🎙️PODCAST: Better Results, Fewer Side Effects—Why Isn't Every Oncologist Using This? #ADC #BreastCancer

A newer breast cancer drug may work better with fewer side effects—here’s why—does your oncologist know about it? #breastcancer #cancertreatment #antibodydrugconjugates

👉 Get your free guide, '10 Things to Elevate Your Chemo Journey'

👉 Want personalized attention to help you along your individual cancer journey? Explore 1:1 sessions with Dr. Chaplin

👉 Want to find out more about Dr. Chaplin's journey of bringing a cancer drug to market? Explore his innovations

--------------------------------------------
Episode Description:

Two patients.

 Same type of drug.

 Completely different outcomes.

 In this breakdown, Dr. Chaplin walks through something most people (and even many oncologists) miss:

 Not all drugs in the same class perform the same.

 Some antibody drug conjugates are:
• twice as effective
• significantly easier to tolerate
• and rapidly replacing older versions, but still unknown to many oncologists

 So many patients are still being given the outdated ones.

--------------------------------------------

Inquiries: 

info@elevatingcancertreatment.com

https://elevatingcancertreatment.com

--------------------------------------------

Disclaimer:
The information provided in this podcast is for educational and informational purposes only, and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard or read in this podcast or on this channel.
Reliance on any information provided by Dr. Jay Chaplin or Elevating Cancer Treatment is solely at your own risk. Dr. Jay Chaplin is a scientist and drug developer, not a medical doctor providing patient care. The content presented here reflects general scientific understanding and research, and may not be applicable to your individual health circumstances. Individual medical conditions and treatments vary, and no two situations are exactly alike.
Always consult with your personal healthcare provider before making any decisions about your health or treatment plan.

Transcript

SPEAKER_00 0:00

And here comes the cat. There's your pillow. Come on, you little weirdo. So there's a relatively new drug for a certain type of breast cancer that most oncologists don't know about yet. And this is a fairly frequent phenomenon. Oncologists are people too, and it takes a while for them to get up to speed with new developments. So today we're talking about breast cancer. We're talking about two client stories, and we're talking more generally about the class of drugs called antibody drug conjugates, ADCs, which are now being developed for many different types of cancers, many different particular indications. So even if you don't have breast cancer, this is probably an important episode for you to know about to understand that class of drugs as a whole. Stick with us. Hello and welcome to Elevating Cancer Treatment, where we explain the science and debunk myths to help you navigate your health journey. My background is a little different. Beyond educating about cancer, I'm actually designing new drugs that are defining the future of oncology. This direct hands-on experience offers me a very different perspective of how these cancer treatments work on the body, interact with the cancer cells, and cause side effects. And these are insights that I'm excited to share with you. If that sounds interesting, make sure to like this video, subscribe to the channel, and hit that notification bell so you never miss an update. And please share it if you find it useful. I'm Dr. Jay Chaplin. An important reminder, I'm a PhD, not an MD. The information in this video is education and it's not medical advice. Every cancer is unique and no general information applies to everyone. Please remember that. Always consult with your healthcare provider for guidance on your specific situation. And two quick things. First, as a thank you for being here, I've created a free resource, 10 things to elevate your chemo journey, which you can download from the link below. And second, by signing up, you'll also get updates on that innovative cancer treatment I'm working on. I'm confident it represents a significant advancement in immunotherapy. So please take a moment, download your free guide, and join us in shaping the future of cancer treatment. One of our clients is going to be hopefully switching drugs. Why? Because they have recurrent PER2-negative metastatic breast cancer. For that, one of the best drugs, one of the heaviest-hitting drugs, is in a class called antibody drug conjugates. The particular one in this case is Trodelvi. Trodelvi is the drug that all of the oncologists know. It is an antibody against a protein called TROP2 on the surface of the breast cancer cell. And attached to that antibody, which is just a way of targeting the drug to the tumor cell, attached to that are many copies of extremely toxic chemotherapy drugs. So toxic that you couldn't use it as an actual chemotherapy. If you just infused it into the body, it would be far too toxic. You would die from it. So how does it work? This drug is attached to the antibody. It does nothing as long as it's attached. And that's where the magic of the linker arm in between them comes in. That linker arm has to be really good. It has to hold the drug on the antibody in the vial, in storage, in the IV bag, in your bloodstream, until that antibody with a payload attached gets eaten up by the cancer cell. And then, only then the linker is supposed to fall apart and release this highly toxic drug inside the cancer cell and only inside the cancer cell. That's how it makes it a magic bullet. It goes to the right place and it only delivers the drug to the right place. And that's how you can use these incredibly toxic agents. So when these things work, they work beautifully, they work magically. You can see tumors, massive tumors, disappear in four or five rounds of treatment. It can be really spectacular when it works well. So you have to have the target protein on the surface of your tumor, and the drug has to be engineered the right way. And why do I bring this up? Because these drugs get better all the time. That's why we end up having new versions of them. Any of these that have been around for more than five or six years, there's probably another version that's coming out because payloads, the chemotherapy drugs attached to them get better, the linkers get better, everything gets better. We're constantly getting better at this. And why does that matter? That matters because the drug isn't released as much, so the side effect profile gets better. Or you can use more toxic drugs because it's attached better. So then you get a better delivery to the cancer and it gets killed off better, it's more effective. We see this all the time. So, again, as I was saying, this client is scheduled to go in and get Trodelvi. Trodelvi is not the best option anymore. In January of 2025, a little more than a year ago, a new version came out called Datroway. If you're scheduled for Trodelvi, talk to your oncologist about getting Datroway. Why? The side effect profile is easier to tolerate. It's not so much about the frequency or incidence of these side effects, it's that the harshest side effects don't actually exist. They're different classes of side effects, so it's an easier drug for you to tolerate. The other thing is it's much more effective. Datroway has twice the length of progression-free survival that Trodelvi does. It works twice as long for you. Why would you not take that? It's clearly superior. This was never discussed with our client. I don't think that their oncologists knew about it. Oncologists are people too. It's hard to keep up with all of this stuff. Many oncologists think that all of these drugs are the same. Trodelvi and Datroay target the same protein on the same cancer cell. The idea is the same. You attach something toxic with the linker, they're the same, right? But they have very, very, very different performances. So, again, if you're about to go on Trodelvi, talk to your oncologist about Datroay. It's clearly superior and they may not know about it. So, again, why do I bring this kind of thing up? We have another client who in the past was given a different antibody drug conjugate. Many people have forgotten about this. One of the first antibody drug conjugates to come out was a drug called CADSila. It was using the antibody Herseptin that's used to target HER2 on the surface of HER2-positive breast cancer. Now, if you have a lot of HER2 on your breast cancer, you can just use the antibody. It'll block the growth pathway. That helps. But if you have any of it, even a little tiny bit, you can use these drugs, CADSila or its follow-on, which we'll talk about in a moment. Again, those bind to the tumor, they get internalized, they carry along with them this toxic payload. They're not just antibodies, they're antibody drug conjugates, and that directly kills the cancer cell, or at least that's the theory. This client was soured on the class of drugs because they used CADSila. It had horrible side effects. They went through with it anyway, and in a very short period of time, less than three months, they came back, they had a recurrence. It's understandable when you go through extremely rough side effects and have very little efficacy that you might not want to have anything to do with that drug class again. CadSila was, again, one of the first ones approved. That was back in 2013. Its successor, NHAR2, which has almost completely replaced it by now, you can't even really find CADSila in many cases. NHER2, again, has a better side effect profile and is much, much more effective. How much more effective? Your overall response rate for CADSila is only about 34%. You can take that drug, and only about a third of people have any real response at all. NHIR2 is more than double that. It's a 74% response rate with a better side effect profile. So a lot can happen in six years. Again, CADSila was approved in 2013, NHAR2 was approved in 2019. What changed in that time? Couple of things. The type of payload changed, so the payload, the toxic part on NHAR2 got much more toxic and much more capable of killing, which is why the efficacy went up. But the other part of that is, again, specifically the magic of that linker. The very first generation of antibody drug conjugates had very unstable linkers, and so you couldn't use something super potent because a lot of the linker would just dissolve in the bloodstream and the drug would float free. It wasn't as targeted. More of it would get to the cancer, but a lot of it would get to everything else. Cadsilo, for its time, was actually a very good drug. It was just rapidly engineered into obsolescence. Its linker was way more stable than the first generation of antibody drug conjugates, but way less stable than the third generation in Hair 2 and others after it. CADSila would lose about a third of its payload in the bloodstream before it was internalized by the cancer and delivered the payload there. So if you have 10 copies of payload attached to one CADSila antibody drug conjugate molecule, you'd lose a third of those to the rest of the cells. If you're using a fairly toxic payload, that's a lot of collateral damage to normal healthy tissue, which is exactly what people with CADSila saw. It had pretty bad side effects. Now, in Hair 2, still has bad side effects, but that's because it's using a massively more toxic payload with a much better and much tighter linker. You get some loss of payload, but it's much less than with CADSyla. So the balance there is in Hair 2 is much more effective and slightly better for the side effect profile. But again, this is one of those examples where even in the span of six years, the drug technology can improve massively. So again, there was a window in there, and for that client, they were in it when both of these drugs were on the market. But their oncologist clearly did not know either that NHERI2 existed or that NHER2 was superior, or else they wouldn't have given CADSila. But unfortunately, they got CADSila anyway. So if you are in a position where your oncologist is recommending an antibody drug conjugate, please, please, please, please, do a bit of research. Make sure that there isn't another antibody drug conjugate in the same class. Make sure that if they're recommending one and only one, that it is the only one. Because if there's more than one, they can be radically different, even though they sound exactly the same. Please, if there's multiple, dive into what the side effect profiles look like. Do compare and contrasts. Look at any head-to-head data about efficacy. Because again, as we've said, there can be massive differences. 34% efficacy versus 74% efficacy. Which one are you going to choose? Don't get stuck with the 34%. We want better than that for you. Beyond these videos, if you need more personalized guidance or a deeper dive into specific treatments to have your treatment be as effective as possible, I offer one on one sessions and medical advocacy. You can find information on our website, which is linked down below. Again, if you found this video informative, please give it a thumbs up, click the notification bell, and subscribe to our channel for more science based cancer insights.