Podcast transcript: The promise of advanced therapies: the patient experience

Adlai Goldberg

First of all I'd really like to welcome and say thank you to Asaf Adler for, for joining us today as part of the patient experience on this exciting new world of cell and gene therapies. As part of this podcast, it's really important for us to also understand and get the perspectives of cancer survivors or people that are struggling with cancer. And I have this opportunity to speak with Asaf Adler, who himself is a cancer survivor and has quite a remarkable story. And so I'd like to kind of kick this series off by first asking Asaf if you could give us just a brief introduction to you.

Asaf Adler

So, first of all, thank you for the opportunity to be here and tell this story. I think that these couple of years have been tremendous and amazing for medicine, for life science companies as these treatments are evolved. But my story kind of started back in 2010 where I was first diagnosed with a melanoma. It was in the head and, you know, I was just in the middle of being a student, second year. Out of nowhere, got diagnosed for the first time and I can tell you that, you know, when you get the word the word cancer, your head spins and you're not really sure what or how much time or what should you do. And I think that will, that without question will, will kind of evolve and be with me for, for the next years, probably until the moment I close my eyes. Because you need to make decisions on, on the journey that you, you take that will affect and the possibilities and the opportunities for treatments are just getting developed and advanced throughout the time. So the, the decisions that I made at the first time that I was diagnosed, will be different from the second time I'll be diagnosed, seven years later in 2017. So, I just wanna, you know, to kind of say, I, I think that the dilemmas that I went through back in 2017 are even different from the ones today and I hope they'll be even different from the ones in the upcoming years. And that's a good thing to say 'cause we have opportunities.

Goldberg

So, so, you've been diagnosed, you've been diagnosed with cancer twice, so 2010, 2017. How quickly did it advance to stage four lung cancer?

Adler

So, in 2010 back, I had quite a massive surgery, take the melanoma out of the head, from the neck and just make sure that it hasn't kind of by passed or went through to other parts of, of the body and thank God it was just in the head and I, I went through, what was considered at that time, the best treatment possible and even preventive. So, I was given, um, shots every two weeks of Interlochen and taking some pills that were considered to be also kind of helpful for preventive. And that was very, very I say innovative at that time back in 2010 for, for my situation. In 2017, and that's a, that's an interesting thing to say, I really, I'm, I'm really bad at dates, I don't remember anything but I do remember the day that I was diagnosed, it was 4 January 2017. I was making sushi in my kitchen and honestly, the way that I found out through an email back doing just PET scans, you know, once, once you do – once you enter that world of cancer, you kinda do all these check ups once a year, every couple of months, depends on, on the, the progress or the windows that you have. But I got that that they found that there were, you know, suspicious spots in the lung, but also more things to discover or more things to check and that kinda rocked my world. My, my wife was, was pregnant at that time. We were, you know, facing our, our first daughter and I just remember that day. I, I can definitely say it was the worst day of my life because I thought how unfair it is that I will not get a chance to see my daughter. I, I just remember that horrible thought and I, I didn't know what is up next. There was so much uncertainty about what lies ahead and what are the options, what are the opportunities. And you think about, you know, traditional therapies such as chemo or radiation and all those horrible things that they just ruin the body and you immediately take that into, into that journey. But I was, I was happily surprised that there were more opportunities and more options that were laid in front of me and that's thanks to medicine and, you know, companies that have evolved and made tremendous progress throughout the, the seven years. So, the options then the opportunities that I had in 2017 were very different than the ones that I had in, back in 2010.

Goldberg

Can you spend a little bit of time talking or sharing with our listeners about the uncertainties surrounding all of these decisions you had to make in, in 2017?

Adler

Sure. So, after the first or the initial diagnosis in 2017, I went to my oncologist and he laid out in front of me the different journeys or the options that he thought that lied ahead. And that included a surgery. I had, you know, thank God I was able to, well take the massive part of my, my left lung out but besides that the thing that is, is more frightening in melanoma but it's a very, I wanna say clever cancer, it could hide, it could transform, it could change and they're more afraid of what they cannot see versus what they can see. So, in combination of a surgery they offered me two options. One was immunotherapy and the one, the other one was targeted therapies. So, the first one, the options that, that were lied ahead, um, were Keytruda, and then they offered me another options, which were a combination of two medicines for BRAF which is a mutation that I had that kind of supposed to lock that mutation and that these are called targeted therapies. so, I kinda, I kinda jumped ahead on, on the story but the, the cool thing about this, and this will also kind of evolve with us on, on the future of therapies, is that I was diagnosed and then they, they had to check because the, the advancement and, and the progress of medicine and treatments, they wanted to check if I have a mutation called BRAF and what they did was that they took a biopsy out of my out of my lungs and where the, the metastatic melanoma was, which, which was a procedure by itself that is a simple but very painful procedure I would say. And they found out that I do have that BRAF mutation. That was great news because there were more options now. So, the options that were lied ahead, you know, with the BRAF I'd say medicine was, was because I had that mutation, that's a positive. And these, these are only things that were, you know, discovered in the last couple of years and what they did was that they said, you know, if, if you take the Keytruda, you take infusions, you need to come to the hospital every couple of weeks and of course there are side effects for each but if you take the BRAF it's oral, or it's just pills, you take them twice a day. You know, they have side effects by itself, and we didn't know what, what to choose from, you know. To answer your question, I remember that day when I came to the, to the doctor and he says, here's option one, here's option two, whatever you take you take as a journey. You, you, you won't be able to switch in the middle and I remembered having those thoughts and didn't know what to decide. I actually was so nervous. I, I went out of, out of that room and I almost fainted out, because I didn't know, like, what to choose and what are the side effects and what, what options and how will this affect and, you know, there were so many questions than answers. Because even today, um, science and medicine don't have all the answers and to be honest, today, we're almost five years and to after that, I'm still taking that treatment. I'm, I'm gonna finish the fifth year. I'm sharing a little bit more light down the road. I'm very, very happy I chose the BRAF medicine that had an amazing affect on me and thank God I, I'm here to, to tell this story.

Goldberg

So, so you entered into this new treatment, so I guess it was a clinical trial. How quickly did things turnaround for, for you? And kind of the flip side of the coin, you know, had you been diagnosed two years earlier would this treatment have even been available?

Adler

So, so, let me start with, with the good things about how fast that it happened and I wanna add about, a little bit about more context. So, I was lecturing at that point in, in, in a university and I'm, I was lecturing about financial statements analysis. Now, when I was diagnosed I, I continued my life as is and I, I had the surgery but I, I did, you know, they said in order to get to that you first need to start with those, you know, with the pills and let's start with that and we'll see how fast it progresses, it could take weeks, it could take months, there, you know, there is no one size fits all here. There's no clear answers. So, what happened was that I started a day after my 30th birthday, April 1st 2017. That was the first day that I, I started taking those pills. And what happened was that I, I went three weeks later to do a PET scan. Now I remember going into that PET scan and, and thinking about, you know, what are the odds that something will change or where did it grow, will they find new things? And the reason why I, I said about the lectures because I continued to lecture and, and continue my life as is. I continued to work, I continued, you know, to be supportive to my wife as, as she went along with, with, you know, her pregnancy and this one day just before class, it was the first thing I, I used to give those, those lectures I think it was at six or seven o'clock afternoon. And I remember getting an email saying here are the results. So, the results for the PET scan were arrived. And I was kinda standing at the door, and I was like, am I going to open this, like, now just before entering, you know, an auditorium full of, like, 100 people, 100 students. I'm like, how am I supposed to even talk. And I took a deep breath, and I opened it and I, I was reading, you know, the lines, I'm, I'm very, I'm already an expert in PET scans results by today, believe me. I've doing those probably more than people should. Um and I opened them, and, and I, I remember the words saying full remission. There were no evidence of, of cancer. There was no metastatic at all in the body and three weeks earlier I had a three centimeters metastatic in my left lung. And I remember kind of looking at it, and I said no way, I'm sure there's something wrong here. There's, there's things, you know, there's wrong results going to wrong people in, in reality. But I was looking at this and I couldn't believe this. I remember calling my, my parents and my wife and I was like, wow, and this is amazing news. And then I, I, I get one of the students coming out of the class and I was like, hey, you're five minutes late and I was like, oh I need to continue my lecture, right. I need to bring a 90 minutes lecture on financial statement analysis and I need to tell them, you know what, I'm gonna stay here for a while. You know I have some, some amazing, I have some amazing news and I don't know even where or how or why did I did this but at the end of the lecture I, I, just like in the last five minutes, I, I stop and I say, hey, you know what class, I have something to share with you. I wanna share with you that over the past couple of weeks, still lecturing to you, I've been going through quite severe things. I've, I've dealt with, I'd say, hard things to decide and I have some amazing news to tell you today as well. So that was, that was probably one of the happiest, I won't say the happiest moment 'cause that was probably the birth of my daughter. But it was one of the happiest moments of my life.

Goldberg

And so you've really described as we've been talking, a lot about what was the worst day of your life and, and now receiving news that you're in full remission or cancer free, is one of the best days of your life. Can you, um share with me, kind of what the emotional journey has been from that worst day to one of those best days that you've just described?

Adler

Sure. So, I always try to have, you know, two feet on the ground. I, I always try to think about the positive things of life. But it's, it's quite hard, especially when you're, you're in that journey of going to a hospital after a hospital visit and talking to doctors and, you know, I, I can't blame anybody but, you face a doctor, very experienced one and he tells you things that you really don't wanna know or you really, you know, you just think it's, it's a bad dream and you wanna wake up. And I remember every time leaving that, you know, the doctors office or surgeon or anything just like going back to the car and looking up and saying, why did I deserve this? Like, what did I do wrong to deserve going through this? And for the second time? And you know what, my wife told me something that I, I still and I will probably carry with me, she said, because you can, because you will learn out of this experience because you will become stronger. Because you will be able to help others and teach and just, you know, bring the best out of you. And this will only bring you good things in life. You will get the perspectives and the, you know, of, of things what's important and what's unimportant. And I can tell you something probably not many people will, will be able to understand, but cancer has been the gift of my life. since that moment, I learned what's best for me. What do I wanna do in life? And how important is family for me and, and what do I wanna do with my professional life as well. So, I, I from that day wanted, and I, I have been reading about treatments and advancements and, you know, I even went, entered the life science sector. And I've been working in, in life science ever, you know, from, from that moment and, and working with the most amazing people on earth to help and drive innovation and spreading the word about what is possible, what are the opportunities and even sharing the story here today, that's part of, of, of my treatment. That's part of my recovery. I'm here to say that we need to invest more, we need to look at things, we need to know that what, what has been considered as un, uncured or unrecovered or, or, you know, the odds are nothing. Today, is a different world, right. Today, there are advanced treatments and, and there will be even more. I've, I've taken target therapies and look, look how amazing that did for me. Personalized and individualized therapies as they will go, you know, that will, that will spread even a better word and, you know what, it's, it's a really important week for melanoma in, in general. This week on June 18th, the first patient was dosed with the BioNTech, the phase two of the mRNA cancer vaccine. There is an mRNA cancer vaccine in the world. What an amazing world, you know, what an amazing era we're living in and it even gives me goosebumps thinking about all these amazing people that are working so many hours just providing with other people hope. And, and the whole thing surrounds with hope. It's giving people the ability to, to get cured or to, to have remission and to be with their families and to spend more time and valuable with friends and loved ones and it's all about that. It's all about what legacy do we wanna leave behind us and what happy moments do we wanna, you know, enjoy with life. And just thinking about the last couple of years and what I've been through and from my personal and professional life, you know, I just wanna say thank you. Thank you to everybody. Thank you to, to, to the staff. Thank you to, you know, the, the people at Novartis and Pfizer for, for, for giving those products for example. But also, you know, maybe my wife will hear this one day and I wanna say thank you for her as well. She's been next to me for the whole journey and probably without her, I would be lost. So, I really hope that, you know, patients will have their loved ones surrounding them and guiding them and being there at their hard times because that's what we need. We need somebody to tell us, you know what, today is, is, it's not a good day but tomorrow will be. And tomorrow will bring the words and new hope and because of those advanced treatments that is possible.

Goldberg

Well, Asaf, you, you, you have shared with us, quite an incredible story and not just an incredible story but, you know, some true words of wisdom and I also wanna say thank you to you for sharing those lessons with us and, and your perspectives on your journey through and with cancer and, and all that you've been through and more importantly, kind of how, you know, it's really changed your life as well. And so, with that Asaf, and on behalf of the listeners, I just wanted to say thank you for taking the time to share, share your story and really look forward to seeing how your story continues to unfold and the days and years ahead. So, Asaf, many, many thanks for your time today.

Adler

Thank you for the opportunity. I really appreciate that.