Jimmy Carter's Melanoma Drug
All those new drugs that end in "ab"
(which stands for antibody)
are hard to rhyme
for someone with any mental flab
or a brain made a bit ragged by time
like mine.
But for an even worse
poetic curse
try Pembrolizumab (formerly MK-3475)
now being used to keep Jimmy Carter alive
and, with some luck, help the ex-President thrive
with odds something like one in three
that he may make even further past ninety.
Meanwhile, like some stealthy intruder
those in the "Name Department" at Merck
now use the more euphonious "Keytruda"
to dramatize this drug with which they work.
Still , as Juliet said to Romeo,
Act Two, Scene Two,
they say, "What's in a name?"
So, they'll try to assure you
that if you've got the dough
and promise doctors not to blame
should something go astray,
they may be "ab"le to put your cancer in slo-mo
at (only?) $12,500 per month
to live perhaps many another day
which, though it might make one sad
I suppose isn't TOO bad
at least as far as ex-Presidents go.
And now they're trying it on lungs with "non small cell carcinoma"
which you may not need a medical diploma
to realize that it's much more common than melanoma
for it's something that both non-smokers or ex-smokers can get
with, or sometimes even without, that vicious cigarette.
Though for now, the results aren't entirely sure,
it may also work and then all bets are off.
How long will our society be able to fund a possible cure
for all the troubles arising from such a VERY expensive cough?
HZL
8/21/15
JULIET
From: hzlehrer@hotmail.com
To: hzlehrer@hotmail.com
Subject: Carter's Melanoma
Date: Fri, 21 Aug 2015 05:11:44 -0400
'Tis but thy name that is my enemy.
Thou art thyself, though not a Montague.
What’s Montague? It is nor hand, nor foot,
Nor arm, nor face, nor any other part
Belonging to a man. O, be some other name!
What’s in a name? That which we call a rose
By any other word would smell as sweet.
So Romeo would, were he not Romeo called,
Retain that dear perfection which he owes
Without that title. Romeo, doff thy name,
And for that name, which is no part of thee
Take all myself.
UPDATED: Merck's melanoma 'game-changer' Keytruda ...
www.fiercepharma.com/story/mercks...keytruda...pricing.../2014-09-05
Treatment of Advanced Non-Small Cell Lung Cancer (NSCLC)
www.mercknewsroom.com › News Releases › Corporate News
Apr 19, 2015 - Treatment of Advanced Non-Small Cell Lung Cancer (NSCLC) withKEYTRUDAFDA gives priority review for Keytruda in lung cancer - PMLiVE
www.pmlive.com/.../fda_gives_priority_review_for_keytruda_in_lung_...
Jun 3, 2015 - Merck & Co rounded off a busy ASCO conference with the news that its checkpoint inhibitor Keytruda has been granted a priority review by the ...
Pembrolizumab (formerly MK-3475 and lambrolizumab, trade name Keytruda[1]) is a drug marketed by Merck that targets theprogrammed cell death 1 (PD-1) receptor.[2] The drug is intended for use in treating metastatic melanoma.[3][4]
Pembrolizumab was invented by Gregory Carven, Hans van Eenennaam and John Dulos at Organon Biosciences which later became Schering Plough Research Institute and then Merck & Co.[5] MRC Technology humanized the antibody pembrolizumab for Organon in 2006.
On September 4, 2014 the US Food and Drug Administration (FDA) approved pembrolizumab under the FDA Fast Track Development Program. It is approved for use following treatment with ipilimumab, or after treatment with ipilimumab and a BRAF inhibitor in advanced melanoma patients who carry a BRAF mutation.[6]
Clinical trials[edit]
A large phase I trial led to response rates of 37-38% in patients with advanced melanoma and an overall response rate of 26% in patients who had progressive disease after treatment with ipilimumab.[7]
The drug is in Phase II clinical trials for non-small-cell lung cancer (NSCLC) in patients with oligometastatic disease.[8]
See also[edit]
References[edit]
- ^ "Statement on a Nonproprietary Name Adopted by the USAN Council" (PDF). November 27, 2013.
- ^ Pollack, Andrew (May 29, 2015). "New Class of Drugs Shows More Promise in Treating Cancer". New York Times. Retrieved May 30, 2015.
- ^ Hamid, O; Robert, C; Daud, A; Hodi, F. S.; Hwu, W. J.; Kefford, R; Wolchok, J. D.; Hersey, P; Joseph, R. W.; Weber, J. S.; Dronca, R; Gangadhar, T. C.; Patnaik, A; Zarour, H; Joshua, A. M.; Gergich, K; Elassaiss-Schaap, J; Algazi, A; Mateus, C; Boasberg, P; Tumeh, P. C.; Chmielowski, B; Ebbinghaus, S. W.; Li, X. N.; Kang, S. P.; Ribas, A (2013). "Safety and tumor responses with lambrolizumab (anti-PD-1) in melanoma". New England Journal of Medicine 369 (2): 134–44. doi:10.1056/NEJMoa1305133.PMID 23724846.
- ^ Duek, Nechama (June 9, 2014). "Israeli-American team unveils revolutionary drug in fight against skin cancer". ynetnews.com. Retrieved June 2015.
- ^ US 8952136 Antibodies to human programmed death receptor PD-1
- ^ "FDA Approves Anti-PD-1 Drug for Advanced Melanoma". cancernetwork.com.
- ^ Sharma, Pamanee; Allison, James P. (April 3, 2015). "The future of immune checkpoint therapy". Science. doi:10.1126/science.aaa8172. Retrieved June 2015.
- ^ Press release, "Penn Medicine's New Immunotherapy Study Will Pit PD-1 Inhibitor
From: hzlehrer@hotmail.com
To: hzlehrer@hotmail.com
Subject: Carter's Melanoma
Date: Fri, 21 Aug 2015 05:11:44 -0400
Former president Jimmy Carter reveals that his cancer has spread to his brain during a news conference at the Carter Center in Atlanta on Aug. 20. (AP)
Jimmy Carter spoke plainly when he said Thursday that doctors had found “four spots of melanoma” on his brain. The 90-year-old former president was relaxed and matter-of-fact as he talked about the uncertainty he faces. “I’m perfectly at ease with whatever comes,” he said.
Flanked by family members and friends at a news conference at the Carter Center in Atlanta, he detailed the treatments that he has already begun and will continue in coming weeks, including radiation and the IV infusions of a new type of anti-cancer drug that tries to harness the body’s immune system to fight the disease.
The brain lesions, each no larger that 2 millimeters, were discovered after an Aug. 3 operation at Emory University to remove a tumor from his liver. During the surgery, Carter said, doctors suspected that the cancer had originated in another part of his body and performed full-body scans.
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When he found out he had brain cancer, he said, “I just thought I had a few weeks” but “didn’t go into an attitude of despair.” He called the recent events a “new adventure.”
Carter did not discuss his prognosis, other than to say that he had radiation treatment scheduled for later Thursday. His office said he could undergo additional treatments if needed. The former president added that several members of his immediate family — his brother, two sisters, mother and father — all died of cancer.
Jeffrey Gershenwald, the medical director of the Melanoma and Skin Center at MD Anderson Cancer Center in Texas, said that, historically, a melanoma patient diagnosed with metastases in the liver and brain would face a very poor prognosis.
“When caught in [such an] advanced stage,” said the surgical oncologist, who is not involved in Carter’s care, “we measure median survival in months, not years.” But he said that Carter has far more options now than he would have had even a few years ago.
Carter said he is receiving one of the newest drugs in the anti-cancer arsenal, pembrolizumab, better known as Keytruda. The drug, the first in a promising new class of medications called immunotherapy, has been on the market for 11 months.
Carter’s melanoma was diagnosed after he fell ill with “a very bad cold” in May during a trip to Guyana to monitor elections there. He returned to Atlanta early, and doctors performed a complete physical examination.
By the end of June, doctors were certain that he would need to have an operation on his liver, Carter said, but he chose to delay surgery so he could finish a book tour for his memoir, “A Full Life: Reflections at Ninety.”
“The doctors told me that it was a very slow-growing cancer,” he said. “Apparently, it wouldn’t make any difference between the middle of July and August, so we scheduled it when I got through with the book tour.”
Former president Jimmy Carter reflects on the “ease” he felt when learning his cancer had spread to his brain and on the best things he has done in his life. (AP)
About 3.5 million cases of skin cancer are diagnosed every year in the United States, primarily basal cell and squamous cell carcinomas. Melanoma is rarer and deadlier, with about 70,000 cases diagnosed a year and resulting in nearly 10,000 deaths, according to the American Cancer Society. Doctors are not sure where Carter’s melanoma originated.
“Melanoma can sit idle for a long, long time,” said Tim Turnham, executive director of the Melanoma Research Foundation. “Some people are diagnosed in their 50s and 60s” for cancers that “go back to blistering sunburns when they were children.”
In the span of only several years, immune therapies have quickly become one of the most important new tools in cancer treatment, especially for melanoma.
“Five years ago, [Carter’s] doctors would have had nothing available, especially for someone his age,” Turnham said.
Louise Perkins, chief science officer for the Melanoma Research Alliance, the largest private funder of melanoma research, agreed that “the landscape of treatment for melanoma has changed dramatically.” But, she added, “There’s no universal cure.”
Keytruda, manufactured by Merck, has shown remarkable results in some patients, according to Antoni Ribas, a researcher at the University of California at Los Angeles and the lead investigator of a crucial study of Keytruda.
Ribas, who is not involved in treating the former president, said patients who benefited from the drug “responded immediately,” with some tumors shrinking or vanishing in a matter of weeks. “I have a series of patients who had weeks or months to live and who are now going on with their lives.” But he said that only about one third of patients had positive results.
Experts said that Carter is likely to tolerate his treatments well. He’s not receiving traditional chemotherapy, which can have severe side effects, such as nausea.
Carter is the second-oldest living president, separated by just over 100 days in age from George H.W. Bush. He served in the White House from 1977 to 1981.
After his presidency, he continued his humanitarian and human rights work through the Carter Center. He was awarded a Nobel Peace Prize in 2002 for that work.
Beyond his international travel schedule, Carter and his wife of 69 years, Rosalynn, have maintained a quiet but active life in Plains, Ga., his home town. He noted that he doesn’t expect the cancer treatment to halt his usual contributions to his place of worship, Maranatha Baptist Church.
“I plan to teach Sunday school this Sunday — and every Sunday as long as I’m physically and mentally able,” Carter said.
Carter noted at the news conference that get-well wishes have poured in from President Obama and all living former presidents, as well as from Secretary of State John F. Kerry and former secretary of state Hillary Rodham Clinton.
“It’s the first time they’ve called me in a long time,” Carter joked.
The former president said he will be treated at the Winship Cancer Institute, about two miles from the Carter Center. The institute and Carter’s organization are both affiliated with Emory University.
“I’ve been as blessed as any human being in the world,” he said.
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