What if the way we’ve been treating metastatic cancer is completely backwards? Dr. Dawn Lemanne, an oncologist who’s revolutionizing treatment resistance, challenges everything standard oncology accepts as inevitable. After decades of failed large randomized trials, she’s proving that resistance can be reversed using evolutionary biology principles borrowed from agriculture.

“We can have two people with identical mutations and they may respond differently to the same treatment,” Dawn explains. Her game-changing approach: test the tumor directly against various drugs—including unexpected ones like metformin analogs—rather than following standard protocols. She’s reversed androgen deprivation therapy resistance by giving testosterone to prostate cancer patients, and uses mathematical oncology to predict when tumors will escape treatment.

The biggest mistake oncology makes? “Maximal and continuous treatment—that’s a recipe for resistance development.” Dawn’s patients track tumor dynamics in real-time using liquid biopsies, creating personalized treatment timing that prevents resistance before it happens. Her n-of-one approach puts patients in control, measuring everything from continuous glucose monitors to exercise intensity.

If you’ve been told resistance is inevitable, this conversation will change how you think about fighting back.