I had a memorable conversation with former President Jimmy Carter back in the 1980’s that I’ll never forget. The interview was set up to help publicize the former president’s Habitat for Humanity homes project, which was just one of the many selfless things he did to make this world a better place.
During our chat, I initially went off script. The first thing I asked him was why he chose to pardon all Vietnam war draft evaders. I smiled, then he smiled, and the connection commenced. He knew that I supported the idea and he knew that I was in the mood to talk. So was he, evidently.
The unexpected questions got the former president’s attention and suddenly the conversation included such topics that had little to do with building houses. I also mentioned the historic Camp David Accords and his move to essentially reorient U.S. foreign policy towards an emphasis on human rights.
Carter did far more good while in the Oval Office than most folks know or choose to remember. As my longtime Newsweek colleague and fellow lymphoma survivor Jonathan Alter noted a few weeks ago in a piece in Washington Monthly, “Carter brought more positive change to the Middle East than any president in the decades before or since; signed more legislation than any post–World War II president except LBJ; and warned of the dangers of climate change before the threat even had a name.”
Alter added, “Carter’s human rights policy played a huge and largely uncredited role in the collapse of the Soviet Union—more so, perhaps, than any policies enacted by his successor Ronald Reagan.”
But Carter’s work after his presidency was arguably even more impressive. No former president has done more for the world than Carter. It isn’t even close. Citizen Carter was larger than life.
And if you ask me, his greatest achievement is what he did after he learned at the age of 90 that his melanoma cancer had spread to his brain. Carter was deeply depressed about this news and told his loved ones that he did not have much time left. But his doctors were very quick to correct him, telling him that he could live many more years thanks to his overall good health.
Carter immediately felt more optimistic about his future. And after his doctors gave him a thorough description of his treatment, something called “Keytruda,” an immunotherapy that works with your immune system to help fight multiple types of cancer. Carter became a hugely important part of the immunotherapy cancer drug explosion. It was a perfect fit. He spread the word like no one else could have.
Multiple oncologists and pharma executives have told me that Carter’s very open and detailed talks about Keytruda and immunotherapy were the greatest thing to ever happen to this new type of cancer treatment. Carter saved countless men and women with his unofficial lobbying to patients.
A Man of Great Passion
When Carter died last week, I started thinking about him and all his good deeds. Sadly, the news of his death also brought out some nut bars making statements that are not just unkind, they are also untrue.
Carter loved spreading the word about this cancer breakthrough, which binds to the protein PD-1 to help immune cells kill cancer cells. It is used to treat many different types of cancer. These include cancers that express the protein PD-L1, that have certain mutations (changes) in genes involved in DNA repair, or that have a high number of tumor mutations.
Many oncologists say that he was the biggest reason why Keytruda broke through.
Keytruda is used alone or with other drugs to treat certain types of biliary tract cancer (including bile duct cancer and gallbladder cancer), breast cancer, cervical cancer, classic Hodgkin lymphoma, colorectal cancer, endometrial cancer, esophageal cancer, gastroesophageal junction cancer, head and neck squamous cell carcinoma (SCC), and hepatocellular carcinoma (a type of liver cancer).
It is also effective in malignant pleural mesothelioma, non-small cell lung cancer, primary mediastinal large B-cell lymphoma, renal cell carcinoma (a type of kidney cancer), skin cancer (SCC of the skin, Merkel cell carcinoma, and melanoma), stomach cancer, types of urothelial carcinoma (a type of bladder or urinary tract cancer), and other solid tumors.
Keytruda is a type of monoclonal antibody and a type of immune checkpoint inhibitor, which is also being studied in the treatment of other types of cancer.
According to the Cancer Research Institute, Carter’s remarkable journey from cancer diagnosis to recovery helped transform the conversation around immunotherapy, offering hope to millions facing similar battles. His openness about his treatment not only elevated awareness but also underscored the life-saving potential of cutting-edge science.
A Wonder Drug
Keytruda (brand name), or pembrolizumab (generic name), is an immunotherapy medication. It does not always work, but it can be very effective on on at least 19 types of cancer.
Keytruda belongs to a group of drugs called programmed death receptor-1 (PD-1) inhibitors. It’s also a type of immunotherapy. This means that it helps your immune system attack cancer cells. Keytruda works by inhibiting (blocking) the activity of an immune system protein called PD-L1. It’s also known as a checkpoint protein, which attaches to PD-1 receptors (attachment sites). PD-1 receptors are found on cancer cells and healthy cells.
When PD-L1 attaches to PD-1 receptors, this signals certain immune system cells called T cells to stop attacking “invaders” (cancer cells are an example of cells that your body sees as invaders). The action of PD-1 receptors allows cancer cells in your body to continue to grow without being attacked.
Some cancer cells have higher levels of PD-1. The extra PD-1 receptors help the cancer cells survive without being attacked by your immune system’s T cells. Keytruda attaches to PD-1 receptors so that PD-L1 proteins cannot attach to them. By blocking the action of PD-L1, Keytruda lets your T cells continue attacking cancer cells. This boost in immune system function is meant to prevent your cancer from growing and spreading.
This drug felt like a miracle for the former president, who shared his immunotherapy experience with anyone and everyone he could. It proved to be a huge boost for the drug, and of course for Carter. As I noted last year, Jimmy Carter’s life journey has inspired many, many people, including me. I’d beaten stage IV cancer twice before and I had read up as best I could on immunotherapy. I knew that if a man in his 90’s could beat cancer, a man who was 64 could do it.
A Man of Great Compassion
I’ve always thought of Carter as a man with great and real compassion. But the former submariner was tough as hell. Carter graduated from the United States Naval Academy in 1946 and served as a submariner from 1946-1953 when he left active duty service as a lieutenant and continued his service as a reservist until 1961. The Seawolf-class submarine USS Jimmy Carter (SSN 23) and the newly renamed Carter Hall are named after him.
There was an innate kindness and strength in this man. He was an effective peace broker and so much more. Now he has left us and I don’t have any qualms when I say that President Jimmy Carter was one of the most significant Americans of the last century.
No other President has come even close to doing the good works of Jimmy Carter throughout his life. And perhaps of all the good things he did in his life, his impassioned work to really get the word out about a new and effective cancer fighter that has saved countless lives may have been his crowning achievement.
