PITTSBURGH (KDKA) — Three years ago when Linda Malsch found a lump under her arm – she feared it was cancer. She was right, though she was surprised to hear what type of cancer.
“It came back melanoma. They were shocked and I was shocked,” she said.
Shocked, because Linda never had any suspicious moles, which is a warning sign for melanoma. She was immediately treated with surgery and the drug interferon. Her follow up scans looked good, for a while.
“A year to the day almost that I got off it, I had a PET scan and I had a lesion on my liver, and a small one on my spleen,” Linda says.
The cancer had spread.
“The prognosis for those patients, historically, was uniformly dismal, where the survival was in the months as opposed to years,” says Allegheny Health Network cancer surgeon Dr. Howard Edington.
Just a month before Linda got the news, a new drug called Keytruda got expedited FDA approval. And because the cancer had spread to her internal organs despite treatment, her doctor thought this new drug would be a good choice for her.
She started getting it intravenously for half an hour every three weeks.
“He said we’re gonna use that, cause it’s a lot better, it’s showing better results, it’s not as rough on you,” Linda said.
Keytruda is a manufactured antibody — just like the ones your own immune system creates in response to viruses and other harmful material.
The designed antibodies target the cancer cells, and leave healthy ones alone.
“It has been recognized for decades that melanoma has an immune response,” Dr. Edington says.
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In studies, the progression and stabilization of a particular cancer, and also how well it responded to treatment, were better with Keytruda than with older medicines.
But with the longest experience of just a couple years, there are still questions about how often and how long a patient should continue to take the drug. This came up when former President Jimmy Carter was treated with it.
“That was a question with Jimmy Carter,” says Dr. Edington. “How long should you treat him in the face of disease that appears to have completely regressed?”
You cannot get the drug if you’re pregnant or breastfeeding, or if you have an autoimmune disease already. Side effects are related to the immune system. In some cases, there’s an attack on the thyroid or the intestines. These issues go away when the drug is stopped.
Keytruda can cost hundreds of thousands of dollars a year, but insurance is covering it.
Dr. Edington is most excited about what this drug does for a patient’s prognosis.
“From uniformly dismal to now potentially very hopeful,” he says.
Linda’s scans have shown great response and no recurrence of cancer.
“Hopefully, live a long life and watch my grandkids grow up,” she says.