Carleton's case highlights the miraculous results that can occur when just the right drug is matched to just the right patient. While this is the ultimate goal of personalized medicine, the science isn't quite there yet.
For instance, only half of melanoma patients have the B-Raf mutation, and even among those who do, some don't respond as well to the drugs as Carleton because their cancers might consist of a dozen other unknown genetic mutations.
To put it in perspective, all of the patients in the MD Anderson trials were in a similar situation to Carleton: Multiple traditional cancer therapies had failed and they were at the end of their rope. When treated with drugs targeted to their specific genetic abnormalities, about one in three had a good response. For patients with those abnormalities who received traditional treatment, only one in 20 had a good response.
Even for those who qualify for this approach, "most advanced cancers still don't respond probably due to the presence of multiple genetic abnormalities that contribute to resistance to the treatment given," says Dr. Richard Schilsky, deputy director of the Comprehensive Cancer Center at the University of Chicago. "That said, the approach is much more promising than just pulling something off the shelf for a patient with advanced cancer."