Nine years ago, Jimmy Carter held a news conference at the Carter Center in Atlanta to discuss his cancer diagnosis and treatment. At the age of 91, Carter shared that a severe cold in May had prompted a comprehensive medical examination, leading to a melanoma diagnosis in August 2015—a form of skin cancer that poses significant risks. He underwent liver surgery that month, and doctors discovered four spots where the cancer had spread to his brain.
If his diagnosis had occurred a few years earlier, he would have had a prognosis of about six months to live. However, on Tuesday, the former president celebrates his 100th birthday.
Experts agree that luck played a role in Carter’s longevity, but they credit the immune therapy he received as a key factor in his survival. Dr. Stephen Hodi, who leads the Melanoma Center at Dana-Farber Brigham Cancer Center, described Carter as a “poster child for immune therapy,” highlighting how his case illustrated many complexities faced by patients.
At the time of Carter’s treatment, immunotherapy was still emerging as a promising tool against cancer. Four years prior, the FDA had approved the first checkpoint inhibitor, ipilimumab. Carter received pembrolizumab, which had been authorized just the year before.
Today, these immunotherapies are crucial components of cancer treatment alongside surgery, chemotherapy, and radiation, benefiting not only melanoma patients but those with various other cancers as well.
Dr. David Lawson treated Carter with pembrolizumab, noting that at 91, Carter remained remarkably healthy and resilient. During the August 20 news conference, Carter expressed concern that his treatment might hinder a planned humanitarian trip to Nepal.
Lawson emphasized that he aimed to treat Carter just like any other patient. He stopped the pembrolizumab after six months—shorter than the usual two-year course—since the former president was responding well and had interactions with many people, leading Lawson to be cautious about maintaining Carter’s immune strength.
Carter’s treatment coincided with initial explorations into how effective these therapies could be for patients with brain metastases. Research has since indicated that many with such conditions can benefit from checkpoint therapy. Hodi noted that today, he would likely administer both pembrolizumab and ipilimumab to most patients facing similar challenges.
While doctors often consider age when determining treatment plans, Dr. Antoni Ribas mentioned that checkpoint inhibitors can be effective even for patients in their 90s, demonstrating that the immune system remains potent throughout life. Nevertheless, older patients are more likely to take breaks from medication if they experience side effects.
Carter’s treatment included surgery and radiation for the tumors in his brain, but experts agree that without pembrolizumab, he would not have lived much longer than six months. Ribas pointed out that the life expectancy for individuals with liver and brain metastases, even with radiation and surgery, is typically measured in months.
The key function of checkpoint inhibitors like pembrolizumab and ipilimumab is to reactivate the immune response against cancer cells. Research suggests that about half of melanoma patients respond favorably to immunotherapy, with survival rates improving significantly compared to previous treatment options.
For doctors dedicated to cancer treatment, Carter’s long-term survival serves as a testament to the progress made in combating this disease. As Hodi put it, Carter’s story is “fantastic” and a cause for celebration.
Reflecting on his most notable patient, Lawson expressed admiration for Carter as a remarkable individual and wished him a happy birthday with hopes for many more to come.