Dr. David Fajgenbaum

That came back with nothing useful.

So I will totally give it to him.

The inexpensive test that I wanted him to order came back 99% of his cancer cells were positive for PD-L1 expression.

99%, which is not a guarantee, but it is a high likelihood that therefore a drug that inhibits this might be useful.

And we got Michael on this medicine.

And April of this year marked nine years that he's been in remission from his angiosarcoma.

Other patients have been treated with this.

Other doctors learned about this and started treating their patients.

And it turns out about a third of people with this horrible cancer, previously uniformly fatal cancer, will respond really well to pembrolizumab, to this medicine.

It's now standard of care for his form of cancer.

It's now standard of care without ever doing a clinical trial.

And that goes to show you when you have a disease that's this bad and you find a drug that works this well, you can change the paradigm for the disease for relatively, I mean, as close to zero dollars as humanly possible.

So the reason I think that our system is like this drug works for this disease is because in order to get a drug approved, a drug company has to develop a drug for a specific disease and submit it to the FDA for that disease.

The FDA approves it for that disease.

And if that drug company...

mentions a single word about that drug working in another disease, they will get fined billions of dollars for what's called off-label promotion.

So when the FDA approves a drug, what they're really doing is they're approving a drug company to market a compound for a specific disease.

And that company cannot market that compound for any other diseases until they come back to the FDA to get that change made.

But every time a drug company does that, it costs lots and lots and lots of money.

So they don't go after all the opportunities they have.