Are We Curing Cancer or Just Managing It? Precision Oncology Explained by Dr. Dino Prato

Here's a tough question. Are today's cancer drugs really curing cancer, or are they just managing it for a little while? I'm Dr. Dino Prado, founder of Envita Medical Center. For the last 25 years, I've sat across patients who did everything right at top hospitals, but their cancer still came back. Today, we're looking at some uncomfortable data, so let's let the research tell us what's going on, and here's what it says. In Europe, we have 48 cancer drugs that were approved by in 2009 and 2013. And at that time of approval, only one in three showed that a patient could actually live longer. And when they did that, the median benefit was just two to three months. So it extended life maybe two to three months, and quality of life improved for about 10% even after five years later, about half of those drugs still had no clear proof that they helped people live longer. So reviews of cancer drug approvals across the board show the same thing. The average life extension, maybe three months. And that's not a cure. That's just a short delay. In the US The FDA approves drugs before we even know if they can help people live longer, using what they call fast track track or surrogate markers, like response rates, meaning, like it might shrink the tumor, but then it comes back. But it actually doesn't mean people live longer. But fewer than one in five drugs show that they have real quality of life, length of life, benefits that are significant. And what about the quality of life, which I always think is the most important measure, which should matter most to the patient? You know, reporting that they had a small response and then the cancer came back even more aggressive, or that they're living longer with better quality of life. That's really the key. So many cancer drugs are designed more to control disease, disease than to cure it. And that makes sense. If you're a pharmaceutical company, you're not interested in cure, you're interested in managing the disease. That's why we see all these specialty drugs going up, you know, 10, 15, 20,000amonth just to manage the cancer. Now, I'm not saying that these drugs don't have their place, but in the method that we're using it today, where it's not precision and it's basically a one size fits all model, we have a problem. So why does this keep happening? And because the system is built for speed, the FDA has special fast track programs to get drugs out quickly. For serious diseases like cancer, that's good in some ways. It also means that Many approvals are based on indirect signals instead of the real survival data. And yet this is what's called the gold standard double blind placebo clinical trials. This is what NCCNN guidelines uses the national comprehensive cancer networks use to decide care for everybody. It's not based on the individual, it's on averages on some that may respond and others that don't. So when you take progression free survival, that's how long a drug keeps a tumor from growing. Sounds great, but the studies show it often doesn't translate into people living longer. And that's what we want to, that's what we're talking today talking about today. Many new cancer drugs are validated to shrink, to stall a tumor, but not deliver the long term remission. That really is the goal of cancer treatment. So now let's talk about what this means to real patients. Standard oncology typically looks at about maybe a dozen data points. These things like tumor marker staging, few markers like biopsy, imaging and scans and that helps to pick treatment for the averages. You know, basically you'll do radiation, chemo surgery, that's what people will do. But it doesn't explain why your tumor is resistant to therapy. Or what are the exact markers, what makes your tumor cold from an immune system perspective or hot or helps it to respond to key things like immunotherapy. And when treatments are given at maximum tolerated doses without personal targeting, resistance builds in pretty fast. And that's why so many patients see short term response rates that do not last. And this is the real problem we have. So what do we need to do differently? Well, in precision oncology we take an entirely different approach. We call this medicine 3.0 of the oncology space. And our goal isn't just to control the cancer, it's for to aim for durable remissions, understanding what the cancer needs to respond to. Now we're not always able to achieve that, but we're doing everything we can. In fact, by design, it's designed to do that. So we use deep multi omics mapping not just DNA mutations, but RNA proteins, immune activity, immune profiling, spatial biology. And we look at how the cells live, interact in and outside the tumors and we help them to respond. For example, we take cold tumors and turn them hot, meaning get the immune system moving so that it can use your body's own natural surveillance mechanisms to go out and remove micro metastatic and tumors in the. We figure out why a tumor is invisible to the immune system or why it's evading the immune system. And then we design Plans to flip the switch on that. See. So it's so important that we need to look at not just the tumor, but the tumor microenvironment. That means information around the tumor and all the messaging and not just blast it with drugs that are average drugs but need to get precision. And when we get precision, we don't need to give high doses, we can be very precise, we can get direct to tumor, we can give micro dosing, we can give the regional direct care that penetrates these stubborn cancers or the resistance they may have with tumor stem cell cells or fibrous material or many different methods of evasion, multi drug resistance. So one of the things we do in precision oncology is what we call adaptive targeting loop. This adaptive targeting loop is where tumors evolve and they try to change. So we through the testing can see the changes ahead of time and change with the tumor to help it respond. Adjust the plan as the patient needs for each individual. The plans are built on each person N of one not standard for one size fits all. It's an outcome driven mindset. We measure real time signals like circulating tumor cel immune reactivity, other DNA and RNA genomic markers and scans and tumor markers as well. But it's this combined data that's telling us you're responding or not. And if we need to change trajectory, we can, we can do it very quickly. So the goal is not just temporary responses, but it's long lasting remission. Trying to understand what is going to be the long term key to quality of life and preserving the patient's life. So if you're listening and you're thinking I've had treatments that haven't worked or I've tried other things, here's why. Because until now you really haven't done precision at this level. So you really don't know what's working. You're kind of guessing whether it's natural or conventional care. You really don't know what's working because it's kind of a hit or miss. And the current system rewards this speed short term response model that is what used currently in oncology. And that's why so many drugs are approved without really proof of durable survival benefits too often. And this gains only weeks, months, maybe three months of somebody's life, but doesn't do what we want it to do, which is aim for long term remission. But it doesn't have to stay this way. We have precision oncology N of one medicine flips the script, maps the biology, deeply penalizes the care, delivers an adaptive response to the tumor, evolving and aiming for full term remission. And dare I say with the goal of cure, not just temporary, long term. That's how we move in managing cancer and precision oncology. Precision personalized medicine is to help fight for long term remission using your specific data points. So this is the key and this is what makes it really different. And it's exciting because you have to think about it. In the conventional world of oncology, the mindset is manage. And that's the difference with precision oncology focus the best match, best responses and adapting in real time bump.