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Having money & risking off label drugs brings cure.
Former President Jimmy Carter's extraordinary announcement that he is cancer-free surprised me in the most pleasant way.
The key word is “surprised” because, even though I'm delighted for Carter and his family, I had feared we'd read his obituary in coming months.
Carter, 91, announced this summer that he has a dangerous form of melanoma that spread to his brain and his liver. Last week, however, Carter said his “most recent MRI brain scan did not reveal any signs of the original cancer spots, nor any new ones.”
Who would have thought it? First he told us he has one of the deadliest cancers and reminisced about his wonderful life and, just like that, the cancer is gone? Is this a medical miracle? I asked myself.
All eyes suddenly have turned to Carter's treatment and a new immunotherapy drug, pembrolizumab, which doctors at Emory University's Winship Cancer Institute are using to treat him.
The very expensive drug, better known as Keytruda, is among the first of a promising class that makes the patient's immune system do the fighting against cancer. The Food and Drug Administration approved it last year with some restrictions. The cost: about $12,500 a month, or about $150,000 a year, according to The Wall Street Journal.
Carter's good fortune with the drug, made by pharmaceutical giant Merck, made me wonder: Are we on the throes of a medical breakthrough? Is pembrolizumab a cure-all for patients with advanced melanoma?
“We cannot use the word cure,” Dr. Ahmad Tarhini, a melanoma expert at the UPMC CancerCenter, told me. “Cure means that there are no traces of cancer and that it will never come back. Only time will tell.”
Yet Tarhini is highly optimistic about immunotherapy drugs, which are being tested on advanced cancers of the lung, colon and other organs. He wasn't surprised when he heard about Carter. Patients like him, with stage 4 melanoma, have the worst prognosis of all melanoma patients. In the past, they were treated with radiation and experienced a relapse of their disease within months.
The new drug is different because, unlike traditional chemotherapy, it prompts the body's immune system to battle harder against cancer cells. The immune system has the capacity to develop immune memory that may prevent the cancer from coming back, Tarhini said.
The drug, he said, gives us hope that we may end up with a “meaningful, durable response that could go on for years.”
The emphasis here is on the word hope, of course. Because when it comes to cancer, you can't take away hope from the complex treatment equation of surgeries, drugs and radiation. Hope, in many cases, is a better medicine than all those treatments combined.
There's one other aspect about Carter's case that will resonate with many cancer patients. His doctors' use of the drug was considered “off-label” because the FDA approved it only for patients with advanced melanoma who have exhausted other therapies. Carter did not fit that criteria because he had not been given other drugs. That's not necessarily a bad thing. His doctors took a risk, however calculated, to give him a chance at a few more years of life. The risk worked.
No one knows how Carter will fare in the end. As Tarhini told me, “only time will tell” how well these drugs perform. Problem is, sometimes cancer patients have no time to waste.
The key word is “surprised” because, even though I'm delighted for Carter and his family, I had feared we'd read his obituary in coming months.
Carter, 91, announced this summer that he has a dangerous form of melanoma that spread to his brain and his liver. Last week, however, Carter said his “most recent MRI brain scan did not reveal any signs of the original cancer spots, nor any new ones.”
Who would have thought it? First he told us he has one of the deadliest cancers and reminisced about his wonderful life and, just like that, the cancer is gone? Is this a medical miracle? I asked myself.
All eyes suddenly have turned to Carter's treatment and a new immunotherapy drug, pembrolizumab, which doctors at Emory University's Winship Cancer Institute are using to treat him.
The very expensive drug, better known as Keytruda, is among the first of a promising class that makes the patient's immune system do the fighting against cancer. The Food and Drug Administration approved it last year with some restrictions. The cost: about $12,500 a month, or about $150,000 a year, according to The Wall Street Journal.
Carter's good fortune with the drug, made by pharmaceutical giant Merck, made me wonder: Are we on the throes of a medical breakthrough? Is pembrolizumab a cure-all for patients with advanced melanoma?
“We cannot use the word cure,” Dr. Ahmad Tarhini, a melanoma expert at the UPMC CancerCenter, told me. “Cure means that there are no traces of cancer and that it will never come back. Only time will tell.”
Yet Tarhini is highly optimistic about immunotherapy drugs, which are being tested on advanced cancers of the lung, colon and other organs. He wasn't surprised when he heard about Carter. Patients like him, with stage 4 melanoma, have the worst prognosis of all melanoma patients. In the past, they were treated with radiation and experienced a relapse of their disease within months.
The new drug is different because, unlike traditional chemotherapy, it prompts the body's immune system to battle harder against cancer cells. The immune system has the capacity to develop immune memory that may prevent the cancer from coming back, Tarhini said.
The drug, he said, gives us hope that we may end up with a “meaningful, durable response that could go on for years.”
The emphasis here is on the word hope, of course. Because when it comes to cancer, you can't take away hope from the complex treatment equation of surgeries, drugs and radiation. Hope, in many cases, is a better medicine than all those treatments combined.
There's one other aspect about Carter's case that will resonate with many cancer patients. His doctors' use of the drug was considered “off-label” because the FDA approved it only for patients with advanced melanoma who have exhausted other therapies. Carter did not fit that criteria because he had not been given other drugs. That's not necessarily a bad thing. His doctors took a risk, however calculated, to give him a chance at a few more years of life. The risk worked.
No one knows how Carter will fare in the end. As Tarhini told me, “only time will tell” how well these drugs perform. Problem is, sometimes cancer patients have no time to waste.
I do agree disgusting and unhuman
public health care of some countries in europe covers not only off label but also experimental treatments
this said if you have brains and money you dont even check for the drugs you get a lab to make it for you and researchers to cure....the very welthy are on a different level but of course having money only is useless on this
public health care of some countries in europe covers not only off label but also experimental treatments
this said if you have brains and money you dont even check for the drugs you get a lab to make it for you and researchers to cure....the very welthy are on a different level but of course having money only is useless on this
Happy for former president Carter could get proper treatment. I wish every patient could have that opportunity. Health insurance is business in USA. I believe no other country in the world does that horrible health care system.
Hope we Hbver's will take an advantage of drugs like Replicor & others on the pipeline.
1 Comments
Unfortunately most of us "normal people" will not be able to afford off label drugs like former President Carter was able to, since at least in the US, insurance only covers FDA approved medication for a specific dignosis. Also, his cancer spread to his liver (did not start with liver cancer) which made his treatment different than say us with HBV primary HCC. Pretty amazing at 91. We could all be so lucky, but know government and former presidents get the best of care and fast.
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