Shawn Ryan Show - #240 Dr. David Fajgenbaum - Can AI Find Cures to Rare Diseases Using Existing Medicine?
Episode Date: September 29, 2025Dr. David Fajgenbaum, MD, MBA, MSc, is a pioneering physician-scientist, tenured professor at the Perelman School of Medicine at the University of Pennsylvania, and national bestselling author who tra...nsformed his personal battle with the rare, deadly Castleman disease into a global mission to accelerate cures for humanity's 12,000 known diseases. Diagnosed after losing his mother to cancer, Fajgenbaum endured five near-death experiences before using his medical training to identify sirolimus—a repurposed drug—as a life-saving treatment, achieving remission marking over a decade cancer-free as of 2025. A Georgetown University graduate with advanced degrees from Oxford and Wharton, he co-founded the Castleman Disease Collaborative Network (CDCN) and Every Cure, leveraging AI and drug repurposing to unlock hidden treatments, earning spots on TIME's 2025 TIME100 Health list and major media recognition for his "cure thyself" story. Through his book Chasing My Cure and speaking engagements, Fajgenbaum inspires hope, advocates for patient-driven research, and pushes for policy changes to speed up cures for rare diseases affecting millions worldwide. Shawn Ryan Show Sponsors: https://americanfinancing.net/srs NMLS 182334, nmlsconsumeraccess.org. APR for rates in the 5s start at 6.327% for well qualified borrowers. Call 866-781-8900, for details about credit costs and terms. https://bunkr.life – USE CODE SRS Go to https://bunkr.life/SRS and use code “SRS” to get 25% off your family plan. https://shawnlikesgold.com https://ROKA.com – USE CODE SRS https://simplisafe.com/srs https://USCCA.com/srs https://ziprecruiter.com/srs https://gemini.com/srs Sign up for the Gemini Credit Card: https://Gemini.com/SRS #GeminiCreditCard #CryptoRewards #Advertisement This video is sponsored by Gemini. All opinions expressed by the content creator are their own and not influenced or endorsed by Gemini. The Bitcoin Credit Card™ is a trademark of Gemini used in connection with the Gemini Credit Card®, which is issued by WebBank. For more information regarding fees, interest, and other cost information, see Rates & Fees: gemini.com/legal/cardholder-agreement. Some exclusions apply to instant rewards; these are deposited when the transaction posts. 4% back is available on up to $300 in spend per month for a year (then 1% on all other Gas, EV charging, and transit purchases that month). Spend cycle will refresh on the 1st of each calendar month. See Rewards Program Terms for details: gemini.com/legal/credit-card-rewards-agreement. Checking if you’re eligible will not impact your credit score. If you’re eligible and choose to proceed, a hard credit inquiry will be conducted that can impact your credit score. Eligibility does not guarantee approval. The appreciation of cardholder rewards reflects a subset of Gemini Cardholders from 10/08/2021 to 04/06/2025 who held Bitcoin rewards for at least one year. Individual results will vary based on spending, selected crypto, and market performance. Cryptocurrency is highly volatile and may result in gains or losses. This information is for general informational purposes only and does not constitute investment advice. Past performance is not indicative of future results. Consult with your tax or financial professional before investing. Dr. David Fajgenbaum Links: Website - https://davidfajgenbaum.com X - https://x.com/DavidFajgenbaum IG - https://www.instagram.com/dfajgenbaum LI - https://www.linkedin.com/in/davidfajgenbaum Every Cure - https://everycure.org Castleman Disease Collaborative Network - https://cdcn.org TED talk - go.ted.com/davidfajgenbaum TED YT - https://youtu.be/sb34MfJjurc Chasing My Cure (Amazon) - https://www.amazon.com/Chasing-My-Cure-Doctors-Action/dp/1524799637 Learn more about your ad choices. Visit podcastchoices.com/adchoices
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Dr. David Faganbaum.
John, thanks for having me.
Welcome to the show.
Thanks for having me.
Hey, my pleasure. So, wow, you've had quite the journey with health. And you made some amazing discoveries. And I don't know a whole lot about it, but we're going to dive into all that. But thank you for coming. I'm really excited about this. And, you know, one of my biggest fears, probably my biggest fear is terminal illness. And we started diving into health stuff last year, you know,
primarily about all the stuff you were hearing on the news about red dyes and all the shit that's in foods and the water and just everything.
And it really got my attention.
And so I've been looking for somebody, you know, on the subject of cancer and you're like right there.
So this is something I've been a subject I've been wanting to dive into for a long time.
So I just really appreciate your time and coming here.
I'm so happy to be here and looking forward to this conversation.
Cool. Well, everybody starts off with an introduction here.
Nice.
David Fagginbaum.
Trailblazing physician, scientist and tenured professor at University of Pennsylvania's Perilman School of Medicine.
Channeled your expertise in immunology and drug repurposing to tackle some of the world's most elusive diseases.
Founder of the Castleman Disease Collaborative Network to accelerate breakthroughs for rare hyper-inflammatory disorder that nearly claimed your.
life five times. Co-founder of every cure, an innovative non-profit harnessing AI to repurpose existing
drugs and unearth hidden treatments for untreatable conditions. Best-selling author of Chasing My Cure
that chronicles your journey and is now being turned into a film. A TED speaker whose 2025 talk
how nearly dying helped me discover my own cure and many more has ignited a movement to change
medicine, a husband, a father, and now living over a decade in remission from
Castleman's.
And you have a great quote that I just wanted to share.
The greatest cures often hide in drugs we already have.
It's up to us to find them.
That's right.
Love that quote.
Love that quote.
So I want to do a bit of a personal story on you, kind of a life story on how this all
happened.
I know you were a hell of a collegiate athlete when you got diagnosed.
most correct and so we'll start there and then go through all your research how you how you cured
yourself and all that good stuff but first we got a couple of things to knock out kind of funny
because I was just talking about red dyes but here's a bag of vigilance elite gummy bears
made here in the USA no funny business no THC no CBD it's just candy with all the horrible shit
that comes along with candy but they taste amazing my kids are going to
love this right on and and then one other thing I got a Patreon account they've been with us
since the beginning it's a subscription account and we've turned it into one hell of a community over
the years they've been with me forever and so one of the things that we do is we offer them
the opportunity to ask each and every guest a question this is from stephen casey
what roadblocks exist in the current medical establishment to the types of
of breakthroughs like yours.
And what can the average person do to advance ideas
like repurposed treatments, off-label use,
experimental use to change the industry
that seems locked in tradition?
Yeah, I mean, the biggest roadblock is that the drugs
that we already have, 80% of them are generic,
which means it's not profitable to find a new use for them.
And so no one's gonna advance those non-profitable opportunities.
So someone's gotta do it, you know, as you said earlier,
we're gonna do that.
But what can you do it, you know, as,
As he asked, you can ask your doctor, you know, is there anything else that maybe is a proof
for one other disease that can maybe help my condition, connect with disease organizations for
whatever the condition is that you or your loved one has?
They oftentimes know about these other medicines could be used and then just be relentless.
You know, if your first doctor tells you that they're not going to, you know, help you
out or be able to, you know, get you that medicine that might help you, you know, go see someone
else.
You know, I'm just, while we're on the subject of doctors, I mean, the health, in my
opinion the health the health care industry is just a complete disaster and um you know i don't know
exactly how it works so i might butcher this a little bit but you know you get the insurance policy
and then they have all these doctors in network you go to those doctors and it's it's it's it's
it's like they just rush to get you out of there you know and so um you know one thing that me and my
family have done is we found um i don't even know what you call but it's it's like the concierge doctor
Yeah, it's kind of like, I think that's what it is.
And they don't take insurance.
You have to, you have to pay out of pocket to do it.
And, you know, but a lot of people, they don't have, they don't have the means to do that.
And I switch because I'm getting older.
I'm over 40 now.
I know shit's going to start happening to me.
And, you know, the big thing I noticed is, you know, if I bring my blood test into
you know, an in-network, typical MD, they look at it for about 20 seconds.
They're like, oh, yep, everything looks good.
And then you take it to, you know, another professional, an MD, who doesn't take insurance,
and they go through it line by line by line, tell you everything that's going on,
order more tests, get more blood tests, go get the can't.
They're very proactive.
And so, you know, not just for people that don't have the means, but, I mean, how do people
find a real doctor, you know, when they, when they have, you know, terminal illnesses come up.
And it's, I mean, it's, I would imagine you're in a, you're in a hurry, you know, to find somebody.
So it's the right question.
And I think that you're right.
I think that some of these concierge doctors, they definitely put more time and effort in.
I mean, that's sort of part of the value you get from seeing one of those doctors.
But I'd also say even outside of that, just within the traditional insurance system,
there are some amazing doctors out there but you've got to find them you know the chance of that like
the most amazing doctor for your disease is is down the street from you is probably pretty low if you've got
a bad cancer or a bad rare disease you might need to get in your car and drive you know just find
that person and I think that we all when we get sick we all want to want our doctor or our local doctor
whoever it is to have all the answers for us to take care of us but for a lot of these really
bad diseases that are really hard to figure out, sometimes you've got to find the expert and
you got to take that extra step that you don't want to take. You know, you want to trust your
local doctor, but I think that sometimes you have to do that extra step to find the right person
for you. What, could you elaborate on that just a little bit? I mean, I mean, for those of us that
have very limited knowledge in health care at all, let alone specific diseases, I mean,
is that a Google search? Is that an AI search? I mean, how do, how does, how does a, how does a
uneducated person in the healthcare industry know what they're looking at.
I mean, how do they, how do, where do they even start to find a good doctor?
I think the first thing is a Google search.
You know, whatever your disease is, you know, throw that into Google, maybe throw in disease
organization, because there might be an organization for that disease.
You can call someone and all they think about is that disease.
They've got a kid with the disease or they have it themselves.
So start on Google, talk to that group, and they will almost always have a few great doctors
they know of that know so much about it.
And I think that that's the key thing for some of these really tough diseases, you know,
they're really tough to treat.
And so you really want to find someone who's got that experience.
And in some cases, like in my case, even the world's expert didn't have an answer for me
because the world didn't have an answer for how to treat my disease.
And that's, you know, obviously a situation you don't want to be in.
All right.
Thank you for that.
Oh, absolutely.
Let's move into your story.
Sure.
So where did you grow up?
What were you doing?
Grew up in Raleigh, North Carolina, youngest of three.
I got two amazing older sisters.
And from the time I was about eight or nine years old, I set my mind on I wanted to be a college quarterback, a division one quarterback.
That's like that became my thing.
I grew up in, you know, Raleigh where NC State and UNC and Duke and those schools around there.
And that became just my total obsession.
I had just like how you got this amazing stuff on your walls, I had poster boards on my walls with like how fast my 40-yard time was, how far I could
pro football. And that just became all I could think about it. From the time I was about eight until
I was 18 was, you know, I wanted to play college football. I wanted to be a quarter rec somewhere.
And that was all I worked on. And I just, you know, worked day and night. And then had the opportunity
got recruited by a bunch of Ivy League schools and Patriot League schools. I ended up choosing to go to
Georgetown for college. Nice. Which you probably didn't know we had a football team of George.
We do a football team with Georgia. We do.
So what was going on when you got diagnosed?
Well, so for me, the big change, yes, misdiagnosed.
And actually, even before that, there was this major change.
So I get to Georgetown, that's like I achieved this dream, going to play college football.
A couple weeks after I get there, I got this phone call that just changed my life.
And it was my dad.
And he said, David, I need you to come home tomorrow.
Your mom is brain cancer.
And I was just sort of like, what?
Like, what, mom?
Because she just was the most amazing person in the world.
And she had supported me through everything.
And, you know, I'd just gone off to college and came home and learned that she had
this horrible form of brain cancer where basically no one lives for more than a year or two.
And I was optimistic and hopeful that, you know, that we were going to, that she was going to
be the one that was going to live, you know, battle this disease.
And she fought so hard, Sean.
But over the course of 15 months, the cancer recurred and it progressed.
And, you know, and she ended up passing away October 2004.
But during her battle, I saw her do so many things that, to your question,
that ended up becoming so critical for me when I got into my battle.
I mean, Sean, she had this horrible brain surgery where they actually opened up her skull
during the surgery while they were taking out parts of the tumor and woke her up while the skull
was open woke her up while they were cutting out pieces of it it's this really intense crazy surgery
they closed it up she came out in the in the waiting area and then they took her back and
i remember my dad my sister's and i going back to see her and we were so nervous like is my mom
going to still be there they just took out a bunch of her brain with this brain cancer is this
going to be the same person that we've loved and just the most amazing person in the world and we get
back and we see her and she's got this wrap around her head and a bulb coming out of out of her
skull and she looks at us and she pointed to her head and she said chiquita banana lady and we just
burst into laughter like she thought she looked like the chiquita banana lady and we were like
oh my gosh like we've still got our mom here like she's still here this is who we loved before
but it showed me that even in the midst of literally the worst surgery you could ever go through
she was thinking about us.
She wanted to make a joke for us, which to me was just this incredible selfless act.
But she passed away, as I mentioned, 15 months after that surgery.
And just before she passed away, I promised her I would dedicate my life to trying to find treatments for patients like her.
I said, Mom, I'm going to be a doctor.
I'm going to try to find drugs to help people just like you.
And she loved the idea.
She had very limited speech towards end for life.
And the two words she could still say were unconditional love.
And she said unconditional love.
And I was like, all right, I got to do that.
And so I decided to go into medicine.
I was pre-med.
I went to Oxford for grad school, pen for med school.
And I was on my way to, you know, to fulfilling the promise to my mom.
You were 19 when that happened.
I was 19 when she passed away.
That's right.
Man, you know, when I lived in Florida, I came home from a deployment when I was contracting
for CIA and I had a neighbor.
Her name was Wendy.
and beautiful woman, beautiful person, two twin boys that were graduating, getting ready to graduate high school.
And she came over and told me that she had brain cancer, and I was like, I didn't know what to think.
You know, I was like, oh, you'll get through it, you know.
And, and, I mean, went on a deployment again, came home two or three months later.
man she was like a totally different person i i just that was the first time i realized how
how bad a brink that this is where my fear that i was just telling you about derives from
and i remember you know watching her she gained a tremendous amount of weight lost all her
and it got it got so bad that you could go talk to her and you knew that she could understand
It looked like she could understand when I was saying,
but she couldn't formulate the words and get them out to me.
And you could just see, like, tears building up in her eyes
because it makes me sad right now because I just had a tremendous amount of respect for her.
And like I said, she was a beautiful person.
And she fucking held on.
Yeah.
She held on.
I think her kids were juniors in high school, actually, at the time.
And it was like a week after they graduated high school.
and they got, they got their, you know,
they knew where they were going to go to school.
She, I mean, she held on for that long,
and I was just like, holy shit, man, that stuff is nasty.
It is.
And I just wanted to share that.
And, I mean, but.
I think you were sharing that.
And, yeah, I mean, when these kids went through
to lose their mom at that age, it's heartbreaking.
It's totally heartbreaking.
It's heartbreaking and it's also, I mean, the amount of suffering that Wendy, your mom, people with brain cancer endure, I mean, to hold on, to have the courage and the drive and the will to hold on to know that her kids are going to be okay, you know, with her gone. It makes me choke up right now, but I mean, it's, it's, man, I just don't wish that on anybody, anybody.
It's the worst.
And that same feeling of like not wishing on anyone.
I mean, for me, it just, there was just this something that just clicked in me and
just snapped, which was like, I'm going to dedicate my life to getting revenge against
these things because brain cancer is one of the worst ones out there, but there are some
other just horrible, horrible diseases.
And it was like, this disease just took my mom and I'm going to spend the rest of my life
however long I've got getting as much revenge as I can on as many of these horrible
diseases as I can.
And you made that promise to her.
I promised her.
How did you, what did you say?
She said that she was concerned about how I would be after she was gone.
She was worried about me.
And this is a couple weeks before she passed.
And I said, mom, I'm going to be okay.
And I'm going to dedicate the rest of my life to trying to find treatments for people like you, for patients like you.
And I'm going to just do this until I help as many people as possible.
And I knew that meant I would want to go to medical school, but I, like, still didn't really know exactly what that meant.
And I also told her that I would start a grief support group for kids in college that were dealing with grief and loss.
I also didn't know what that was going to really entail, but now I just promised my mom these two things on her deathbed.
And now, like I said, she responded by saying unconditional love.
And so for me, it was like, all right, I got two things I got to do.
this life. I got to support other college students that are coping with the death of a loved one.
We named the group AMF. My mom's initials were her name was Anne-Marie Fagan. Her initials were
AMF, and we started this group that stood for alien mothers and fathers. It's been over 20 years.
It's actually still exists. It's now called actively moving forward. And so I knew I had to do that.
And then I now I knew I also had to make sure that as long as I'm breathing, that I'm fighting to try
to find treatments for people.
command you for doing that let's move on with the with the journey here yeah so um you know we get to
now i'm a third year med student making progress um towards this dream um even had just finished an
obfrey and rotation i helped to deliver babies into the world which is sort of like a pinnacle
experience in medical school and then i started feeling more tired than i'd ever felt before um i mean
think about the hours you work you know fatigue and
And this was a fatigue that I'd never felt before, even as a med student.
And I noticed these lumps and bumps in my neck.
I noticed fluid in my ankles.
And I was really healthy.
I was like, what's going on here?
I don't know what's going on.
Horrible abdominal pain.
So I took an exam in the hospital, and I was feeling so unwell that I basically stumbled
down the hallway from where I took the exam to the emergency department, told them about my
symptoms.
They ran some blood work, and the doctor came back really rapidly.
And he looked at me and he said, David, your liver, your kidneys, and your bone marrow are shutting down.
Holy.
We have to hospitalize you right away.
And I'm like, wait, what?
Like, I'm, I'm, I'm, I'm, I'm, I'm, how, I'm, how, me?
How fast did this come on?
This was about two weeks of symptoms.
I went from, like, I was as healthy as you could be.
A few months before that, I'd won a bench pressing contest in the state of Virginia.
Like, I was as healthy as you could possibly be.
And, um, and then all of a sudden, just now in the ICU or sort of,
first hospitalized. Within a couple days, I was in the ICU. I had a retinal hemorrhage that made me
temporarily blind in my left eye. It's visions back. I needed daily transfusions to keep me alive.
I was on something called dialysis because my kidneys weren't working. And like, literally,
I was actively dying. I mean, everything was shutting down. I was active dying. And we
didn't know what it was. Like the doctors are like, we don't know what this is. Like maybe it's an
autoimmune disease. Maybe it's lymphoma, a form of cancer. But like, whatever it is, we got to figure
this thing out really quickly because it was killing me. And, um,
I got more and more sick, so sick that my doctors told my family that I wasn't going to survive.
And so my family came into town, my best friends came in town, like literally one by one marched in.
We snot cried.
We hugged.
I said everything that I ever wanted to say to them.
They said goodbye to me.
Holy shit.
Yeah, this is when I was 25 years old and kept getting more and more sick.
And so at a certain point, my family had a priest come in the room.
and read me my last rights because they were sure that I wasn't going to make it.
And fortunately, right around that time, they did something called a lymph node biopsy
where they cut out my lymph nodes because they thought I had cancer of the lymphones called lymphoma.
And when the doctors looked at it, they said, we don't think this is lymphoma.
We think it's something called idiopathic, multi-centered Castleman disease, which I was a med suit
and I'd still never even heard of it before.
But basically, it's a disease where your immune system attacks your organs until you die.
It just destroys you and kills you.
But the only thing they knew to try was chemotherapy.
They were like, well, if your immune system's trying to kill you, maybe we'll try to
kill the immune system with some chemo.
And so they gave me chemo in this sort of last-ditch effort right around the time.
I had my last ride to me.
And it just sort of kicked in just in time.
And I survived that.
But then I would go on to have a bunch of relapses.
What is it?
What's going through your head as a 25-year-old man knowing that you're being told that you
have a terminal illness?
I mean, you're saying goodbye to your, you're, you're saying goodbye to your, you're
family you got a priest reading your last rights i mean how do you handle that it was i think about
this all the time if it would happen to me because it's i mean these these things just say that
they seem to be more and more it's like every day yeah you know i hear somebody else my mom got
diagnosed with cancer my you know my you know my my friend who my friends like all the it's just
it's like every day yeah you hear somebody else is diagnosed with cancer that's right
Yeah. I mean, it was heartbreaking. I was devastated. I had this amazing girlfriend, Caitlin, that I wanted to have a life with. I'd made this promise to my mom. I was going to treat all these patients and I was going to discover all these treatments. I wasn't going to be able to follow through on. I just felt like there was just so much that I was never going to experience that I wanted to so badly. And I didn't have any regrets about what I did in life, but I just had this feeling of regret about things I never would get to do or that I never got to do. And I was just heartbroken. But, you know, I think
that I ended up spending about six months in the hospital and critical condition. And I think
about, you know, some of the things that you've gone through as a soldier and sort of just like
fighting, you know, one day at a time. And I think that there's three things that helped me to get
through that, those six months of survival. And I'd love to hear if you've thought about these
in the same way. But for me, it was like, for those whole, for the entire six months, I kept
thinking about what I wanted for my future, which I kept visualizing like a family with
Caitlin. I kept visualizing like me in the lab trying to find drugs for patients. I had to have
this vision for what I was fighting for. So that was the first thing. The second is that I had this
like amazing support group around me. My dad, my sister's Caitlin. Like they were literally
holding my hand, like giving me strength. I could feel their strength from the way they were
holding my hands from their voices like that that gave me strength. And then the third thing is
that it really was this like it's this cliche of like one step at a time or what.
like one breath at a time.
But it was, for me, it really was one breath at a time.
Like, if you told me at the beginning of those six months, like, David, you're going
to suffer the most horrible pain for the next six months.
Every breath you take is going to be horrible.
I gained 100 pounds of fluid.
Like, you're just going to be in constant agony while your organs are being destroyed
by your immune system.
There's no way I could have been like, I can do this for six months.
But I knew I could do it for like an hour.
And then like, all right, I can do it for an hour.
Maybe I can do it for two hours.
And then those hours just started stacking up.
All right, I did for a day.
Like, I can keep doing this.
As long as I've got my family around, I couldn't have done it if I was on my own.
But as long as I've got them supporting me, I can do this.
And all of a sudden, they stacked up.
And then I made it through.
Did you ever come to acceptance?
Well, I don't know if I would say acceptance, but there was one point where I was ready to give up,
where I started slowing down my breathing.
And my family was around me.
And my sister, Gina, was holding my hand.
And everyone was saying goodbye.
I just had my last right spread to me.
And it hurts so bad to take every breath.
And it was just like I was fighting.
And then I started to slow down.
And I was going to let go.
And I heard my sister, Gina, and I can picture it.
I can hear it.
And she said, just breathe, Dave.
Just breathe.
And I heard that I was like, all right, I can do this.
I can do another breath.
And I was like, I'm not going to slow down.
But in my mind, when I was slowing down my breathing and letting go,
I was expecting that I was going to be letting go
maybe a couple days of life early.
You know, maybe it's like maybe it's a day of life
that I, you know, a day of suffering, basically,
that I was going to be sort of letting go.
Like you said, Wendy, she was fighting.
Like, you can fight for survival.
There's that, when you're at the end,
you can keep fighting or you can let go.
And I was going to let go.
I was right to let go.
But when she said, just breathe, Dave, just breathe.
I was like, all right, I can do that.
I'm going to keep doing a couple more breaths.
And, Sean, if I'd let go then,
I would have known that I would be here 15 years later
sitting here with you.
Like, I, like, but I took that extra breath.
I kept fighting and then thankfully the chemotherapy kicked in and, you know, I'm sitting here with you 15 years later.
Man, I mean.
Yeah, if she hadn't said keep, if she hadn't said, just breathe, Dave, just breathe.
I'm not here.
So it is, I mean, I often think about that.
I mean, what, like I said, when I was just talking about Wendy, you know, maybe your mom.
Yep.
You know what I mean?
I think that you can, you can prolong.
You can at the very end.
Death.
I mean, how does that, from somebody that faced it, I mean, five times, I mean, what, is it just letting go and then you think it just happens?
That's right.
You're fighting.
You've got, you've got adrenaline.
You're like at cortisol.
You're like literally giving everything you've got to every breath.
You're like, you're doing everything you can to stay conscious, to stay there, to keep going.
And obviously, you know, I only was.
sort of prepared to go once and I don't sort of let go once but but you know quickly said
now I'm going to keep fighting because of my sister but yeah with each of so that was the first one
and then two two near death experiences happen the next few months in that six month period
where my doctors again were like he's not going to make it and then every all the blood work
everything said I wasn't going to make it but I got more chemo by the end they were giving me
seven different chemotherapy drugs like the worst chemoes they have at the highest possible doses
is thinking, like, maybe we can stop this somehow.
And thankfully, they would sort of just get me by.
But then when I relapsed again a year later
and then relapsed again, a year after that,
again, both of those times, it wasn't like,
this is maybe going to be it.
It was like, this is it.
Like, you fought really hard, you made it.
But for me, each time my doctors told me
that I wasn't going to make it after that first one,
I was like, yeah, but you told me I was going to make it last.
I'm going to keep fighting.
I'm not like, I got this amazing girlfriend, Caitlin.
I want to get married to her.
I don't care if I'd, you know, I'd go shortly.
Well, I didn't want to go shortly after I got married to, but I wanted to get married to her.
I wanted to have this family.
I wanted to do these things.
And so I think that there is a real ability to keep fighting.
But of course, for me, the chemotherapy was necessary.
It's not like I could have willed myself into doing this.
It was that, you know, chemotherapy, you get my diseases under control and I could keep fighting.
Did you think about what would happen after death?
I did.
Um, I, uh, you know, I said a lot of prayers. Um, and I, uh, you know, I, you know, I spent so much of that time when I was on my deathbed, um, sort of sad about the things that I was going to leave behind here that I spent a lot less time forward looking into what, what was going to happen afterwards. There was a lot more just, you know, sadness about what was behind me.
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and I haven't gone through anything like that, so I can't, I cannot relate. You've been in battle
and you, you know, I just, you know, it was, it was different for me. I fear it a lot more than I did
back then i mean back then i figured i i had thought that i had reached the pinnacle in my life i was a
navy seal i was you know cia contractor where do i would where do i even go from here you know yeah
i could have gone maybe and tried out for development group but i mean it was pretty damn close to
the pinnacle and um you know but and so i just kind of always if it got hairy i kind of always
considered myself dead already or or i i just never really expected to come back from any of those
deployments wow you know but but i mean in relation to now i mean that was an easy thought i didn't
i had brothers and sisters and parents you know but i didn't have kids your wife yep nobody on my
radar you know all i was doing was was that and so so i can't really relate you know what i mean
to what you were going through.
I didn't have a fiancé.
I didn't have my future was exactly what I was doing at that point of time,
which was what I loved.
And so it was, if I'm going to go, it was a great way to go.
But luckily I made it through.
Yeah, well, I thought you did.
But you too.
But so let's move on.
Yeah.
So I make it through that six-month period, somehow, some way.
And I got put in an experimental drug, a drug that was going on.
into clinical trials for my disease, my rare disease, this disease called Castleman's with,
you know, a thousand patients diagnosed a year in the U.S., like super rare.
And we thought it was going to keep me in remission.
So I went back to med school.
Caitlin moved down to Philly.
We're like living together and I'm back on track.
You know, I'm still leading this grief support network called AMF, but I'm back on track.
You know, I'm going to find treatments for patients.
I'm going to finish med school.
I'm going to take care of patients.
And then I started to relapse on that experimental drug.
And, Sean, that was so hard mentally and emotionally to go through.
Like, this is the drug that's supposed to work.
Like, it's working for other patients with my disease.
And it just wasn't.
I, like, relapsed right through.
It ended up back in the ICU with all my organs shutting down.
And mentally to go through that, that was really, really tough.
And my doctor explained to me, this is now for the fourth time.
You know, David, you know, you're actively dying.
This is, it's unlikely you're going to survive this.
And the drug you were just on is the only drug that anyone is working on for your disease.
There are no more leads.
Like, this is it.
The drug you're on that you just relapsed on, this is it.
There's nothing else.
And I remember my dad and my sisters and Caitlin were around me.
And I remember there was like a minute or two of us just like crying our eyes out.
Like this is, you know, this is the world's expert.
This doctor is in Little Rock, Arkansas.
He's like the world's expert for Castleman's.
And I'd gone to see him, just like we're talking about earlier, like, you go to the expert.
And he's telling me, like, there's nothing else.
Like, this is it.
We tried everything.
And he said, I'm going to give you the chemotherapy that you got in the past, all seven of those
chemotherapy drugs.
I'm going to give them the highest possible human dose we can give.
Let's hope they work.
But you're approaching the lifetime maximum of chemotherapy, this one drug called atromycin.
We're not going to be able to keep giving you more.
And this stuff's going to stop working.
So, like, you just sort of need me to be prepared for that.
And so we were in balling our eyes out.
And then when the doctor left the room,
something sort of clicked the same way
that it clicked with my mom.
And that's what I told them
that I'm going to dedicate the rest of my life
however long that is,
trying to find a treatment for Castleman disease.
And I didn't know what that would be.
And frankly, I didn't have a billion dollars
in 10 years to create a new drug,
which is about how much time and money it cost
if you want to make a brand new drug.
So I didn't have the money.
and of the time, but I had a really simple and important realization, and that was those seven
chemotherapies that I kept getting that kept sort of barely saving my life, none of them were made
for Castleman disease. They were all made for cancer of the lymphids for lymphoma, but they were
saving my life from Castleman. So I was like, well, wait a minute, you're telling me there's no
more drugs for Castleman disease, but you just use seven drugs for lymphoma and those just saved my life.
So like, what if there's an eighth drug for lymphoma, what if there's a ninth drug for something else that
could work for Castleman's. And my doctors were sort of like, well, but there's nothing else that
we know of. And I'm like, yeah, but we have, have we tried all 4,000 drugs for Castleman
disease? And so that became my just total, like, locked in focus. It was like, I can't develop
a new drug from scratch. I want to get married to Caitlin, have a family. I want to develop drugs and
treat patients. I got to find a drug that already exists for something else, and then I got to try
it on me. And that became just my total focus. Where do you start? So,
To start, I spent a lot of time just sort of researching online, like, are there any case reports of doctors trying different things?
Like it happened in Japan, there was a doctor that was trying these different drugs.
And so then when I relapsed for my, and had my fifth deadly flare, I actually started trying those drugs that were being used that had been used in other parts of the world.
I asked my doctors, you know, would you prescribe this drug?
It had been used in Japan.
And we tried it and didn't work at all.
And I said, well, can you try this other drug?
It was used for a disease like Castleman's.
And that drug kind of worked, but I just relapsed right through it.
I ended up back in the ICU.
And I felt so disappointed because I had spent that year, like, thinking about what could be tried
and we tried these two drugs.
But the third thing I had done was that I started storing my blood samples every couple
weeks in the freezer at a lab at UPenn because my belief was if I relapse, and I thought
I probably would, that I needed to get those blood samples so I could figure out what was going
wrong so that way I could target it.
I needed to get, like, basically some evidence to figure out.
out what to what to go after.
And so thankfully, I survived that fifth episode again, again with the seven chemotherapies.
And when I got out of the hospital, and actually even when I was still in the hospital,
I turned to my sisters and to Caitlin.
And it was like, let's get all the samples we can.
All those samples that are in freezers, the lymph nodes that are here and there, get them
all to Philly.
I'm basically going to go to the lab and I'm not going to leave until I figure something out.
And so got back to Philly.
And then I just worked basically day and night running experiments on.
I thaw those blood samples, sort of measuring proteins in the blood, measuring what those immune cells were doing.
And I eventually identified that a communication line in the immune system, you've got all these immune cells all over your body, and they got to communicate with one another.
And I discovered that one of those communication lines was turned into overdrive.
Sort of like, to me, I thought of it as like, it seems like maybe the fire alarm is going off in my immune system, even when it shouldn't.
It's like a false alarm.
And so, therefore, it's attacking everything.
And what was really important about that discovery, Sean, is that there's a drug that's been around for decades.
decades that can turn that communication line off. And it was made for organ transplantation.
So like if you were to get a kidney, your immune system would attack your kid, that new kidney,
that transplanted kidney, unless you took this medicine, which would prevent your immune system
of attacking that transplanted kidney. And that drug turns this one communication line off.
So I went to my doctor, a doctor in D.C. and I was like, hey, would you consider prescribing this?
And he's like, well, it's never been done before for Castleman's. Like, it could cause problems.
Like, it could turn things in the wrong direction with your immune system. Maybe this could kill
you. And I said, well, but I've almost died five times and I'm out of options. And so
he prescribed it. And so I started taking it and it's, Sean, it's not been over 11 and a half
years. I've been doing great on this drug. No, no relapses, just full remission. Wow. Do you
still have to take the time? I take it every day. I took my three pills this morning. And, you know,
the moment that that these drugs are, are these three pills, started working for me, Sean,
I immediately have gone into this just total focus and obsession like, holy shit, like how many
other drugs are made for other diseases that could treat more diseases?
You know, like this drug wasn't made for me and it's saved in my life.
Are there other drugs that are out there that could treat more diseases?
And are there people suffering today that could actually benefit from a drug that's already
sitting in their CVS?
Because I shouldn't be here.
I mean, I'm alive thanks to this medicine that I discovered.
But if I had died at any point of those previous three and a half years,
we wouldn't know that Cyrilliamus could treat Castleman's there's thousands of people around the world
that are benefiting from this drug and it's like no one would have figured it out how many more
of these hidden cures are just sitting there did you did you ever i mean did you talk to the
doctor in arkansas about this i mean what it would what was that conversation like yeah
talked to him about it you know he's he's he's incredible and i'm i still work closely with him
um yeah i mean he he basically said look david it's never been tried before it's probably not
going to work. But there's probably not too much downside, or to your point, even if there is a
downside, like, I'm already going to die from this disease. So, like, we should at least give it a
shot. But there was no data. It hadn't been using a human before with Castleman. So, like,
I can understand the hesitancy because, like, it could have turned things even worse. But it also,
it was sort of my last-ditch effort to try to stay around. What did he say afterwards?
He, you know, it was sort of a test of time because, you know, I started to feel. I started to
feeling better, my blood results started getting better.
It was clearly working early on, but I'd gotten better multiple times before.
And then it came back within a year.
And so I sort of wasn't willing to get too excited.
Like I just sort of was like, all right, it's going to be a test of time.
Like, you know, cautiously optimistic.
And I started taking it in January of 2014.
And Caitlin and I, our wedding day, it was May 24th, 2014.
So it was like, am I going to make it to May 24th?
It was sort of this countdown.
Wow.
And we made it to May 24th, and my hair grew back, like, just in time.
for wedding day because all the chemo like it came back just in time and like wedding day like
my hair's back I made it to May 24 2014 and we had the most amazing like every wedding is
amazing this wedding was like extra special because everyone that was in attendance was like
I can't believe this is happening like and I couldn't believe it was happening like and then of
course you know when you think about you know saying till death do us part it's like it has a whole
different meaning when you know that the person you're marrying and for me Caitlin they're
Like, she was there with me through everything.
You, we had a little conversation before the interview about how you guys were engaged
and you had a question for, could we revisit that?
Absolutely.
What an amazing woman.
She's incredible, isn't she?
Just with me through everything.
And so, yeah, the question I had for her was, right when I finished those six months in the hospital, Sean, you've seen the picture of me.
My head's bald from chemo.
I've got this huge belly because of my liver, my kidneys aren't working.
and actually I'll tell a story about that in a minute and Caitlin came down to visit me in North Carolina
that's where I've been hospitalized and we're sitting on this couch in my sister's house and I got my
hand over my head I remember just been like Caitlin you know I've got a I've got a terminal illness
and are you sure you want to be with me like you could find so many amazing people like you're amazing
like are you sure you want to be with me i'm going to be sick and like i don't know how much
longer i have and i remember she looked at me and she like looked offended and i was like wait
what she was like of course i do like why would you even question that like absolutely i want to
be with you and then what i was saying to you what i was joking about i was like once you said that
i'm not going to ask you anymore like i'm going to take that you know you've told you've said it
i've warned you and you said you want to stick around with me and so i never asked again
And she's just been amazing.
She, you know, just by my side.
But I got to tell you the story from just before that conversation, right before I was,
or about two months before I was discharged from the hospital, it was New Year's Eve 2010.
And I was just sort of, I just got in chemo.
I've just sort of like finally well enough to walk around the hospital.
And my dad and I decided to do a walk on December 31st, New Year's Eve night, about 8 p.m.
And so I've got this huge belly, my head's ball from chemo.
got my infusion that I'm rolling with.
And we passed by the family waiting area on the cancer floor.
And there's a guy who's like visibly drunk.
He's sort of like swaying in his chair on this unit.
And we come by the next time and he's falling on to the ground.
And so my dad runs over to him and helps him back into his chair.
And he looks at my dad and he says, thanks so much.
Good luck to you and your wife.
And we're like, wife, what is he talking about?
Then I look down to my belly and I realize he thinks that I'm
my dad's pregnant wife and that we are walking laps to deliver our baby on New Year's Eve.
And so I turned to my dad and go, man, dad, I go, you got an ugly wife. And we just die laughing.
But like, that's what I looked like, Sean, when Caitlin was, like, offended that I was like,
are you sure you want to be with me? Like, that tells you how committed she was to me.
Wow. That's amazing. Is she a medical professional, too? She's not. She's, uh, she used to work in the
fashion industry. And now she's full time with our kids. She also helps a lot.
with castlemans and every cure and raising awareness his the what was the drug that cure that the
cure you the drug's called syrilymusis the other name for it's rapamycin and that's a drug that
maybe some of your your listeners will be familiar with rapamycin is an mTOR inhibitor
and actually it's thought to have some anti-aging properties and so sometimes people take low doses
of serilimus or rapamycin i take a really high dose like my dose like destroys my immune system
Damn, have you, has this been, have other people with Castleman's been treated since then?
Yeah, so once it started helping me, and once the months and the year started going by,
right around the time actually I joined the faculty of the University of Pennsylvania to build a center to do more of this,
basically to study the immune system to figure out are there drugs that already exist that you could repurpose,
that became my life's mission.
So I started that at Penn, and then we started treating Castleman's patients with this medicine.
And it actually worked for the first three patients that we treated.
And I was sort of like, oh, my gosh, maybe we figured it out.
Like, maybe it's going to work for everyone.
It turns out that it works for about a quarter of patients.
And so there's still more work to be done.
But, yeah, I mean, the first patient that I saw that we treated was this young boy named Joey,
who was in the Children's Hospital of Philadelphia.
And I'll never forget, like, seeing him just before treatment was started and then seeing him a couple days later.
And like, seeing the blood work and seeing that things were improving.
In days.
Within days.
Within days, he was critically ill in the hospital, and within days seeing things were starting to stabilize, and they started getting better.
And I would come by every day, and his mom would hand me the lab test, and I would look at it, and I was like, oh, my gosh, Joey, this is working.
And, like, for me, that meant so much.
He's now a sophomore in college at Temple University in Philadelphia.
I just saw Joey a couple weeks ago.
And, like, he wouldn't be here, if not for this drug that I came across, that saved me, and now we've got patients all over the world on it.
It just means everything.
I mean, how does that, I mean, if it works 25% of the time, I mean, that's, I mean,
a thousand people a year in, in the U.S., you said that have this 250 that are going to go on to do greater, great things.
Yeah, exactly.
I mean, how does that feel to you?
It feel, it's incredible.
And, you know, the feeling, and actually the thing that's most incredible, Sean, and I don't know if you'd immediately appreciate this,
but for me, what I found is the most incredible part is when I get to hear about what these people
are doing basically in this overtime that they've got so like Joey's a
sophomore in college Kyla who we've repurposed another drug to save her life
she's now trained to become a nurse she wants to take care of the other sick
you know of people with illnesses like nurses took care of her Michael who has a
rare cancer we repurposed a drug for his cancer he walked his son down the
aisle a year ago eight years after he was diagnosed with this terminal
cancer and then just
last weekend here in Nashville, he walked his daughter down the aisle. And like, when I get to
see those pictures, when I got to hear about those things that they wouldn't have done,
like, for me, that's like, it's one thing to be like, oh, months or years, but it's like,
oh, I got to walk my daughter down the aisle nine years after I was diagnosed with a terminal
cancer, that's what I just, that's just the most incredible thing for me.
Man, that has to feel amazing. It's incredible. It's incredible. And it's, you know, it's sort of like
it'll really drive you to want to keep doing it, right? Because it's,
It's an experience when you hear about any one of these things where you're like, I just want to do this for more people.
And so it's this combination of like when you can help people like that that means so much.
And of course, in my case, I'm like every day I breathe.
I can remember what it was like.
But the other thing is that there's also all the suffering happening right now in the world.
And there's people, as you mentioned, getting diagnosed with this disease and that disease.
And every day, Sean, I'm hearing from a patient with a horrible condition or many of them.
And so you sort of juxtapose like all of the incredible.
hope that you get from all the people you can help. And then all of the people who are suffering
right now from horrible diseases. And that's just true not to say, like, we've got to make sure that
all the drugs that we've got, there's about 4,000 drugs that are FDA approved. We've got to make
sure every one of them is used for every disease they can possibly treat. So that way, these people
suffering over here, if there's a drug for them, we got to get it to them. And it's not that I
believe, Sean, that every patient with every disease could be treated with an existing drug. I don't
believe that's the case. But I do believe that if there's a drug that could treat some of them
or a fraction of them that's already at our CVS, we've got to find it. Yeah, you know, I mean,
I don't know how often this happens, but just two examples off the top of my head. I mean,
Viagra was originally a blood pressure medicine, correct? Now people are getting busy in their 80s,
and hopefully I'll be one of them. But, you know, and then the other one that comes to mine is,
And I've never used it, but Ivermectin, you know, with COVID.
I mean, we've, a lot of people, Joe Rogan, you know, swears by Iverneptin, you know, to fight COVID-19.
And so how many other of these drugs are there?
There are a lot of drugs that can be used in multiple ways.
You know, Viagra is a funny one because not only, as you mentioned, it go from heart disease to erectile dysfunction, but it actually is also used for this rare pediatric lung disease called pulmonary or hypertension.
kids were dying because they weren't getting enough blood flow to their lungs, and a random doctor thought to themselves,
huh, if this can increase blood flow for these, you know, older men, could it maybe increase blood flow to the lungs of these little kids?
And then it was tried and it worked.
And like, for me, those sorts of examples were like you would never think of pulmonary arterial hypertension in little kids as being similar at all to erectile dysfunction, right?
And it's because even though the conditions appear very different, they share the same underlying
problem, which is limited blood flow.
And so there's a lot of examples in medicine.
And there's another drug you've probably heard of called thalidomide.
It caused all these horrible birth defects back in like the 50s.
That drug can treat leprosy and also this rare cancer or this blood cancer called myeloma.
And leprosy and myeloma, again, they seem so different, but they share the same underlying
problem.
And so it turns out that just like you said, there are drugs that can do one thing in the
One thing in the body, they can actually have an effect across multiple diseases.
And typically, this is discovered through sort of random chance.
Like this doctor I mentioned in Houston who was like, huh, I wonder if Viagra could be useful for these kids.
It happens sort of randomly.
And there isn't like a system that exists.
There's never been an entity, whether it's in the government or within industry, that's just been focused on saying, okay, among the 4,000 drugs that are approved that are available, what are all the other diseases they can treat?
And because it hasn't been done systematically, I could decide.
discover a drug like Cyrilimes could save my life.
And, you know, drugs can be found like Tosolizumab could be used in all these different ways.
So there's all these drugs out there, and there's just never been an entity to say, like,
we're going to match in everything we can.
So how do you, I mean, how many drugs have you, how many drugs have you personally found the treat?
We've advanced 14 drugs for, 14, for diseases they weren't intended for.
14 drugs.
Yeah, 14.
Is that incredible?
And that's in the last just 11.
years, you know, since, you know, Cyrillimus, of course, being one of them. And that's primarily
from my lab at Penn, where we're focused on just a few rare cancers and inflammatory
diseases. And so about three years ago, I'm sitting here thinking, okay, in our small
lab at UPenn, we're advancing at that stage, it had been over 10 drugs for diseases they weren't
intended for. It's like, how many more are they out there? And what was so important that this came
up about three or four years ago is that one of my really close friends from medical school,
Mitchell was really pioneering the use of artificial intelligence to use medical record data to
try to figure out subtypes of patients that could benefit from one drug or another drug.
And we came together and we said, what if we could utilize artificial intelligence to scan
across every drug and every disease?
Like my lab works on a few diseases and a few drugs.
What if we could actually scale what we're doing for these few, but to all?
Like what if we could use AI to look across all of the world's knowledge to come up with
how likely every drug, all 4,000 of them, or to treat every disease?
disease, all 18,000 diseases. And if AI can help us to figure out what looks most promising,
then we can do the hard work afterwards. We can work in the lab. We can do the clinical trials.
We can do what's needed to prove it. But let's actually start by using AI to make these matches.
And so Grant and I co-founded a nonprofit called EveryCure along with Tracy Sikora, our other co-founder,
which is on this mission, which is to save and improve lives with the drugs we already have.
And we start out by using AI to scan everything, the world's knowledge of everything versus
everything to find out the very best opportunities to take forward.
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Wow.
Let's, I want to get into that more in depth, going back a little bit.
I mean, you're researching.
I mean, how many drugs are there?
There's 4,000.
4,000 drugs.
I mean, there's a lot of conspiracies around pharmaceutical
industry and that they don't want to cure cancer and they don't want to cure these drugs.
They just want to prolong, you know, and basically what I'm getting at is they just want
to make money. They don't really give a shit about people's lives. I don't know if that's
true or not. You know, a lot of conspiracies running wild in the world today. But one question
I have is, I mean, when you find a drug like this, especially the one that you were just talking
about that was kind of a sleeper back that they were using and then the 50s, it was pretty birth
defects. I mean, I don't know what company developed that, but I mean, do these, when you're
taking a drug that's, you know, that's a Pfizer drug or whatever, are these companies helping
you do the research? Are they funding it? I mean, because they stand to make a lot of money
if you repurpose the drug and you do the research, correct? It's a great question. And it ends up that
it's like such, it's so much more complicated than it should be. And the reason it's complicated is
that once a drug gets approved for one disease, it has about an 8 to 12 year lifetime before
it goes off pad and it becomes generic. So basically, drug companies, when they develop a drug
for one disease or a couple diseases, they've got an 8 to 12 year clock before it becomes generic.
And once it becomes generic, then anyone can make a copy of that exact same drug. And they all
make, there might be 10 people making the same drug, and the price plummets because it's all the
identical drug. And so drug companies stop making money once their drug becomes generic. So they
have to think in those 8 to 12 years, what are the diseases that are most profitable? And so
they tend to go after the most severe diseases because the most severe and the most common
diseases, because that's typically where they're going to be able to charge the most amount of money.
So how common is it and how severe is it? That's usually where they go. But they can't typically
go after a lot of different diseases because they want to really focus on maximizing profit for the
few they can. So it's not that they're avoiding diseases. And again, this is partly in my opinion,
but I'm saying it as someone who, you know, lost my mom to cancer and who personally has battled
these horrible diseases. If I was seeing things like people hiding cures, I'd be the first person
to talk about it. What I'm not, I don't see that. What I see is that drug companies focus their
drugs on whatever diseases they can make the most money on in those eight to 12 years because
their businesses. And the moment that drug goes off pad and all research stops. So what that
means is that we've got 4,000 drugs. Well, 80% of them are all.
already generic. So there's no drug company that has any interest at all in selling more doses
of that drug because there's 10 manufacturers and they all sell them for a penny a pill.
And so the problem is that, in my opinion, the problem is not that drug companies are not pursuing
these additional uses. The problem is that if I discover that ruxillidinib can be useful for a new
condition after ruxlidinidin, like I got to figure out a way to drive forward the science for it.
I got to figure out a way to get, whether it's the government or philanthropist or individuals to donate to do the research because the drug company is like, hey, I made it like a few years ago, but like 10 other people are making it right now.
And I don't make any money off of that drug.
I'm on to another drug now.
And so I think that that's a problem in our system is that 80% of our drugs are not profitable to find new uses for them.
So that means someone's got to stand up and do the work, right?
It's like whether it's the government or some entity.
And so that's where we at every cure said, like, we figured someone else was doing it.
Like, when I got into something, like, there's got to be someone who's doing that.
And it's like, oh, wow, there's no one who's picking these things up once they're generic and finding more uses for them because no one's incentivized to do it.
So we've taken that up.
How do you fix this at scale?
I mean, I have a feeling you're going to say AI, but I mean, and maybe that is the answer.
Is there a better answer?
Is there, would it be, I mean, I'm just curious, you know, let's say the U.S. government gets.
involved, you know, and they start to incentivize the drug companies to continue their research.
Yeah.
Maybe they grant the patent for another 10 years, or maybe they subsidize it.
And, I mean, what is your answer?
I think what you just described, I think that's the only way you can do it is that if you
want to do this fully at scale, I think what you have to do is you have to incentivize these
companies to say, like, yeah, you get more patent life or maybe your drug that's off
patent, you can, you know, get a patent back on it.
The thing is, is that if you do that, you're going to end up saving a lot of lives because that's going to drive a lot of cures.
You're also going to increase the cost of health care because those cheap drugs that are generic, it's good for the health care system for them to be cheap.
That means that they go from being thousands of dollars or tens of thousands of dollars a dose to like tens of dollars or hundreds of dollars a dose.
That's good for cost of our health care system.
So it's going to increase cost.
It's going to increase cures.
And so like that's where the that's where the challenge is, is that if you incentivize that you're going to,
to increase pharmaceutical costs. Now, I would make a pretty strong argument that even though
you're going to pay more for drugs, you're going to end up saving the health care system in the
long run because people are going to spend less time in the hospital. They're going to have less
other issues, less, you know, comorbidities because you're going to be treating the actual diseases
and they're not, you know, with the drugs we already have. So it ends up becoming probably, I think,
close to a wash or a cost saver. I mean, what I think is needed is for the federal government to
also just rather, one is you can incentivize a drug company to do it, or you can just spend
on proving these things work and then use the cheap version of it, you know, use the drug that's
already out there. And that's basically what we're doing right now. At every cure, we actually
have a federal contract with an U.S. agency called ARPA-H, where they are actually funding a lot of
the work that we're doing, and we're finding new uses for medicines that will end up saving money
to the healthcare system without actually, you know, creating these sort of incentives that maybe
aren't aligned.
team. We're about 50 people.
50 people? Yeah.
Is that enough?
I mean, I think that when you think about the world we're in, which is we got 4,000
FDA approved drugs and they're approved diseases, but there's 14,000 more diseases
that don't have any approved drugs. That's a crazy stat, right, Sean?
You know, a lot of those 14,000 are very rare diseases, but they collectively, we're talking
tens of millions of people have these 14,000 diseases with no treatments. And so
there's a huge opportunity to match these 4,000 drugs.
these 14,000 diseases that, yeah, a 15 member team's not going to be able to do.
So, you know, I think that at some point we're going to need an effort, whether it's ours
or in others, that's as big as the Pfizer's and the Merks of the world that are like doing
the non-profit drug development.
I mean, we joke that every cure is, it's a nonprofit drug company, basically.
You know, we're just looking for the non-profitable stuff to help people.
You know, we don't care what the drug was made for.
We don't, you know, care how common the disease is.
we just want to relieve suffering with the drugs we already have.
But we joke that we're both like the biggest drug company of all time because we'll use any
drug out there that can help people.
But we're also the smallest drug company because we don't own any drugs.
We're just using the things that are already out there.
But I think that proving out the impact of what we're doing and using AI to focus us in
on the right opportunities, I think is important.
And then as we help more and more people, I hope that that will lead to more support,
whether it's from individuals who care about someone with a horrible disease or whether
it's philanthropist or the federal government, I hope it's going to lead to more, more opportunities
here. Because like I said earlier, I'm alive because of a drug that wasn't made for my disease.
And there's a lot of people suffering today that could benefit from a drug we already have.
And so it's government funding in conjunction with donations.
That's right. Philanthropy as well.
Where do people donate?
So you can go to every creditor org slash donate, and you can donate along.
We're a nonprofit organization, and we put every one of these dollars towards making sure that the drugs we have help the people
can benefit. Man, that's amazing. Thank you. I'm donating. I love it. Thank you.
Donate. I love what you're doing. Thank you. So let's talk about some of the other successes that
you've had. Sure. So I shared a little bit about, maybe I'll share a couple of these patients. So one of
them is Michael. He had, he was diagnosed with a horrible form of cancer called metastatic angiosarcoma.
And that's where basically this cancer is in multiple places in your body. And no one lives past a year with
metastatic angiosarcoma. This is 2016, and we found a study from 2013. It was just a laboratory
study. It wasn't done in patients and clinical trials by any means, but it was a lab study,
but in that lab study from 2013, it indicated that this one marker was up called PDL1 and a few
people's tumors from angiosarcoma patients. And what was important about that is that there's a
drug that's really good at inhibiting PD1 that already existed for other cancers. It was approved
for melanoma at the time and also approved for lung cancer. And so we saw that result in this
paper and thought, well, maybe his tumor also has increased PDL1 and maybe that drug could work
for it. It had never been used before for his form of cancer. But he was told by his doctor that
they were out of options, that there was nothing else that could be done. The chemo that they had tried
wasn't working.
And so we actually ended up getting that test done.
And it came back that it was very positive for the thing that we thought it would be
from that paper.
And we were able to get Michael on this drug called Pemberlizumab as the first patient ever
with angiosarcoma.
And as I mentioned, a year ago, he walked his son down the aisle on his wedding day
eight years later.
And just last weekend here in Nashville, last weekend he walked his daughter down the aisle
on her wedding day.
Damn.
And this is amazing.
I mean, this drug like was always.
always there. No one had ever tried it before. What's important is that this drug is also now
used for other patients, the angiosarcoma. Unfortunately, it only works in the number. It's about
18% of patients. And so it's not, you know, when it worked for Michael, we're like, oh, my gosh,
we saw it angiosarcoma. Got so excited. And it doesn't turn out that it works for everyone.
But for those 18% of patients, it's everything, right? You know, if it works for you, it is a
life changer. Maybe it's just one life. Exactly. It's a success about, and because it's a
already because the drug was already there. It's not like you had to create a new drug yet
it's already there. You just had to give it to someone. And so that, you know, is just, that to
me, you know, means the world. And that was also, that was the first time that we went into a
disease outside of Castleman's or related to Castleman's. It was sort of the first time
it was like, oh my gosh, we can do this outside of the diseases that we're, you know, focused on,
which was so important for us to, you know, want to keep pushing this mission forward.
Another one is a young girl named Kyla who has castoms.
She has the same subtype of castoms as me, the really deadly one.
And she spent about a year in the hospital.
Nothing was working at Chicago, Lurie Children's Hospital, and nothing was working.
And one day her doctor called me late.
I remember during the pandemic, it was like 8 p.m.
And one night and said, you know, we've been trying things for a year.
Nothing's working.
The drug that I'm on, Cyrillimus didn't work, chemotherapy wasn't even working for.
You know, is there anything you can try?
And just a couple of weeks before, a couple members of my lab had discovered that this one part of the immune system was an overdrive, not M-Tor, but something called Jack.
And I recommend it's early days, but like you could try a jack inhibitor in Kyla.
You know, we've shown the stuff in the lab, maybe it'll work.
And so Kyla became the first patient ever with Castleman's to be treated with a jack inhibitor.
And she responded so well, Sean, and she is doing so well today.
I mentioned she's trained to become a nurse now.
And like, it's just incredible that, like, this drug was always there.
We actually have just opened up a clinical trial of that drug.
We're going to study to more Caswellins patients because when you do these, they're called
like N of ones where you try a drug off label in one patient and it works, that's great.
But you really want to get more data to prove that it works.
That way you can get more patients on and you can really figure out who's it going to work for.
So we have a trial, but we just opened up for that.
How do you, I mean, how many test subjects do you need for a successful trial?
It's a great question. So it really depends on a couple things. The more effective the drug is, the fewer test subjects you need in the trial. Because if it's clearly effective, like you could have a trial of just 20 people, but if like the 10 people that got the drug all do better and survive and the 10 people don't get the drug, none of them survive, that's sort of, you know, night and day. So it's one part is how effective is it? Like what's the effect size? And the other one is how common is a disease? Because really rare diseases, sometimes you're forced to like have very small and
But if it's a common disease, you know, the bigger, the better in terms of how confident you are in the result.
And how to, so, I mean, when you find, when you, when you repurpose these drugs, I mean, how does the word get disseminated across the world, across the country and the world, you know, on how to cure these disease?
You know what I mean?
I mean, for the everyday, I guess I shouldn't say everyday professional because I'm sure they're very specific trained doctors for that, you know, specific disease.
disease. But I mean, how does the word, how do you, how do you get that out? How does, how's it
happen? This is so important. I mean, honestly, right now it happens very randomly and sporadically,
like you publish a paper in a journal and you hope a doctor reads that journal or you give a talk
at a conference and hope the doctors are there. It's very sporadic, but we're trying to fix that
with every cure. And I'll share an example that's, that is actually also got a Nashville
connection. An amazing doctor named Chip Chambers had two kids born with a rare condition called
Data 2 syndrome. Data 2 causes kids to start having strokes at very young ages, and they usually
pass away in their teenage years because they've had hundreds of strokes. It's horrible.
And about 15, almost 20 years ago, a doctor sort of randomly tried a drug in one of his patients
with Data 2 because he thought the patient's profile looked similar to another disease.
He's like, oh, I try this drug that I use in this disease for this one because nothing's working for
these kids and it worked really well for that first kid that kid stopped having strokes and the
doctor gave it to a few more of his kids with this condition and he helped he was great with the
patients he took care of but the word never spread and so then chip chambers you know comes around he
has two kids with data too and he learns about this doctor who's doing that he's like oh my god
this is amazing i'm going to get my kids on it chip starts a foundation called the data two
foundation he starts reaching out to every doctor around the world he's sending emails he's tweeting
And now everyone, well, and another important step, we published a paper with guidelines.
Okay, this is how you treat data too.
So it's out there for the world.
And then he started telling everyone he could.
So now every kid in the world that's diagnosed a data too, they get this drug.
They stop having strokes and they live full lives.
But there were a lot of years between that first doctor doing it.
And he did his job.
He was helping his patients.
He did, I mean, he was brilliant to think of that.
But to your point, you got to disseminate it.
You can't just treat your patients.
But the thing is, it's not a doctor's job to like,
be a PR marketing for how to treat patients, right?
Like their job, like take care of their patients.
They need a brilliant job.
But that's where I think every cure has to come in.
And honestly, that's why being on a podcast with you like this, I think is so important.
Because when we find these drugs, we got to get the word out to people.
And getting able to work with people like you and others to get it out is literally a tweet,
social media posts can be the difference between life and death for someone.
Man, I mean, isn't there some type of, I mean, like I said, have no insight into the healthcare industry.
than through the podcast, but isn't there some kind of a database that all physicians use and they
can type in a specific disease or treatment for anything? And it's these drugs right here.
These are what we do. The closest to that is a website called up to date. And the idea is that
the world's expert for every disease enters that in and keeps up to date. That's what's called
up to date. So that's sort of the theoretical place. However,
Sometimes when you use a drug, like they were using data too for that wear condition or using that TNF node for data too, if it's just happening in one part of the country or one part of the world, it may not get into that database for up to date.
It may be that there's sort of debate, okay, well, it's only been using a couple people like are we short?
There hasn't been a trial done yet.
And so it's not perfect.
Up to date's a really good place.
It's not perfect.
And then the other issue is that, you know, it's updated by individual experts.
And so they might miss things that are here or there.
And it's also not widely available.
Not everyone has access to up to date.
And so, like, we at every cure feel that we got to make sure that up to date pages are up to date.
And we also got to make sure that we get the word out to people that don't have access to it.
Damn, I wish there was a better way than that.
I know, right?
I wish there was a better way.
I mean, that would just, that would jet launch it.
We would.
And that's what we're hoping to do with every cure.
And I'd love any ideas you have for how to get it out.
I mean, that's like, that's all we care about.
It's like the drugs we got should treat all the patients who could benefit.
it from the drugs. And it's like, we got to just figure out how to make that match.
More podcasts.
Yeah, exactly.
It would be great if the media, the mainstream would jump on this, and it would be
great if they had the database of them. I mean, it sounds like they do, but I mean,
it's something that's, it just seems like there should be something that the world can tap
into and it lists out every possible drug and scenario that they can read.
It should, I totally agree. How does that not exist? Yeah, it's, it's sort of
the kind of thing that we all think someone must have done or there must be something like
that. And then you sort of sit around and then all of a sudden you realize like if no one else
is going to do, I guess we have to do it. You know, it's like, I guess somehow these things just
everyone's got their lane, right? And it's like sort of, oftentimes we lose track and there
isn't someone who's taking that big picture look. Man, man. Let's move into the AI stuff.
Sure. So you're utilizing AI to basically, to do the, the, the initial research.
How do you do that?
Sure.
So we use something called a biomedical knowledge graph, which is basically like if you took
every drug, disease, gene, protein, everything you can imagine that's related to medicine
and bioscience and just put it on the wall, like mapped it up, and then you put connections
between every one of those things.
So we know that interleukin 6 is elevated in Castleman disease, and you'd put that onto your
map.
You'd map every single concept and then the relationship between everyone.
You'd create a map that basically represents what we know about all of medicine.
Like every drug, every disease, every gene,
every relationship between all of them.
So now you've got sort of a map
of what we know about all of medicine.
And then we train machine learning algorithms
on treatments that we know work.
Like we say, psiltoxamab treats Castleman disease.
Cyrillimus is effective for organ transplant rejection.
We train the algorithm over and over again
on all the known treatments.
And it gets really good at picking up the pattern of connections.
Okay, if that drug treats that disease
and that drug treats that disease.
And then we say, okay, now that you know
what a good treatment looks like
in this map of knowledge,
now give me a score from zero to one for how likely every other drug is to treat every other disease.
There's 4,000 drugs, there's 18,000 diseases.
We're basically asking it to calculate 75 million times, the 4,000 drugs against 18,000 diseases,
75 million times how likely every drug is to treat every disease.
And it's between zero and one.
So then our medical team, we look at the things at the very top.
I say, what are the point nine-nines?
What's machine learning, artificial intelligence saying is the highest?
most likely drug to treat a disease, and that's where we start.
Wow.
So it sifts through everything.
It goes through the world's knowledge.
And actually, when we ran it for the first time, Sean, we built the nonprofit three years
ago, spent a lot of our first year fundraising.
But we finally, you know, hired our first data scientists.
We finally ran the algorithm for the first time about two and a half years ago.
And it took 100 days to run the algorithm to like literally scan everything the world knows about
everything, 100 days.
And we didn't know it would take 100 days, but like just every day, it's like slow and we don't have the results back.
Finally get the results 100 days.
Sean, now it takes 17 hours to scan the world's knowledge of everything to get a score, 75 million scores in 17 hours, which the reason that's really important is because then you can actually improve the algorithm and say that's actually not the way to do it.
We want to do it more like this.
You can run experiments and see like what's the best way to get the best results.
And if it's a 17 hour turnaround time, you can just keep doing it.
Wow.
Wow.
I mean, would it be a possibility that that AI database could be the answer to what we were just talking about?
I think so.
A part of it could be.
So, you know, when we score every drug against every disease, you now, in that database, you now would have a bunch of drugs for diseases that score poorly or that are middle level.
And so there's parts of it that maybe would be not that helpful.
But the things at the top, absolutely.
The things at the top very much can be.
So, you know, at the very top for, let's say for a horrible disease, let's say like ALS, there's two drugs that are FDA-approved for ALS.
They don't work very well, but there are two drugs that are FDA-approved.
That's got to be at the very top of the list.
And then right below those two FDA-approved drugs, there are some drugs that are sometimes tried where there's early data.
That should be next in the list.
And then you should get into like these sort of AI predictions of like, well, what's AI telling us?
But what I wouldn't want is for people to sort of skip the things at the top where there's like good data.
and just go to like what AI is predicting.
Because for us, like at every cure, when we make these predictions,
we look at the things at the very top,
but we don't automatically say whatever score is number one,
we're going to give to patients.
It's like, whatever score is number one,
we're going to look really deeply into it.
We're going to study in the lab.
We're going to do clinical trials.
And we're going to figure out, is it the right thing for patients?
But not necessarily, we don't trust fully in AI.
It's basically what I'm saying.
It's like AI for us is a great starting point,
but there's still more work to be done.
Gotcha.
Let's take a quick break.
Sure.
And when we come back, I want to talk about some of the diseases that you're targeting nowadays.
Sounds great.
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All right, Dave, we're back from the break.
And, you know, we're talking about all these horrific.
rare diseases, some of them not so rare.
I mean, are you looking at any preventatives specifically, you know, specifically for cancer?
Yeah, so there's one of our programs, so we've got six active programs at every cure,
so different drugs that we're repurposing for diseases.
And one of them is around the numbing medicine, lydicane.
So, you know, when you go to the dentist, you get an injection of lydicane and the role
that it can play in preventing recurrence of breast cancer.
So actually, if you inject lydicane around a breast cancer, too,
tumor, there's a really compelling evidence from a big clinical trial that was done in India
that you're going to reduce recurrence of breast cancer and also reduce mortality from breast
cancer. Now, this is an example where it's not total prevention because it's not like it's
preventing the breast cancer in the first place, but it's preventing the breast cancer
from coming back, which, of course, is so important because that's oftentimes what's so
deadly about breast cancer. And it's an example where lytocanes, it's like really cheap old
substance where unless a nonprofit like ours or another nonprofit comes in, the work's just
not going to be done to push it forward. And so we're really optimistic about that. And we're actually
also studying the role that lytocaine might play in other cancers as well. Are you studying or do you
have any insight onto what causes cancer? Yeah. So the breakthroughs over the last 10 or 15 years really
indicate that cancer occurs when mutations occur in the genomes of those specific cells. And so
they're called somatic mutations. It basically means like we're all born with our own
genetic makeup, but within the cells, let's say, in your pancreas, a mutation occurs.
And that could be because of exposure to UV light or it could be from exposure to carcinogens
in the environment, what you eat. And those genetic changes, if they happen in the, if they happen
in a part of the genome that isn't that important, that cell just dies and you never even knew
the mutation happened. But if that mutation happens to happen in a part of the genome that's
important for, say, cells to replicate or maybe to grow blood vessels, then that cell now has
an advantage and then it accumulates more mutations and all of a sudden you have cancer. And so it's
sort of this, it's sort of this random set of things that have to happen for you then to develop
cancer. And of course, you can do things in your life to reduce your risk of cancer by, you know,
eating well and exercise and doing all the right stuff because that's going to reduce the amount of
those somatic mutations that occur to your cells. But it is sort of this very much,
random thing, which is tough because that's why, you know, sometimes young kids get horrible
cancers and why, and it's also why you see cancers emerging in older years because basically
more of these mutations have occurred to the course of life. I mean, is there, is there
anything to, I've heard a lot that inflammation can cause cancer, sugar can cause cancer. I mean,
is there anything to that? Yeah, so the inflammation for sure, you know, the more you proliferate,
the more your cells are proliferating, which often occurs in the setting of inflammation,
the more chances there are for genetic mistakes
and basically mutations to occur
because of the increased proliferation.
So absolutely.
Sugar, I think there's a lot of data
that sugar plays a really important role
in cancer development and progression.
Like once it starts,
I haven't seen as much on it,
like sort of causing it to start in the first place.
But it's also really hard to keep track of all the research
because there's just like so much work being done.
And then, you know,
I've also heard that a lot of these diseases, and I might rattle a couple off that this is not true about, but, you know, cancer, Alzheimer's, a lot of these, I mean, I've read things and interviewed people that say none of these are actually organic diseases.
They are potentially, you know, a product of our, of our filthy environment.
Is there truth to that?
I think that our filthy environment contributes and probably increases risk and
increase the numbers.
I think all the conditions you mentioned have happened as long as we've been around.
They're in textbooks from the, you know, 1700s.
Okay.
But they maybe weren't as common.
And so one reason why they might not be as common, I think is exactly what you said.
There's things in our environment that are making them more common.
The other is that we're living, thankfully, living a lot longer.
You know, we're not dying from, you know, infections from bacteria, you know, that's
in our water, for example, so we're living longer, which means there's more opportunity for
these other diseases to sort of emerge. So I think that my experience with a lot of these things
is that I think that there is definitely a lot of truth and data backing up the idea that our
environment is playing a really important role in increasing the number of these cancers
and conditions. But oftentimes it's a lot more complicated than just like it's just the
environment because these things have been in textbooks for a lot longer than a lot of these
chemicals have even been around you know in another thing i mean there's a lot of ever since
covid it's really caught fire after covid i mean there's a lot of hesitation with vaccines
there's a lot of hesitation to to uh pharmaceuticals you know and and there's this massive movement
on on i don't i don't know what kind of holistic type medicine i mean what are what are your thoughts
on that i mean i think it could be you know i mean i don't know i don't really know much in this
in this sector.
But, I mean, it seems, my fear is that we demonize all of the progress that we've made
with medicine due to, you know, due to conspiratorial claims.
And so I'm just curious.
I mean, I think there's got to be a healthy balance here.
I mean, there has to be.
Yeah.
I mean, my feeling is that I, and we just want to help patients with the medicines that are available.
And if it's from a holistic doctor or if it's from sort of traditional,
Western medicine or if it's from pharmaceutical companies, you know, the drug that I'm on
Cyrillimus, it actually was discovered in the soil on the island of Rappanui in the Pacific.
Like it literally was discovered in the soil and then a drug company figure out ways to manufacture
it. And so like my drug is about as natural of a drug as you could ever take. But it's a
pharmaceutical drug and it's used for transplant rejection and it destroys your immune system.
And so there's, we like to oftentimes think of things as very black and white. There's like
there's the natural stuff, then there's the pharmaceutical stuff. Well, my pharmaceutical stuff
was natural. We just figure out how to make the exact same thing over and over again. And so it's
a lot grayer than I think that it's easy to wrap our heads around. And I think that we've just
got to follow the data. And like, what are the drugs that can help people? And is there data to
suggest that it can help people? If so, like, we should put people on them. And I think try to get less
caught up on, you know, is it from a drug company or, you know, what's the source of it? But I think
just really just actually track, like, you know, is there good data here? And to your point earlier,
like when I was dying from my Castleman disease, there was no data for Cyrillimes to save my life.
I had lab data that made me think it might, but sometimes you do follow the things that don't
have much data because the alternative is that you're going to die. And you just, you do that.
But if you do have data on drugs, like, you know, what sort of breaks my heart is when I hear
about people with terminal cancer that say, I'm not going to take this medicine because it's a
pharmaceutical product, I'm going to take something else. And then you hear about them passing away.
And you just think to yourself, like, I wish they had given themselves a shot with the traditional pharma stuff.
And who knows if the pharma stuff would have worked.
But we have a lot of data to show that it does work in some people.
And we talked about earlier 18% of people and 20% and 25.
And these things don't work in everyone.
But if they work in you and they could work in you, I really want to make sure that we tried in you.
Because, you know, the work's been done to prove that it can help some people.
What about, I mean, what are some of the diseases that you are targeting nowadays?
What are you going after?
I mean, we had a brief discussion about Alzheimer's on the break here.
I mean, that that's another massive fear of mind that it seems to just be happening more
and more, more, more, more.
That's frightening.
And so, I mean.
Yeah.
So, you know, as we shared earlier, this sort of way that our AI platform works is we look
across every drug and every disease
and basically see what matches score the highest.
And so we start from there.
So we don't pick a disease a priority
and say we're gonna work on it.
We let the algorithm point us towards a match.
And then our team looks into it
and we spend lots of time reviewing through them.
Our team has now reviewed over 6,000 of the top matches.
It's out of 75 million.
So we've got a ways to go,
but 6,000 brilliant MDs, PhDs reviewing through them,
looking for treatments that are hiding in plain sight.
And out of the ones we've looked through,
We currently have six active programs.
We're actually just getting ready to add three more.
So we'll have nine active programs
in the next month or so that look across conditions
that I mentioned earlier, the example,
breast cancer is one of them.
That's one of the more common cancers.
We've got another program in a condition
called Bachman-Bup syndrome,
where it's only been described in about 20 kids ever,
where kids are born with this horrible rare condition
where they basically, they're hypotonic,
which means their muscles don't work,
so they're on feeding tube.
and they're basically bed bound and they would be bed bound their whole lives.
But there's a drug called DFMO that's been around for a long time that wasn't made for
this condition and it actually is really effective.
So the kids that have been started on DFMO early in life are standing up, sitting up.
Some of them are even walking.
The kids that are started later on in life, maybe they're feeding tubes out, but they're not
quite at the same level.
They would have been if they were a typical child.
This is why we started this organization.
It's like maybe only a couple dozen kids are going to benefit in the short term, but maybe a couple hundred are going to benefit in the longer term.
And they're going to benefit like, you know, walking to school and like, you know, running with their siblings doing things that they wouldn't have been able to do with a drug that that wasn't made for their condition.
And so those are the kinds of things that that's just not going to, in our industry, a couple dozen kids, no one's going to take a cheap old drug, you know, and work on a couple dozen.
And it's not that they're not going to work on.
I take that back because I should really emphasize that there's been amazing work done
because the condition is called Bachman Bup, and that's after two doctors, Dr. Bockman
and Dr. Bup, who have done just the most outstanding work in the world to advance
treatments for this condition.
But the point being that, like, typically that's where it would stop with like, you know,
this doctor and that doctor, they're doing the best they can for these kids.
But us at every cure, we're trying to find as many of these as we can.
So that way, to your point, we get the word out.
So if you're a child in some other part of the world and you've got this condition,
let's get you diagnosed and let's get you on the medicine you know when you're when you're
sifting through the the the AI program that you guys have i mean how do you i mean that's still
i mean you said 14 000 diseases have no treatments have no oh that's only that has that's
and then another 4,000 have treatments so it's a total of 18 000 diseases that affect humans
diseases how many drugs 4 000 4 000 4000 drugs i mean that's a that is a even with
a i sifting through all that i mean that's a lot of stuff to see
sift through. And so, I mean, how does the, how does the program kind of notify you? I mean,
is there, is there like a tier ranking that says like, hey, this, this drug we've, you know,
the AI has found may work for a spider web of diseases. And I mean, do they rank them? How do you
guys sift through all of that? Yeah. So we get a score from zero to one for each, every drug
against every disease. So like, DFMO for Bachman Bup gets a score and DFMO for breast cancer gets
a score. And that's probably a low score because it's probably not going to work in breast cancer,
but you get a score for every match. And then you look at the things at the very top. So you
rank order to the less. And you say, what are the point nine-nines, which basically the algorithm
is saying this is like, there's some heat here, right? Like there's some, there's probably
something here. Maybe it's this drug. And Dfm of Bachman-Bup's an example where like there's
too much of this thing and this drug inhibits that thing. And so it's like the match is being
made even at that simple of a level. Like in my case, there was too much of M-Tor.
that signaling pathway, and Cyrillimus inhibits mTOR. And so it's like, it's looking for the,
and most of the time it's not that simple, but it's looking for matches like that. And it's
going to give a high score if there's something clear like that. And then the other thing is we
also generate a separate score. We call it our unmet medical need score, which is basically
how bad is the disease. So we score also, the higher the score, the worse the disease, lower
score, less bad the disease, because we want to be going after good matches for really bad
diseases. As you said before, we're a 50-member team with limited resources. When you can go after
any drug and any disease, like there's a lot of opportunities. But if we're going to spend our
time on earth going after like the really bad diseases with the really good matches. And so we
use both scores to get us started. So you actually sift through each drug? It's not each
disease. It's each drug. And it's actually not even each drug or each disease. It's actually
each drug disease match. Like if you look in this spreadsheet, it's like DFMO for Bachman-Bup,
Lidicane for breast cancer
Cyrillimus for Castleman's like
That's what the row is like the row is actually the match
And then there's a score next to the match
And then like you might
You might not see breast cancer again
Until number 10,000
Like the second best for breast cancer
Might be way below the first best
But it's actually the match they get to score
How many matches are there?
75 million
Because there's 4,000 drugs and 18,000 needs
So if you multiply 4,000 times 18,500
You get 75 million
Because you try every
So basically we're asking the
algorithm is like simulate how likely each one of these 4,000 drugs would be to treat each one of
these 18,000 diseases.
That is a lot of information to surf through.
It's insane.
Yeah.
And so like, yeah, our team of 50, we're working really hard.
Man, how many, I mean, how many, just, I'm just curious.
How many have you been able to go through so far?
So the team of 50, we've now gone through the top 6,000.
And that's like deep review, like, you know, reviewing through to understand what data exists
and why it might score well.
out of those top 6,000, we've identified about,
I think it's about 60 or 70 right now
that have gotten what we call a deep dive
where an MD or a PhD or an MD PhD trained person
will really try to understand what are all the data for or against,
like why would this drug likely work or not work?
And then out of those 60 or so, we've done deep dives,
about 15 of those have then basically taken down
to where like we have a good plan.
Like we think that if we do,
this clinical trial, we're going to be able to unlock this drug helping a lot of kids or
adults. And then out of those, you know, I mentioned now like the nine active programs
that we're moving forward. And we've only, so we started as a non-private three years ago.
We spent most of our first year doing fundraising, most of our second year really building
on our infrastructure. It's really only been about one year where we've had the team
working hard going through all these scores. And so the opportunities, I think, are so huge.
How do you find the patients to do the studies on?
Yeah, so once we find a match that we think looks really promising, the next thing we do is find out who are the disease experts and who are the doctors that see the most patients?
Is there a disease group?
Like, for a lot of these diseases, there's a parent of a kid with a disease where they've, like, rallied around and created a nonprofit for that disease.
We want to get in touch with them and understand their disease more.
We want to understand what's missing.
Could this drug really make a difference?
And when we connect with them, it's like, we want to help your kids.
condition or your condition, you know, will you work with us? You know, we've raised money from
the U.S. government and from philanthropists and foundations. You know, we're going to bring some
money into here. You know, do you want to work with us on this? And not surprisingly, there's a lot
of enthusiasm because, I mean, you think about something like Bachman Bup, those kids, like the
couple dozen that have ever been found, their parents probably weren't expecting that there
would be sort of a, you know, full-blown effort for their condition. And again, thankful to Dr.
Bock and Dr. Bup for all the work they've done and we're excited to work with them.
Wow, that's, that's incredible, man.
I love, love, love what you're doing.
Thank you.
You know, what do you think about, and this is a little off the main subject here, but
I've got a really good friend here, his name's Rich, and he's done very well for himself.
and he's his whole family like multi-generational live with him and it was his it was his
grandpa and his grandpa had like his legs were purple you know I don't think he had any feeling
in his toes you know nothing in his feed and he was going to a local um doctor here at
Nashville and this guy told him to go to Argentina and I think
think it was i think i believe it was stem cell and he went down to do the stem cell somewhere in
argentina grandpa does a stem cell all the color comes back into his legs within like 12 hours
they're on the plane ride back home and he's telling he's telling rich he's like my feet are
fucking killing me like i he's like this is this is horrific pain oh now and rich is rich is like hey you know
are, are you okay?
And he goes, yeah, I feel amazing.
He's like, I haven't felt any pain in my legs and 25 years or what some, I mean, so, you know,
in your opinion, I mean, why, why do we have to go to Argentina for things like that?
Why do we have to go to Mexico for, for, you know, better stem cell?
Yeah.
Like, what is holding the U.S. behind on this stuff?
It's a great question because, you know, in the U.S., and I've wondered this, too, like in the U.S.,
Like in the U.S., we do what are called autologous stem cell transplants for people with cancer all the time.
That cancer, I mentioned, multiple myeloma.
You oftentimes treat people with their own stem cells.
Like you basically take their stem cells out, you give them chemo, and then you give them their some cells back.
We do that.
We do what's called an allogenic stem cell transplant.
We get someone else's stem cells, like their bone marrow stem cells, and that can sometimes be curative for leukemia and for lymphomas.
Like, so we're doing it already in some settings, but I'm not sure.
why some of these other settings it hasn't come forward because some of that the stem cell
work with autologous and allergenic stem cells it's been 20 years that we've been doing that
in the US so I'm not sure why it's because what that tells me is that like the US FDA is willing
and they're open when these sorts of stem cells are effective in certain ways maybe it's for
cancer maybe there's a different sort of risk profile because there's a big there's a big risk
when you do these stem cell transplants for cancer like you have like a 10% chance of death
within that year from the treatment.
You got a 90% chance that you might be, not 90% cured,
but if a high chance you might be cured,
but you got a 10% chance you're going to die
from the stem cell transplant.
And so it might be that the FDA is willing
to sort of put a stamp on that sort of a risk
when like you've got a deadly leukemia
and maybe less willing to like put that sort of a risk
if it's not as deadly.
And again, that's not from any data that I have,
but that's the only way I can wrap my head around it
is like, why do we do it here
but we don't do it over there?
Thank you for the, thank you for answering that.
I don't know the full answer, though.
Well, Dave, is there anything I should be asking you that I haven't asked yet?
You know, there's one thing you were asking me about my mom earlier,
and you asked about the last conversation that I had with her,
and she actually left a message for me even after she was gone.
A couple weeks after she passed away,
and I actually would love to read this to your audience if it's okay.
A couple weeks after she passed away, my dad and I were cleaning out her purse, and I came across this newspaper clipping that I keep in my wallet.
And to me, this is like, it just embodies my mom because I don't know if you can see it, but this is basically like on a piece of cardboard, probably from some cereal box, and it's like, you know, got some tape on it.
This is just like who my mom was, and it's got a quote.
That, as you can tell, I take it everywhere with me.
It's now been 21 years.
It says, Pope John Paul said it best in his address to the use in Camagauai.
Dear young people, whether you were believers or not, accept the call to be virtuous.
This means being strong within, having a big heart, being rich in the highest sentiments,
bold in the truth, courageous in freedom, constant responsibility, generous in love,
invincible in hope.
And like I said, I found this two weeks after she died.
And I remember reading it and just thinking to myself, like, this is her message to me about how I need to live.
Bold in the truth, courageous in freedom, constant responsibility, generous in love, invincible and hope.
And these are words that, like, I just take with me everywhere I go.
And I love the idea of your listeners and your audience taking this with them as well.
Man, thank you for sharing that.
Absolutely.
Thank you for sharing that.
And I just want you to know it was an honor to interview you, and you're changing, you are changing lives, literally, saving lives.
And, I mean, it's just bettering the world.
So thank you for what you're doing.
It's an honor to be with you.
You're a true warrior.
And, you know, we're fighting hard.
We're fighting a battle.
Like we said, 4,000 drugs, 4,000 diseases have treatments, but 14,000 don't.
So, like, we've all got to take this up.
It can't just be, you know, one group here or one group there.
Like, we've got to take this opportunity to make a difference.
And there's a lot of drugs out there that can help people.
So we're going to keep fighting.
And actually, you know, I was telling you during the break about how we've sort of turned the Castleman into this, like, warrior here.
And this is like our, you know, our Castleman warrior.
And I've been wearing this pin for the last about 12 years.
And so I want to give this warrior pin to you, my friend.
And you're an ultimate warrior.
I appreciate you.
Thank you.
Thank you.
Absolutely.
Absolutely.
Oh, man.
It's going right here in the studio.
And, man, thank you.
You're a warrior, and I appreciate you, you know, giving me the opportunity to share about our work because we got a lot of work to do.
And it's actually going to be, you know, raising the word, raising awareness through things like this that are going to help a lot of people.
Well, I'm going to tell all my friends about this.
And they'll be listening to it anyways.
but I hope this I hope this podcast helps and I would love to see again hopefully on good terms
I love that yes exactly all good help yeah but seriously it was an honor thank you again
thank you so much thanks sir that's awesome