New Breakthroughs in Cancer Fighting Technologies with Chip Petricoin

Foreign.

All right, look, I think there's something incredible that's happening around the world. And, you know, I come with every episode, and I bring optimism, but not only do I have the optimism, but I'm actually seeing on the ground success that is developing. And it's my responsibility to bring that to you. But let's rewind the clock. 2010, my stepmom was diagnosed with breast cancer. I just created finished creating the first video medical encyclopedia on the Internet. It had 8,000 videos featuring the top medical experts in the world. And just then, my stepmom was diagnosed with breast cancer. And so then we launched Breast Cancer Answers with the American Society of Breast Surgeons to help patients just like my stepmom. Within three years of that, our audience grew tremendously. We did, like, in one year, we did 1.1 million followers and 6.3 million video views. And then it grew to like 14 million video views and the library started to grow. And just then, 2013, my wife, the love of my life, became the next breast cancer patient in the family. Now, this summer, we celebrated my wife's 10th anniversary of survivorship, my stepmom's 13th anniversary, and we just successfully went through my dad's one year successful fight at the Mayo Clinic with lung cancer. And what I see is both the victories, the pain, I see the losses of lives of people that we love. But I've got hope, and I want to give you what's coming down the road. I want you to see where the fight against cancer is going, and I want you to start thinking about those limitations that we've lived with coming down, because we're about to live through a big transformation. Coming up in just a few moments, we're going to go out to Virginia and we're going to talk with Emmanuel Chip Petrocoin, who is going to blow your mind on where this is headed. And we're going to do that in just a few moments. This podcast is brought to you by the Wirebuzz team. Now, if that name sounds familiar, it's because I've spent the past decade growing Wirebuzz into a digital marketing powerhouse designed and to maximize clarity in complex sales processes so we can help accelerate revenue. And we do this in three phases. Phase one, we transform your website to function like your best salesperson and then also incorporate persuasive on demand sales videos. Now, your entire team is aligned on messaging, and they're injecting massive clarity into your prospect's head. So your site looks great, but it also has engaging content that helps your team sell on demand 24. 7 the next phase phase two we train your sales and marketing teams to sell remotely or in person to expand the impact of your sales team. And the third phase is we develop and run targeted ads to your prospects. Scale those ads to help you achieve more business results. Sign up for the Wirebuzz Company newsletter to learn more about effective and simple ways to improve your company messaging, attract more digital attention, and ultimately make more sales. So I think you're in for a real treat today and something you're going to want to share with other people in your life, which is where this road is headed. I've been so lucky to advise the chairman of the President's Cancer panel for the last two administrations. Got to work with him on the research for the project Moonshot announcement. And that was about the cancer moonshot, excuse me. And it was a real honor to do that. But what's really cool for me is getting to hear the whispers of what's coming up next. And that gives me an opportunity to bring the leading experts right here to you in every topic, really, so you could start to see where the road ahead is leading. Because really the road ahead is about applying what we know and then persevering through what we're discovering and then again applying it so we can help people. So where's the next stage in the fight against cancer headed now? Well, in Virginia is Emmanuel Chip Petrocoin. He's the co director of the center of Applied Proteomics and Molecular Medicine, professor at George Mason University. And Chip, thanks for joining me on the todcast.

It's a pleasure, Todd, really, especially with your background and your own real world connectivity to the changing landscape of cancer treatment. It's great to be able to talk with you about this.

Yeah, thank you. I'm super excited to share what you're doing. We have mutual friends that are raving about what in the world is going on inside of Chip Petrocoin's head. And I need to break this down. Like, for those that don't know, can you do me a favor? Like, where did you get started in researching cancer and what provoked you getting started on this path?

Yeah. So I started on the path where I'm now basically in my postdoctoral work. After I got my PhD, I went to the US Food and Drug Administration on the NIH campus right around the corner from where I'm right now and had the opportunity, both from a regulatory standpoint at the fda, but also as a research scientist there, to see kind of the net Impact of proteins. The field of proteomics at that time, or what we call kind of the global study of proteins, was in its infancy. We were kind of in the midst of the beginnings of the genomics revolution when I was at the NIH and and I saw from a regulatory standpoint that proteins were pretty important. In fact, almost all of the molecular diagnostic tests that we use in our kind of monitoring our own health and wellness, when we go get, say our own physicals and we get our blood testing results back and we have all these measurements of all these molecules that the doctor uses to assess our health and wellness, I realized that almost all of those are proteins actually that are being measured when you get your blood test result back, even in our own daily lives and how our physicians are managing our care, seeing how we're doing from a health and wellness standpoint, almost all those measurements are protein based. I saw at the FDA that most of the regulatory oversight we had in the measurement of those molecules, these are protein based molecules. I also saw that 90% to 95% of the drug targets to almost all FDA approved therapeutics are actually protein based. I know that when we get our prescriptions, we pick them up from pharmacy. Inside almost all of them are these package inserts that are these in three point font of the way works, right? Nobody ever reads those. But if you ever care to go to section 12 on that package insert, it tells you how the drug actually works. And if you look on that, almost every single time, the way the drug works is by inhibiting or activating or modulating a protein has nothing to do about genes. You won't see one mention of genes or genomics in that, but you'll see mentions of proteins and what, what the drug targets actually are. So if you think about genomics as kind of the hardware of the cell, it's the proteins that do all the work. They're the software of the cell, if you think about it from a computer analogy. And because of that, I recognize that cancer is really a proteomic disease, not a genomic disease. And I was fortunate enough to link up with my colleague and co director, Lance Liotta, who was the chief of the laboratory of pathology at the NCI 300 yards from my building. And we met and we talked about the impact of proteomics kind of in the headwind of genomics at the time, because again, as I said, it was the golden years of the genome and the sequencing of the human genome and the cancer genome project was in full force. So we set out to basically form the first interagency program between the NCI and the FDA and a clinical proteomics program where we bring in knowledge from the FDA and the regulatory science side and then kind of the molecular profile and the NCI was doing, we were able to make a huge amount of headway inventing a large number of technologies to analyze the protein and protein architecture of the cell which represented all the drug targets of cancer. And we were recruited under an Eminence Scholar recruitment program to George Mason University in 2005. We were able to move our entire laboratory from the NIH to George Mason University and really start to apply the knowledge we began on the NIH campus, really start to apply that in precision medicine, clinical trials and collaborations with biopharm. And it's just exploded since then.

It's super cool for the lay public. Is that the path? Like sometimes things get developed at an FDA level or an NIH level and then they move into a research facility and get developed further.

There's many, many paths. But yes, that is certainly one of them. Where one of the nice things about the National Institutes of Health is it's kind of a collision zone where you have a lot of scientists physically co located on a campus where there's seminars going on constantly and there's able abilities, water cooler conversations or when you're putting your lunch tray back on the line that you bump into people that are world renowned scientists and you can have a five minute conversation that changes your life. And so that was one of the great aspects of working at the nih was being able to kind of collide, if you will, with like minded scientists. And yeah, the academic research ecosystem is a great ecosystem to kind of expand or explode out ideas. And we were able to be provided a great opportunity at George Mason where the president, the deans basically were like let her rip basically. And we were able to spin out a large number of companies to kind of expand on our ideas and be able to commercialize on the promise. I think it's important for listeners to realize that no idea ever impacts the patient unless it's commercialized. All of the scientific ideas, you can't have them lie fallow at the bench or at the door of the research laboratory. They have to transition into a commercial entity to actually impact patients. We were fortunate that we were able to commercialize a number of our findings, our technologies to allow the promise of what we were finding to get to the bedside. And translating it to the bedside is of utmost importance because that's where patients are impacted.

Yeah, Absolutely. So let's get to commercialization in a moment, because I want people to see what the path is right from research, breakthrough and development all the way to where it could be used in a patient room or in a facility to elevate patient outcomes. We'll get to that in just a second. Yeah, but you mentioned the impact, the net impact of proteins. Can you talk about how understanding the protein can allow you or enable a provider to better treat a very personalized and specific type of cancer?

Absolutely. And you mentioned at the beginning of the program, you bringing on ideas that are kind of coming up or even over the hill a little bit. And this is exactly where the field of proteomics is poised right now. It's a little bit paradoxical. In the. The current ecosystem of patients dealing with breast cancer and other cancers, they're seeing the benefits of the genomic era kind of coming at them by doctors being able to order the genomic testing of their tumor, that is allowing that information to help them make treatment decisions. Just in the past five years, physicians are able to get comprehensive genomic profiling that was only available at, like, you know, MD Anderson Memorial Sloan Kettering. You know, only a few places in the world were offering kind of this comprehensive genomic profiling to patients. And of course, it was not democratized. It was not, you know, a patient would have to travel 1,000 miles to get access to it. Now, that's completely changed. You've seen the commoditization of genomic profiling, where any patient anywhere can get access to this information. However, paradoxically, this information is not actually directly looking at the drug targets. When a patient gets a genomic profile of their tumor and the physician sees that this gene is altered or this gene is mutated, that is an indirect measurement of whether or not the protein that is encoded by the gene is actually altered and activated. And that's actually inferred by the genomic information. The physicians are actually not getting a direct evaluation of whether or not the drug target, which is the protein, is actually activated and expressed. And so, paradoxically, while we have this great promise of the genomic revolution and genomic medicine, paradoxically, it's actually all inferential and not directly measuring. We're not there yet. We're a step there now with proteomic technologies that can actually directly measure whether or not the drug target is activated and in use in that patient's tumor, we now have the ability to measure kind of the architecture, almost the wiring diagram of that patient's tumor and, say, in this patient's tumor, these pathways, these protein pathways that are the drug targets are activated or not, and then take that mapping and match it to the tailored therapies that are coming into the armamentarium of what the physician can use. And we can match which drugs are FDA approved or in clinical trials that hit those drug targets. And we map it to the actual architecture, the wiring diagram of each patient's tumor. And then we're now providing that information to physicians that are using that, along with the genomic testing they're having done, to finally say, aha. Now I know exactly what drug targets are activated and in use in this patient's tumor. I can pull from the shelf the drug that turns that pathway off and be able to know with high confidence that they're providing the patient the key. Missing, you know, the right drug at the right time, as they say, and providing that missing information that they otherwise wouldn't have seen before.

Okay, I love this. So is in the easiest way to explain this and I'm sure I'm off track. Okay. But is, is proteomics the next phase in the fight after genomics?

Like it's the, it's a post genome revolution. I, I explained to my wife sometimes who's not a scientist, you know, and she's kind of a, a typical layperson. Right. That's a non scientist, but is educated and is reading the news and is trying to understand, you know, how and.

Trying to have a conversation with you on a daily basis. Right. So she probably knows more than the layperson.

Yeah, well, she definitely has some good by osmosis. Right? Yeah. But I said to her, you know, it's, I look at like genomic based profiling is kind of like a static map of say a roadmap, as if you were looking back in the old days of just, you know, unfolding the map of like how to get from this town to this town. Whereas proteomics is kind of like Google Maps or Waze. It's telling you in real time what's happening with what roads are blocked, what roads are green, you know, which, which direction to take. And if you just had the static map, you wouldn't know. It would be like, okay, well I kind of have to guess and kind of see how to get from A to B. Tells me to take this highway, but it doesn't tell me which highway to really take at this exact moment. And I look at that as proteomics kind of giving you that real time direct information about which path to take. And now we have reports that Are coming in that tell that patient that kind of real time information.

Okay. I love everything about this. And for those that are listening, you should be feeling what I'm feeling right now, which is the optimism and the opportunity. Because at the end of the day, we're on the path in the fight that will help us create more personalized treatment. Because these cancers are like galaxies of diseases, like breast cancers, like multiple types of cancers. And we put a name over it, but inside that umbrella is like a galaxy of different diseases. And so being able to understand the protein allows you to treat it in a significantly more effective way. And it's super cool. Can we talk about commercial? Like, where are you guys in the timeline? And then also where is this coming up? Like, I know there's a company there, link, that's involved in this. Kind of paint that picture for me so we can start seeing the path that you already laid out from the research to where it shows up in a. On a clinical or patient setting.

Yeah, no, absolutely. And as I said, nothing, nothing helps the patient unless it's commercialized. And so we were able to, you know, we developed and invented this protein technology. It's actually a protein array technology called the reverse phase protein array, to be technical. But what this array does practically is it's like the Google maps. It tells you this protein array tells you which proteins are actually activated and in use in your specific tumor. And you mentioned the fact that we now know that tumors are so individualized at the molecular level. Right. This galaxy. Right. We used to think about breast cancer as kind of a one size fits all description. The genomic revolution actually allowed us to see for the first time that at the molecular level, every cancer patient's tumor is different. Think about that. It's different at the molecular level. It's kind of daunting when you think about, well, how are we going to individualize therapy if every patient's tumor is so different? What the proteomic kind of map reveals is that while patients may have different molecular defects in their genes and their tumors, at a pathway level we're finding some patients categorize into, oh, you have this pathway highlighted, but you share this pathway with another patient's tumor. And we have drugs that hit those pathways either as like a carpet bomb or. Or they hit them in specific hubs to turn that pathway off. And we developed a technology called the reverse phase array that essentially maps that architecture, almost like a wiring diagram emerges. And that technology platform we licensed out to theralink Technologies, as you mentioned, because you have to use this platform in order to map that, that architecture, that tumor specific architecture, and really understand what drug targets are activated. So Thera Link licensed this technology from George Mason University and they have this empowering, one of a kind platform that allows them in their laboratories to have physicians send a tiny, tiny, microscopic piece of the tumor to Theralink. Theralink uses its platform to measure in that patient's tumor what are the drug target signaling architecture, what's that Google map look like, what's that Waze diagram look like of which highways are green or red. And it basically then maps that to which drugs hit those specific pathways that are on that patient's tumor. So they have women with breast cancer. Today, physicians are sending their tumors to Theralink and in less than 10 days, because of course you can't wait. You have to have the assay performed in real time and that information delivered back to a patient. So in 10 days, TheerAlink delivers a report back to the physician that says which drug targets are completely turned off and which pathways and drug targets are completely turned on in that patient's tumor, along with a list of drugs that hit those specific proteins and turn them off. And so this is happening today. So pleased to see how Theralink has been able to take a research technology and then scale it into a commercial platform that patients from anywhere in the United States can send their tumor for this kind of one of a kind profiling really beyond genomics. It's the next over the hill view of the tumor.

It's so incredibly inspiring to me. In the interest of full disclosure, I am a special advisor to the CEO of the Link because I heard about what Chip Petrocoin was doing and knew I wanted to help be a part of this amazing transformation in the fight. You know, I was there when Genomic Health started Oncotype DX and got to help them bring that to market starting in 2010. Still am a advisor and watched them take something from, from a concept to now standard of care. And I see the path that their link is going through to concept to standard of care. And in the middle of that is a whole lot of adoption opportunities from providers. But I think what we're about to witness is the next big transformation in the fight and that excites me tremendously. What, what is it about cancer? And do you have a backstory here in, in what inspires you or drives you on a daily basis? Because just being a part of something is just a small portion of it. I'm sure there's a bigger part to your story and your mission?

Well, sure. I mean, I think like many, many, many people, I have had family members that have been touched by cancer. My mother had breast cancer. I have close family members who passed away from cancer. Some of which, like many of us, you know, have been with them the whole, their whole journey and, you know, have witnessed, you know, a lot of trials and tribulations. But also, as a scientist, I saw, you know, very much the gaps in what we were able to do for my family members. And of course, you know, it was ironically juxtaposed on the fact that I was in the oncology molecular ecosystem at the same time. It was in some ways frustrating, but also I viewed it as an opportunity because I could see what needed to be done to maybe help them better or help someone like them more in the near future. And so definitely inspired by these events, driven by these events, like many of us are. And yeah, I mean, I think that what we're seeing now is truly a revolution in the precision medicine space. You know, everyone talks about precision medicine, but we have to remember, you have to. I always say precision is a misnomer. In the clinical laboratory space. We talk about precision and accuracy. Precision is just getting the same answer over and over again. Accuracy is getting the right information, being accurate. So actually, I like to say I'm more interested in practicing accurate medicine than precision medicine. And I think what now we see with the ability to directly measure these proteins, it becomes accurate medicine and not just precision medicine. And yeah, I'm excited because a lot of times when I talk to oncologists about the Theralink assay, or just in general, they're essentially like, you had me at hello. Right. You know, the physicians get the fact that the protein, you know, they've taken biochemistry before and so they understand, you know, yes, of course. Proteins are the drug targets. Yes, of course, if they're activated, you can directly tell that they're in use. The drugs turn the proteins off. We'd like to know if they're on you say you have. They were like, we didn't even know you could do this. It's more about.

Right.

The technology. Like, wow, we completely get it. I've had a number of oncologists tell me I was waiting for a technology that could do this, was waiting for something that could do it. I didn't know if I was going to live to see it, but now I see it and I can't believe that we have this arrow in our quiver. So that was really very heartening and humbling to hear that I was part of the development of a technology platform that could finally deliver on it. Not just me, there's 30 people in the lab that were doing the lion's share of the work. I'm just in some ways just a standard bearer for it. So there's a lot of people that went behind the development of this.

Yeah, I totally get it. First time I heard about this was from my friend Peter Beisch and Dr. Beisch was telling me about the. He used a similar analogy as Waze and the green and the red and we were at dinner and honestly I couldn't listen to almost any of the other conversation when it changed off this topic because my brain lit up as like, well that makes total sense. Right. So it's a really interesting development. And so what are the, like, what are the next steps for making this approach broadly available?

Yeah, and I think your analogy with genomics health, you know, your own kind of, you know, connectivity with the company and how they got this very interesting research finding at one time, you know, there's this finding and then now it is a practice changing assay that you have to order because it really impacts patient management. And you mentioned that kind of in between period of like what happens between that discovery and then like everyone ordering it. That's where we're at right now. I think what we're trying to do is showcase the clinical evidence and impact of these protein and protein activation mapping. My laboratory beyond what Theralink is doing commercially and marketing, kind of the marketing commercial side. Physicians do not like snake oil. They want to see the real world data, they want to see rigorous clinical trials, they want to see rigorous data. That's what we're in right now is connecting with key opinion leaders who do not associate themselves with things that are not rigorously validated. And we're working with them to provide data driven rigorous validation. So my laboratory is kind of the protein biomarker engine for the I SPY2 trial, which is a very large, well known, 30 site clinical trial in breast cancer where we're showcasing the use of this protein mapping technique, where We've published about 20 papers in the I Spy trial showcasing how the protein activation mapping is providing key missing information on predicting response. My lab was involved in three stand up to cancer dream teams where we showcased this technology in those settings. So I guess my point is where we're at is taking the technology platform and placing it in opportunities where we can basically blow people's minds of what is coming out of the technology because we have to convince people that despite the promise of it, and they get kind of the roadmap. They kind of like, well, I need to see it in action. I need to see if it really delivers on what I, you know, you had me at hello. Now, you know, does it really do what you say it can and does it do what I think it can? And so we're in that, we're in that process right now of showcasing it, deploying it in key precision medicine studies where it can do its thing and showcase the power of the information. And at the same time, Thera Link is providing this information commercially to breast cancer patients. Right now all around the United States, physicians are using it and theralink plans over the next year to broaden it from breast cancer to ovarian and lung and colorectal. And really it's a pan tumor assay. So they're doing a good thing by starting walking before they run and making sure that they deliver something that is not just clinically useful, but actually is potentially superior than genomic based approaches. But at the end of the day, what they care the most about is can it elicit practice? Changing behavior that changes patients clinical trajectory. It's all about extending life and extending quality of life.

Now you mentioned a term called, what is it, Pan cancer? Is that what you said?

Yeah, kind of beyond across all cancer types.

Okay. And for the, yeah, for the listener who might be thinking, wait a minute, if this could be used for all different types of cancer, why are we starting it with just one little area? Let's do it, Chip petrocoin. Let's roll it out. And for those that may not know, like one of our clients, one of my clients and friends at Garden Health, and they are a diagnostic company, they liquid biopsy and that is the circulating, the blood that's circulating and they're looking for fragments of cancer. They started, they, they knew that they could be pan cancer and they knew that in order for them to be successful, they had to commercialize in one area first, then land and expand. And this is the tried and true way. And if you go with an add approach and you've got some type of an attention disorder, you don't serve anybody because you don't get that first big impact in an area. So I like that you guys are doing that. So tell me about, like, you know, a moment ago you just talked about key opinion leaders and how important they are in the process. How do top institutional key opinion leaders feel about, about proteomics? And what the link is working on right now and the technology, where's there from what you've heard, what's the, what is the word out on the street about what you guys are doing?

I think it's basically, it's a combination of we can't believe that you guys can do this because scientifically it's a no brainer. It's not like we had some magic insight into how proteins and measuring protein activity, they're like, yes, of course, of course, that's tremendously important. Of course that would leapfrog genomic analysis. But you know, can you do it at scale? Can you deliver it with the right turnaround time? So not just at scale, but the speed of information delivery. Because like we said, patients, you know, can't wait months to get this information. They have to make sure.

But that's also the job of commercialization. Commercialization will solve that problem.

So there, I mean it's a part of that is can you do this commercially, you know, and this, can you do it under the right clinical oversight? So to get a little geeky, you know, any laboratory that.

Wait, you're just starting right now to get geeky?

Well, just kidding. To further expand into geekiness, you know, any laboratory that delivers information that impacts, you know, our health. You know, when we get, like I was saying before, we get, you know, information back from our blood tests, from our physical or you know, radiologic, anything that we do where a physician uses that information to make a treatment decision, that has to be done in a laboratory that is CLIA Clinical Laboratory Improvement act or College of American Pathologists cap accredited. You know, when you go to like a LabCorp or Quest or you know, any clinical, they're CLIA CAP accredited laboratories. A garden you mentioned is a CLIA laboratory. Any of these clinical genomic labs that are being used for sequencing tumors, they have to. So theralink, which is also CLIA CAP accredited, you have to have. So the physicians that are like, hey, this is unbelievable that you can do this proteomic assay. These key opinion leaders, it's got to be scale, it's got to be done in a CLIA environment. You know, you have to have the connectivity into their emr. You know, there's all of this stuff, these operational stuff, right? Connectivity stuff that you have to do. That's not even anything to do with the assay itself. It's the connectivity, it's the reporting. How's the report generated and is it clear and concise and is there a call to action on the report. So there's a lot of work that's done behind the scenes that patients kind of, you know, don't see because they just want the information to go to their doctor and let you know, we need to make a plan. Doc, my cancer is progressing. What are we going to do here? So this is the part that Thera Link is doing that these key opinion leaders see. Like, wow, you're checking a lot of the boxes that I like to see in my own ordering process. So Thera Link has partnered with a number of companies that are getting their, their assay actually on the menu, so physicians can actually choose it, because inside an emr, you know, there's, there's, there's the way that physicians order tests now. It's not like the old days where they just, you know, wrote out a script and gave it to you.

And Chip, let me jump in. Right, real quick. For those that may have gotten lost on the acronym emr, that's electronic medical records, and that is how a provider communicates back to not only their own, let's say, hospital system and their records, but also to insurance. And that's how the left hand knows what the right hand is doing. And patient records are organized through an emr. Go ahead, Chip.

Yeah, and so, so part of what the key opinion leaders are telling me is like, you know, you need to get this kind of connectivity. You have me at, hello. And the benefits of the assay, can it be done quickly? Can it be done in a clear setting? Can it be scaled? Can we connect this into my ordering process? And then I think, importantly, they're like, you know, where's the clinical levels of evidence that I can see from myself? Where are the publications that show me that by measuring these proteins and whether or not they're activated or not, actually predicts who's going to respond and can tailor therapy appropriately? And those. We have many publications, and the field is generating a lot of publications along this line. So we're allowing them to kind of see for themselves the levels of evidence. You know, these are very sophisticated and skeptical, rightfully skeptical scientists, but also ready to embrace this technology because they see for themselves and they're frustrated with many of the limitations that genomics medicine is providing because there's a lot of key missing information that happens along the genomic profile. And they wish they had this last kind of piece, this roadmap. And I think that, I guess the best thing that I've seen happen when we've been talking to these key opinion leaders is I would say 100% of the time, they end up wanting to collaborate immediately with their link on their own internal. Like, oh, my gosh, I didn't think we could do this. I can't believe it's here. You got to check these boxes for me. But while I have you on the zoom or in my office, can we work on this really interesting project that I've been wanting to work on with a technology like this, and they become kind of advocates because then those collaborations, they see for themselves the utility of the platform. So it's been really kind of fun to see the uptake in that regard has been. A lot of it has been like, oh, my gosh, you know, I have these tumor samples in my freezer that I've wanted to analyze with something like this, but I've been waiting for this technology to come. And so that allows them to kind of connect in very personally with the platform.

I love it. I love it. You know, that's. The early adopters are the ones that are looking for where the next big breakthrough is. They're the ones that are excited being out on the early edge, and they end up becoming the evangelists.

That's right.

Who help bring the other group of people. And it's a really small percentage of a industry that then trailblazes and brings the rest of the industry along. It's rather remarkable for those that are a bit jaded on the path of medical breakthroughs coming to market, or maybe a bit jaded by the. A feeling that maybe the research isn't done by people that actually care about the outcome. I would love to let you know that I have not experienced that being this close and intimately involved with organizations. I've experienced businesses that are operating to impact patient outcomes. I want to give you a quick little story. And Chip, I know you'll appreciate this tremendously, but it changed the way I see our field in the fight against cancer. When I went up to one of the big labs, I won't mention their name to do right after my wife was diagnosed and had her double mastectomies, I was home caring for her. But maybe in week four or week five, I got up to one of these big facilities, these labs like Chip was just mentioning, and I was there working with their prostate team. And I was on their large campus in. In Silicon Valley, and on the campus, all of a sudden, to the door. The chief of pathology, who I had met once, knocked on the door, came in, reintroduced himself to me, and asked if he could take a private walk with me down the hall into a side room. I don't know what's going on, but this is my first time in public since my wife went through her cancer battle. And she's home recovering. And so I go into the side room, and here's the chief of pathology whose whole day is an everyday reviewing tumor samples. And he says to me, todd, I heard you were on campus and I needed to personally come and find you to let you know that your wife's tumor arrived this morning. And we are starting your wife's analysis so we can help you guys win the fight against her cancer. And I want to let you know that I will have two blind teams, my two best teams, without the other one knowing, both doing research on your wife's tumor. And we will personally give you the best information possible because we believe that patients deserve that. And then I'm crying, literally crying in this room with the chief of pathology, who is also crying with me. What I've discovered is people like Chip and key opinion leaders are driven to help end this. And I wouldn't be involved if I didn't see all hands on deck to help support patients like my wife and my stepmom. And I want you guys to know that there's great people out there that are going to help us win this. And it's happening sooner than you could ever imagine. Chip Petrocoin. Last question. For people that want more information, they want to, like, learn more about proteomics and what you're doing, and they're like, yo, I'm on board. Where do they go and how do they find out more and how do they stay up to speed on the developments that you guys are making?

Yeah, that's a great question. I mean, I think that, you know, they can certainly, you know, Google our Center for Applied Proteomics and Molecular Medicine at George Mason University, we have a nice landing page website that can direct them to kind of different sources of information. The NCI has, of course, and thankfully in the time that I left, they have recognized the potential for proteomics and they've started their own clinical proteomics initiative at the NCI that the listeners can Google. The NCI has a fantastic resource page for their clinical proteomics effort that kind of branches into these different topics and provides educational materials as well. They can, of course, learn about theralink by just going to the theralink website. But as a general concept for the proteomics field. Now, the clinical proteomics field, if you will, is such a growing enterprise that so much Information is right at the door. Look, they could email me directly if they wanted to. I have no problems. I talk to patients and people constantly and I'm happy to. I have a whole resource kind of dossier that I can kind of easily send out as a PDF as well.

Amazing.

I did want to say though, I was very interested to hear what you said about the journey you had that one day with the molecular pathologist at that facility. And I, I just wanted to amplify on that a little bit. I have had people, unfortunately since the Theranos incident, that's so public, you know, talk to me about, you know, you know, maybe a little bit of like, I'm a little bit disillusioned by the scientific community right now. Maybe a little bit with COVID you know, you know, maybe a lot of it. Yeah, disillusioned a little bit. And I think that it is important to highlight the truth behind it. I mean there's 99.9999% of the scientists, the clinicians and even the commercialization ecosystem, including management, are unbelievably ethical. Rigorous science based approach. You never hear about that. 99.999% because they are just grinding along every day doing the right thing and they don't make the front page because what they're doing is the right thing. And I think about it myself with my own, you know, mother who passed away, but she did not pass away from breast cancer. And you know, my relatives and what I'm doing, I have to say, would I allow my mom or my wife or my sister or me to take this test and have that information be used to make a treatment decision? You have to look in the mirror and be able to say yes. If you can't say yes, then you gotta get out of the way because you shouldn't, you shouldn't be in the field.

Yeah, I totally agree. I used to be an investigative reporter. And not just an average one, an award winning one that would be sent on location by Clear channel whenever there was big breaking national news. I would not be anywhere near this space if I saw unethical things playing out. And all those labs we've discussed, I've been in the white coat, I've worn the gloves and gone in there and I've only seen remarkable people. Chip, one question I didn't ask, that's still a curiosity for me. How is this test performed? Is it blood draw?

Great question. It's actually from a tissue specimen. So this requires the biopsy itself. And think about still Blows my mind from just a technical standpoint when we talk about a biopsy right now, most of the biopsies are what we call about an 18 gauge core needle biopsy for the readership. That's kind of like a thin needle, as if you're getting a shot in the doctor's office. That kind of thin needle, that's the size of the needle that goes into the tissue sample. Still invasive. Right. But no cancer is treated before diagnosis. And that diagnosis requires a biopsy so that a pathologist can physically look at it and say, yes, this is cancer. We do not treat cancer just by imaging and say, oh, the image shows cancer. And so we're going to start treatment. They actually have to go in and at least by pathology, confirm the cancer from that same specimen.

And by confirm it, they need to confirm the molecular makeup.

Yeah, they have to physically look under the microscope and see the cancer cells there and say, yes, this is cancer and not inflammation or some type of benign mass. They have to physically look at it. And then from that same tiny needle specimen, which is a tiny sausage that's the size of a needle, a hair, Theralink only needs 100th of that material to look at. So tremendously small amounts of material. And we can use what already was taken. So it doesn't require you to have to go back in and pin cushion the patient and put them under, you know, unnecessary procedure just to get the tissue. So right now it's a tissue based approach. We're working, we're working on a blood based assay. But that will, that's, that's, that's coming, but not here yet.

And I know I said last question like two questions ago or three questions ago. Here I go again. When a, from my understanding, the cancer, like every part of us, morphs and evolves in order to stay alive. So the makeup of the cancer is going to be different at different stages in a patient's treatment. So it's helpful to evaluate where the tumor is. Now, is that going to be part of understanding as the morphing or evolution of that cancer develops is when you guys go to liquid, well, liquid biopsy, a blood draw, is that going to enable you to track where the cancer is now by the protein expression so you could target it with more precise treatment?

Yeah, well, you hit the nail on the head. Cancer evolves and adapts based upon its environment.

And so eventually that's why one chemo may work for a couple weeks and then it doesn't. Right.

Comes back and what we're Seeing just to back up for a second is actually the progress of precision medicine. In the trajectories that have been usual 20 years ago to what are usual now. Twenty years ago, when it was truly a one size fits all, you had like five chemotherapies. They're all poisons. Eventually everyone develops resistance to it and then the doctor didn't have anything else to do and the patient was in hospice and then it would sadly pass. That was the usual trajectory, right. Some period of response to the first poison and then that was kind of like maybe had another one and that was it. Now we actually have breast cancer patients, on average, just as an example, that are at seven, eight lines of therapy. That means they may be 20 to 25 years out from their first diagnosis. And they're kind of living with breast cancer as a chronic, manageable disease. Almost as if the doctor was treating diabetes. Right. And kind of selecting from another drug that targets as the cancer rewired around the therapy, there's another one. And so what's really awesome right now as a kind of ending optimism, further optimism is this is the perfect time for this proteomic test to map the Google map of what's happening at that time. Because we can do that dynamically. The patient progresses and they have a new path emerge that we see this, aha. This, this new pathway is lit up. We are at the same time having an explosion in the number of FDA approved targeted therapies. Just in breast cancer alone. In the past five years, we've had like 30 new targeted therapies emerge that we never had before. So now we have not only the mapping systems like we just talked about, but we now have a shelf filled with specific targeted therapies that can be given sequentially, mapping precisely to that specific individual's green lit up pathway. And then we have the ability to monitor that. So I am definitely optimistic that this next five year window we'll start to see cancer really evolve into a treatable chronic condition. I'm not using the C word. You'll notice in terms of cure, I think that could come, but I think that that'll come with early detection and chemo prevention. But we have a way of patients with active metastatic disease that 20 years ago would have been like, get your will together. Yeah. Get your affairs in order, go on a cruise to now it's like, okay, you know, not, not the information we wanted to hear. But now we have this care plan that all of a sudden you're looking at your care plan. It's like, well, this care plan goes out 20 years. It's like, yeah, that's what we're hoping to. That's, that's the expectation now for many of these tumors. We have a way to go. Tumors like pancreatic cancer and glioblastoma and, you know, some advanced lung cancers. We're just getting more information about what drugs we should use. But even those deadly cancers we're making tremendous headway on. This is a heady time. It's got a lot of work and we have technologies like we discussed coming in to help. But I'm really optimistic and I'm hopeful.

Beautiful. It's an incredible opportunity to get to spend time with you. Thank you for the work that you're doing and, and the path that you're on, which gives us all a whole lot of not only hope, but vision for where this fight is going. He's Emanuel Chip Petrocoin. He's the chair of the science advisory board for the link technologies. For more information, go to the link.com the link is T H E R A l I n k.com Chip, thank you so much for joining me right here on the Todcast.

Thank you very much for the opportunity. Todd, pleasure to talk to you today.

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