Compiled by Walter Sorochan Emeritus Professor San Diego State University Posted December 12, 2015; Updated November 19, 2021. Disclaimer; The information presented here is for informative and educational purposes only and is not intended as curative or prescriptive advice. The statements of this web-site have not been evaluated by the United States Food and Drug Administration (FDA). Nothing stated here should be considered as medical advice for dealing with a given problem, or to diagnose / treat / prevent / cure any disease. This is work in progress.
The exciting health news, during weekend of December 4 to 6, 2015, was that there was supposedly a new drug that destroyed former President Jimmy Carter's cancer. Not exactly a sure cure but giving us hope that cancer can finally be controlled. But was this more media hype than truth? Let's take a closer look at this news. "Jimmy Carter credits the new cancer drug Keytruda for shrinking his brain tumors completely. It's one more possible victory for the newest class of cancer drugs that empower the immune system to fight off tumors. But cancer experts note that it's not at all clear that the drug itself is what shrank Carter's tumors. The former president was also treated with radiation to his brain and had a large tumor on his liver removed. While most immune therapy drugs boost the immune system so that it can battle the cancer, Keytruda was the first drug to take a different approach that disrupts a trick tumors use to hide from immune cells." Fox: Carter tumor vanish 2015 "Keytruda — known generically as pembrolizumab — targets the activity of genes called PD-1 and PD-L1. The interaction between the two genes lets some tumors escape detection and destruction by immune system cells. PD-1 stops immune cells from attacking normal healthy cells by mistake. Tumor cells make PD-L1 turn on PD-1 when immune cells approach. Keytruda, an engineered immune protein called a monoclonal antibody, disrupts this cloaking effect and lets the immune cells do their job and eat the tumor cell." Fox: Carter tumor vanish 2015 Below is a short video explaining how keytruda activates the immune system to fight cancer [ By Cancer Research Institute ] 1:51 mns: A Quick Realistic Outlook: The theory behind immunotherapy has been around for decades, but it is only in very recent years that scientists have been able to put it into practice with, so far, just a couple of remarkably successful drugs. So what are we to understand from this medical media report? Medical doctors admit that is not clear that keytruda was responsible for shrinking or getting rid of President Carter's cancer. Indeed, common sense should remind you that there were a lot of other possible factors not mentioned in the report that may have been helpers in destroying Carter's cancer. Did the food Carter ate have an impact on his cancer? And how about the placebo effect? And let us not forget that the survival rate among those using keytruda therapy is very low at this time. There is also speculation that keytruda may not cure cancer and that cancer may reappear after initial disappearance of cancer. A cancer patient may need to take keytruda for the rest of her/his life for the current price of $ 10,000 every month. Scientists just do not have all the data about keytruda at this time. Medical science does not have all the answers as to what caused Carter's cancer to go into remission, although the drug media wants to take credit for Carter's cancer supposedly going into remission. Doctors admit that it is not clear what caused the disappearance of cancer. But the drug company, Merck, who developed keytruda has claimed credit for the cancer disappearing. Merck charges $10,000 for less than a month treatment; a cost that is out of reach for most cancer patients. Not exactly a humane approach. This is typical of "tooting your own horn" and taking all the credit and money! What is germaine in the media report is the recognition idea that it is the immune system that can destroy cancer and heals the body. Such recognition goes back thousands of years to the Greek physician, Hypocrates, who recognized that: "Food is your best medicine!" Unfortunately, most medical doctors have not had nutrition in their medical training, so it should not be surprising that all of a sudden they are becoming aware that food may be a silent helper in healing the body. Today, new research about the biochemistry of the body and how it works puts the medication keytruda into perspective. Methylation and methyl groups found in foods help bolster the immune system that, in turn, originates in the large colon that, in turn, is controlled by bacteria in the colon. It is the kind of food we eat that controls the good and bad bacteria in the colon. Good bacteria supercharges the immune system while bad bacteria cause disease. The addage 'you are what you eat' is true! In spite of the many shortcomings of keytruda, if it shrinks the cancer tumor, it appears to be working and this in itself is a good sign. As a cancer patient, you may not be cured but the tumor is in some degree of remission. You would have a large part of your life restored, you regain hope and all this is great. The video below gives more information about how a patient at UCLA hospital who was helped [ 3.52 mns.]: Readers who may have cancer need to read the information below to become informed and decide what is best for them. Ask your therapist what your options are and get a second and third opinion. Below is more information about the details of krytruda that is good to know and may help you decide about using it: History of cancer fighting drugs: "The drug keytruda, is part of a new class of drugs that fight cancer by boosting the body's immune system. Keytruda, which costs $150,000 a year, is one of eight new melanoma drugs approved since 2011," said Timothy Turnham, executive director of the Melanoma Research Foundation. Although none of the new drugs has been proven to cure cancer, their arrival was welcome news to patients and cancer advocates. zabo Carter cancer in remission :2015
The Food and Drug Administration gave Keytruda accelerated approval in 2014 for patients, like Carter, whose melanoma has spread. It was on the basis of a big study that showed Keytruda could shrink the tumors of about a third of patients by as much as 90 percent. Fox: Carter tumor vanish 2015
How the drug works? Keytruda works by way of immunotherapy. Keytruda® is a highly selective humanized monoclonal IgG4 antibody directed against the PD-1 receptor on the cell surface. The antibody [drug] blocks the PD-1 receptor, preventing binding and activation of PD-L1 and PD-L2. This mechanism causes the activation of T-cell mediated immune responses against tumor cells. "In clinical trials, anti–PD-1 and anti–PD-L1 antibodies produce durable responses in approximately 20% of unselected patients with advanced non–small-cell lung cancer." Garon: Pembrolizumab safety treating small cancer 2015
Below is an easy to understand video about the process of immunotherapy [Society for autoimmunotherapy of cancer, 11:52 mns]: Keytruda side effects may include: Drugs: Keytruda Article by FDA: Approves Keytruda 2015 is no longer active.
This is not a complete list of side effects and others may occur. Survival rate: There are testimonials that some cancer patients receiving keytruda do survive for longer than two years. But this information is not verified. Survival rate for cancer patients being treated with keytruda at this time is virtually unknown since this treatment is so new. Doctors are not even sure that those being treated are surviving because of keytruda, or of other medications or factors. Survival among patients with advanced melanoma who were given pembrolizumab were good at 12 months – 74% given doses every two weeks were still alive a year later. Szabo Carter cancer in remission :2015 Source: Garon: Pembrolizumab safety treating small cancer 2015 It was on the basis of a big study that showed Keytruda could shrink the tumors of about a third of patients by as much as 90 percent. Fox: Keytruda another look 2015 In spite of the lack of good long-term survival and cure rates, cancer patients should have an open mind to using keytruda or similar medications. It may be only a matter of time before the researchers get it right! Do not lose hope! KEYTRUDA USE: is a prescription medicine used to treat a kind of skin cancer called melanoma: Merek: Medication Guide 2015
KEYTRUDA may be used in a kind of lung cancer called non-small cell lung cancer: Merek: Medication Guide 2015
It is not known if KEYTRUDA is safe and effective in children less than 18 years of age. Biomicrobia, keytruda and cancer research: Medical researchers and the general public may be skeptical about feces being linked to health and disease, but the research in the past 15 years says otherwise. Below are just two such researches: "Sivan and colleagues compared genetically identical mice obtained from two different mouse facilities that had different gut microbiota. Interestingly, these mice reacted differently to syngeneic implanted mouse melanoma tumors, apparently because of differences in the vigor of their anti-tumor T-cell responses. These differences were eliminated by cohousing and could be reversed by fecal transplantation from the mice with anti-tumor immunity, implicating the gut microbiome. Furthermore, fecal transfer augmented responses to anti–PD-L1 immunotherapy. Following sequencing of the bacteria, they found that Bifidobacterium species were overrepresented in mice with better anti-tumor immunity, and introduction of those species into the other mice produced anti-tumor responses." Sivan: Bacteria promote anti cancer 2015 Tsai: 2015 "Vétizou and colleagues linked anti-CTLA4 therapy to human responses to melanoma therapy. Anti-CTLA4 therapy can produce adverse gastrointestinal (GI) tract reactions with the development of antibodies to gut flora. They found that anti-CTLA4 therapy decreased numbers of Bacteroidales and Burkholderiales species and increased Clostridiales species in feces. Patients treated with ipilimumab for melanoma also showed decreased Bacteroidales species in their stool. When this stool was transplanted into mice, it enhanced responses to anti-CTLA4 therapy, and direct inoculation of the relevant Bacteroidales species increased melanoma-specific memory T-cell responses." Vétizou: Cancer immunity needs gut microbiota 2015 Tsai: 2015 Two groundbreaking studies implicate specific bacterial species in regulating gut immunity and response to immunotherapy in physically distant tumors — an entirely new approach in cancer therapy. The influence of the microbiome on cancer susceptibility and therapy effectiveness has been shown. Furthermore, commensal organisms have critical roles in tuning immunity at epithelial surfaces, suggesting their potential role in regulating immunotherapy response. Tsai: 2015 COMMENT: These technically difficult and groundbreaking studies implicate specific bacterial species in regulating gut immunity and responses to immunotherapies in physically distant tumors. This approach presents an entirely new approach to cancer therapy. How important the gut microbiome is as a determinant of response to therapy is not yet known, but immunotherapies may be optimized by manipulation of the GI microbiome in the future. Tsai: 2015
Final thoughts: Don't give up hope. Go for it! The video below says it best [ 4:12 mns]: In light of the current limitation of keytruda .... like how expensive it is for most cancer patients, cancer patients should consider other adjunct options like methylation, ingesting seeds and whole plant foods to help at keep cancer in check. References Keytruda – Immunotherapy Drug Guide. Keytruda guide FDA, "FDA approves Keytruda for advanced non-small cell lung cancer," U.S. Food and Drug Administration, October 2, 2015. Article by FDA: Approves Keytruda 2015 is no longer active. Drugs.com, "Keytruda," Drugs,com, Drugs: Keytruda Fox Maggie, "Here's a Look at Keytruda, the Drug Jimmy Carter Says Made His Tumors Vanish," NBC News, December 7, 2015. Fox: Carter tumor vanish 2015 Fox Maggie, "Here's a Look at Keytruda, the Drug Jimmy Carter Says Made His Tumors Vanish," NBC News, December 7, 2015. Fox: Keytruda another look 2015 Garon Edward B., and others, "Pembrolizumab for the Treatment of Non–Small-Cell Lung Cancer," N Engl J Med, May 21, 2015; 372:2018-2028. Garon: Pembrolizumab safety treating small cancer 2015 Sivan A et al. "Commensal Bifidobacterium promotes antitumor immunity and facilitates anti–PD-L1 efficacy," Science, November, 27,2015; 350; 1084. Sivan: Bacteria promote anti cancer 2015 Vétizou M et al., "Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota," Science, November 27,2015 350, 1079.   Vétizou: Cancer immunity needs gut microbiota 2015 Merek, "MEDICATION GUIDE KEYTRUDA® (pembrolizumab) injection," Merek Oncology, 2015.   Merek: Medication Guide 2015 "Nobel discoveries on DNA repair now fueling cancer drug research," October 08, 2015. Nobel prize & immunotherapies Szabo Liz, "Jimmy Carter's remission shows power of new cancer drugs," USA TODAY, December 7, 2015. Szabo Carter cancer in remission :2015 Tsai Kenneth Y., reviewing Sivan A et al., "Melanoma Meets Microbiome," NEJM, mber 9, 2015. Tsai: 2015; |