In this episode of Precision Signals, Sean Khozin sits down with Dr. David Fajgenbaum — physician, scientist, patient, and founder of Every Cure — to explore one of the most extraordinary stories in modern medicine.

As a third-year medical student, David developed idiopathic multicentric Castleman disease, a rare inflammatory disorder that led to multi-organ failure. He was read his last rites five times. Facing a condition with no clear therapeutic roadmap, he began banking his own blood, performing proteomic analyses, and identified an mTOR pathway signal that led to a life-saving repurposed transplant drug.

He has now been in remission for over a decade. But survival was only the beginning.

David went on to found the Castleman Disease Collaborative Network and later co-founded Every Cure, a nonprofit using AI and computational pharmacophenomics to systematically evaluate every approved drug against every known disease. This episode is about moving from serendipity to strategy in medicine — and what it will take to build systems that leave no patient behind.

Sean Khozin in a conversation with Sushil (Sush) Patel, CEO of Replimune, discussing advancements in cancer immunotherapy, particularly the use of oncolytic viruses. They explore how engineered viruses can turn tumors into targets for the immune system, representing a shift in oncology towards reprogramming tumor biology. Sush shares insights from his extensive career, including challenges faced at Genentech and the regulatory hurdles from the FDA regarding Replimune's clinical trials. They examine the dual mechanism of oncolytic viruses and the complexities of treating diverse patient populations, advocating for collaborative efforts to refine regulatory frameworks. Sush also highlights the potential of future therapies, including advancements in gene editing and AI, while emphasizing the need for cautious optimism in integrating these technologies into cancer treatments.

Most people know Sean Parker as the prodigy behind Napster and Facebook. Far fewer know why he chose to take on one of the hardest problems in science: cancer. In this clip from Precision Signals, we explore the founding insight behind the Parker Institute for Cancer Immunotherapy—that the greatest barrier to progress in cancer research isn’t talent or ideas, but how science is funded. Despite more than $300 billion spent on cancer R&D in the U.S. alone, progress has been slowed by systems that reward safety, incrementalism, and short-term wins—rather than bold, high-risk, potentially curative science. In conversation with Karen Knudsen, CEO of the Parker Institute, we unpack why embracing risk and accepting failure aren’t flaws in science—they’re prerequisites for real breakthroughs.