Freakonomics Radio 664. Are Thousands of Medical Cures Hiding in Plain Sight?
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Feb 20, 2026 
Chris Snyder, economist at Dartmouth who designs market incentives; Heather Stone, FDA policy analyst who built the CureID registry; David Fajgenbaum, physician-scientist who survived Castleman disease and leads EveryCure. They explore drug repurposing, AI and knowledge graphs to match drugs to diseases, crowdsourced registries for real-world cases, and economic pull incentives to make trials and generic repurposing viable.
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From Near-Death To Drug Detective
- David Fajgenbaum nearly died from Castleman disease during med school and used experimental chemotherapy to survive.
- He then launched a grassroots hunt for existing drugs after relapsing because new drug development was too slow and expensive.
mTOR Discovery Saved Lives
- Fajgenbaum identified mTOR hyperactivation in his blood samples and lymph node and proposed using an mTOR inhibitor.
- He used sirolimus (rapamycin), an existing mTOR drug, which rescued him and helped several other patients.
Soil Sample To Life-Saving Drug
- Rapamycin was discovered from soil on Easter Island and later found to inhibit mTOR so well the complex was named after it.
- Its quirky discovery history shows how non-linear and serendipitous drug findings can be.
