James “Jimmy” Carter, the 39th President of the United States, passed away last week on December 29, after 22 months in Hospice care. At his death, Carter holds the title of the longest-lived President.
Carter grew up in Plains, Georgia, and graduated from the United States Naval Academy in 1946; after serving as a Georgia State Senator, Carter was elected Governor of Georgia in 1971. In the 1974 Presidential election, Carter beat incumbent Republican Gerald Ford.
According to the White House, Carter’s presidency was marked by significant job gains and a reduction in the budget deficit. The Carter administration heralded domestic achievements, including the establishment of a national energy policy, civil service reform, and a significant expansion of the national park system. Carter's legacy also includes the record number of women appointed to government jobs and increased representation of Black and Hispanic minorities.
In 2015, at the age of 90, Carter publicly shared his cancer diagnosis of stage IV melanoma with metastasis to the brain. This was a significant moment, as it demonstrated that even at an advanced age, successful cancer treatment was possible. Carter began a novel treatment regimen, including radiation and pembrolizumab, an immune checkpoint inhibitor targeting programmed death-1 (PD-1) proteins found on immune cells.
Speaking at a press conference on August 20, 2015, Carter talked about his treatment to the public with unprecedented detail. This was a significant moment, as it not only provided insight into his personal journey but also raised awareness about cancer and its treatment. Carter explained a personalized mask fitting to ensure that his head remained still, allowing radiation to hit the precise locations with spots on his brain. He also shared that he received a thirty-minute infusion of pembrolizumab, a very novel immunotherapy at the time.
Merck produces the drug pembrolizumab (trade name KEYTRUDA®). On September 4, 2014, the FDA approved pembrolizumab for second-line treatment of melanoma, making it the first immune checkpoint inhibitor approved for use in the United States. On December 18, 2015, the FDA expanded the use of pembrolizumab to include first-line treatment for metastatic melanoma.
Notably, just about four months after Carter began treatment, he announced a clean brain scan showing no signs of cancer.
President Carter’s successful treatment with pembrolizumab is a testament to the drug's potential. Pembrolizumab effectively eliminated metastatic tumor cells that had spread into the brain, a particularly challenging area to treat due to the blood-brain barrier. Carter's experience demonstrates the wide-ranging benefits of pembrolizumab, as he received the treatment with no reported adverse effects at an advanced age when harsher treatments, like chemotherapy, may not even be attempted.
Sources: White House, AP, Today, NBC News, Carter Center (2015), Carter Center (2015), Carter Center (2024)
