Cancer Treatment Works Better When You Do This First (Most Don't)

Part 1 of 3 Series - Most cancer treatment skips a critical step. Here’s what should happen first. #biomarkers #genomics #chemotherapy

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Episode Description:

There’s something about cancer treatment that doesn’t make a lot of sense…

 The most targeted, precise therapies we have?  Often saved for later.

And the most aggressive, broad treatments?  Used first.

But what if that’s backwards?

This breakdown walks through:
• why this happens
• what genomics and biomarkers are actually for
• and how treatment decisions could look very different

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info@elevatingcancertreatment.com

https://elevatingcancertreatment.com

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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_01 0:00

Hello everyone. It's a small desk for two people. My lovely wife had a question for me earlier and we wanted to capture this, though I'm supposed to be more positive. Your question, my dear.

SPEAKER_00 0:10

So the other day we had started talking about if he could have if the industry for cancer treatment be different and he could wave a magic wand, how would he set it up differently with what we have available right now? Knowing that there are lots of treatments that it would be nice that it there were better treatments available, but coming from the place of what we have available right now, how would you be doing things differently?

SPEAKER_01 0:37

I think that that's actually a really good question. And sadly it's one that I need to focus and stay positive on because it's quite frustrating to see how things could be much better and much easier right now, today. But the way that we have engaged with the systems has made it very difficult to do so. 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. So, yes, we're having constant development of newer, better drugs, and that is fantastic. And as you said, even today, we've got a tremendous number of really good drugs available for treating cancer. And in many cases, those do not get used or cannot be used unless you have very deep pockets until after you've already failed on the first line treatments. And that's a part of the momentum of pharmaceutical industry, the regulatory industry, that new drugs are tested in people who have failed standard of care and are looking for something better. But something that's better than standard of care should be the new first-line standard of care. That's just an artifact of the way that we test drugs. Honestly, it would be better to move these targeted therapies and immunotherapies up to first line, and that's something in some cases we can do. More and more pharma companies are doing that, and in those cases it's a matter of getting the oncologists on board and understanding the value in doing that. But in many cases, it's still on the pharmaceutical companies for testing in treatment failure cases. Please don't do that. Pharma companies, please, once you've got your drug on the market, go back, do a small pivotal trial, get first-line treatment in there, and move these therapies up to where they will have the most value. Another thing that we talked about was if I could wave a magic wand and have things change overnight, I would have everyone get good genomics tests and basic biomarker tests right up front.

SPEAKER_00 3:47

And have them reviewed by somebody who knows how to read them.

SPEAKER_01 3:52

And it's not just reading the top line of the generated form.

SPEAKER_00 3:56

Exactly.

SPEAKER_01 3:58

There is so much value in those. And it is a common refrain, it's something we hear all the time, something I hear all the time, that oncologists don't want to do a genomics test because they don't see value in it until you're in stage four or something like that. The value in a genomics test is really as early as you can go, because those genomics tests, they're necessary for figuring out which targeted therapies make sense and could work, and we'll come back to that in a moment. But they're also very useful even with chemotherapy, even if your oncologist just wants to do chemotherapy. Certain mutations make different chemotherapy drugs either more likely to work or less likely to work, and knowing that allows you to not take drugs that can't work for you. It is relatively common for us to go through a client's genomics report after they've been through several lines of therapy and look back and see there was no chance of this particular chemotherapy drug ever working for you. That was just wasted time and effort. That was side effects for no reason. But we didn't have the information because the genomics test was done at the end instead of the beginning. So genomics tests at the beginning. At the beginning. The very beginning. Very first thing. Along with people who can actually interpret them and understand what they mean. Because again, 90% of the value of a genomics test is usually left on the table for lack of a good interpretation. So having those pieces allows you to pick good targeted therapies. It allows you to pick targeted therapies that have the best possible chances of working. If we can look at your particular cancer and map out exactly what are the drivers and find the high value targeted therapies, and then the lower value targeted therapies, and then the third line targeted therapies, we can start with the best thing first that has the biggest chance of getting you a cure. Forget about buying you some time, getting you a cure. Start with that and then work through the other possibilities as we go. And then once we're done with that, only when once we're done with that, once we're done with targeted therapies and chemotherapies and very highly targeted radiation, only once we're done with those things, move into the blunt instruments of chemotherapy and generalized radiation. Those are the things that you use at the end once everything else is off the table, because they can damage your bone marrow, they can damage your immune system, they can cause cardiac damage. You want to do those at the end once you've taken up and failed on all of the targeted therapies. But many people get cures with the targeted therapies. So move those to the front. They do less damage and they're more potent. Do those first. Save the blunt, less effective, works for everything, sorta kinda, and damages you in the process therapies for the end, once everything else that's better has been done. We've got it backwards. We're doing the oldest, least effective things first, because those are our first line therapies. And then we're saving in reserve the good stuff instead of starting with the good stuff. If you were having a meal, would you want to eat mashed potatoes until you were full and then get the good stuff? Or do you want to start with the tasty stuff at the beginning? Hey, good example. Start with the tasty stuff at the beginning.

SPEAKER_00 7:09

Or just go straight to dessert.

SPEAKER_01 7:11

Life is uncertain. Eat dessert first. Okay? I set you up for that. You did? Or have your coffee. Or have your coffee. So what are we missing? We are really missing having people who can understand how to read the biomarker results.

SPEAKER_00 7:25

Which is something that you could train people, you could help. Or if there was a way that you could do classes for oncologists or something, or maybe that's a continuing education thing for them.

unknown 7:35

Yeah.

SPEAKER_00 7:36

That would be a huge appeal.

SPEAKER_01 7:39

Because the way that the software currently scores and puts together reports is You talked about in the other episode. The one on genomics tests. Genomics.

SPEAKER_00 7:48

So if you could wave magic wand and have the cancer treatment industry completely just changed, you would have it be that first they would get their genomics panel done and biomarkers.

SPEAKER_01 8:01

Yep.

SPEAKER_00 8:01

Are those the same?

SPEAKER_01 8:02

They're not. So both, right? Yes. So for clarity, biomarkers is a bigger set. The genomics panel is a kind of biomarker identification. Those are genetic biomarkers. There are also protein-based biomarkers. Proteins can be present or absent even if a gene is not mutated or destroyed. So for some things we need to look at the protein basis, and there you're needing a physical sample of the cancer so that you can cut a slice, put it on a slide, stain with antibodies against that particular protein, see how much there is, where it is, if it's doing what it's supposed to do. Those are staining biomarkers, like for PDL-1, or HER2 for breast cancer and certain other cancers, or TROP2, the things that we would use an antibody drug conjugate to attack and destroy the cancer. The genome tests are for mutations and gene deletions, and if they include RNA, amplifications where there's more copies of particular genes involved with cancer. And so from that we can tell what the signaling pathways inside the cell look like, and we can pick targeted small molecule therapeutics to attack those. It only makes sense to attack the ones that are a problem, because if you attack the ones that aren't a problem, you're just getting side effects body wide for no benefit. So you need to know what the pathways are inside the cancer that are not working properly and attack those specifically. So protein-based biomarkers, you use a microscope, you look at a slide, you stain for proteins, genome-based biomarkers, you're looking for changes to the DNA and RNA inside the tumor cells.

unknown 9:38

He's so smart. He's so smart, this guy.

SPEAKER_00 9:41

Okay, so the first thing you would do, if you could have it your way, you could change the world.

SPEAKER_01 9:45

If I could change the world like that, the foundation, before we got to you and your world being changed, the foundation would be that the pharma companies would test their drugs on the mutation that they were designed for, and they would get the approvals based on that, not on what tissue the cancer came from. Because that's a current problem. If we've got a drug that works on IDH1 mutations and it's approved for glioma, but you have that mutation, you've got a different kind of cancer, you can't get that drug because it's not a glioma, which is dumb because the drug doesn't care what kind of cancer it is. The drug cares what mutation there is. Approve the drug for the mutation. And push those approvals as early as possible. Get them for first line therapy, not second or third line therapy. That foundation needs to change. Okay, that's changed. For you. I like it. I like it. For you, start with the genomics and biomarker panel. Figure out exactly what's going on in your cancer so that we can make the smartest decisions possible. Start with that.

SPEAKER_00 10:48

And there would be a whole group of a whole system around that.

SPEAKER_01 10:53

Of folks who knew how to interpret that and make sense out of it. Yes. Because currently that really doesn't exist.

SPEAKER_00 10:58

But now it does. Boy, that's nice. Yes.

SPEAKER_01 11:03

Once you have that information, you can sit down. We can plan out these are the targets that are of highest value, these are most likely to be effective and have the smallest side effects. These are the next level, these are the next level. Plan out either the immunotherapies or, and not all immunotherapies are created equal, different cancers have different mutations, different biomarkers, different immunotherapies will work for different cancers. You have to know the foundation of your cancer. But you start with either targeted therapies or immunotherapies. You use those until they are exhausted because those are the best. They have this it's not that they don't have side effects. Those have the smallest side effect profile, they have the biggest benefit. Start with the good stuff first, work your way through that, and then if you have to, then go to chemotherapy. Chemotherapy is great as a last ditch effort. They were originally developed as a last ditch effort. We didn't know what else to do. So we used toxic stuff that killed off fast dividing cells, and we didn't know what was causing it. It worked. Okay. It also does damage to the rest of the body. Now, that damage is better than letting the cancer grow unchecked. It's worthwhile. But if we have something better that does less damage to the healthy cells in your body and has a better chance of getting you a cure for your cancer, you start with the good stuff, and then you end, if you have to, with the things that are broad spectrum, that are blunt instruments. If you're gonna have surgery, you don't start with a sledgehammer, you start with a scalpel, and then you work your way through the different instruments, and you only bring up the sledgehammer if you have to. You don't start with a sledgehammer. Our current scenario is you start with a sledgehammer, then you go to the scalpel. We've got it backwards. So we're going to fix that. The world that I want for you is that targeted therapies and immunotherapies are available first. That we know exactly what your cancer is like, we know the highest value for you, we start with the highest value things, and we work through them as we need to, if we need to, and then only get to chemotherapy if we need to at the very end. And most of the time, we shouldn't need to. 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.