Dr. David Fajgenbaum — Achieving Milestones and Repurposing Drugs in the Fight Against COVID (Podcast #54)
Penn HealthX recently welcomed Dr. David Fajgenbaum back to the podcast. Dr. Fajgenbaum was the first-ever guest on the Penn HealthX podcast when it launched in 2017. He is the co-founder and executive director of the Castleman Disease Collaborative Network (CDCN) and the author of Chasing My Cure: A Doctor’s Race to Turn Hope Into Action, a memoir about his experience living with and searching for better treatments for Castleman Disease that was named one of the “Best Non-Fiction Books of 2019.” He has such an impressive bio that it’s too long to list everything, but you can find more here and here. Dr. Fajgenbaum holds an MD/MBA from the University of Pennsylvania Medical School and the Wharton School, a BS from Georgetown University, and an MSc from the University of Oxford.
We were thrilled to have him back on the Penn HealthX Podcast to hear about the work he has done since we last spoke with him, as well as the CDCN’s efforts to help in the coronavirus pandemic.
We’ve embedded both his original podcast and the new one below.
It’s been a productive 3 years for Dr. Fajgenbaum
Dr. Fajgenbaum has accomplished a lot since we last spoke with him. In those three years, he was featured in a New York Times cover story, published his memoir Chasing My Cure, discovered a treatment for Castleman Disease that helped him achieve an extended remission, became one of the 1% youngest grant awardees of a leading NIH grant, and, most importantly, Dr. Fajgenbaum and his wife welcomed their first child.
Based on his research into Castleman Disease, he identified sirolimus, a drug that was in his neighborhood pharmacy throughout his battle with Castleman Disease, as a possible therapy for Castleman patients. Initially attempting the treatment on himself, he has achieved an extended remission on sirolimus. Additionally, he has led efforts to bring sirolimus to other Castleman patients. It has been used several times in patients around the world, but one instance that meant a great deal to Dr. Fajgenbaum was when a Children’s Hospital of Philadelphia patient was treated with sirolimus with great success, based upon the research that he spearheaded. However, he noted that sirolimus is not a panacea, and it does not work for all patients. The CDCN is continuing its search for other treatments to give options to all Castleman patients.
Dr. Fajgenbaum also shared his experience writing his memoir. He wrote the book while juggling his responsibilities as the director of the CDCN — work which could not stop while he wrote. Thus, he dedicated countless hours every weekend for an entire year to writing, while reserving the time during the week for running the CDCN. I recently finished the book myself, and I could not recommend it highly enough. And I’m not the only one.
The CDCN has shifted some resources to help in the fight against the coronavirus
As the news about the coronavirus pandemic started to take center stage in the media, Dr. Fajgenbaum found himself hoping that labs would shift their focus toward the virus. As he continued thinking about it, he realized that few groups were positioned as well as the CDCN to address some aspects of COVID research. Thus, he turned hope into action and used his lab’s expertise in cytokine storms and drug repurposing to research coronavirus.
One of the main projects that the CDCN undertook was to review all of the published research on COVID to identify potential treatments. Dr. Fajgenbaum assembled a team of 31 researchers to review all 2,500+ papers (and counting) published on COVID treatments to date, identifying 115 different drugs that have been used in COVID patients since the start of the pandemic. This work has been covered in other media.
On a positive note, there do seem to be a few drugs that have activity against COVID. However, the lack of controlled trials and comparison groups makes it impossible to definitely know which drugs are effective. They recently began Phase II of this study, which is to maintain a registry of all drugs used against COVID-19 — the only such registry that currently exists, to his knowledge. Dr. Fajgenbaum emphasized that this work is a starting point, not an ending point, and he hopes that his registry will help researchers understand what has been tried to conduct trials using the most promising candidates.
Two lessons on setting up projects for success
1. Have a clear vision of what you’re trying to do — without knowing where you’re going, it’s hard to get there. Before undertaking a task, he takes the time to make sure the team understands the vision of the project and what success would look like.
2. Once you know where you’re going, form a clear strategy to get there — Dr. Fajgenbaum is an expert in drawing upon the expertise of others and coordinating efforts to achieve the ultimate goal. Notably, this requires a clear vision in place — once that is there, it is far easier to select the resources needed to achieve it.
Where he’s going next
Dr. Fajgenbaum continues to impress us by living out his motto of turning hope into action. In the coming years, he looks forward to continuing to find new treatments for Castleman patients through his work at the CDCN. Eventually, he also looks forward to applying the CDCN approach to other diseases, creating models for similar organizations to follow. Dr. Fajgenbaum will continue to be a champion for drug repurposing, and we look forward to watching all that he will accomplish as he continues “living in overtime.”
