Traditional targeted cancer therapies inhibit or 'cool down' overactive pathways, like pumping brakes on a runaway car. Delpha Therapeutics employs a counterintuitive 'activation lethality' approach, further over-activating pathways to 'overheat the engine' and cause catastrophic failure in cancer cells—a fundamentally opposite but highly effective strategy.

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Experiments show that transferring a cancer cell's dysfunctional mitochondria—but not its nucleus—into a healthy cell is what induces cancer. This disruptive finding supports the view of cancer as a metabolic disease that can be targeted by starving its mitochondria of fuels like glucose.

The drug exhibits a multimodal mechanism. It not only reverses chemoresistance and halts tumor growth but also 'turns cold tumors hot' by forcing cancer cells to display markers that make them visible to the immune system. This dual action of direct attack and immune activation creates a powerful synergistic effect.

Step Pharma's synthetic lethality approach targets two redundant enzymes in the same pathway. Deleting one makes cancer cells entirely dependent on the other. This direct dependency is harder for biology to circumvent compared to approaches targeting different, interconnected pathways, creating a "cleaner" kill mechanism.

To overcome on-target, off-tumor toxicity, LabGenius designs antibodies that act like biological computers. These molecules "sample" the density of target receptors on a cell's surface and are engineered to activate and kill only when a specific threshold is met, distinguishing high-expression cancer cells from low-expression healthy cells.

Instead of focusing solely on T-cells, Create's platform first targets myeloid cells, which constitute up to 60% of some solid tumors. Programming these cells transforms the tumor microenvironment, enabling a 5-10x influx of CD8 T-cells. This overcomes a key barrier for T-cell therapies in solid tumors.

Successful immunotherapies like anti-PD-1 work by shifting the battlefield's arithmetic. They enhance the efficiency of each T-cell, allowing one cell to destroy five or ten cancer cells instead of three. This turns the fight into a 'numbers game' that the immune system can finally win.

Instead of just killing cancer cells, the primary mechanism is to insert a gene that forces the infected cell to produce and secrete a potent drug, like an anti-PD-L1 antibody. This creates a hyper-concentrated therapeutic effect directly in the tumor microenvironment, a concept termed "molecular surgery."

Dr. Radvanyi explains that immune agonist drugs often fail because accelerating a biological pathway is inherently less controllable than inhibiting one. This is analogous to genetic knockouts being more straightforward than over-expression models, presenting a core challenge in drug development beyond just finding the right target.

Instead of searching for elusive natural markers to target, EARLI's platform creates its own. It programs synthetic genetic "switches" that activate only inside cancer cells, turning them into factories that produce their own cancer-fighting therapies. This shifts the paradigm from biological discovery to biological engineering.

Cellcuity's drug is effective in breast cancer patients without PIK3CA mutations (wild type). This challenges the dominant precision medicine model that requires a specific genetic marker, showing that a pathway's aberrant activity can be a sufficient therapeutic target on its own.