Monday December 7, 2015
By Brady Dennis and David Weigel
Former president Jimmy Carter. (John Amis/Reuters)
Former president Jimmy Carter told a large Sunday school class he was teaching that there are no signs of the cancer in his liver and brain months after his melanoma diagnosis, a family friend in attendance said.“We were very, very surprised,” said Jill Stuckey, who is also a church member at Maranatha Baptist Church in Plains, Ga. “This was just wonderful news out of the blue.”
Stuckey said it began as a typical Sunday. Carter arrived with his wife, Rosalynn, and greeted the roughly 300 people in attendance at his Sunday school class. He then told them that he had received a scan the previous week and that it showed “no signs of cancer.” Those in attendance broke into applause, Stuckey said.
“There were a lot of happy people at the church,” she said. “I went running down the hall and got to spread the news.”A one-sentence statement posted Sunday afternoon on the Carter Center website quoted the former president as saying, “My most recent MRI brain scan did not reveal any signs of the original cancer spots nor any new ones.” He said he would continue to receive regular treatments for the disease.
Carter, 91, had a small cancerous mass removed from his liver on Aug. 12, and shortly afterward doctors found four spots of melanoma on his brain. He has been in treatment since.
“From very beginning [of this], I’ve said that in any battle between cancer and Carter’s brain, Carter’s brain will win,” said Gerald Rafshoon, who has known the former president for half a century and served as his White House communications director. “I’ve been up against that brain. It’s a tough opponent.”
Fans of the former president have been making pilgrimages from across the country to see him teach since he announced that he was being treated for melanoma. His first post-cancer lesson drew drew nearly 1,000 people to a church built for a few hundred, and people slept in their cars as they waited overnight for limited first-come, first-served seats.His doctors reported last month that he was responding well to his treatments and that they saw no evidence of new tumors.
When Carter publicly disclosed his diagnosis in August, he mentioned that he already had received a pembrolizumab, better known as Keytruda, one of the first in a promising new class of drugs aimed at unleashing the immune system to fight cancer cells. The Food and Drug Administration rapidly approved the “breakthrough” drug in 2014 for patients with advanced melanoma who have exhausted other therapies, saying it represented a substantial improvement over existing treatments.
Cancer cells have a striking ability to disguise themselves from the human immune system, which aids their spread. Immune therapies work by essentially pulling back that cloak of invisibility, allowing the body to recognize and attack cancer as it would any other harmful invader. Keytruda, manufactured by Merck, is designed to block a cellular pathway known as PD-1, which hinders the immune system’s ability to attack melanoma cells.
Immune therapies such as pembrolizumab have transformed the treatment — and the outlook — for some cancer patients over the past few years. They quickly have become a cornerstone in the treatment of certain cancers, in addition to long-standing approaches such as surgery, radiation and chemotherapy. The new therapies tend to be expensive — Keytruda costs roughly $150,000 per year — but they have shown remarkable results in some patients. Dozens of studies are underway in hopes of expanding the treatments for broader use in a range of cancers, including bladder cancer, breast cancer and Hodgkin’s lymphoma. Earlier this fall, for example, the Food and Drug Administration approved the use of pembrolizumab in some patients with advanced lung cancer who already had tried other treatments.
More than perhaps any other cancer, melanoma has been transformed by the advent of immunotherapy treatments. The FDA has approved nearly a dozen new therapies for the disease since 2011, half of them aimed at using the body’s immune system to recognize and wipe out the cancer.
While only a portion of melanoma patients have responded to this new generation of treatments, those who do often have shown dramatic, long-lasting responses.Antoni Ribas, a researcher at the University of California at Los Angeles and the lead investigator of a crucial clinical trial of Keytruda, said in an interview Sunday that he was glad to hear of Carter’s apparent response but not surprised. He said that although only about a third of patients with malignant melanoma tend to respond to the treatment, older patients who tend to have melanoma that has many mutations and is related to chronic sun exposure “tend to be the ones who do best.”
In that sense, he said, Carter’s age actually might have worked in his favor.
“The reason is because the immune system has to focus on something that’s different in the melanoma from the normal cells,” said Ribas, who is not familiar with Carter’s case. “The more mutations, the more likely the immune system will figure out there’s something different that needs to be attacked.”
Michelle Boorstein contributed to this report.