Jimmy Carter and His ‘Breakthrough’ Cancer Drug

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Former president Jimmy Carter, who announced Thursday he has melanoma that had spread to his liver and brain, is being treated with two cutting-edge therapies that offer new hope to the 76,000 Americans diagnosed annually with this type of cancer.

Carter, 90, explained in a news conference at the Carter Center in Atlanta that melanoma — most commonly occurring as skin cancer, but which can also cause internal tumors — had formed a mass in his liver, as well as four very small tumors in his brain.

The liver tumor was removed during surgery at Emory University, where doctors also will use targeted radiation on Carter’s brain tumors and injections of a medication the Food and Drug Administration designated as “breakthrough therapy” and fast-tracked for approval less than a year ago.

The drug, called Keytruda (pembrolizumab), is “one of the most exciting advances in the treatment of melanoma,” said Keith Black, M.D., chairman of the department of neurosurgery at Cedars-Sinai Medical Center and an expert in brain cancer and immunotherapy.

Immunotherapy drugs use the body’s own immune system to fight cancer by “supercharging” its T cells to fight and kill tumors. Melanoma tumors, in particular, “have gotten some of the best results” with these drugs, Black said. They also cause fewer side effects than more traditional chemotherapy. Carter already has been given one intravenous injection of the drug.

Five years ago, the prognosis for someone with advanced melanoma in the brain and liver would have been very poor, surgical oncologist Jeffrey Gershenwald, medical director of the Melanoma and Skin Center at MD Anderson Cancer Center in Houston, told the New York Times. But, he said, “clearly the advances in the last four years are tremendous, so we’re offering new hope to patients like President Carter.”

Carter also is being treated with targeted radiation therapy for his brain tumors, which aims precisely focused radiation beams at the tumor site and avoids radiation of the entire brain, which can damage healthy tissue, Black said. Carter will undergo four radiation treatments at three-week intervals.

Melanoma is a type of cancer that starts in the cells that give skin its pigment, but as it advances, it typically spreads via the blood to lungs, liver and brain. Skin cancer is the most common cancer in the U.S., according to the Centers for Disease Control and Prevention, and melanoma is its deadliest form. About 9,700 Americans will die from it this year.

The 39th president said he had been monitoring elections in Guyana in May when he began to feel unwell. He returned to Atlanta and his cancer was discovered during a physical exam. In August, following a promotional tour for his latest book, A Full Life: Reflections at Ninety, he underwent surgery to remove about 10 percent of his liver.

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When a scan also revealed the brain tumors, Carter initially thought he had “just a few weeks left.” But, he added, “I was surprisingly at ease. I’ve had a wonderful life, I’ve had thousands of friends, and I’ve had an exciting and adventurous and gratifying existence.”

In an interview with AARP in June, Carter was similarly sanguine when asked about the future: “I know that there’s going to come a time in the near future when I can’t be so vigorous and travel around the world. So we’re prepared for that — and we’re obviously prepared, I’d say in a religious way and psychological way, for inevitable death.”

Photo: Jessica McGowan/Getty Images

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