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>> I met Jerry in 2014,
after he had been reporting hoarseness
trouble swallowing and a sore throat for about six months
and on office exam he had a laryngeal cancer
with a paralyzed vocal cord.
It was bulky and filled a lot of the airway,
he was aspirating
and he already had significant nodal disease.
At that time of course,
we talked about options of surgical treatment
and non-surgical treatment,
but unfortunately his imaging showed
he had distant metastatic disease involving the lungs,
which takes curative treatment off the table.
>> I was in dire straits when I first got there
I mean, the doctors up here only gave me four months to live
and that's with some treatment
to help me live a little longer, what they didn't do.
When I got up there
they didn't even say anything about a feeding tube
and they wanted to put me on treatments right away.
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>> So in 2014 the guideline-recommended treatment
for distant metastatic disease is systemic chemotherapy,
and Jerry started off with the combination
of the usual agents, platinum-based chemotherapy,
5-FU and cetuximab,
and the goal was never to cure disease
because we know chemotherapy does not cure
head and neck cancer, it was to palliate symptoms.
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After five months of chemotherapy,
he stopped treatment for three months
because he had no evidence of disease on scans
and he was feeling well.
Unfortunately in September of that year,
eight months after the initial presentation
he came to the office with dermal metastasis
and that's again, a sign of distant metastatic disease
that is spreading throughout the body
through the bloodstream.
And unfortunately, because he had already gone through
most of the chemotherapeutic agents and this had progressed
despite that, he was running out of options.
Now fortunately at that time
we participated in a clinical trial called J1337
which was a new trial aimed at studying immunotherapy
in terminally ill patients
who had already had conventional chemotherapy
for metastatic disease and had failed.
And so Jerry was a perfect candidate for this trial,
which looked at pembro.
Pembro is one of the monoclonal antibodies
aimed at PD-1 receptor.
So Jerry was all game, and signed up for the trial
and his response has been nothing short of remarkable.
>> With the idea about a clinical trial
would probably be better for me if it worked,
and so she started me on the mystery drug.
There were quite a few I was on it before
some of them had some bad reactions
I never had any reactions, but did (indistinct)
it was just all good.
The bumps where it metastasized on my neck,
they started shrinking
and when I was doing the clinical trial,
it wasn't hard on me at all.
I would leave here Monday night,
catch a plane, take the treatment,
and most Tuesday nights I'd fly home
so I'd only be going away one day, one full day.
>> The J1337 trial was one of the earliest trials
looking at immunotherapy in head and neck cancer patients
I believe it included other cancer subtypes,
but we really didn't know in 2014,
if immunotherapy was gonna be effective
in head and neck cancer
and which patients were gonna respond
and what the response rate would be
and even what the side effect profile would be.
So this trial utilized pembrolizumab
and it entailed infusions of pembrolizumab
once every three weeks indefinitely
until we saw a response.
And Jerry had a total of, I wanna say 26 infusions
and his scan showed a remarkable response.
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>> I feel good for an old man.
I mean, honestly I'm 71 now
and I feel, I'd probably get around work better
than some of the guys that are 50,
and I honestly, I feel honestly good in 99% of the time
I'm happiest man in the world to still be alive.
And everybody still calls me the miracle man
here in Arkansas, dead man walking.
>> He has been off treatment for over a year
and continues to have no evidence of disease on scans
and live a very active, normal life.
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