In this educational talk Dr. Dino Prado, founder of Envita Medical Centers, outlines a comprehensive, immune‑centric precision oncology strategy for glioblastoma multiforme (GBM). He begins by describing the aggressive, infiltrative nature of GBM and the limitations of standard care (surgery, radiation, temozolomide, tumor‑treating fields) due to the blood‑brain barrier (BBB) and tumor‑induced immune evasion. The core of the presentation is a step‑by‑step framework built around a fictitious patient, “Tom,” to illustrate how deep molecular profiling (DNA sequencing, RNA transcriptomics, immunospatial biology) informs a customized treatment plan. Key components include: 1. Deep planning – next‑generation sequencing, methylation and IDH status, and immune‑spatial mapping to identify actionable targets. 2. Smart delivery – intra‑arterial routes and BBB‑penetrating agents to get drugs to the tumor. 3. Genetically targeted, fractionated chemotherapy – low‑dose, micro‑dose regimens that generate damage‑associated molecular patterns (DAMPs) to alert the immune system. 4. Immune‑centric therapies – autologous NK and dendritic cell adoptive transfers, cytokine support (IL‑2, IL‑15), oncolytic viruses, and careful steroid use. 5. Phytotherapeutic and off‑label repurposed drugs – high‑dose IV melatonin, sodium phenylbutyrate, mebendazole, low‑dose methylene blue with vitamin C, each matched to molecular pathways (STAT3, histone deacetylase inhibition, microtubule disruption, mitochondrial support). 6. Mitochondrial restoration – agents that revive cytochrome c function and apoptosis pathways, addressing the tumor’s metabolic resistance. 7. Gut microbiome optimization – dietary interventions (fermented foods, reduced refined sugars) to boost Akkermansia, Bifidobacteria, and overall immune tone. 8. Monitoring – serial MRI, circulating tumor cells (CTCs) with GBM‑specific markers, and methylation scores to provide early warning of recurrence. The talk emphasizes that each patient’s plan must be individually tailored, integrating molecular data, delivery tactics, immune activation, metabolic support, and lifestyle measures to convert a “cold” tumor into a “hot” one, thereby improving quality and length of life. Dr. Prado concludes with a call for precision, combination‑focused care and a blessing for the audience.
Chapters
Imagine this, you had brain surgery to remove the tumor, then radiation plus temozolomide, even more radiation and less than two years later, the tumor is back. Glioblastoma multiform. GBM spreads like finger like shaped tentacles through the brain. Good drugs often can't reach it because of the blood brain barrier and that's why so many patients see a return. I'm going to go over with you some of the techniques we've used to help our patients and the breakthroughs that I see coming in GBM and why it's so important to have precision oncology when dealing with brain cancers. I'm Dr. Dino Prado, founder of Envita Medical Centers. For the last two decades we've helped patients who've failed the top hospitals across the country, patients who've had glioblastoma multiform, that we've been able to extend their quality of life, length of life, and some who've had very long remission over the years. The key is the immune system. This should be no surprise to you, but I'm going to talk about that very practically today because immunity is so critical, immunity, mitochondrial health, these are going to play a big role. We'll start with deep planning, then we'll talk about smart delivery, the blood brain barrier and then waking up up the immune system and why that's so important and so pivotal in the treatment of glioblastoma multiform. I'm going to use Tom here as a story and he's just a fictitious name, so this will help you because we've seen this over the years, two and a half decades. And when we see these patients with glioblastoma multiform and other brain cancers, it's so important to understand that the surgery oftentimes may not give us what we want. You know, maybe nine, 10 months, you go through surgery, it comes back, you add radiation and other spot treatment, you might get 18, 19 months, but it's still not enough because the treatment is not immune centric. I'm going to talk about that and focus on that here. So standard of care, surgery, radiation, temozolomide. Many centers add tumor treating fields if the patient is eligible. And these steps can buy time. But GBM still often reoccurs because it infiltrates the tissue and it hides behind the blood brain barrier and these tentacles and little spreads that we even can't see with imaging. The problem isn't only the drugs, it's the delivery and the biology of the tumor. So we're going to talk about deep planning and how this makes a difference. So let's talk about Tom here again. We looked at his GBM so that we can design a plan for his biology. The first step is next generation sequencing. We want to look at all of the targets of those genes, all the mutations, they could be hundreds of those. And we want to look at on label, off label ways and phytotherapeutic ways to deliver the medicines past the blood brain barrier to help this patient. The same thing with RNA transcriptomics. We want to overcome the resistant pathways, growth patterns and the most important piece, the immune spatial biology. So we understand the immune environment around these tumors and we can develop a custom treatment for these cancers to help them hold remission. That's the goal. And you know, it's not an easy goal, but it's the key to getting there is the immune system. So if we look at things like mgmt promoters, methylation predictors tells us who benefits from temozolomide. Well that's one treatment on the DNA side we can look at, we can look at idh. This is important because you know, now we have treatments if your IDH mutant gliomas now have IDH targets. These targets are important because they slow growth, they buy time. But these medicines, they don't eliminate the glioma. Glioblastoma multiform. What I'm talking about today in our episode is a strategy for elimination, not just slowing it down. So these drugs may be part of the combination if this information is there, but it's slowing things down, buying us time. But the map helps us decide what are the agents that we can add to make the difference. And here's the important thing. Precision helps us to add specific targets for each individual's presentation of glioblastoma multiform. They're all different and we're going to focus on an immune centric plan that uses damps damage associated molecular patterns, immunotherapies that help improve the outcome. So here with Tom we're going to design an immune centric care first we're going to look at genetically targeted chemotherapy. This is where we use micro dose chemotherapy but with a caveat so that it gets delivered past the blood brain barrier. So now we can kill the cancer, but we can send out these damage associated molecular patterns, these dams. So the immune system in its area can now become alerted through these danger signals and start to wake up the dendritic cells and T cells for the glioblastoma because the natural killer cells are going to be the key. We don't want these tum cold, we need them to be hot. This is where we get the best responses when we have immunity. And immunity is so critical in these cancers. The dendritic cell strategies and the natural killer cell strategies have been around for a while with glioblastoma multiform. Also key interleukins to help stimulate the immune system, help the NK and CD8T cells expand, stay alive and fight the cancer. Other immunotherapies such as oncolytic viruses direct to tumor, again stimulating dams, priming the immune system, helping these cancers get an immune cent so important along the way. Sometimes steroids like dexamethasone is used because there's swelling and symptoms. But we got to be careful because these blunt the immune system, they weaken the immune system and that can affect our overall goal and outcome with patient care. So we need delivery that gets past the blood brain barrier so we choose the right routes of delivery, the right targets of delivery, so we can be intra arterial, we can be using medicines that help us get past the blood brain barrier so that we can affect the cancer where we need to. So we're not just stopping at standard of care here. We're talking about a custom precision build that's custom for each patient. Going back to this example I'm using, like Tom's case, we've seen these glios over the years have actionable targets with DNA, RNA and immunotherapy. So the genetically targeted fractionated chemotherapy was step one because now we have the right targets. But the other key is going to be aait autoglous adaptive immunotherapy where we've specifically build natural killer cells and dendritic cells for this specific patient with glioblastoma multiform and expand it using the right cytokines and immune modulators. And why? Because these natural killer cells, they can pass the BL barrier. They can get to the tumor when the targets are correct. So we do this through our international facility and we've seen that this is critically important because immunotherapy is so important for this type of cancer. And then we add in key phytotherapeutics based on their targets. I'm giving examples here. So this wouldn't be the same for every patient, but we'll use Tom as an example. We've typed out his phytotherapeutics to specific maps like stat 3 and other markers. We used specific phytotherapeutics that were mapped out with specific detailed markers to sensitize the chemo to work better to sensitize the immune system to work better. Like melatonin intravenous high dose, maybe also 200 milligrams at bedtime. This helps with mitochondrial support. Sodium phenylbuterate after the great work of Dr. Brzezinski where it's kind of working on that Antineoplastin. These histone decarboxylase H, D, A C inhibitors to help sensitize the tumor better to treatment. Had targets for menbendazole, which is a parasitic drug. But it passes a blood brain barrier and can work on the microtubules as a, as a repurposed drug for his targets. Methylene blue to help the electron transport chain in low doses that could have an effect to help the patients help mitochondrial dysfunction related to the cancer. So these are examples. So over time, let's say Tom was given the right care and medicine right immunotherapy. His headaches eased, speech improved, scans stabilized. And we saw that using on and off label drugs and customized immunotherapy gave the patient the advantage he needed. We watched early on so that we could make adjustments. We used MRI response assessment in neuro oncology. We also looked at circulating tumor cells that are specially design for GBM type markers. And we also look at methylation scores. And all this helped us to look at the prognosis so we could monitor the treatment before the cancer return. Because oftentimes a glioblastoma multiform you won't know until the tumors return. Now we have tools that help us look at it as leading indicators, not lagging indicators. CTCs, methylation scores, monitor the patient. Mitochondrial health is so important. I can go back to cases that we treated many years ago that are still in remission today because we corrected the mitochondria and that was the key. It was getting the mitochondria mitochondria to work, to improve, to heal things like we talked about, such as methylene blue. In that case could be helpful because when the mitochondria is broken, your program cell death is broken, meaning you're not getting apoptosis. So the cancer cells not dying off the way it should naturally normally, because that mitochondria is not working well. So we want to turn it back on, get those electrons working properly, get the mitochondria to make a difference. When there is mitochondrial dysfunction in glioblastoma multiform you have poor energy flow, damaged membranes, blocked apoptosis signals. So we want to back on cytochrome C and there's a Little trick to this in Tom's case. I'm going to use this as an example here. We were able to do low dose methylene blue with low dose vitamin C. So we could push the cytochrome pathway C, which made the difference in helping turn on the electrons in the brain, all while doing it simultaneously with key immunotherapy. You see, this is strategies that are really important because the combinations in this case made a difference for this fictitious patient. But I'm giving you an idea. Because every patient's going to be different. Treatment programs are going to tailor depending on what each patient needs. And then going on further to some of the basic, basic things that everybody could do was improving gut microbiome health. Because a gut microbiome is so important to the health of the brain. It's the second brain. It's 70 to 80% of your immune system from your gut and it also affects the brain. So here we wanted to get rid of all the food allergies, gut inflammatory foods build the body to have diversity, have the fermented vegetables, sauerkraut, yogurt, kimchi, and help restore the gut's immunity. Also removing all the inflammatory foods increase the butyrate in the gut. And all these things can be done by just getting rid of all the refined processed sugars and carbohydrates, decreasing the inflammation in the gut wall. But this is so important because now we're decreasing inflammation, we're improving immunity, adding akkermansia and bifidobacteria and other things that can help the immune system. So we have a better immunotherapy response and we help to try to turn on CAPS base 9 with mitochondrial health, which is what normally kills, helps the cancer cells turn on their apoptosis to die off. All of this with DAMS targeting and immune centric care, getting direct to tumor, sometimes going straight to the tumor, with interventional radiology, oncology, sometime close to it with the same procedure. Sometimes also utilization of medicines that help us pass the blood brain barrier much more specifically so we can help the patient. And using tools like immunotherapies which pass the blood brain barrier. See, with glioblastoma multiform, you don't have guarantees. It's a difficult cancer. But when you have this more precision planning, you've given yourself such a huge advantage because now you have everything working to your benefit on label drugs, off label drugs, phytotherapeutics, cellular biologics, all targeted to help. So let's recap. Glioblastoma multiform DNA, rna, DNA, immunospatial biology map everything out. So we take out the guesswork and we finally start getting targeted. Now we're delivering the medicine past the blood brain barrier direct to tumor as much as possible with an immune centric protocol using damage associated molecular patterns and getting this to work using the right cytokines and using cellular biologics like autoglass adoptive immunotherapy to stimulate the immune systems to go in and fight the cancer. Help the powerhouse, the mitochondria so that it can restore to health using the right targets for the mitochondria and help that mitochondria restore its caps base 9 or apoptosis switch so it can start killing the cancer on its own and then helping the gut microbiome so we have strong immunity. Akkermansia, other foods, dietary lifestyles. You can watch my other videos on that so you can learn about the dietary food components. But those are important because now we have gut health and now we have immunity. And so when the brain tries to put up a wall, don't just walk away and say, gee, this is all I have, is the only treatment. But do the deep mapping, the deep planning, putting the combinations together so you get the latest in care that gives you the best ch of surviving and the goal of longer term remission, which should be the goal with every patient. I hope this was helpful and may the Lord bless you on your journey to healing.
