Blood Cancer Recurrence Isn't Treatment Failure—It's This

Most people think blood cancer comes back because the chemo stopped working. But here's what often is really happening. The big disease gets knocked down, meaning the large burden gets knocked down. The scans look better and the blood counts look better. Everyone breathes, feels better, and then it's back. Not because the patient didn't fight hard enough, but because they didn't see something, something that was already there. It's called minimal residual disease. Minimal residual disease means a tiny number of cancer cells are still in the body. After treat, those hidden cells can wake up later and restart the whole cancer. With blood cancers, minimal residual disease is the last crumb of the cancer. It's like embers after a wildfire and flames that look like they're gone, but the embers are still hot. And one gust of wind can bring the fire back. So we're going to talk about how to solve that today. So the real finish line in the blood cancer is not just remission. It's the key that everyone is missing. The real finish line is to erase minimal residual disease, so relaps has a much less chance of occurring. And finally, patients can live longer. And I'll show you a technique with the ability to do this in six days and attack minimal residual disease, which makes a big difference for blood cancers without the long, disastrous complications of graft versus host disease that patients fear from a full donor transplant. I will show you just how powerful and simple this technique is, with the potential promise of longer term remissions for patients. Stick with me as we attack blood Cancers today. I'm Dr. Dino Prado, founder of Envita Medical center. For the last 25 years, my team and I have helped thousands of patients who failed the top cancer hospitals across the United States when they were told nothing was left. And yet, with precision targeting and immunotherapy, and using the latest technologies from around the world, we were able to help save many lives. Many, many lives. By the grace of God. This episode is for educational purposes. Make sure you're with a doctor before you change anything. So let's get started. Blood cancers, including leukemia, lymphoma, myeloma, and even the modern day medicines like chemotherapy, targeted drugs, car T cells, antib, and even transplants, they can relapse and the cancer comes back. Because some of these cancer cells are built to survive, they resist treatment, they hide. They go in these quiet places and they become dormant. And then chemotherapy can knock it down. But it still will leave this minimal residual disease behind, this hidden seed. And later the seed can grow. And so the mission Becomes simple. Can we get rid of it? And there's a way to do that. You usually need immune power, but in this case it's a unique targeted power. Let's take a look at this. In a transplant medicine, when someone's getting a transplant, there's a real effect called graft versus host leukemia. That means the donor's immune cells can recognize the blood cancer as not yours and hunt it down. That's powerful. But here's the price many patients pay. An allogeneic stem cell transplant. Their immune donor cells can land them into the hospital for three to four weeks under monitoring. Because of this strong immune response and then having to deal with it potential and the complications can be serious. With graft versus host, it can attack the immune cells of the patient. Severe infections can happen because the immune system is suppressed and it takes a long time to recover. You can have organ toxicity from the transplant related complications. What if we could borrow the cancer killing power but not keep the donor cells long enough in the body to cause any of this graft versus host problems? That's the whole idea behind what I'm about to explain with precision. Oncology for blood cancers. A short, controlled targeted hit and leave immune strike makes all the think of it as like fighter jets coming in. They kill the remaining residual disease of those cancer cells that are hidden and then they disappear like ghosts in the sky. This is the concept that's based on the work published by professor Simone Salvin and his colleagues out of Israel. He was describing this in his paper, this mismatched donor lymphocytes that are activated. And in our international facility, we've adopted this technology to help with blood cancers. So here's how we describe this. Basically, you take blood from a parent or a child of the patient, then those immune cells are Activ IL2 and they're reintroduced to the patient. And what they do is they go in, they kill minimal residual disease and within six days they die off. So you don't want to ever use this during actual blast crisis. A patient may have a blast crisis, it's aggressive because they have chronic myeloid leukemia with immature blast cells rapidly overtaking the bone marrow, or they behaving like acute leukemia, causing severe fatigue, fever, infection, bleeding, organ enlargement. You want to knock this down. This is where chemotherapy comes in. Tyrase kinase inhibitors come in and we want to control that. But once that, we're concerned that the disease is going to return and we want to shut it down. And this is where professor Salvin and his team Did a fantastic job. They were able to build a protocol to eliminate this minimal residual disease. Once those donor immune cells are brought in, they kill the minimal residual disease and they're gone. So now you don't have the grasp versus host complications, but you've eliminated the minimal residual disease in most of the patients. And so here's the key to that. So think about it as a powerful immune strike that burns out and then disappears. And it provides almost like a safety valve to the patient. In our international cellular facility, we use programs like this. And the immune system is borrowed from a family member, could be, like I said, a parent or a child, done through a blood draw. And then those cells are collected through apheresis and they are amplified and then targeted. So let me try to explain this like a movie. We make room in the first step, not the full extreme conditioning used in like a transplant situation, but enough to create space so that the donor cells can work. We build a strike team from the donor's blood. And often this can be, let's say a half match family donor, like a parent. Or from the donor blood, the immune killer cells are collected. And these include T cells, natural killer cells. And we power them up with like Cytokines, let's use IL2 here, for example. It gives us signaling. And then we get them energized, focused, and we re return them to the patient. And they go in like a strike team. Those activated donor cells are infused into the patient and now they can hunt down and kill these cancer cells that have gone rogue. They search for them. They look for these leftover minimal residual disease cells. And here's the twist. The intentional mismatch. This sounds strange at first, but it's part of the idea. The mismatch, foreign signal which can push a stronger attack against the cancer cells, Especially when the disease burden is low. And when we're talking about minimal residual disease, this is the key for safety. Because after six days, they burn out and they're not there and you really can't find them anymore. So it's a hit, hunt, clean and exit pathway, A six day borrowed immune response to knock out blood cancers. So I want you to remember this because big bulky disease is hard to treat. You're not going to use this if the disease is kind of in its active, most aggressive phase, but you want to use this at the end to remove the min, minimal residual disease. So if we have active disease, we want to knock that down first. That's what we do in the clinical treatment. And then this is what I Call the secret sauce is ending it with blood cancers using the minimal residual disease platform. So this helps us to focus the immune system to strike, blast the cancer cells and do their job. In a 2023 publication, they described 33 patients with drug resistant blood cancers that were treated in a compassionate act usage. They reported complete remission in 23 out of the 33 patients. In the summary, just using this method alone. That's why we like to use it, knock down the cells. They also reported no graft versus host disease or complications or toxicities. And that's what I love about precision oncology. Get in and do the work, don't get the side effects and help people get their life back. And so this is what was described in the study and this is what we see in the clinical experience. This is not, you know, a large randomized trial or an approved treatment. So it's used in our international facility. But in the right patients, we can test for minimal residual disease. We can do that with circulating tumor cells and imaging and other tools that kind of give us an idea that this minimal residual disease is around and we need to treat it. And when we know it's around, treat it. We help a patient receive a longer remission. That's the goal of the treatment. Now here's where this gets easier to understand. Sometimes in the right patients, you can even tag it. For certain B cell blood cancers that express, let's say a CD20, you can use rituximab. You combine that to the cancer cells, that can help the immune killer cells from the donors recognize a target through a mechanism called antibody dependent cellular cytotoxicity, where the natural killer cells can attack the antibodies that are tagged to the cells. So in Professor Sullivan's report, he described combining this platform positive patients. So think of it like this. Rituximab is the bright sticker in the blood cancer for the B cells. And the natural killer cells are there to strike them down and kill them and then get out. That's the power of this. You've seen this story. A patient finishes treatment, everything looks better and they feel like it's all over. And then weeks later, months later, the disease returns. And this is why I believe when you test a patient and you have minimal residual disease, this is the key to treating blood cancer. So you want to knock them down and then check for minimal residual disease. Now, in knocking them down, we can also use precision target many of the patients to help them get that disease burden down and then finish with this technique. If the minimal residual Disease is still present. That's really one of the keys in precision oncology. With blood cancer, the future is bright and we're always looking at ways to spot treat without hurting people. One more critical point, if someone is again, as I mentioned earlier, in a blast crisis or an emergency phase of a blood cancer, they need to stabilize that first before we can check for minimal residual disease and knock it out. I just want to make that clear because sometimes you need to be in an urgent hospital, sit under the care physician, you need the right chemo and treatments to knock that down. So you first want to knock out the fire and then handle the minimal residual disease. And that's where we see better long term responses for many blood cancers. So I hope this was helpful and I hope this gave you an idea of a workflow for minimal residual disease and blood cancers. We've gotten a lot of responses on what do you do with blood cancers. And this is one of those techniques in precision oncology that you're likely not to hear about anywhere else, but very powerful and can play a role in the treatment alongside care. If you know someone that has leukemia, lymphoma, myeloma, any other types of blood cancers where this minimal residual disease can occur, this is where this technology can work. And we can test for it using circulating tumor cells. So what should you ask your doc? Do I have any more minimal residual disease? Did we test for it using circulating tumor cells? And if I do, what's your plan to eradicate it? Are there any immune options to help me eradicate this disease? Am I a candidate for this treatment where we can spot, treat with a donor immune cells and knock it out? That's the questions you want to ask. And if the doctor says, I don't know, I'm not sure, we don't do that type, Just do nothing and wait for the disease to return. You can use a borrowed immune strike like this to really aim at getting rid of the cancer for good. So I hope this was helpful and this opened your eyes to a new technique for blood cancer. And I ask you to help us get this channel out there so that more doctors and patients can open their mind to precision oncology. That's how information works. And the more you like us and share us, you help the channel get out there and it changes the way the world thinks about cancer. So we can move out of the one size fits all model to precision care and helping people live longer with a better, better quality of life. I hope you found this helpful and may the Lord bless you. On your journey to healing.