“I’ve had a wonderful life,” Jimmy Carter told reporters in August 2015, after announcing that his melanoma had traveled into the liver and brain. “I feel that it’s in the hands of God and my doctors, and I’ll be prepared for anything that comes.” He was 90. A person in his position was unlikely to live more than six months.
Carter lived to 100. NBC News reported when he died that doctors credit one thing above others for changing the odds of that diagnosis: immunotherapy, and the very public example he set with it.
What he was treated with
Four small spots of disease, about 2 mm each, had turned up on his brain, CURE reported at the time. He began radiation that afternoon. He also said he would take pembrolizumab, sold as Keytruda, by intravenous infusion every three weeks. The drug is an antibody that disables a protein called PD-1, so that immune T cells grow more active in recognizing and attacking cancer.
The field was young. The FDA approved the first immunotherapy drug, Yervoy, in 2011, and Keytruda was cleared in 2014. Before them, said Dr. Amod Sarnaik of Moffitt Cancer Center, melanoma had seen no new approach in decades. “It was a rather depressing time,” he said.
The “Carter effect”
Doctors say his openness mattered. Sarnaik told NBC News that without what happened to Carter, “I don’t think that we would be talking about immunotherapy in the national domain.” Dr. Adam Friedman of George Washington University said Carter’s outcome “would have been considered a miracle just 15 to 20 years ago,” and that the “Carter effect” spawned “a new era of hope for patients who would ordinarily be hopeless.”
Carter’s own recovery had other ingredients too. He had surgery and radiation, some of the finest cancer specialists anywhere, and a strong faith.
What it means for patients now
Dr. Michael Davies of MD Anderson Cancer Center counts at least 15 new approvals for stage 4 melanoma since Carter was diagnosed. Immune therapies are sometimes combined with other drugs or surgery, and used earlier in the disease. They now treat lung, breast, endometrial, and head and neck cancers, plus a few uncommon colon cancers. Dr. Suresh Ramalingam of Emory’s Winship Cancer Institute, where Carter was treated, said studies in pancreatic cancer are under way.
Long-term numbers back it up. In September 2024, Merck presented ten-year follow-up from the KEYNOTE-006 trial. Among patients with advanced melanoma, 34.0% treated with Keytruda were alive at 10 years, compared with 23.6% of those on ipilimumab. The risk of death fell 29% with the drug, and median survival was 32.7 months against 15.9 months.
Dr. Caroline Robert of Gustave Roussy called the results remarkable and noted a 30% reduction in melanoma mortality compared to a decade earlier.
Sources
- The 'Jimmy Carter drug': What is immunotherapy and how does it treat cancer? (NBC News, Erika Edwards)
- Jimmy Carter Provides Update on His Health, Says He Has Melanoma (CURE, Andrew J. Roth)
- Ten-Year Data for Merck's KEYTRUDA Demonstrates Sustained Overall Survival Benefit Versus Ipilimumab in Advanced Melanoma (Merck)
