Former US President Jimmy Carter appeared relaxed and even made the joke from time to time when he publicly announced yesterday he melanoma that has spread to his liver and brain. The 0-year-old hoped it had advantages, as many are these days, advanced therapies that help the immune system to destroy cancer cells. (These treatments have exceeded Science 'Breakthrough of the year in 2013) Melanoma in some patients, was the first cancers to succumb to any of these immunotherapies, and specific treatment Carter takes has many oncologists excited: There is a monoclonal antibody called pembrolizumab Keytruda and sold under the brand name. Approved in the US there is a year for advanced melanoma, pembrolizumab belongs to a class of drugs called hot PD-1 inhibitors. By blocking PD-1 protein, the therapy enables the body to produce T cells that can chase after cancer.
Yet researchers have much to learn about pembrolizumab and other PD-1 therapies in development. Keytruda is also extremely expensive, about $ 150,000 per year. In clinical trials, PD-1 blockers generally work in less than half of the participants (see here and here). A study published earlier this year suggested that PD-1 inhibitors may work better in tumors with many mutations, and a small pembrolizumab clinical trial supported this. It found that people with advanced cancer were much more likely to respond if they had supposedly mismatch repair mutations in their tumors. This could also help explain why, so far, PD-1 inhibitors have produced the best results in people with lung cancer and melanoma, both are often heavy mutation of tumors.
What does all this mean for individual patients such as cancer Carter is still uncertain. "I had a wonderful life," he said in a conference television news from the Carter Center in Atlanta, with a grin. "I'll be ready for whatever comes."
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