Treating Carter's Cancer Took Decades, Not Months
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By Charles Balch MD and John M. Kirkwood MD
Former President Jimmy Carter recently announced that he's cancer-free thanks to a new immunotherapy drug. A few years ago, his form of melanoma was a virtual death sentence.
The hopeful news underscores the incredible progress we've made treating this life-threatening disease -- and highlights the importance of encouraging the development of even more effective new cancer medicines.
The former president and humanitarian benefited from a breakthrough drug that his physician describes as "a whole new class of therapy . . . [that] allows our own immune system to fight a cancer." As cancer experts with decades of research and clinical experience, we've worked with our colleagues and industry to develop these "immunotherapies" and experienced firsthand how frustratingly slow the progress has been.
That's why, while we recognize the concerns about the cost of these new therapies, we believe that the public and policy makers shouldn't discourage investments in drug development or lose sight of the immense value these medicines deliver to patients.
There's no denying that the price of cutting-edge drugs for illnesses like cancer have risen at alarming rates.
In 1996, new cancer drugs cost roughly $54,000 for each additional year of life they provided. By 2013, that number had risen almost four-fold to more than $200,000.
This is a societal, political, and economic issue. But the dramatic rise in life expectancies and quality-of-life gains should be part of any conversation about drug prices.
As recently as early 2011, the average patient who received President Carter's diagnosis -- stage IV melanoma spread to the liver and brain -- had from 3 to 6 months to live. There had been no major breakthroughs in three decades.
The speed at which treatments have improved is miraculous. Pharmaceutical firms have released three major immunotherapies since 2011. Now, up to two-thirds of patients respond to treatment.
While the breakthroughs that have recently appeared to come from just a few short years of work, the discovery process that led to the new miracle drugs took decades.
Since 1998, there have been at least 96 failed attempts to develop new treatments for melanoma. Only ten successful new agents and combinations have been discovered in the same period.
Those failures, and incremental successes, helped researchers refine their understanding of melanoma and the role of the immune system in recognizing cancer as a foreign invader.
This cumulative discovery process was never cheap -- and it's only getting more expensive. Over the last ten years, the average cost of developing a new drug has risen from around $800 million to roughly $2.6 billion, according to researchers at Tufts.
If drug developers can't cover their research and development costs, fund ongoing research, and offer their investors a reasonable return, then those developers simply won't dedicate adequate resources to discovering new treatments and cures for melanoma and other deadly diseases.
Cost isn't irrelevant -- but it's important to keep in mind the value newer therapies provide and the need to encourage their creation.
We don't know what new breakthroughs researchers will make in the coming years, but the field of immunotherapy is young, and the tools to accelerate progress are going to reduce the costs of drug development. But we do know that discouraging the development of such medicines could rob future patients of lifesaving therapies.
Charles M. Balch, MD, a professor of surgery at both Southwestern Medical Center and MD Anderson Cancer Center at the University of Texas, is the editor of Cutaneous Melanoma. John M. Kirkwood, MD, is professor of medicine, dermatology and translational science, and co-director of the Melanoma Program at the University of Pittsburgh's Cancer Institute.