Melanoma Immunotherapy: Why Most Patients Get the Wrong Treatment
In this clinician‑led presentation Dr. Dino Prado (Envita Medical Centers) outlines an immune‑centric, precision oncology strategy for advanced melanoma. He argues that conventional treatment—primarily checkpoint inhibitors and BRAF/MEK inhibitors—often yields low response rates because it ignores the full molecular and microenvironmental context of each tumor. Prado advocates a four‑step workflow: (1) deep molecular mapping that combines DNA next‑generation sequencing, RNA transcriptomics, and spatial biology to chart tumor‑cell mutations, immune signatures, and the surrounding “neighborhoods”; (2) root‑cause analysis to identify infections, toxins, heavy metals, and lifestyle factors that suppress immunity; (3) remodeling the tumor microenvironment by removing immunosuppressive cell gangs (T‑regs, MDSCs) and delivering targeted agents via interventional radiology; and (4) activating natural‑killer‑cell (NK) therapies, including tumor‑infiltrating lymphocyte (TIL) expansion and the clinic’s proprietary AAIT adoptive immunotherapy, which pairs fresh NK cells with dendritic cell training and danger‑signal conditioning. He emphasizes that NK‑cell‑centric treatment can reduce reliance on toxic drugs, improve response rates from the typical 8‑30 % to >90 %, and even cross the blood‑brain barrier to treat brain metastases. Integrative support—high‑dose IV vitamin C, curcumin, EGCG, phytotherapeutics, diet and lifestyle changes—is presented as a synergistic layer that enhances immune function and mitigates side effects. The overall message is that precise, data‑driven, immune‑focused care can transform melanoma outcomes while minimizing toxicity.
Chapters
Melanoma can be cured when it's found early and removed. But today we're talking about advanced cases where to spread deeper into the body. And the winning play is your immune system, especially the term here, NK and melanoma, getting immunotherapy. Right, Especially your natural killer cells. And it can reduce the need for other therapies and side effects. And we'll cover this in this episode. The key to deep mapping and planning is important right up front so you can see everything. Not only the DNA and the next generation sequencing, but the RNA transcriptom spatial biology and immunity. So we know the tumor's neighborhood and we understand the immune system and the blockades so we can overcome them. It's like flying a drone in the sky so we can see the neighborhoods, understand the immunity, immunity. And when we really understand the immunity, we can help our patients. Understanding melanoma at a deeper level is what we're going into today. I'm Dr. Dino Prado, founder of Envita Medical Centers, and For the last 25 years, we've helped patients that have failed cancer treatments at top hospitals around the country using the latest in precision technology, the best in conventional natural integrative care. That's what we do, but it's matched on targets. We go beyond the couple of dozen targets that are used in conventional planning to over a thousand plus detailed markers with your immune system at the center of it all. And that's what's made the difference. So let's go into the first segment here. We're going to talk about deep mapping. So the first part is this thing called next generation sequencing. It's just the DNA and here we're looking for mutations. Typically when they find this BRAF mutation, the BRAF V600 that's found in melanoma, it can cause problems in other pathways. I won't name them all here because they're all DNA, different pathways, but I want you to think of it like a whack a mole or think of it as like a street. If you block one area, it'll find a new area to grow. So it'll hit, let's say EGFR or another growth pathway. These DNA need to be completely mapped out and that's not being done. Typically, a patient will be done a BRAF mutational pill and be given other pills for some of these combination therapies. But we're going to try to avoid these altogether. And if we need to use them, we're going to go beyond just the DNA and we're going to look at the RNA and the DNA. So we cover all the barriers and try to bring in integrative phytotherapeutics at an IV level, which can actually help enhance these therapies, making a one plus one equal five in our clinical experience. But if we get the immunity correct, we may never need these drugs. So these drugs can have pretty bad side effects. Cardiac fevers and discomfort, and then try to lower doses. And these are mutations. Now what's nice about these therapies, when done in combination, some of the studies show that they have up to a 35% long term response. But let's see if we can improve that. Because when we do the transcriptomics, now we have the RNA and the DNA, which others do not do, we can go further in the mapping. Think of this as a deep map spiderweb where if you treat the cancer in one area, it tries to pop up and grow in a different area. We need to support all the pathways and that's the difference in precision oncology, we're not guessing it's details. And then we treat these pathways if we need to. Again, I go back to the key here is we get the immune system right, we can avoid this altogether. So the next part of precision testing is spatial biology. This is like sending a drone up into the sky so you can see the tumor and all the neighborhoods around the tumor. Think, think of it this way. There are gangs, I've said this before, around the tumor that are blocking the police, your immune system, from getting to the tumor. We can remove those gangs by changing the tumor microenvironment. And this is often why people may not respond to the most common therapies like PD1s or CTLA4s or these different PD1 inhibitors. They might work on, let's say some of the patients and not all of them. And the same thing is of all these drugs. But if we can see the neighborhoods and open up the pathway, it's very important. And the key here is melanoma is a hot tumor, usually hot, meaning it really works well with the immune system system. So we could get, we got to focus on that immune part. Also. We need to do a root cause analysis to understand in deeper mapping what's caused this cancer, what's bringing about immunotoxicity, infections, chemicals and heavy metals. Those are important because they can further weaken the immune system, cause blockades and prevent us from the goal of getting your immune system back on track to really go after this advanced cancer. Sometimes you'll see melanoma, even go into the brain and we'll talk about that and even how those natural killer cells are critically important in that treatment. So when we look at all of this, we know that there is work to be. And when we do the work, we get the data and then the data gives us precision and tailoring and that's what gives our patients the advantage. So let's go over what we see in the typical plan with melanoma. The backbone of melanoma today in these more advanced cancers is checkpoint inhibitors. These are the default backbone, PD1 blockers. And just a number of these that basically lift the T cells off, switch, they turn them on so they can go and kill. The problem is we don't always know how much this monotherapy is going to do the work. So maybe the response is somewhere between 8, 25% in trials, maybe 15 to 16% in trials. I give you these different numbers because there's different trials that show us our long term response. We want to bring that number way high. Our goal is to get that way into the 90 percentile. And that's what's important about looking at that tumor microenvironment. We don't have to guess whether it's going to be the PD1 or the BRAF medications that are going to work or these combination therapies, but actually knowing what the patient needs, this is what you need to know is let's remove the guesswork and let's get to the targeting. This is exactly why profiling is important. First, before you start doing things, and even if you're in the middle of care and it's advanced, you still need a profile so you can see what the workarounds are that are going to give you the best chance of responding. That's the key. So no matter which PD1 inhibitor, and there's several of them that can be chosen, that is temporary, may not work long term. So that's why these combinations and getting your natural killer cells involved even more can be important. Sometimes just using a PD1 inhibitor is partial. It's not going to do the job all the time. And so we need other ways, and I'll show you more comprehensive ways for your natural killer cells to do the work that they're supposed to do. As God them when we see mutations, I want to spend a little bit of time on these BRAF V6 hundreds or BRAF inhibitors that you might be familiar with, or these MEK inhibitors. These are combination therapies with EGFR and others that are used to help increase the five Year survival and it can be helpful. But the problem is that unless you do deep mapping, you really don't know where these cancers can pop up. It's like a spider web of pathways and if you block one, another one pops up. So if we know them all instead of just testing for a few DNA, but all the RNA and spatial biology, we have a much better chance of increasing that response rate significantly, significantly higher if we even need to use these in the first place. Because I said the key to melanoma is the immune system. It's nk. Melanoma, natural killer cells are the key to the game. And when we use those, we can avoid cardiac toxicity and a lot of other problems. In the way that I'm about to go over here in a moment, liver toxicity and damage to the eyes and other side effects, we want to kind of prevent that. So that's one of the things that these BRAF inhibitors can cause in some patients. But if we need them, you have to look at them at a different level so that you're covering all the pathways. And you can bring in integrative agents like things like EGCG and green tea or vitamin in an intravenous dose or curcumin that can enhance these pathways. And there's much more that can be done depending on your individual pathways. And there's data here that it can potentially help with PD1 therapy or the signaling for the NK cells in the microenvironment and etc. So that's why it's so important to do mapping. I don't want you to get just lost in just a few drugs and therapies, but it's the key to get the whole mapping down. And then you got to look at how that map is customized for you. Because two patients with the same type and stage of melanoma don't respond identical to the same therapies. So we want to that number way, way up and we do that by getting the targets and then we can support it with integrative agents, even something as simple as high dose vitamin C, which even in a few studies has shown to help that PD1 inhibitor help the immune system, increase the immune cells infiltration into the tumor or the recovery of the cells to help the PD1 PD L1 and it can synergize with the activity. So there are places where integrative care is very powerful. We've been using it for years, but we like to target it just like we would target any other therapy. So it's not a one size fits all it's specific, but here is the most important part I'm about to go over. It's the cellular immunotherapy. The natural killer cells is the key. Changing the game with the entire immune system being orchestrated for you right now. Recently approved in melanoma is TIL therapy till, which is tumor infiltrated lymphocytes. These are natural killer cells that have made their way into the tumor. And so what they do is they take a biopsy, they try to get some of these natural killer cells extracted from the tumor. And so they try to grow these natural killer cells, these tills. These are inf. They're already natural killer cells that have made it into the tumor and they grab it from the biopsy and try to take them out and grow them. But there's some problems with these. They've actually shown that in some patients, when people have failed all other therapies and they use these tills, patients can have incredible responses, including complete remission. So it's very powerful. But at the same time, these cells can be very exhausted, they can be hard to grow, it can be hard to find them in the tumor, meaning there's not enough of them present. So there's different things that can get in the way. Our natural killer cell version, which is called AAIT a toggless adoptive immunotherapy. This particular the is in our international facility. We're able now to grow the natural killer cells. New, fresh, strong natural killer cells with great cytotoxicity and dendritic cells which are the ones that teach the natural killer cell where the melanoma cancer cells are. And we train them using dams. These are danger signals that are damage associated antigens and other signaling pathways which help the dendritic cells teach the natural killer cells what to do to get a great kill. And with these we don't see the cytokine storm effects that we see with the tills. Potentially we've been using these for years. Very gentle heat, warmth around the tumor. And we've seen these work very well for immunocentric cancers like melanoma. With our patients, it's so important to get the immune system in the game when that immune system is working. Now, we are in a whole different level with melanoma. The NK's are coming in, they're doing what they need to do. These are your natural killer cells that God has given you, that kill tumor and restoring them. The other critical piece to this is understanding you may need to change these tumor microenvironments for Example, even if when they use tills, they can be potent, but they also can requ high doses of cytokines and these can overshoot the tumor, cause more inflammation, it can cause side effects. It has to be done under certain monitoring because some of the drugs they use here needs to be monitored in hospitals and settings where with ait we don't have that problem. We can gently but powerfully go after these cancer cells and melanoma and a lot of other cancers using the body's own natural killer cells in a very powerful but gentle mechanism. And so we've developed that over several decades. But when the tumor microenvironment and I go back to the g are blocking the tumor from the police, your immune system, we need to change that microenvironment. That doesn't matter if you're on a PD1 inhibitor, it doesn't matter if you're on a braf mutational drug. It doesn't matter if you're on the do tills because if that microenvironment doesn't change, the treatment won't work. That means it'll get, you'll get hyper immunity at the tumor. So you'll get T regulatory cells which will block your natural killer cells. That's FoxP3. You'll get myeloid derived suppressor cells from the bone marrow that'll block it. You'll have a series of different cell types in those neighborhoods that'll block it. And we need to change that environment. So now whatever the natural killer, cel can be effective so we can get direct to tumor using CIPI chemo immunoprecision injection and use immune modulators direct to the tumor using a catheter the size of the hair. Get right to the tumor and come out. And now we've created immunotherapy and these dams and this whole immune system response right at the tumor, which is exciting because remember, the key to melanoma, it's all about your immune system. It doesn't matter what treatment you use. That immune system is the key to bringing us into remission and holding it. And so we just understand that we can get right to the lesion to the tumor and deliver the medicine there and come out with a band aid and be specifically specific to the tumor. So using interventional radiology oncology, it's a very powerful way to get to the melanoma, get them activated, change that environment into the favor of the natural killer cells and then use the immunotherapy to wipe out that tumor that's fantastic. Now, with brain metastases, you would use systemic therapy and stereotactic radiation and different PD1 inhibitors intracranially to help the patient. But I'm going to come back to the NK in melanoma because if the immunotherapy is correct, these natural killer cells can get to the brain and blood brain barrier and go after the melanoma in the brain all on their own. That's why it goes back to the natural killer cell. So even in the tils, which is a brand new therapy, relatively new for melanoma, just approved for very late stage cancers that don't respond to anything, these natural killer cells get to the brain. And we've seen that with our aait, they get to the brain and they're able to get to the tumor because these tumors are in areas that are hard to treat, but the natural killer cells are able to pass the blood brain barrier. So here's the things to remember. Number one, you need deep mapping. You don't want to just start random care so you know all your DNA and your immune signatures before you start. Then you look at the root causes because these could be weakening the immune system. And you look at the neighborhoods around those tumors and you change it. And then you stimulate a natural killer cell based therapy, the one that's right for you, and then your PD1s and everything else is just the success rates go way up from the measly responses. We might see 20, 30% and our goal is to get them up into the 90, 95% because we're doing all the detailed work and we're taking the guesswork out and we're also reducing the side effects because now if we know what we need to do, we can micro dose and be targeted, not have to harm healthy cells of the body, or give too much of a dose of one thing or use combinations because one drug is partially working and the other one's going to support it. And now we've got added side effects. Instead we're going to focus on the immune system, get the immune system involved and then if we need any other treatments, we will combine those with the right markers, the right targets and the right micro doses to help the patient. So that's the difference with precision oncology. This is how you change the game in melanoma. And the faster you can target this, the better, so you're not chasing it. And then when you're doing that, you're going to increase progress, progression free survival and response rates because it's really an immune centric cancer. Less guesswork, more life. Map out the tumor, DNA, rna, get that data, understand what you're treating. In our case, we love using the natural killer cell therapy here because it's an immune centric treatment for those patients that are candidates. And that is important with the tumor microenvironment, getting those neighborhoods cleaned up and giving the body the nutrition it needs. The IV therapy, phytotherapeutics to support the pathways, cleaning up the diet, the lifestyle to get the immune system strong, get the sugar out of the diet. But the key here, it's an immun centric protocol. These, these are the powerful things of integrative precision oncology. And this is how you win, is with your immune system. I hope this was helpful. And may the Lord bless you on your journey to healing. Sam.
