How Jimmy Carter, the longest-lived US President, beat cancer: The treatment that extended his life

Jimmy Carter , the longest-lived US President has passed away at the age of 100 in his home in Plains, Georgia, announced The Carter Center announced. Just under three months ago, Carter celebrated his 100th birthday. Carter spent 22 months in hospice (February 2023) before breathing his last on December 29, Sunday. The 39th president of USA survived a long battle with cancer. At the age of 91, he came to know that his melanoma cancer had spread to his brain. While he thought he had just a few weeks to live, a promising therapy extended his life by many years. His melanoma was discovered during surgery to remove a small mass in his liver, however the disease had spread to other parts of his body, including four "very small" spots in his brain.

However a new treatment at the time - Keytruda , an immunotherapy , along with surgery, and chemotherapy worked very well for him. Few months into the therapy, Carter declared himself cancer-free, however his health woes escalated after a fall in 2015 post which he faced troubles with his vision and mobility due to which he was unable to travel.

Here's all you need to know about the treatment that helped Carter become cancer-free

What is immunotherapy?

It is a type of cancer treatment that helps immune system to fight cancer, according to the National Cancer Institute . The many kinds of immunotherapy that's used to treat cancer include immune checkpoint inhibitors , T-cell transfer therapy , monoclonal antibodies, treatment vaccines, and immune system modulators.

Former President Carter underwent 'checkpoint blockade' immunotherapy which is essentially a treatment that cuts off molecular breaks which usually keep our immune system under control.

"The idea is that by cutting off these molecular breaks, we let the immune system run at a higher level than it otherwise could, and therefore overcome some of the ways in which cancer can cloak itself from the immune system," Dr. Jedd Wolchok, director of the Meyer Cancer Center at Weill Cornell Medicine, told People in an earlier interview.

Carter’s melanoma was then treated with immunotherapy drug pembrolizumab, which got approved by FDA the previous year.

Wolchok told the publication that survival time for brain metastases which Carter suffered from was six and a half months. He required six months of treatment to recover and remained cancer-free till the very last.

“President Carter has been off treatment for many years, and I think that's an advantage of immunotherapy because the drugs are not directly targeting the tumor cells. The drugs are actually enabling immune cells to do the heavy lifting and controlling the cancer,” he had said in an interview few months back.

“So if the drugs are working well, you shouldn't need to continue them for very long periods of time because the job of the medicines is to really invigorate the immune cells and recognize the cancer in a more forceful way. We know that the immune system has a memory and it remembers those educating events for decades. Now, it is true of course, that the immune system can become less effective as we get older, but thankfully we have seen that this kind of treatment can help people even when they reach an advanced age,” Wolchok added.

What is the purpose of immunotherapy?

The immune system naturally detects and destroys abnormal cells, often curbing cancer growth. Tumor-infiltrating lymphocytes (TILs) found in and around tumors indicate an immune response, and their presence is linked to better outcomes. However, cancer cells can evade immune detection by altering their genetics, turning off immune cells, or disrupting the surrounding environment. Immunotherapy enhances the immune system's ability to fight cancer more effectively.

Types of immunotherapy

Here are some types of immunotherapy as per National Cancer Institute

Immune checkpoint inhibitors: These are drugs that block immune checkpoints. These checkpoints are a normal part of the immune system and keep immune responses from being too strong. By blocking them, these drugs allow immune cells to respond more strongly to cancer.

T-cell transfer therapy: It is a treatment that boosts the natural ability of the T cells to fight cancer. In this treatment, immune cells are taken from your tumor. Those that are most active against your cancer are selected or changed in the lab to better attack the cancer cells, grown in large batches, and put back into the body through a needle in a vein.

Monoclonal antibodies

: These are immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be better seen and destroyed by the immune system. Such monoclonal antibodies are a type of immunotherapy.
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