LOUISVILLE, Ky. (WDRB) -- A year ago, we told you how local residents with skin cancer went from stage 4 to cancer-free in a matter of months using a new drug called Keytruda. Now that same drug is helping a Louisville man with a rare type of lung cancer and capturing the attention of the medical world.
Dr. Jack Casey is a busy 91-year-old. These days, the former doctor spends much of his time taking care of his wife who's recovering from orthopedic surgery.
"I do dishes, make beds," Jack said with a chuckle.
But things took a bad turn for Jack about a year ago. The active 3-time-a week tennis player was losing weight and getting tired more easily. He decided to go to the emergency room one day when he was having chills.
"And, they came up with a chest x-ray at the last minute, and it showed, they said, pneumonia," Jack recalled.
When antibiotics didn't help, doctors took another look, and made the grim discovery: a rare and advanced case of lung cancer.
"And, they said, 'You know, this is stage 4, and not a whole lot to do," Jack said. "Why don't you contact Hosparus?'"
At first, it was a fate Jack and his wife, Jill, accepted. So did his son, Joe, a former surgeon, and for good reason.
"Here you have an individual who's 90 years of age, he's got a very rare, aggressive tumor, with stage 4 disease spread beyond the original site, and then with no known treatment," Joe Casey said.
But, then Jack and his wife started talking about their options. They knew that the James Graham Brown Cancer Center, one of the leading facilities of its kind in the nation was just a few miles away. And they wondered "what if?"
As soon as they saw Jack, the folks at Brown were wondering "what if" too. Jack remembers hearing those six magical words: "We think we could help you."
"Actually, I thought they were kind of excited for the opportunity," Jack said. "That this was a rare cancer, and there's this new drug. And, they thought there's some possibility here."
"This particular cancer had good markers of effectiveness," said Dr. Goetz Kloecker, an oncologist at the Brown Cancer Center. "And, because of that, the lower toxicity, and the relatively high likelihood of response to treatment, the decision was made to go ahead with immunotherapy.'
Brown immediately started Jack on pembrolizumab, better known as Keytruda.
It's the same drug we told you about in 2016 that was able to wipe out stage 4 skin cancer in several local residents. But it had never been tried with this kind of cancer. If there was anywhere it was going to be tried, though, it was at Brown.
Dr. Jason Chesney explains why.
"The majority of the patient population with this rare type of sarcomatoid lung cancer are not going to be seen by academic oncologists," Chesney said. "They're going to be seen by community oncologists, and they're not going to try immunotherapies like this."
Jack started his treatments in early May. After three rounds, he got his first scan. The cancer was gone -- in less than two months.
Jill recalls getting the good news from her husband on the phone.
"Joe called me and said, 'Everybody down here is high-fiving. Everybody down here. They're going to uncork the champagne.' I couldn't believe it. I just thanked God.
But Jack's final scan in August showed something new and unexpected. After beating cancer, he ended up in the ICU at University Hospital because the Keytruda that proved to be his savior had caused a severe case of pneumonitis, lung inflammation that left him near death and on life support.
"We planned his funeral, it was that bad," Jill recalled. "When they took him off life support, they told me, 'Mrs. Casey, it will be about three hours.'"
But Jack had one more surprise for everyone. He slowly began to recover, and says he now feels better than he has in a year.
"I lost about 40 pounds," Jack said. "I've gained back about half of that. I still don't have much stamina, but it's increasing."
Casey's story is so groundbreaking, it has been made into a case study that researchers hope will lead to clinical trials and eventually FDA approval of Keytruda for Casey's type of lung cancer.
"So that when a medical oncologist sees that rare patient with sarcomatoid lung cancer they will see this and say, 'Hey, we should try this,'" Chesney said.
Thanks to a new agreement from the makers of Keytruda and a similar drug Opdivo, patients who qualify for treatment at Brown can get them for absolutely free, no matter what kind of cancer they have, even if the patient’s insurance company refuses to pay for it.
For more information, contact the Brown Cancer Center at (502) 562-HOPE.
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