In Jimmy Carter’s cancer treatment, drug could be a game changer

When Jimmy Carter announced in August that cancer had been found in his liver and brain, he said he would “do what the doctors recommend” to try and extend his life.

“I trust them completely,” he said of the team treating him at Emory University’s Winship Cancer Institute.

On Sunday, that trust seemed to have been validated in unexpected, high-profile fashion. While teaching Sunday School at Maranatha Baptist Church in Plains, Carter said his cancer was gone. A few hours later, the Carter Center in Atlanta released a more formal statement in which the former president said his most recent MRI brain scan “did not reveal any signs of the original cancer spots nor any new ones.” It also said he would continue to receive regular treatments of the immunotherapy drug pembrolizumab every three weeks.

The Winship team wasn’t commenting on Sunday, instead deferring to the Carter Center. Meanwhile, several cancer experts not involved in Carter’s treatment stressed that while this didn’t mean he was cured, the news was encouraging.

Carter’s doctors had sounded cautiously optimistic back in August, pointing out that treatment therapies for tumors in the brain had improved dramatically in the past few years. Rather than enduring whole-brain radiation, Carter would be able to have less invasive, more targeted treatments to hone in on the four small melanoma lesions found in his brain. Meanwhile, pembrolizumab, which rallies the body’s own immune system to fight the cancer, was being hailed as a possible game-changer.

One cancer expert who is not involved in Carter’s treatment said Sunday that, generally speaking, advances in radiation treatment of metastatic melanoma in recent years have led doctors to expect such positive results. While the new immuno-therapeutic drugs like pembrolizumab are helping patients in ways never seen before, Dr. Vernon Sondak said the advances in radiation therapy also have made tremendous differences in outcomes for patients.

“In the past, we didn’t have the tools. Usually for a person with metastatic disease in the brain, the person would be dead in a few months,” said Sondak, chair of the department of cutaneous oncology at Moffitt Cancer Center in Tampa. The spread of melanoma to the brain has been one of the disease’s “Achilles heels,” Sondak said.

But now, doctors such as Dr. Walter J. Curran, Jr., the radiation oncologist at Winship Cancer Institute of Emory University who treats President Carter, have much greater ability to precisely administer doses of radiation.

“This may be a miracle, but it’s a miracle happening for a lot of patients around the country and around the world,” said Sondak.

Social media came down heavily on the miracle side Sunday.

“Tempted to say he does so much good God wanted him to stay a little longer,” former CBS News anchor Dan Rather tweeted.

“I gasped when I saw both Jimmy Carter and Morgan Freeman trending, but it turns out it’s just because they are immortal,” Christine Nangle wrote @nanglish.

Doctors stress that not all patients will respond well to treatments. But while no one’s immortal, a Stage IV melanoma diagnosis like Carter’s no longer is tantamount to a death sentence.

Outcomes for the illness began to change as few as five years ago, when drugs that rally the body’s own immune system to fight the disease began to show promise.

And, one of Carter’s physicians at Winship Cancer Institute of Emory University, Dr. David Lawson, happened to be one of several researchers at sites around the country who were studying the effect of these drugs.

These so-called immunotherapeutic drugs have shown great promise in treating melanoma. Lawson was involved in studies that resulted in approval of the drug Yervoy in 2011. Since then, several others also have been approved by the FDA, including pembrolizumab.

Carter was scheduled to receive four treatments at three week intervals starting in late August. He got permission from his doctors to delay the fourth treatment so he could spend a week in Nepal building houses for Habitat for Humanity. But civil unrest in the remote mountain country led to that project’s cancellation; instead, on Nov. 2nd, Carter and his wife, Rosalynn, helped build a Habitat house in Memphis.

During a post-lunch interview, Carter said he’d lost five pounds since starting treatment, but otherwise experienced few side effects. Not going to Nepal had allowed him to get back on schedule for that fourth and final treatment, he said.

A week later, the Carter Center released a statement saying the former president’s doctors had told him that recent tests had shown there was no evidence of new malignancy, and that his original problem was responding well to treatment.