawing attention to the emerging field of immunotherapy. The writer Oliver Sacks announced last month that he, too, is being treated with immunotherapy for melanoma.
As the one organization that has supported cancer immunotherapy from the beginning, the Cancer Research Institute (CRI) is immensely gratified to see the approach finally taking hold and making a real difference in the lives of patients. But the work is far from over. CRI is committed to funding much-needed research into immunotherapy, so that more patients will benefit from this powerful approach.