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Jimmy Carter's treatment underscores importance of immunotherapy

Immunotherapy
Former President Jimmy Carter has become a symbol of hope and resilience during his fight against stage IV melanoma, and now, his openness has shed important light on the emerging science around immunotherapy.

Sometimes it takes a national news event to shine an important light on key developments in cancer care and treatment. Such was the case last week, when former President Jimmy Carter announced he began targeted radiation and immunotherapy treatments for metastatic cancer that spread to his brain. The world-renowned peacemaker has become a symbol of resilience during his fight against stage IV melanoma, and now, his openness has shed light on the emerging science around immunotherapy. 

It has been reported that President Carter is taking pembrolizumab, an immunotherapy drug approved last year by the U.S. Food and Drug Administration. The therapy, designed to clear the way for T-cells to locate and destroy hidden cancer cells, is typically used on metastatic cancer patients who are ineligible for surgery and have exhausted other immunotherapy treatments.

Dr. Glen Weiss, a Medical Oncologist and the Director of Clinical Research at our hospital outside of Phoenix, calls immunotherapy “one of the most exciting aspects of cancer therapy to date.” Putting it in layman’s terms, Dr. Weiss says the immune system works like an alarm that is triggered into action by a foreign invasion of some kind, like an infection. In some cancer patients, the alarm system malfunctions and fails to alert the immune system that cancer cells are present and developing within their body.

Immunotherapy helps balance the playing field by using a monoclonal antibody like pembrolizumab, to jumpstart the faulty alarm system and trigger the immune system to attack the cancer cells, Dr. Weiss explains.

While immunotherapy marks significant progress in the fight against disease, it has limitations and drawbacks. The regimen “doesn’t work for everyone,” or for all cancer types, Dr. Weiss says. Like many treatments, immunotherapy also comes with specific side effects; most commonly these may include rash, nausea, diarrhea, fatigue, and cough. A number of integrative care services, ranging from nutritional therapy to naturopathic medicine, may help relieve these symptoms. A recently rebooted immune system may also become overzealous and indiscriminate, attacking healthy and cancerous cells alike. Such risks may be managed with medication designed to dull the immune response.

Dr. Maurie Markman, President of Medicine & Science at Cancer Treatment Centers of America® (CTCA), explains that immunotherapy side effects may differ from reactions to chemotherapy drugs, but they can still prove disruptive. Overall, however, he says, “the drugs may be better tolerated than chemotherapy.” President Carter may experience similar side effects, but Dr. Markman emphasizes that his reaction likely will have more to do with the 90-year-old’s body chemistry than his advanced years. “I focus on the whole patient, not their age,” Dr. Markman says. “I wouldn’t exclude a patient from receiving therapy that could be beneficial to them.”

There is no age “cut-off” for any type of cancer treatment, he says, adding that President Carter’s outlook and the example he is setting for other cancer fighters are likely to resonate with the cancer community. “He’s extremely inspiring—his approach to his illness, dealing with it with resolve, yet reason,” Dr. Markman says. “He can be a poster child for treatment.”

Learn more about immunotherapy and its role in fighting cancer.