Cancer Strategy: Why Patients Are Seeking a Drug Designer

How I optimize cancer treatment using genomics, immunology, and strategy.

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Episode Description:

People often ask:  “What does working with you actually look like during cancer treatment?”  It’s not pre-recorded content.
It’s not one-size-fits-all advice.
And it’s definitely not fighting your oncologist.  

It’s reviewing your biopsy results.
Your genomics, every detail - not just the two or three mutants mentioned as "actionable".
Your biomarkers, including what WASN'T tested for.
Your PET scans.
Your actual tumor biology.  

Sometimes it means identifying a mutation that changes which immunotherapy will work.  Sometimes it means realizing a recommended drug has almost no chance of helping you.  Sometimes it means avoiding a procedure that doesn’t need to happen.  In our flagship post, Dr. Chaplin walks through real examples of how precision medicine changes outcomes — from melanoma and Keytruda to TNBC, radiation strategy, and overlooked genomic markers.  If you want clarity instead of overwhelm, this is where to start.

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Inquiries: 

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_00 0:00

So, what's it like to work with me during cancer treatment? Hi, I'm Dr. Jay Chaplin. I'm a PhD immunologist and a cancer drug designer. I'm not an MD. For more than 30 years, I've worked in drug development, both in immune biology and translational science aspects. I also work directly with clients, helping them navigate complex cancer treatment. And today I want to show you what that actually looks like. Not in theory, not in marketing language, but in real conversations about real people. Because what I provide is different from what most patients receive. And I think it's important to understand why. Hello, and welcome to Elevate Cancer Treatment, where we explain the science and debunk myths to help you navigate your health journey. 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. 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 chemotherapy. Why? Most doctors will recommend the most commonly effective treatments, but those may not fit into the biology of your specific cancer. Most online cancer programs or coaches are one size fits all, their pre-recorded content, which has the same big problem. One size fits all is rarely your size, and a bad fit in terms of cancer treatment can cost you extra time, extra resources, peace of mind, and cause you to lose out on good treatment options. Many of the people who come to me are overwhelmed. For example, in a first meeting, one client told me I could be dead in two years. Their doctor had said that immunotherapy did not improve survival odds. That information was true, but very outdated. That was based on older papers back while trials were still being conducted, before the survival curves had separated for the two populations. Now we have another decade of follow-up data, but that doctor was still using the old data. What I explained to them calmly was this. Immunotherapy doesn't always work. But when it does work, it often works very quickly. And when it works well, it can produce durable remissions. What do I mean by durable remissions? Well, we now have 10 plus years of follow-up data showing that some patients, about 34%, remain cancer-free long-term because their immune systems developed memory. That's right, 34% of advanced melanoma patients survive over 10 years on Kichruda alone. No one had told him that. And you could feel the shift. Because it's not about false hope, it's not about big generic promises, just accurate and specific data. That's the first thing I do. I reduce fear with real-world results and accurate clinical data. A recurring pattern I see is incomplete testing. In multiple cases, patients were told that they had genomic testing, but when I reviewed the reports, either only one gene had been analyzed or they had been given an inherited mutation test, the kind that tells you if your family has a higher risk of cancer. But that's not a mutation test for the tumor, and testing one gene is not a modern panel. Modern somatic tumor panels examine thousands of mutations. Without that data, we're just guessing at treatments. So I guide clients to ask whether biopsy material remains. If so, how much? How was it stored? All those things matter. Get it sent out for the best comprehensive profiling. There's a biomarker video on this. Some of those biomarker tests are great, some of them are really bad. I guide them to use platforms that give actionable information. In one case, a melanoma patient had been tested for one gene, mutations in the BRAF gene. That is breathtakingly incomplete. Many melanomas have over 100,000 mutations, and while BRAF is one of the most common, it only occurs in about half of all cases. The more information we have together, the more precisely we can tailor your therapy. We can work together for better efficacy and fewer side effects. That's not guesswork or untested alternative medicine. That is precision oncology, which is what we specialize in. Another client recently had a second genomics panel because it had been years since the original. Not only had many new mutations developed, one of the ones discovered, but not discussed, was in a gene called beta-2 microglobulin, or B2M. This gene is part of the system that allows killer T cells to see inside every one of the cells of your body, looking for errors. Without it, those T cells can't work. This means that some immunotherapies, like Urovoy and Relatlimab, can't work at all for that patient, even though they're still being recommended by their oncologist. By not taking those and just taking Ketruda or Opdevo, they aren't wasting their time on a treatment that has no chance of being beneficial, and they can instead focus on other treatments that really can. There's something else I see more often than I'd like. I frequently meet clients whose cases could have been handled more simply much earlier, but they weren't. A small lesion that wasn't fully evaluated, or a biopsy that wasn't sent for complete profiling, which led to selecting chemotherapy that had poor chances of working, or a treatment that was technically standard of care and common, but really not strategically optimized. And by the time they reach me, the situation is more complex. Their tumor is more aggressive, it's a more critical situation. Not because anyone was intentionally negligent, but because modern cancer care moves fast. And subtle decisions very early on can change the trajectory later in massive ways. Cancer biology compounds, and it compounds very rapidly. If you miss an actionable mutation early on, you lose time. If you underappreciate receptor expression early, like a report just saying that a tumor is HER2 negative rather than actually scoring it, you may miss a window of opportunity. If you don't fully characterize the tumor's adaptive strategies, you end up chasing it later on instead of staying ahead of it by planning well. This plays out in another way. One of the most painful patterns I see is someone saying, I wish I had known this six months ago. And that's not about blame, it's about timing. Even cases that look simple at first, they benefit from precision. Especially those simple cases, because simple cases are where you have the most leverage. We don't need genomics, this is just a chemotherapy case. Simple cases have the most leverage. I work with clients to optimize early so that they can prevent that complexity later. Cancer rarely becomes critical all at once. It becomes dangerous over time and through a series of small, unexamined assumptions. Now, whether your case is simple or complex at this moment, it is an investment to work with me. And nothing is more expensive than either pursuing a treatment that can't possibly benefit you, or missing out on a treatment that could benefit you greatly, because your specific genomics were not reviewed thoroughly. In another case, a client had a tumor repeatedly described as neuroendocrine. That word appeared over and over and over in their pathology report. But no one had checked for somatostatin receptor, SSTR2. Somatostatin receptor expression is very common on neuroendocrine tumors. So what? If that receptor is present, there are therapies, including drugs that selectively halt tumor growth, as well as approaches that target radioligand therapies, drugs that can selectively deliver radiation only to the tumor cells, not systemic radiation, targeted. These can potentially eliminate both the primary tumor and adjacent malignant cells. These are great therapies that were not even being evaluated for. With another client, we discussed androgen receptor expression, because triple negative breast cancers upregulate testosterone receptors in about 35% of cases. It's true. And folks rarely think about this or discuss the options. In these cases, the standard treatment of aromatase inhibitors to block estrogen production couldn't fully work. You'd have all of the side effects of the treatment without actually stopping the cancer. It would slow it down, it might shrink it a bit, but it would lead to a delayed treatment failure or recurrence. It shrunk, but it didn't go away. It's much better to prevent recurrences than to try and treat them after they've happened. In a case like that, I suggested adding in a testosterone blocker early so that the treatment would actually work as it was intended. That's not guesswork. That's understanding how the tumors adapt and getting ahead of them. Other ways that this works are with radiation treatments that can be optimized. I have multiple clients that are planning for radiation treatments, and we're discussing strategies to both sensitize the tumors for better killing, better treatment efficacy, and ways to decrease damage to normal healthy tissue and reduce those side effects. These rely on using specific metabolic features of most cancers to essentially paint a big bullseye target on them prior to the radiation treatments. It makes them much more sensitive to the radiation. So we look at the unique biology of your tumor and ask what is this tumor using to survive? And then we can interrupt that specific pathway or capitalize on it for better treatment. Because being as thorough as possible and as early as possible is crucial in dealing with cancer. When patients start immunotherapy, they're often warned very heavily about side effects, and there are horrific stories online. So for immunotherapy, the benefits are really clear, and so are the side effects. Yes, I am not trying to minimize the impact of side effects because they're real and sometimes they're also oversold. For instance, 20 to 28% of people on Kichruda have diarrhea, but only 1 to 1.6% have serious cases like you get with standard chemotherapy. Similarly, vomiting does happen, but it only happens in 10 to 37%, big numbers I know, but they're still below the 40 to 70% rate with most chemotherapy regimens. The story is that these immunotherapies have worse side effects than chemotherapy, but the truth is that, while those side effects do occur, they're actually much less frequent and less severe than chemotherapy. We also look at which checkpoint inhibitor or combination is being proposed or used. Whether the dosing format for these immunotherapies matters. Hint, it often makes a very big difference, both for efficacy and side effects. Same with timing of those infusions. Time of day can make a big difference. We look at common steroid use that blunts immune activation. This is something that's done all the time but undercuts the entire purpose of the infusion. We look at whether supportive therapies, supplements, and off-label drugs are enhancing or interfering with the main treatment. That's really important. In one case, I advised moving away from cryotherapy for suspicious skin lesions. Instead, we talked about using Imiquamod cream, which stimulates innate immune cells. We just did a video on that. That way, every single skin lesion becomes an opportunity to train the immune system. That's synergy, it works really well with the immunotherapies. Just like faking a fever with a hot tub works to boost activity of your killer T cells. That's very helpful in preventing recurrence. Another approach is for clients who are about to undergo dendritic cell therapy. We work together to boost monocyte numbers so they get better cell yields at their blood draws and more effective treatments from those providers. In many cases, we can double the total dendritic cell yield and significantly increase the functionality and responsiveness of the resulting dendritic cells. In a different immunotherapy example, the oncologist was pushing a highly potent combination of checkpoint inhibitors and one with the worst possible side effects. That client's tumor had a particular mutation that made it far, far more susceptible to immune checkpoint inhibitors. And it's a mutation that isn't normally caught on genomics profiles or TMB MSI scores. And that meant that for them, just plain old ketruda or opdivo would likely have an even better effect for them than the harsh combination therapy would have for an average patient. That's an example of using specific tumor biology to your advantage, and that's what I like to focus on. In another case, a patient was being scheduled for an invasive sampling process. But they already had biopsy material. For their cancer type, that specific sampling process was unlikely to provide meaningful additional data. It would have been uncomfortable and probably both unnecessary and unhelpful. Sometimes what I add isn't another drug, it's clarity about what doesn't need to happen. This is also why we always start with a full review of records, all drugs, including the off-label or repurposed ones, and all supplements. In many cases, there are multiple specialties involved, whether it's cardiologists and oncologists not really working together, or integrative specialists or metabolic practitioners. It's very common for clients to have multiple different drugs and multiple different supplements that interfere with each other. For example, I very frequently see both immune-boosting peptides or mushroom extracts being used right alongside immunosuppressive treatments like curcumin and mobendazole, or using antioxidants alongside chemotherapy drugs that work through oxidative damage, including things like artemisinin. Or people taking steroids for most cancers, when it's a really bad idea, or refusing them for leukemias and lymphomas, where it's a great idea. They might double up on berberine and metformin and cause extra damage, trying to suppress a prostate cancer when prostate cancers don't respond to those or blood glucose levels. And there's so much more. It's unbelievably how complex this can be. Clients often say to me, I'm a lawyer, or I'm an IT professional, or I'm an engineer, I'm not a chemist, I'm not a biologist. My role here is to translate. For example, if your lymphocyte counts are low on your blood work and you're about to start immunotherapy, we increase your protein intake and remove any blocks to good immune function. We try and get those lymphocyte numbers back up. We'll stimulate bone marrow production of new lymphocytes so that the immunotherapy has the resources necessary to work well for you, because the immunotherapy is the primary drug that you're taking. If your red blood cells are low, we look at drug interactions and adjust support without adding the nutrients that interfere with treatment. Yes, some of those can interfere with treatment. We look at PET scans. If a PET scan came back positive, we check to see whether it was the right type. Yes, sometimes oncologists use the wrong type of PET scan, or they aren't interpreted correctly. And we look at whether those results make sense. For instance, I know someone who had an entire set of lymph nodes removed from one side of their neck because of a false positive PET scan. That's an operation that didn't need to happen, and damage to their immune system that could have easily been prevented. In another case, two different types of PET scans were being used at the same time, and the two different types are being interpreted as the same thing. This led to ignoring good treatment options in that process, and that case is actively being re-reviewed for the new treatments. We go into these scans, we discuss the differences between the CT scans, the different forms of PET scans, MRIs, the blood markers, what each one is best for and worst for, along with whether you can actually trust them. There are always caveats, particularly with the blood marker tests. Those are not as reliable as most people believe. If someone is eating well but blood glucose is high on the blood work, we rebalance to limit tumor growth if it makes sense for their particular cancer. We might discuss metabolic therapies, if sugar is an especially important factor for that cancer. We'll discuss dietary modifications based on actual clinical data and what target numbers need to be hit to get that benefit. A lot of people have sleep disruptions. That can happen because of the stress coming along with treatment or the chemotherapy itself. And we talk about and distinguish whether difficulty falling asleep or staying asleep. That changes the kind of intervention. Everyone knows about melatonin and magnesium, but those only help with the falling asleep part. Staying asleep is helped more by theanine and apigenin, though the details matter. This kind of thing is not generic wellness coaching. It's not cookie cutter advice, it's not something I can pre-record for you. I specialize in specific and mechanism-based support for your individual circumstances. And that comes into play with the people I work with. The people I work with best are engaged. They want to understand their treatment and why they're getting it. They want to know what will work best for them and why one drug is chosen over another. They want to know the difference between grasping at straws and genuine leverage. They want strategy and the confidence of knowing that they're selecting the best options. So I don't just give recommendations, I don't just give them a protocol. I provide language they can forward to their physicians. I outline what to request and why to request it. I back it up with literature citations, I show how it fits into the broader picture. I work with oncologists, not against them, by giving them verifiable clinical data and clear language they can understand, and that they can get behind, rather than vague questions that they don't have the time to research. I always try to elevate the conversation. If you're looking for someone to analyze your data, interpret your biology, and help you think strategically, we can work very well together. My goal is really simple. For you, I want clarity, precision, and using your specific biology as intelligently as possible. Because when you understand what's happening, fear gets much smaller, and the results get much, much better. 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.