In August, former President Jimmy Carter announced that he was being treated for melanoma, a skin cancer that had spread to his liver and brain. Now, Carter says that his latest brain scan shows no sign of cancer spots.
This is not necessarily a “cure,” but it’s hard to imagine a more striking illustration of recent progress on treating malignant melanoma, once considered an imminent death sentence.
We sought some perspective from Dr. Elizabeth Buchbinder, a melanoma specialist at the Dana-Farber Cancer Institute.
Jimmy Carter says there’s no cancer showing up on his MRI. What does that mean?
EB: It’s incredibly exciting. It basically means that the lesions that were seen there before have resolved or disappeared or whatever term you’d like to use. And so it’s a great response. It’s what we would call a complete response on imaging, which is really really excellent, obviously.
The issue becomes this: We have limits to what our imaging can see. So we never know that there’s no cancer anywhere. But we know that there is none we can detect, which is very exciting. So all the cancer that we could see previously is now no longer detectable.
What does that mean happened biologically?
Biologically, he had a couple things happen, because he got radiation, which damaged his cancer, and he got [the drug] Keytruda. And what the Keytruda did is it turned on the immune system to act against those tumors. So the immune system then attacks and basically gets rid of cancer cells. And so very likely his immune system got turned on, attacked those cancer cells, eradicated what was there, and hopefully is continuing to eradicate anything we can’t see, and it now recognizes the cancer as something that it needs to get rid of.
When you have a great response like this, is it likely to remain so great?
“We’re really seeing a lot of people who are living a long, long time with either minimally detectable or no detectable cancer.”
Very likely. With immune therapy in particular, and even going back to some of the earliest immune therapies that we have used, such as an older one called Interleukin 2 — when it’s used, if you have a complete response and no longer have any detectable cancer, the chances of that continuing are much much higher than if you just see a little bit of shrinkage, or some degree of shrinkage but can still detect cancer. So chances are very, very good that Jimmy Carter will continue to do well going forward and not have trouble with cancer in the future. We can never say 100 percent, but this is definitely a very good response.
I imagine you now need to throw a bit of cold water on all the people who will call and say ‘I want what he got.’ What would you say to those patients? Continue reading