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[@hubermanlab] Using Existing Drugs in New Ways to Treat & Cure Diseases of Brain & Body | Dr. David Fajgenbaum

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@hubermanlab - "Using Existing Drugs in New Ways to Treat & Cure Diseases of Brain & Body | Dr. David Fajgenbaum"

Link: https://youtu.be/PCbD3hFyfCk

Short Summary​

Dr. David Fagenbomb, a translational medicine professor and Castleman's disease survivor, shares insights on repurposing existing FDA-approved drugs to treat rare and common diseases, born from his own near-death experience. He highlights the untapped potential of generic drugs for new conditions and his nonprofit "Every Cure" aims to systematically identify and validate these repurposing opportunities, advocating for broader awareness and implementation in clinical practice.

Key Quotes​

Here are five direct quotes from the YouTube video transcript that represent particularly valuable insights, interesting data points, surprising statements, or strong opinions:

  1. "David, we've tried everything. You know, we tried these chemotherapies. We tried this one experimental drug. Um there's nothing more that we can do." (This quote highlights the feeling of hopelessness and the limited options patients often face when conventional treatments fail).

  2. "I just believe that the 4,000 drugs we have today should help all the patients who can benefit from them. Period. Like, no one should suffer if there's a drug at your CVS that could help you." (This is a powerful statement of principle and a key motivator for Dr. Fagenbomb's work).

  3. "...the average small molecule drug that's approved for a condition can bind to between 20 and 30 different proteins in the body. So we call a drug, you know, we say it does one thing, but actually it's doing a lot of other things in the body..." (This data point emphasizes the complexity of drug action and the potential for repurposing).

  4. "I don't care in particular the name of the disease or the name of the drug. I just believe that the 4,000 drugs we have today should help all the patients who can benefit from them. >> Period. Like no one should suffer if there's a drug at your CVS to get help you."

  5. " And um what I discovered was that a communication line in your immune system or in all of our immune systems called mTor um was turned into overdrive." (This discovery helped save David's life by finding out that mTOR was the route cause for his deadly symptoms. By targeting that cause David was able to suppress his symptoms and live on the drug for years).

Detailed Summary​

Here's a detailed summary of the YouTube video transcript in bullet points:

Key Topics:

  • Repurposing Existing Drugs: The video focuses on the potential of using existing, FDA-approved drugs for new, unintended uses to treat diseases, particularly rare diseases, and improve health outcomes.
  • Drug Company Incentives: Explores how drug companies are incentivized to focus on new uses for patented drugs, rather than generic drugs, leading to a gap in research and application of potentially beneficial generic drugs.
  • Agency and Self-Advocacy in Healthcare: Emphasizes the importance of patients taking an active role in their healthcare, seeking information, connecting with disease organizations, and asking questions.
  • The Story of David Fagenbomb and Castleman's Disease: David shares his personal experience with Castleman's disease, a rare condition, and how his own research led him to a treatment that saved his life.
  • Every Cure: The discussion highlights the work of Every Cure, a non-profit organization founded by Dr. Fagenbomb, dedicated to finding and implementing new uses for existing drugs to treat diseases.

Arguments and Information:

  • The Medical Blind Spot: Medicine has a blind spot due to the way drugs are studied, patented, and categorized, leading to overlooked treatments and potential cures.
  • 4,000 Drugs, 14,000 Untreated Diseases: While there are thousands of FDA-approved drugs, many diseases still lack effective treatments, suggesting a potential for repurposing existing medications.
  • Drugs Have Multiple Effects: Most drugs interact with many different pathways in the body, but are typically only studied and approved for one or two specific uses.
  • Incentive Structures Hinder Repurposing: After drugs become generic, there's little financial incentive for companies to research and promote them for new uses.
  • Examples of Repurposed Drugs:
    • Aspirin: Beyond pain relief, reduces the risk of heart attacks and colon cancer recurrence.
    • Viagra (Sildenafil): Initially for heart disease, now used for erectile dysfunction and a rare pediatric lung disease.
    • Lidocaine: Shown to reduce mortality in women with localized breast cancer when injected around the tumor before surgery.
    • Thalidomide: Initially for nausea in pregnancy, later used for leprosy and multiple myeloma.
    • Colchicine: Used for gout, now shown to reduce the risk of heart attacks, particularly in individuals with diabetes.
    • TNF Inhibitors: Can stop kids from experiencing strokes related to the rare condition, data 2.
    • Pembrolizumab: Initially for melanoma and lung cancer, now used for dozens of cancers, including a specific type of sarcoma (angio sarcoma).
  • The Role of Disease Organizations: These organizations connect patients, physicians, and researchers, sharing knowledge and treatment options.
  • Need for Centralized Databases: Calls for the creation of databases that provide information on existing drugs, potential new uses, side effects, and relevant experts/disease organizations.
  • David Fagenbomb's Story:
    • His mother died of brain cancer (Glioblastoma), inspiring him to pursue medical research.
    • Developed Castleman's disease during medical school, experiencing organ failure and near-death experiences.
    • His frustration with the lack of treatment options led him to research and discover that the drug serilymus could treat the disease and he has now been in remission for over 11 years while taking this drug.
  • The Santa Claus Theory of Civilization: Before his illness, David believed in a system where science and medicine were a well-oiled machine, always improving and that that information was always available to everyone. However, he later realized that this is not the case and there are major gaps and silos of information not being effectively dispersed.
  • Importance of Support Network: Having a strong support system and a positive outlook are crucial for overcoming health challenges. He credits his sisters, father, and fiancé (now wife) as providing him strength.
  • What's needed for a tenacity to lean into challenge: He credits vision for the future, his family around him, and ability to do anything for 1 minute, 1 hour, 1 day.
  • Role of the Anterior Midsingulate Cortex: Neuroscientist Joe Parvevesy identified the anterior midsingulate cortex of the brain as essential to building and reinforcing positive action and results and thus the drive to keep on pursuing challenges.
  • The Importance of AI: Artificial intelligence can be used to search, scan, connect breadcrumbs, organize medical knowledge as it relates to disease and treatment.