Podcasts about accommodations

Dr. Monty Pal and Dr. Jason Westin discuss the federal funding climate for cancer research and the persistent problem of drug shortages, two of the major concerns facing the oncology community in 2026. TRANSCRIPT Dr. Monty Pal: Hello and welcome to the ASCO Daily News Podcast. I am your host, Dr. Monty Pal. I am a medical oncologist and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. There are always multiple challenges facing oncologists, and today, we discuss two of them that really stand out for 2026: threats to federal funding for cancer research and the persistent problem of drug shortages. I am thrilled to welcome Dr. Jason Westin, who believes that one way to meet these challenges is to get oncologists more involved in advocacy, and he will share some strategies to help us meet this moment in oncology. Dr. Westin is a professor in the Department of Lymphoma and Myeloma at the University of Texas MD Anderson Cancer Center, but he actually wears a lot of hats within ASCO. He is a member of the Board of Directors and has also previously served as chair of ASCO's Government Relations Committee. And he is also one of the inaugural members of ASCO's Political Action Committee, or PAC. He has testified before Congress about drug shortages and many other issues. Dr. Westin, I am really excited to have you on the podcast today and dive into some of these elements that will really impact our community in 2026. Thanks so much for joining us today. Dr. Jason Westin: Thank you for having me. Dr. Monty Pal: You've had such a range of experience. I already alluded to you testifying before Congress. You've actually run for office before. You wear so many different hats. I'm used to checking my PubMed every other day and seeing a new paper out from you and your group, and you publish in the New England Journal [of Medicine] on practice-setting standards and the diseases that you treat. But you've also done all this work in the domain of advocacy. I can't imagine that balancing that is easy. What has sort of motivated you on the advocacy front? Dr. Jason Westin: Advocacy to me is another way to apply our skills and help more people than just those that you're sitting across from at the time. Clinical research, of course, is a tool to try and take what we know and apply it more broadly to people that you'll never meet. And advocacy, I think, can do the same thing, where you can have a conversation with a lawmaker, you can advocate for a position, and that hopefully will help thousands or maybe even more people down the road who you'd never get to directly interact with. And so, I think it's a force multiplier in the same way that research can be. And so, I think advocacy is a wonderful part of how doctors care for our patients. And it's something that is often difficult to know where to start, but once people get into advocacy, they can see that the power, the rewarding nature of it is attractive, and most people, once they get going, continue with that through the rest of their career. Dr. Monty Pal: So, I'll ask you to expand on that a little bit. We have a lot of our younger ASCO members listening to this podcast, folks that are just starting out their careers in clinical practice or academia. Where does that journey begin? How do you get to the point that you're testifying in front of Congress and taking on these bigger sort of stances for the oncology community? Dr. Jason Westin: Yeah, with anything in medicine and in our careers, you have to start somewhere. And often you start with baby steps before you get in front of a panel of senators or other high-profile engagement opportunities. But often the first setting for junior colleagues to be engaged is doing things – we call them "Hill Days" – but basically being involved in kind of low-stakes meetings where you're with a group of peers, some of whom have done this multiple times before, and can get engaged talking to members of representatives' offices, and doing so in a way where it's a natural conversation that you're telling a story about a patient in your clinic, or that you're telling a personal experience from a policy that impacted your ability to deliver optimal care. It sounds stressful, but once you're doing it, it's not stressful. It's actually kind of fun. And it's a way that you can get comfort and skill with a group of peers who are there and able to help you. And ASCO has a number of ways to do that, both at the federal level, there's the Hill Day where we each April have several hundred ASCO members travel to Capitol Hill. There's also state engagement that can be done, so-called visiting at home, when representatives from the U.S. Congress or from state legislators are back in district. You can meet with your own representatives on behalf of yourself, on behalf of your organization, and advocate for policies in a way that can be beneficial to your patients. But those initial meetings that are in the office often they're low stakes because you could be meeting not with the representative but with their staff. And that staff sometimes is as young or even younger than our junior colleagues. These sometimes can be people in their 20s, but they're often extremely knowledgeable, extremely approachable, and are used to dealing with people who are new to advocacy. But they actually help make decisions within the office. So it's not a waste of time. It's actually a super useful way to engage. So, it's that first step of anything in life. The activation energy is always high to do something new. But I'd encourage people who are listening to this podcast already having some level of interest about it to explore ways that they could engage more. Dr. Monty Pal: You know, I have to tell you, I'm going to riff on what you just said for a second. ASCO couldn't make it any easier, I think, for folks to participate and get involved. So, if you're listening to this and scratching your head and thinking, "Well, where do I begin? How do I actually sign on for that meeting with a local representative?" Go to the ASCO ACT Network website. And I'll actually talk to our producer, Geraldine, to make sure we've got a link to that somewhere associated with this podcast after it's published, Jason, but I actually keep that on my browser and it's super easy. I check in there every now and then and see if there's any new policy or legislation that ASCO, you know, is sort of taking a stance on, and it gives me some fodder for conversation with my local representatives too. I mean, it's just an awesome, awesome vehicle. I'm going to segue right from there right to the issues. So, you and I are both at academic centers. You know, I think this is something that really pervades academia and enters into implications for general clinical practice. There's been this, you know, massive sort of proposal for decreased funding to the NCI and to the NIH and so forth. Tell us what ASCO is doing in that regard, and tell us perhaps how our community can help. Dr. Jason Westin: We live in interesting times, and I think that may be an understatement x 100. But obviously investments in research are things that when you're at an academic center, you see and feel that as part of your daily life. Members of Congress need to be reminded of that because there's a lot of other competing interests out there besides investing in the future through research. And being an elected representative is a hard job. That is something where you have to make difficult choices to support this, and that may mean not supporting that. And there's lots of good things where our tax dollars could be spent. And so, I'm sympathetic to the idea that there's not unlimited resources. However, ASCO has done an excellent job, and ASCO members have led the charge on this, of stating what research does, what is the benefit of research, and therefore why should this matter to elected representatives, to their staff, and to those people that they're elected to serve. And ASCO has led with a targeted campaign to basically have that message be conveyed at every opportunity to elected representatives. And each year on Hill Day, one of the asks that we have is to continue to support research: the NCI, NIH, ARPA-H, these are things that are always in the asks to make sure that there's appropriate funding. But effectively playing offense by saying, "It's not just a number on a sheet of paper, this is what it means to patients. This is what it means to potentially your loved ones in the future if you are in the opposite situation where you're not on the legislative side, but you're in the office receiving a diagnosis or receiving a difficult piece of news." We only have the tools we have now because of research, and each breakthrough has been years in the making and countless hours spent funded through the engine of innovation: clinical research and translational research. And so ASCO continues to beat that drum. You mentioned earlier the ACT Network. Just to bring that back again is a very useful, very easy tool to communicate to your elected representatives. When you sign up on the ASCO ACT website, you get emails periodically, not too much, but periodically get emails of, "This is a way you can engage with your lawmakers to speak up for this." And as you said, Monty, they make it as easy as possible. You click the button, you type in your address so that it figures out who your elected representatives are, and then it will send a letter on your behalf after like five clicks to say, "I want you to support research. I want you to vote for this particular thing which is of interest to ASCO and by definition to members of ASCO." And so the ACT Network is a way that people listening can engage without having to spend hours and significant time, but just a few clicks can send that letter to a representative in Congress. And the question could be: does that matter? Does contacting your senator or your elected representative do anything? If all they're hearing is somebody else making a different argument and they're hearing over and over again from people that want investments in AI or investments in something else besides cancer research, whatever it is, they may think that there's a ground shift that people want dollars to be spent over here as opposed to at the NIH or NCI or in federally funded research. It is important to continue to express the need for federal funding for our research. And so, it really is important for folks to engage. Dr. Monty Pal: 100%. One of the things that I think is not often obvious to a lot of our listeners is where the support for clinical trials comes from. You know, you've obviously run the whole gamut of studies as have I. You know, we have our pharmaceutical company-sponsored studies, which are in a particular bucket. But I would say that there's a very important and critical subset of studies that are actually government funded, right? NCI-funded clinical trials. If you don't mind, just explain to our audience the critical nature of the work that's being done in those types of studies and if you can, maybe compare and contrast the studies that are done in that bucket versus perhaps the pharmaceutical bucket. Dr. Jason Westin: Both are critical, and we're privileged that we have pharma studies that are sponsored and federally funded clinical research. And I think that part of a healthy ecosystem for us to develop new breakthroughs has a need for both. The pharma sponsored studies are done through the lens of trying to get an approval for an agent that's of interest so that the pharma company can then turn around and use that outside of a clinical trial after an FDA approval. And so those studies are often done through the lens of getting over the finish line by showing some superiority over an existing treatment or in a new patient population. But they're done through that lens of kind of the broadest population and sometimes relatively narrow endpoints, but to get the approval so that then the drug can be widely utilized. Clinical trials done through cooperative groups are sometimes done to try and optimize that or to try and look at comparative things that may not be as attractive to pharma studies, not necessarily going for that initial approval, but the fine tuning or the looking at health outcomes or looking at ensuring that we do studies in representative populations that may not be as well identified on the pharma sponsored trials, but basically filling out the gaps in the knowledge that we didn't gain from the initial phase 3 trial that led to the approval. And so both are critical. But if we only do pharma sponsored trials, if we don't fund federally supported research and that dries up, the fear I have, and many others have, is that we're going to be lacking a lot of knowledge about the best ways to use these great new therapies, these new immune therapies, or in my team, we do a lot of clinical trials on CAR T-cell therapies. If we don't have federally funded research to do the important clinical studies, we'll be in the dark about the best ways to use these drugs, and that's going to be a terrible shame. And so we really do need to continue to support federal research. Dr. Monty Pal: Yeah, there are no softball questions on this podcast, but I think everybody would be hard pressed to think that you and I would come on here and say, "Well, no, we don't need as much money for clinical trials and NCI funding" and so forth. But I think a really challenging issue to tackle, and this is something we thought to ask you ahead of the podcast, is what to do about the general climate of, you know, whether it's academic research or clinical practice here that seems to be getting some of our colleagues thinking about moving elsewhere. I've actually talked to a couple of folks who are picking up and moving to Europe for a variety of considerations, other continents, frankly. The U.S. has always been a leader when it comes to oncology research and, one might argue, research in general. Some have the mindset these days that we're losing that footing a little bit. What's your perspective? Are you concerned about some of the trends that you're seeing? What does your crystal ball tell you? Dr. Jason Westin: I am highly concerned about this. I think as you said, the U.S. has been a leader for a long time, but it wasn't always. This is not something that's preordained that the world-leading clinical research and translational research will always be done in the United States. That is something that has been developed as an ecosystem, as an engine for innovation and for job development, new technology development, since World War II. That's something that through intentional investments in research was developed that the best and brightest around the world, if they could choose to go anywhere, you wanted them to come to work at universities and academic places within the United States. And I think, as you said, that's at risk if you begin to dry up the investment in research or if you begin to have less focus on being engaged in research in a way that is forward thinking, not just kind of maintaining what we do now or only looking at having private, for profit sponsored research. But if you don't have the investment in the basic science research and the translational research and the forward-thinking part of it, the fear is that we lose the advantage and that other countries will say, "Thank you very much," and be happy to invest in ways to their advantage. And I think as you mentioned, there are people that are beginning to look elsewhere. I don't think that it's likely that a significant population of researchers in the U.S. who are established and have careers and families – I don't think that we're going to see a mass exodus of folks. I think the real risk to me is that the younger, up-and-coming people in undergraduate or in graduate school or in medical school and are the future superstars, that they could either choose to go into a different field, so they decide not to go into what could be the latest breakthroughs for cancer patients but could be doing something in AI or something in a different field that could be attractive to them because of less uncertainty about funding streams, or they could take that job offer if it's in a different country. And I think that's the concern is it may not be a 2026 problem, but it could be a 2036 or a 2046 problem that we reap what we sow if we don't invest in the future. Dr. Monty Pal: Indeed, indeed. You know, I've had the pleasure of reviewing abstracts for some of our big international meetings, as I'm sure you've done in the past too. I see this trend where, as before, we would see the preponderance of large phase 3 clinical trials and practice setting studies being done here in the U.S., I'm seeing this emergence of China, of other countries outside of the U.S. really taking lead on these things. And it certainly concerns me. If I had to sort of gauge this particular issue, it's at the top of my list in terms of what I'm concerned about. But I also wanted to ask you, Jason, in terms of the issues that are looming over oncology from an advocacy perspective, what else really sort of keeps you up at night? Dr. Jason Westin: I'm quite concerned about the drug shortages. I think that's something that is a surprisingly evergreen problem. This is something that is on its face illogical that we're talking about the greatest engine for research in the world being the United States and the investment that we've made in drug development and the breakthroughs that have happened for patients all around the world, many of them happen in the United States, and yet we don't necessarily have access to drugs from the 1970s or 1980s that are cheap, generic, sterile, injectable drugs. This is the cisplatins and the vincristines and the fludarabine type medications which are not the sexy ones that you see the ads in the magazine or on TV at night. These are the backbone drugs for many of our curative intent regimens for pediatrics and for heme malignancies and many solid tumors. And the fact that that's continuing to be an issue is, in my opinion, a failure to address the root causes, and those are going to require legislative solutions. The root causes here are basically a race to the bottom where the economics to invest in quality manufacturing really haven't been prioritized. And so it's a race to the cheapest price, which often means you undercut your competitor, and when you don't have the money to invest in good manufacturing processes, the factory breaks down, there's no alternative, you go into shortage. And this has been going on for a couple of decades, and I don't think there's an end in sight until we get a serious solution proposed by our elected officials. That is something that bothers me in the ways where we know what we should be doing for our patients, but if we don't have the drugs, we're left to be creative in ways we shouldn't have to do to figure out a plan B when we've got curative intent therapies. And I think that's a real shame.  There's obviously a lot of other things that are concerning related to oncology, but something that I have personally had experience with when I wanted to give a patient a CAR T-cell, and we don't have a supply of fludarabine, which is a trivial drug from decades ago in terms of the technology investments in genetically modified T-cells, to not then have access to a drug that should be pennies on the dollar and available at any time you want it is almost like the Air Force investing in building the latest stealth bomber, but then forgetting to get the jet fuel in a way that they can't use it because they don't have the tools that they need. And so I think that's something that we do need to have comprehensive solutions from our elected officials. Dr. Monty Pal: Brilliantly stated. I like that analogy a lot. Let's get into the weeds for a second. What would that proposal to Congress look like? What are we trying to put in front of them to help alleviate the drug shortages? Dr. Jason Westin: We could spend a couple hours, and I know podcasts usually are not set up to do that. And so I won't go through every part. I will direct you that there have been a couple of recent publications from ASCO specifically detailing solutions, and there was a recent white paper from the Senate Finance Committee that went through some legislative solutions being explored. So Dr. Gralow, ASCO CMO, and I recently had a publication in JCO OP detailing some solutions, more in that white paper from the Senate Finance. And then there's a working group actually going through ASCO's Health Policy Committee putting together a more detailed proposal that will be published probably around the end of 2026. Very briefly, what needs to happen is for government contracts for purchasing these drugs, there needs to be an outlay for quality, meaning that if you have a manufacturing facility that is able to deliver product on time, reliably, you get a bonus in terms of your contract. And that changes the model to prioritize the quality component of manufacturing. Without that, there's no reason to invest in maintaining your machine or upgrading the technology you have in your manufacturing plant. And so you have bottlenecks emerge because these drugs are cheap, and there's not a profit margin. So you get one factory that makes this key drug, and if that factory hasn't had an upgrade in their machines in 20 years, and that machine conks out and it takes 6 months to repair or replacement, that is an opportunity for that drug to go into shortage and causes a mad dash for big hospitals to purchase the drug that's available, leaving disparities to get amplified. It's a nightmare when those things happen, and they happen all the time. There are usually dozens, if not hundreds, of drugs in shortage at any given time. And this has been going on for decades. This is something that we do need large, system-wide fixes and that investment in quality, I think, will be a key part. Dr. Monty Pal: Yeah, brilliantly said. And I'll make sure that we actually include those articles on the tagline for this podcast as well. I'll talk to our producer about that as well.  I'm really glad you mentioned the time in your last comment there because I felt like we just started, but in fact, I think we're right at our close here, Jason, unfortunately. So, I could have gone on for a couple more hours with you. I really want to thank you for these absolutely terrific insights and thank you for all your advocacy on behalf of ASCO and oncologists at large. Dr. Jason Westin: Thank you so much for having me. I have enjoyed it. Dr. Monty Pal: Thanks a lot. And many thanks to our listeners too. You can find more information about ASCO's advocacy agenda and activities at asco.org. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks so much. ASCO Advocacy Resources: Get involved in ASCO's Advocacy efforts: ASCO Advocacy Toolkit Crisis of Cancer Drug Shortages: Understanding the Causes and Proposing Sustainable Solutions, JCO Oncology Practice Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:     Dr. Monty Pal   @montypal   Dr. Jason Westin @DrJasonWestin   Follow ASCO on social media:      @ASCO on X     ASCO on Bluesky    ASCO on Facebook      ASCO on LinkedIn      Disclosures:     Dr. Monty Pal:    Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview   Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical   Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis   Dr. Jason Westin: Consulting or Advisory Role: Novartis, Kite/Gilead, Janssen Scientific Affairs, ADC Therapeutics, Bristol-Myers Squibb/Celgene/Juno, AstraZeneca, Genentech/Roche, Abbvie, MorphoSys/Incyte, Seattle Genetics, Abbvie, Chugai Pharma, Regeneron, Nurix, Genmab, Allogene Therapeutics, Lyell Immunopharma Research Funding: Janssen, Novartis, Bristol-Myers Squibb, AstraZeneca, MorphoSys/Incyte, Genentech/Roche, Allogene Therapeutics

When I learned of Lauren Tetenbaum's work around workplace menopause advocacy, I knew I wanted her to come on the show.  Talking about menopause at work is long overdue.  When there is something that directly impacts 50% of our population, 100% of us are impacted in some way.  We need to be talking about menopause at work.  Period.  Lauren Tetenbaum, LCSW, JD, PMH-C is a licensed clinical social worker, women's rights advocate, writer, and mom dedicated to supporting and empowering women through life transitions. With experience as both a lawyer and a psychotherapist, Lauren specializes in counseling women navigating identity shifts related to motherhood, career, and reproductive health. Lauren frequently contributes thought leadership to media and professional organizations; she is the author of the 2025 book Millennial Menopause: Preparing for Perimenopause, Menopause, and Life's Next Period.  Listen in to hear Lauren share: Why reproductive healthcare is a workplace issue The perimenopause/menopause symptoms that impact women at work Accommodations workplaces can make that support women in perimenopause/menopause (that benefit others too!) Benefits that workplaces can easily add to improve healthcare access for midlife women When and how to prepare for perimenopause instead of waiting for it to “hit you” in a way that profoundly impacts your life The costs we are seeing for employers who are choosing to NOT address menopause in the workplace How men can advocate for menopause friendly policies, education, and accommodations in the workplace Links Mentioned:  Connect with Lauren: millennialmenopause.com Get Lauren's book: Millennial Menopause Lauren on IG: @thecounselaur: https://www.instagram.com/thecounselaur/ Lauren on LinkedIn: https://www.linkedin.com/in/laurenatetenbaum/ Organization: Let's Talk Menopause Organization: The Menopause Society [Dec 9th and Jan 8th] Shameless Rising: a 2-part workshop series to release the noise, reclaim your voice, and reignite your vision in 2026: saradean.com/rising [Open Enrollment] Join Sara's Aligned Leadership Incubator: saradean.com/aligned Hire me to speak: saradean.com/speaking Coach with me: https://saradean.com/executive-coaching-services Connect with me on LinkedIn: https://www.linkedin.com/in/saradeanspeaks Watch Shameless Leadership episodes on YouTube: https://www.youtube.com/@saradeanspeaks Learn more about your ad choices. Visit podcastchoices.com/adchoices

Pressure is rising on DEI programs, but the smartest companies aren't retreating—they're getting clearer. In this episode, Bill Banham welcomes global inclusion expert Dean Delpeache back to the show to unpack the legal, cultural, and practical forces reshaping workplace equity and belonging. From U.S. executive orders to multinational ripple effects, Dean breaks down what's actually changing inside organizations and what's just media noise.We explore a critical reframing: equity isn't about engineering outcomes—it's about ensuring access. Accommodations, transparent processes, and consistent selection criteria do more than satisfy compliance; they unlock performance. Dean details how teams can move away from identity quotas while still expanding the pipeline through intentional sourcing: partnerships with veteran groups, disability organizations, and community networks that widen opportunity without promising a numeric end state. The result is defensible, humane hiring that holds up under scrutiny.One of the most inspiring threads is the rise of neurodiversity at work. We talk candidly about shedding stigma, normalizing accommodations, and redesigning interviews to assess real job skills. Dean shares simple, high-impact changes—like structured questions, work samples, and clearer expectations—that help candidates shine and help managers make better decisions. We also dig into how leaders can host courageous conversations about race, belonging, and systemic barriers, using ERGs and time-boxed dialogues to turn discomfort into progress.We close with the data that ties it all together: belonging drives advocacy. When people feel included, they're dramatically more likely to recommend their employer, fueling talent attraction more credibly than any ad spend. If you're navigating DEI rollbacks, stakeholder pressure, or global alignment, this conversation offers a roadmap: document fairness, widen access, train inclusive leaders, and amplify belonging. If this resonates, subscribe, share with your team, and leave a review telling us what you'll try first.Support the showFeature Your Brand on the HRchat PodcastThe HRchat show has had 100,000s of downloads and is frequently listed as one of the most popular global podcasts for HR pros, Talent execs and leaders. It is ranked in the top ten in the world based on traffic, social media followers, domain authority & freshness. The podcast is also ranked as the Best Canadian HR Podcast by FeedSpot and one of the top 10% most popular shows by Listen Score. Want to share the story of how your business is helping to shape the world of work? We offer sponsored episodes, audio adverts, email campaigns, and a host of other options. Check out packages here. Follow us on LinkedIn Subscribe to our newsletter Check out our in-person events

In this episode, Hailey starts exploring Pierce County in the fall. Located right along the infamous Great River Road, this county welcomes visitors with stunning fall colors and a community spirit that's hard to beat. And once you're here, you'll see that the magic doesn't stop with the leaves changing…Pierce County has a special kind of charm all year round!The Bobber is brought to you by Something Special from Wisconsin: https://www.somethingspecialwi.com/Read the blog here: https://discoverwisconsin.com/a-year-of-adventure-begins-in-pierce-county-this-fall/Pierce County: https://www.co.pierce.wi.us/; Trimbelle Recreation Area: https://www.co.pierce.wi.us/community/county_parks/trimbelle_recreation_area.php; Kinnickinnic State Park: https://dnr.wisconsin.gov/topic/parks/kinnickinnic; Swede Pickings: https://swedepickings.com/; Young Acres: https://www.youngacres.com/; Ellsworth Cooperative Creamery: https://www.ellsworthcheese.com/; Maiden Rock Mercantile: https://www.maidenrockmercantile.com/; Vino in the Valley: https://vinointhevalley.com/; Orange Dragon Art Gallery: https://www.orangedragonartgallery.org/; Aim Joy: https://aimjoyboutique.com/; The Harbor Hotel: https://vinointhevalley.com/; The Cove Guest House: https://thecoveofprescott.com/; The Port of Prescott Hotel: https://theportofprescott.com/; Muddy Waters: https://www.muddywatersbarandgrill.biz/; Two Rivers: https://www.tworiversbar.com/; Snowmobile Trail System: https://www.co.pierce.wi.us/community/county_parks/snowmobile_trail_system.php Nugget Lake County Park: https://www.co.pierce.wi.us/community/Nugget_Lake_Park.php; Trimbelle River: https://www.kiaptuwish.org/our-rivers/trimbelle-river/; Rush River: https://www.kiaptuwish.org/our-rivers/rush-river/; Klaas-Jonas Community Pool: https://www.ellsworth.k12.wi.us/o/klaas-jonas/; Falls Theatre: https://www.fallstheatre.com/; Freedom Park: https://www.freedomparkwi.org/; Winter Market: https://www.tattersalldistilling.com/winter-market/; Ellsworth Farmers Market: http://www.ellsworthfarmersmarket.com/; Pierce County Historical Association: https://piercecountyhistorical.org/; Kilkarney Hills: https://www.kilkarneyhills.com/; Ellsworth Country Club: https://www.ellsworthcountryclub.com/; Clifton Highlands: https://www.cliftonhighlands.com/ Crystal Cave: https://www.acoolcave.org/ Lee-Kay Family Educational County Forest: https://www.co.pierce.wi.us/community/county_parks/lee-kay_family_educational_county_forest.php River City Sweets: https://www.rivercitysweetswi.com/; River Falls Days: https://rfchamber.com/riverfallsdays/; Pierce County Fair: https://www.co.pierce.wi.us/departments/fair/index.php; Cheese Curd Festival: https://www.cheesecurdfestival.com/ Prescott Daze: https://www.prescottdaze.com/; The Bobber: https://discoverwisconsin.com/the-bobber-blog/The Cabin Podcast: https://the-cabin.simplecast.com. Follow on social @thecabinpodShop Discover Wisconsin: shop.discoverwisconsin.com. Follow on social @shopdiscoverwisconsinDiscover Wisconsin: https://discoverwisconsin.com/. Follow on social @discoverwisconsinDiscover Mediaworks: https://discovermediaworks.com/. Follow on social @discovermediaworksFriends of the Wisconsin Great River Road: https://www.wigrr.com/Wisconsin DOT: https://wisconsindot.gov/Pages/home.aspx

Comment on the Show by Sending Mark a Text Message.This episode is part of my initiative to provide access to important court decisions  impacting employees in an easy to understand conversational format using AI.  The speakers in the episode are AI generated and frankly sound great to listen to.  Enjoy!A top performer with a life-threatening migraine condition built a 15-year career, earned awards, and worked remotely with a documented accommodation—until a post-merger culture shift demanded office presence and everything changed. We walk you through the allegation-filled timeline: the hot leads routed to younger men in the New York office, the confrontation that preceded a stroke doctors tied to job stress, and the series of decisions that, the complaint says, turned a medical safeguard into a career liability.We dig into the mechanics of discrimination and retaliation claims: how account assignments can become tools of pretext, why a disputed Citadel loss matters years later, and what it means when a PIP leans on contested narratives despite recent high performance. You'll hear how the continuing violations doctrine can bridge older incidents into a timely hostile environment claim, and why plausibility at the motion-to-dismiss stage hinges on a minimal inference—not courtroom proof. The distinction between granting an ADA accommodation and honoring it in practice sits at the core: resources withheld for remote staff, an ultimatum to attend training in person despite written permission, and the message that office presence equals opportunity.We also examine leadership statements that allegedly acknowledged past bias, rapid promotions for younger male colleagues, and the juxtaposition of a 2023 sales excellence award with a 2024 PIP. The legal stakes are high: timeliness defenses, comparator debates, and whether penalizing a stroke survivor's accommodation can be seen as extreme and outrageous conduct. Ultimately, we ask a broader question many workplaces face now: when office-first culture collides with health, is performance enough to protect an employee whose life depends on remote work?If this deep dive helped you see the issues more clearly, follow the show, share this episode with a colleague, and leave a quick review telling us where you stand on accommodations versus culture. Your take might shape a future mailbag. If you enjoyed this episode of the Employee Survival Guide please like us on Facebook, Twitter and LinkedIn. We would really appreciate if you could leave a review of this podcast on your favorite podcast player such as Apple Podcasts. Leaving a review will inform other listeners you found the content on this podcast is important in the area of employment law in the United States. For more information, please contact our employment attorneys at Carey & Associates, P.C. at 203-255-4150, www.capclaw.com.Disclaimer: For educational use only, not intended to be legal advice.

As managers and employees, how can we ensure that we support equitable disability accommodations for everyone? The Americans with Disabilities Act (ADA) offers a wealth of protections, but many workers and leaders are unaware of what these protections entail. Luckily, there are experts like Rachel Shaw out there to shed light on their intricacies and help educate us all.Rachel is a leading strategist in workplace inclusion and disability compliance and the author of “The Disabled Workforce: What the ADA Never Anticipated.” She joins me to add clarity to the laws in place to protect people with disabilities—including mental health and pregnancy—and ensure we have access to an equitable work environment that allows us all to be productive contributors, whatever differences of ability we might experience in our lifetimes. Understand your rights and responsibilities around disability inclusion:The most proactive and effective way to ask for an accommodation;The essential accommodation process every organization needs to develop;How much it really costs companies to approve employee requests;What's missing from the ADA and how it's being addressed.Related Links:Connect with Rachel Shaw on LinkedIn - https://www.linkedin.com/in/rachel-shaw-00037745/Learn more about Rachel's work - https://rachelshaw.com/Buy “The Disabled Workforce” - https://www.amazon.com/Disabled-Workforce-What-Never-Anticipated/dp/1544708599Episode 390, How to Manage ADHD in the Workplace - https://www.bossedup.org/podcast/episode390Episode 460, Balancing Work with a Complicated Pregnancy - https://www.bossedup.org/podcast/episode460Episode 123, Pursuing a Promotion While Pregnant - https://www.bossedup.org/podcast/episode123Episode 335, What do mom-friendly Workplaces look like and how to create them - https://www.bossedup.org/podcast/episode335   Episode 311, How to Talk About Marital Status, Parental Status, and Pregnancy in the Interview - https://www.bossedup.org/podcast/episode311Episode 315, How to Talk About Disability or Chronic Illness in the Job Interview - https://www.bossedup.org/podcast/episode315LEVEL UP: a Leadership Accelerator for Women on the Rise - https://www.bossedup.org/levelupBossed Up Courage Community - https://www.facebook.com/groups/927776673968737/Bossed Up LinkedIn Group - https://www.linkedin.com/groups/7071888/ Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

There is a specific moment in the life of a Human Resources professional that is fraught with a peculiar kind of tension. It happens when a door opens, an employee sits down, and they say, simply, "I need something to change."We like to think of the workplace as a rational machine, governed by clear inputs and outputs. But what happens when the machine encounters the messy, unpredictable reality of the human body? In this episode of Human Solutions, we explore the "messiest corner of HR": the medical accommodation.Host Pete Wright and AIM HR Solutions' Terry Cook take us into the labyrinth of the Americans with Disabilities Act (ADA). It turns out, the difference between a lawsuit and a success story often hinges on things we rarely think about—the precise wording of a job description, the speed of a reply, and the strange social dynamics of an office chair.We explore why the most dangerous thing a manager can do is try to be "nice" without a process, why "undue hardship" is much harder to prove than you think, and the uncomfortable silence HR must maintain when the rest of the staff starts asking why that guy got to work from home.It is a conversation about the friction between compassion and compliance, and why, sometimes, the best way to help a human being is to strictly follow the rules.In this episode, we cover:The "Magic Words" Myth: Why an employee never actually has to say "disability" or "accommodation" to trigger a legal obligation.The Interactive Process: Why the answer isn't "yes" or "no," but rather a conversation about what is safe and essential.The Trap of Benevolence: How granting a request off the books can create a precedent that makes future equity impossible.The Paradox of the Chair: A look at how a $1,000 ergonomic chair can disrupt the morale of an entire department—and why morale doesn't count as an "undue hardship".The Manager's Dilemma: How to train supervisors to handle the frustration of not being allowed to know why their employee is being treated differently.Links & NotesThe Job Accommodation Network (JAN): A critical toolkit for understanding workplace accommodations.AskJAN.orgCompliance Resources:ADA.govEEOC: Employer ResponsibilitiesAIM HR Helpline: For AIM members dealing with complex accommodation scenarios.Phone: 800-470-6277Email: helpline@aimnet.org AIM HR Solutions Training CatalogAIM members can reach the HR Helpline at 800-470-6277 or helpline@aimnet.org for inquiries Monday through Friday from 8:30 a.m. – 5:00 p.m. (EST). Email requests will be responded to within 24 hours. 

Sooner or later, most households will experience health or mobility issues of some kind. An injury, illness, or age-related loss of mobility will often exacerbate existing clutter problems. In episode #281 of The Clutter Fairy Weekly, Gayle Goddard, professional organizer and owner of The Clutter Fairy in Houston, Texas, explores steps we can take to plan ahead for changes and accommodations that injury, illness, or disability can necessitate in our homes.Show notes: https://cfhou.com/tcfw281The Clutter Fairy Weekly is a live webcast and podcast designed to help you clear your clutter and make space in your home and your life for more of what you love. We meet Tuesdays at noon (U.S. Central Time) to answer your decluttering questions and to share organizing tools and techniques, success stories and “ah-hah!” moments, seasonal suggestions, and timeless tips.To participate live in our weekly webcast, join our Meetup group, follow us on Facebook, or subscribe to our mailing list. You can also watch the videos of our webcast on YouTube.Support the show

Comment on the Show by Sending Mark a Text Message.Think your medical condition or disability doesn't “count” because it isn't visible or permanent? That assumption costs careers. We dig into how disability rights actually work on the ground, why silence helps employers more than employees, and the simple forms of “notice” that trigger your legal protections. From anxiety and migraines to Crohn's, postpartum depression, and recovery from surgery, the coverage is broader than most people think—and the bar for “substantially limits” is intentionally low.We walk through the ADA's three-part definition of disability, highlight how major life activities include concentration, communication, and working, and explain why timing often exposes retaliation. You'll hear practical language you can use with a manager or HR, how to document requests and meetings, and what a good faith interactive process looks like when it's done right. We also share a free resource—the Job Accommodation Network at askjan.org—that can join the conversation and help identify workable accommodations like flexible schedules, remote options, adjusted metrics, or short-term leave.Real-world patterns matter: denials without analysis, discipline after medical leave, and “regarded as” mistakes can all expose employers to liability. We unpack court trends that favor inclusion, including protections for temporary and episodic conditions and mental health. If you've been pushing through symptoms and blaming yourself for “performance,” it's time to flip the script. Accommodations are rights, not favors, and early, clear communication can protect both your health and your job. If this resonates, follow the show, share it with a colleague who needs it, and leave a review to help more workers find the support they deserve. If you enjoyed this episode of the Employee Survival Guide please like us on Facebook, Twitter and LinkedIn. We would really appreciate if you could leave a review of this podcast on your favorite podcast player such as Apple Podcasts. Leaving a review will inform other listeners you found the content on this podcast is important in the area of employment law in the United States. For more information, please contact our employment attorneys at Carey & Associates, P.C. at 203-255-4150, www.capclaw.com.Disclaimer: For educational use only, not intended to be legal advice.

You are listening to a presentation given at the 2025Michigan Conference Cedar Lake Campmeeting. We pray you will be blessed!

Authors Drs. Jessica Ross and Alissa Cooper share insights into their JCO PO article, "Clinical and Pathologic Landscapes of Delta-Like Ligand 3 and Seizure-Related Homolog Protein 6 Expression in Neuroendocrine Carcinomas"  Host Dr. Rafeh Naqash and Drs. Ross and Cooper discuss the landscape of Delta-like ligand 3 (DLL3) and seizure-related homolog protein 6 (SEZ6) across NECs from eight different primary sites. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO PO and an Associate Professor at the OU Health Stephenson Cancer Center. Today, I'm excited to be joined by Dr. Jessica Ross, third-year medical oncology fellow at the Memorial Sloan Kettering Cancer Center, as well as Dr. Alissa Cooper, thoracic medical oncologist at the Dana-Farber Cancer Institute and instructor in medicine at Harvard Medical School. Both are first and last authors of the JCO Precision Oncology article entitled "Clinical and Pathologic Landscapes of Delta-like Ligand 3 and Seizure-Related Homolog Protein 6 or SEZ6 Protein Expression in Neuroendocrine Carcinomas." At the time of this recording, our guest disclosures will be linked in the transcript. Jessica and Alissa, welcome to our podcast, and thank you for joining us today. Dr. Jessica Ross: Thanks very much for having us. Dr. Alissa Cooper: Thank you. Excited to be here. Dr. Rafeh Naqash: It's interesting, a couple of days before I decided to choose this article, one of my GI oncology colleagues actually asked me two questions. He said, "Rafeh, do you know how you define DLL3 positivity? And what is the status of DLL3 positivity in GI cancers, GI neuroendocrine carcinomas?" The first thing I looked up was this JCO article from Martin Wermke. You might have seen it as well, on obrixtamig, a phase 1 study, a DLL3 bi-specific T-cell engager. And they had some definitions there, and then this article came along, and I was really excited that it kind of fell right in place of trying to understand the IHC landscape of two very interesting targets. Since we have a very broad and diverse audience, especially community oncologists, trainees, and of course academic clinicians and some people who are very interested in genomics, we'll try to make things easy to understand. So my first question for you, Jessica, is: what is DLL3 and SEZ6 and why are they important in neuroendocrine carcinomas? Dr. Jessica Ross: Yeah, good question. So, DLL3, or delta-like ligand 3, is a protein that is expressed preferentially on the tumor cell surface of neuroendocrine carcinomas as opposed to normal tissue. It is a downstream target of ASCL1, and it's involved in neuroendocrine differentiation, and it's an appealing drug target because it is preferentially expressed on tumor cell surfaces. And so, it's a protein, and there are several drugs in development targeting this protein, and then Tarlatamab is an approved bi-specific T-cell engager for the treatment of extensive-stage small cell lung cancer in the second line. SEZ6, or seizure-like homolog protein 6, is a protein also expressed on neuroendocrine carcinoma cell surface. Interestingly, so it's expressed on neuronal cells, but its exact role in neuroendocrine carcinomas and oncogenesis is actually pretty poorly understood, but it was identified as an appealing drug target because, similarly to DLL3, it's preferentially expressed on the tumor cell surface. And so this has also emerged as an appealing drug target, and there are drugs in development, including antibody-drug conjugates, targeting this protein for that reason. Dr. Alissa Cooper: Over the last 10 to 15 years or so, there's been an increasing focus on precision oncology, finding specific targets that actually drive the cancer to grow, not just within lung cancer but in multiple other primary cancers. But specifically, at least speaking from a thoracic oncology perspective, the field of non-small cell lung cancer has completely exploded over the past 15 years with the discovery of driver oncogenes and then matched targeted therapies. Within the field of neuroendocrine carcinomas, including small cell lung cancer but also other high-grade neuroendocrine carcinomas, there has not been the same sort of progress in terms of identifying targets with matched therapies. And up until recently, we've sort of been treating these neuroendocrine malignancies kind of as a monolithic disease process. And so recently, there's been sort of an explosion of research across the country and multiple laboratories, multiple people converging on the same open questions about why might patients with specific tumor biologies have different kind of responses to different therapies. And so first this came from, you know, why some patients might have a good response to chemo and immunotherapy, which is the first-line approved therapy for small cell lung cancer, and we also sort of extrapolate that to other high-grade neuroendocrine carcinomas. What's the characteristic of that tumor biology? And at the same time, what are other targets that might be identifiable? Just as Jesse was saying, they're expressed on the cell surface, they're not necessarily expressed in normal tissue. Might this be a strategy to sort of move forward and create smarter therapies for our patients and therefore move really into a personalized era for treatment for each patient? And that's really driving, I think, a lot of the synthesis of this work of not only the development of multiple new therapies, but really understanding which tumor might be the best fit for which therapy. Dr. Rafeh Naqash: Thank you for that explanation, Alissa. And as you mentioned, these are emerging targets, some more further along in the process with approved drugs, especially Tarlatamab. And obviously, DLL3 was something identified several years back, but drug development does take time, and readout for clinical trials takes time. Could you, for the sake of our audience, try to talk briefly about the excitement around Tarlatamab in small cell lung cancer, especially data that has led to the FDA approval in the last year, year and a half? Dr. Alissa Cooper: Sure. Yeah, it's really been an explosion of excitement over, as you're saying, the last couple of years, and work really led by our mentor, Charlie Rudin, had identified DLL3 as an exciting target for small cell lung cancer specifically but also potentially other high-grade neuroendocrine malignancies. Tarlatamab is a DLL3-targeting bi-specific T-cell engager, which targets DLL3 on the small cell lung cancer cells as well as CD3 on T cells. And the idea is to sort of introduce the cancer to the immune system, circumventing the need for MHC class antigen presentation, which that machinery is typically not functional in small cell lung cancer, and so really allowing for an immunomodulatory response, which had not really been possible for most patients with small cell lung cancer prior to this. Tarlatamab was tested in a phase 2 registrational trial of about 100 patients and demonstrated a response rate of 40%, which was very exciting, especially compared with other standard therapies which were available for small cell lung cancer, which are typically cytotoxic therapies. But most excitingly, more than even the response rate, I think, in our minds was the durability of response. So patients whose disease did have a response to Tarlatamab could potentially have a durable response lasting a number of months or even over a year, which had previously not ever been seen in this in the relapsed/refractory setting for these patients. I think the challenge with small cell lung cancer and other high-grade neuroendocrine malignancies is that a response to therapy might be a bit easier to achieve, but it's that durability. The patient's tumors really come roaring back quite aggressively pretty quickly. And so this was sort of the most exciting prospect is that durability of response, that long potential overall survival tail of the curve really being lifted up. And then most recently at ASCO this year, Dr. Rudin presented the phase 3 randomized controlled trial which compared Tarlatamab to physician's choice of chemotherapy in a global study. And the choice of chemotherapy did vary depending on the part of the world that the patients were enrolled in, but in general, it was a really markedly positive study for response rate, for progression-free survival, and for overall survival. Really exciting results which really cemented Tarlatamab's place as the standard second-line therapy for patients with small cell lung cancer whose disease has progressed on first-line chemo-immunotherapy. So that has been very exciting. This drug was FDA approved in May of 2024, and so has been used extensively since then. I think the adoption has been pretty widespread, at least in the US, but now in this global trial that was just presented, and there was a corresponding New England Journal paper, I think really confirms that this is something we really hopefully can offer to most of our patients. And I think, as we all know, that this therapy or other therapies like it are also being tested potentially in the first-line setting. So there was data presented with Tarlatamab incorporated into the maintenance setting, which also showed exciting results, albeit in a phase 1 trial, but longer overall survival than we're used to seeing in this patient population. And we await results of the study that is incorporating Tarlatamab into the induction phase with chemotherapy as well. So all of this is extraordinarily exciting for our patients to sort of move the needle of how many patients we can keep alive, feeling functional, feeling well, for as long as possible. Dr. Rafeh Naqash: Very exciting session at ASCO. I was luckily one of the co-chairs for the session that Dr. Rudin presented it, and I remember somebody mentioning there was more progress seen in that session for small cell lung cancer than the last 30, 35 years for small cell, very exciting space and time to be in as far as small cell lung cancer. Now going to this project, Jessica, since you're the first author and Alissa's the last, I'm assuming there was a background conversation that you had with Alissa before you embarked on this project as an idea. So could you, again, for other trainees who are interested in doing research, and it's never easy to do research as a resident and a fellow when you have certain added responsibilities. Could you give us a little bit of a background on how this started and why you wanted to look at this question? Dr. Jessica Ross: Yeah, sure. So, as with many exciting research concepts, I think a lot of them are derived from the clinic. And so I think Alissa and I both see a good number of patients with small cell, large cell lung cancer, and then high-grade neuroendocrine carcinomas. And so I think this was really born out of a basic conversation of we have these drugs in development targeting these two proteins, DLL3 and SEZ6, but really what is the landscape of cancers that express these proteins and who are the patients that really might benefit from these exciting new therapies. And of course, there was some data out there, but sort of less than one would imagine in terms of, you know, neuroendocrine carcinomas can really come from anywhere in the body. And so when you're seeing a patient with small cell of the cervix, for example, like what are the chances that their cancer expresses DLL3 or expresses SEZ6? So it was really derived from this pragmatic, clinically oriented question that we had both found ourselves thinking about, and we were lucky enough at MSK, we had started systematically staining patients' tumors for DLL3, tumors that are high-grade neuroendocrine carcinomas, and then we had also more recently started staining for SEZ6 as well. And so we had this nice prospectively collected dataset with which to answer this question. Dr. Rafeh Naqash: Excellent. And Alissa, could you try to go into some of the details around which patients you chose, how many patients, what was the approach that you selected to collect the data for this project? Dr. Alissa Cooper: This is perhaps a strength but also maybe a limitation of this dataset is, as Jesse alluded to, our pathology colleagues are really the stars of this paper here because we were lucky enough at MSK that they were really forethinking. They are absolute experts in the field and really forward-thinking people in terms of what information might be needed in the future to drive treatment decision-making. And so, as Jesse had said, small cell lung cancer tumor samples reflexively are stained for DLL3 and SEZ6 at MSK if there's enough tumor tissue. The other high-grade neuroendocrine carcinomas, those stains are performed upon physician request. And so that is a bit of a mixed bag in terms of the tumor samples we were able to include in this dataset because, you know, upon physician request depends on a number of factors, but actually at MSK, a number of physicians were requesting these stains to be done on their patients with high-grade neuroendocrine cancers of of other histologies. So we looked at all tumor samples with a diagnosis of high-grade neuroendocrine carcinoma of any histology that were stained for these two stains of interest. You know, I can let Jesse talk a bit more about the methodology. She was really the driver of this project. Dr. Jessica Ross: Yeah, sure. So we had 124 tumor samples total. All of those were stained for DLL3, and then a little less than half, 53, were stained for SEZ6. As Alissa said, they were from any primary site. So about half of them were of lung origin, that was the most common primary site, but we included GI tract, head and neck, GU, GYN, even a few tumors of unknown origin. And again, that's because I think a lot of these trials are basket trials that are including different high-grade neuroendocrine carcinomas no matter the primary site. And so we really felt like it was important to be more comprehensive and inclusive in this study. And then, methodologically, we also defined positivity in terms of staining of these two proteins as anything greater than or equal to 1% staining. There's really not a defined consensus of positivity when it comes to these two novel targets and staining for these two proteins. But in the Tarlatamab trials, for some of the correlative work that's been done, they use that 1% cutoff, and we just felt like being consistent with that and also using a sort of more pragmatic yes/no cutoff would be more helpful for this analysis. Dr. Alissa Cooper: And that was a point of discussion, actually. We had contemplated multiple different schemas, actually, for how to define thresholds of positivity. And I know you brought up that question before, what does it mean to be DLL3 positive or DLL3 high? I think you were alluding to prior that there was a presentation of obrixtamig looking at extra-pulmonary neuroendocrine carcinomas, and they actually divvied up the results between DLL3 50% or greater versus DLL3 low under 50%. And they actually did demonstrate differential efficacy certainly, but also some differential safety as well, which is very provocative and that kind of analysis has not been presented for other novel therapies as far as I'm aware. I could be wrong, but as far as I'm aware, that was sort of the first time that we saw a systematic presentation of considering patients to be, quote unquote, "high" or "low" in these sort of novel targets. I think it is important because the label for Tarlatamab does not require any DLL3 expression at all, actually. So it's not hinging upon DLL3 expression. They depend on the fact that the vast majority of small cell lung cancer tumors do express DLL3, 85% to 90% is what's been demonstrated in a few studies. And so, there's not prerequisite testing needed in that regard, but maybe for these extra-pulmonary, other histology neuroendocrine carcinomas, maybe it does matter to some degree. Dr. Rafeh Naqash: Definitely agree that this evolving landscape of trying to understand whether an expression for something actually really does correlate with, whether it's an immune cell engager or an antibody-drug conjugate is a very evolving and dynamically moving space. And one of the questions that I was discussing with one of my friends was whether IHC positivity and the level of IHC positivity, as you've shown in one of those plots where you have double positive here on the right upper corner, you have the double negative towards the left lower, whether that somehow determines mRNA expression for DLL3. Obviously, that was not the question here that you were looking at, but it does kind of bring into question certain other aspects of correlations, expression versus IHC. Now going to the figures in this manuscript, very nicely done figures, very easy to understand because I've done the podcast for quite a bit now, and usually what I try to do first is go through the figures before I read the text, and and a lot of times it's hard to understand the figures without reading the text, but in your case, specifically the figures were very, very well done. Could you give us an overview, a quick overview of some of the important results, Jessica, as far as what you've highlighted in the manuscript? Dr. Jessica Ross: Sure. So I think the key takeaway is that, of the tumors in our cohort, the majority were positive for DLL3 and positive for SEZ6. So about 80% of them were positive for DLL3 and 80% were positive for SEZ6. About half of the tumors were stained for both proteins, and about 65% of those were positive as well. So I think if there's sort of one major takeaway, it's that when you're seeing a patient with a high-grade neuroendocrine carcinoma, the odds are that their tumor will express both of these proteins. And so that can sort of get your head thinking about what therapies they might be eligible for. And then we also did an analysis of some populations of interest. So for example, we know that non-neuroendocrine pathologies can transform into neuroendocrine tumors. And so we specifically looked at that subset of patients with transformed tumors, and those were also- the majority of them were positive, about three-quarters of them were positive for both of these two proteins. We looked at patients with brain met samples, again, about 70% were positive. And then I'd say the last sort of population of interest was we had a subset of 10 patients who had serial biopsies stained for either DLL3 or SEZ6 or both. In between the two samples, these patients were treated with chemotherapy. They were not treated with targeted therapy, but interestingly, in the majority of cases, the testing results were concordant, meaning if it was DLL3 positive to begin with, it tended to remain DLL3 positive after treatment. And so I think that's important as well as we think about, you know, a patient who maybe had DLL3 testing done before they received their induction chemo-IO, we can somewhat confidently say that they're probably still DLL3 positive after that treatment. And then finally, we did do a survival analysis among specifically the patients with lung neuroendocrine carcinomas. We looked at whether DLL3 expression affected progression-free survival on first-line platinum-etoposide, and then we looked at did it affect overall survival. And we found that it did not have an impact or the median progression-free survival was similar whether you were DLL3 positive or negative. But interestingly, with overall survival, we found that DLL3 positivity actually correlated with slightly improved overall survival. These were small numbers, and so, you know, I think we have to interpret this with caution, for sure, but it is interesting. I think there may be something to the fact that five of the patients who were DLL3 positive were treated with DLL3-targeting treatments. And so this made me think of, like in the breast cancer world, for example, if you have a patient with HER2-positive disease, it initially portended worse prognosis, more aggressive disease biology, but on the other hand, it opens the door for targeted treatments that actually now, at least with HER2-positive breast cancer, are associated with improved outcomes. And so I think that's one finding of interest as well. Dr. Rafeh Naqash: Definitely proof-of-concept findings here that you guys have in the manuscript. Alissa, if I may ask you, what is the next important step for a project like this in your mind? Dr. Alissa Cooper: Jesse has highlighted a couple of key findings that we hope to move forward with future investigative studies, not necessarily in a real-world setting, but maybe even in clinical trial settings or in collaboration with sponsors. Are these biomarkers predictive? Are they prognostic? You know, those are still- we have some nascent data, data has been brewing, but I think that we we still don't have the answers to those open questions, which I think are critically important for determining not only clinical treatment decision-making, but also our ability to understand sequencing of therapies, prioritization of therapies. I think a prospective, forward-looking project, piggybacking on that paired biopsy, you know, we had a very small subset of patients with paired biopsies, but a larger subset or cohort looking at paired biopsies where we can see is there evolution of these IHC expression, even mRNA expression, as you're saying, is there differential there? Are there selection pressures to targeted therapies? Is there upregulation or downregulation of targets in response not just to chemotherapy, but for example, for other sort of ADCs or bi-specific T-cell engagers? I think those are going to be critically important future studies which are going to be a bit challenging to do, but really important to figure out this key clinical question of sequencing, which we're all contemplating in our clinics day in and day out. If you have a patient, and these patients often can be sick quite quickly, they might have one shot of what's the next treatment that you're going to pick. We can't guarantee that every patient is going to get to see every therapy. How can you help to sort of answer the question of like what should you offer? So I think that's the key question sort of underlying any future work is how predictive or prognostic are these biomarkers? What translational or correlative studies can we do on the tissue to understand clinical treatment decision-making? I think those are the key things that will unfold in the next couple of years. Dr. Rafeh Naqash: The last question for you, Alissa, that I have is, you are fairly early in your career, and you've accomplished quite a lot. One of the most important things that comes out from this manuscript is your mentorship for somebody who is a fellow and who led this project. For other junior investigators, early-career investigators, how did you do this? How did you manage to do this, and how did you mentor Jessica on this project with some of the lessons that you learned along the way, the good and other things that would perhaps help other listeners as they try to mentor residents, trainees, which is one of the important things of what we do in our daily routine? Dr. Alissa Cooper: I appreciate you calling me accomplished. Um, I'm not sure how true that is, but I appreciate that. I didn't have to do a whole lot with this project because Jesse is an extraordinarily smart, driven, talented fellow who came up with a lot of the clinical questions and a lot of the research questions as well. And so this project was definitely a collaborative project on both of our ends. But I think what was helpful from both of our perspectives is from my perspective, I could kind of see that this was a gap in the literature that really, I think, from my work leading clinical trials and from treating patients with these kinds of cancers that I really hoped to answer. And so when I came to Jessica with this idea as sort of a project to complete, she was very eager to take it and run with it and also make it her own. You know, in terms of early mentorship, I have to admit this was the first project that I mentored, so it was a great learning experience for me as well because as an early-career clinician and researcher, you're used to having someone else looking over your shoulder to tell you, "Yes, this is a good journal target, here's what we can anticipate reviewers are going to say, here are other key collaborators we should include." Those kind of things about a project that don't always occur to you as you're sort of first starting out. And so all of that experience for me to be identifying those more upper-level management sort of questions was a really good learning experience for me. And of course, I was fantastically lucky to have a partner in Jesse, who is just a rising star. Dr. Jessica Ross: Thank you. Dr. Rafeh Naqash: Well, excellent. It sounds like the first of many other mentorship opportunities to come for you, Alissa. And Jessica, congratulations on your next step of joining and being faculty, hopefully, where you're training. Thank you again, both of you. This was very insightful. I definitely learned a lot after I reviewed the manuscript and read the manuscript. Hopefully, our listeners will feel the same. Perhaps we'll have more of your work being published in JCO PO subsequently. Dr. Alissa Cooper: Hope so. Thank you very much for the opportunity to chat today. Dr. Jessica Ross: Yes, thank you. This was great. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so as you never miss an episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Disclosures: Dr. Alissa Jamie Cooper Honoraria Company: MJH Life Scienes, Ideology Health, Intellisphere LLC, MedStar Health, Physician's Education Resource, LLC,  Gilead Sciences, Regeneron, Daiichi Sankyo/Astra Zeneca, Novartis,  Research Funding: Merck, Roche, Monte Rosa Therapeutics, Abbvie, Amgen, Daiichi Sankyo/Astra Zeneca Travel, Accommodations, Expenses: Gilead Sciences

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Want to learn more about Vodyssey or start your STR journey. Book a call here:https://meetings.hubspot.com/vodysseystrategysession/booknow?utm_source=vodysseycom&uuid=80fb7859-b8f4-40d1-a31d-15a5caa687b7Contact Ross:https://itineraryboss.com/https://www.instagram.com/rossalcorn33/?hl=enhttps://www.youtube.com/@ItineraryBosshttps://www.linkedin.com/in/rossalcornru/https://open.spotify.com/show/1mmMJ6z3JdEOUJKUjLh8bD?si=fd290a47a091494dTALKED ABOUT SERVICE:https://www.rakuten.com/FOLLOW US:https://www.facebook.com/share/g/16XJMvMbVo/https://www.instagram.com/vodysseyshawnmoorehttps://www.facebook.com/vodysseyshawnmoore/https://www.linkedin.com/company/str-financial-freedomhttps://www.tiktok.com/@vodysseyshawnmoore

Author Reuben A. Buford May discusses the article, "Antiblack Discrimination in Public Accommodations: Differential Drink Pricing in Urban Nightclubs" published in Socius: Sociological Research for a Dynamic World.

College can feel overwhelming for students with ADHD, but support exists. In this episode, I talk with Hannah Choi—executive function coach and communications specialist at Beyond Booksmart. Hannah shares her personal ADHD story and practical tools to help college students build independence, manage their time, and advocate for what they need. From study strategies that actually work to understanding accommodations, we unpack how to set students up for a smoother transition into college.Whether you're a student, parent, or educator, you'll walk away with actionable strategies. We also explore gap years, what colleges are required to provide under ADA, and how executive function coaching builds confidence beyond academics.Meet Hannah Choi Hannah Choi, MA, is an executive function coach and Communications and Engagement Specialist at Beyond Booksmart. She helps college students and adults strengthen time management, task initiation, and self-advocacy skills. Hannah hosts the Focus Forward podcast, leads webinars, and facilitates motivation and accountability programs. She holds degrees in Psychology and American Sign Language from the University of Rochester and a Master's in Education from UC Santa Barbara. Hannah lives in Connecticut with her family. Episode Highlights [0:00] What studying really looks like with ADHD [2:26] Hannah's ADHD discovery and coaching path [11:09] Study strategies that build self-regulation [13:37] How to start practicing self-advocacy [15:52] Accommodations: from 504 to college [21:06] Top executive function skills before college [23:38] Managing all that “free time” [26:33] Building independence (without overparenting) [29:55] The case for gap years and transition programs [35:41] How EF skills impact life after graduation [38:50] Getting unstuck: motivation + task initiation [46:35] Final takeaway: it's never too late to change Connect with Hannah Choi:Instagram: @beyondbooksmartcoaching Website: https://www.beyondbooksmart.com/ Focus Forward Podcast: https://www.beyondbooksmart.com/podcast Thank you for tuning into "SuccessFULL with ADHD." If this episode has impacted you, remember to rate, follow, share, and review our podcast. Your support helps us reach and help more individuals navigating their journeys with ADHD.

Dr. Monty Pal and Dr. Pauline Funchain discuss the latest efforts to diagnose, prevent, and treat the series of immune-related adverse events that have emerged in the era of immunotherapy. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I am Monty Pal, a medical oncologist, professor and vice chair of medical oncology at the City of Hope Comprehensive Cancer Center in Los Angeles, California. Now, it is probably no surprise to this audience that immunotherapy has transformed the treatment landscape for multiple cancer types. It remains a pillar of modern oncology. Having said that, I think we have all been baffled by certain toxicities that we run into in the clinic. Today, I am delighted to be joined by Dr Pauline Funchain to discuss some of the checkpoint inhibitor toxicities that people struggle with most. And we will also touch on some side effects of immunotherapy beyond checkpoint inhibitors: CAR-T cells, bispecifics, so on and so forth. Dr Funchain is a dear friend, and she is an associate professor and associate director of cancer research training and education at the Stanford Cancer Institute. She is co-director of the Immunotherapy Toxicity Program and the Skin Cancer Genomics Program at Stanford, where she also serves as associate program director of hematology and oncology fellowship. Dr. Funchain is also the co-founder of ASPIRE, and we are going to talk about that a little bit today, the Alliance for the Support and Prevention of Immune-Related Events. FYI for listeners, if you are interested in our disclosures, they are available at the transcript of this episode. Pauline, thanks so much for joining us today. Dr. Pauline Funchain: Monty, thank you for this invitation. It is always great to talk. Dr. Monty Pal: So, for the audience, Pauline and I know each other from my days as a fellow at City of Hope. She was a resident at Harbor UCLA and a stellar resident at that. It has just been amazing to sort of see your career grow and blossom and to witness all the cool things that you are doing. ASPIRE, in particular, sort of caught my eye. So again, for listeners, this is the Alliance for the Support and Prevention of Immune-Related Events. Can you tell us a little bit briefly about the genesis of that, how that came about? Dr. Pauline Funchain: So, there was a bunch of us who were really struggling, I mean, all of us have struggled with these immune-related adverse events, these irAEs. You know, they are new disease states, and even though they look like autoimmune diseases, they tend to need a whole lot more steroid than autoimmune diseases do and they do not totally present in the same way. And in fact, you know, Triple-M, or Triple-M overlap syndrome, is a completely new irAE, a new immune state that we have never had before the advent of checkpoint inhibitor. And so a Triple-M, for those of you who are not as familiar, that is the constellation of myocarditis, myositis, and myasthenia gravis, something that never occurs as a natural autoimmune disease. So we were starting to realize that there were some major differences with these irAEs and autoimmune diseases. We could not treat them the right way. We really needed to learn more about them. And a bunch of us who had interest in this said, "Look, we really need to be all in one space to talk about what we are doing," because all of our treatments were our own little homegrown brews, and we needed to really get together and understand how to treat these things, how to diagnose them, and then learn more about them. So, Dr. Alexa Meara from Ohio State, Dr. Kerry Reynolds from Mass Gen, we put together this research consortium, brought together all of our irAE friends, got our best subspecialists together in a research consortium, which is now only about a year and a half old. And we made this research consortium, the Alliance for Support of Prevention of Immune-Related Events, and we reached out to ASCO, and ASCO was so kind to grant us a [Alliance for Support and Prevention of Immune-Related adverse Events (ASPIRE)] Community of Practice. So we met for the first time as a Community of Practice at the ASCO Annual Meeting just this past June and really got an ASCO community together to really think about how to again, diagnose, prevent, treat irAEs. Dr Monty Pal: This is interesting to me. The ASCO Community of Practice phenomenon is something that I was not super familiar with. Can you explain to our listenership what is the ASCO Community of Practice model? If you have particular interests, how do you sort of get one started? Dr Pauline Funchain: Yeah, so ASCO has an entire page on their Community of Practice. There are multiple Community of Practice groups or COPs. There are ones for Supportive Oncology and Survivorship. There is Women in Oncology. There is a group for International Medical Graduates. And there is about, I think 10 or 12 now that have a physical presence at ASCO but also a virtual presence on the ASCO Community of Practice site. So, if you were interested in any one of these, and you can see them on the ASCO Communities of Practice sites, you would ask to become a member. Once granted membership, then there is a whole webpage of postings and conversations that people can have. You can get email digests of conversations that happen on the website, and then you can anchor it with in-person participation at the Annual Meeting. Dr Monty Pal: That is awesome, and I can think of so many different foci within oncology that really sort of deserve a Community of Practice. This definitely being one of them. You know, it strikes me as being so interesting. I mean, the checkpoint inhibitors have been around for a while now. I think when you and I were in training, gosh, back then, these were just a little bit of a pipe dream, right? But having said that, I would probably say that more than half of my kidney cancer practice is either on checkpoint inhibitors, and the vast majority have been on one at some point in their past, right? With that in mind, you know, we have all treated a lot of patients with these drugs. Why is it that we still struggle to manage the toxicities? And just to take that one step further, what are some of the toxicities that, perhaps through ASPIRE or through your experience, people struggle with the most? Dr Pauline Funchain: So, I think we are still struggling with these because again, they are new disease states, right? This is what we all experienced with COVID, a brand-new virus and a brand-new syndrome. We now have 20-plus of these as irAEs. And what we have realized about them is the immune activation that happens with these is so much more than what we have seen with autoimmune diseases. So for instance, if you have a Crohn's or ulcerative colitis, you will top out at 40 to 60 milligrams of prednisone if a Crohn's flare or ulcerative colitis flare happens. But for our severe IR colitises, you know, it is at least 1 mg per kg, often goes up to 2 mg per kg. We, in some cases, have done 1 gram pulses if we are worried that somebody is going to perforate. So that was sort of like the first 5 years of treating irAE, and then now in the sort of second 5 years of treating irAE, we have realized that that is a lot of immunosuppression, and we might be able to get away with less with the newer biologics that are on board. So, we are struggling to try to get the data for some of these irAEs that we knew, we have known for a while, but to try to get newer treatments that may immunosuppress less so that you may still be able to retain that tumor response. And in fact, some of the preclinical studies suggest that some of these biologics may actually synergize with the immunotherapy and actually make the immunotherapy more effective from a tumor perspective and calm down the irAE as sort of the bystander effect. So we are still trying to optimize those. Getting up trials in the space has been very difficult. That is one of the reasons for the genesis of ASPIRE because we realized we needed to band together to have a bigger voice in that realm. Then there are other things that are brand new. So we talked about Triple-M. So Triple-M, again, with Triple-M or any myocarditis or myasthenia, I mean, there is about a 50% chance of death from irAE based on the literature. I think we are getting better at recognizing this, and so at Stanford we have some data to say that if you serially follow troponin, that maybe your outcomes are better. You can potentially lower the percentage of cases that are fatal because you can catch them early. I mean, this is all preliminary data, but again, these are all things that are evolving, and we do not all have the right answer. I mean, even the serial troponin thing, I think, is pretty controversial. And in fact, at one of our quarterly Zoom meetings that we are doing in ASPIRE in December is going to sort of flush out that controversy about serial troponin measuring and what is the best thing to use? Would you use something like abatacept or would you use ruxolitinib? Which one is better? I think there is a lot of controversy still about these things. Dr Monty Pal: You have really piqued my curiosity here because you think about the cons of treating irAEs, right? And I worry exactly about what you had mentioned, right, which is, "Gosh, what is going on with this tumor in terms of immunosuppression?" But you think about some of the newer agents, you mentioned ruxolitinib, I have heard of dasatinib, for instance, in this setting. Frankly speaking, a lot of these, as you point out, are really thought of as being also anticancer drugs. So you have really got me thinking about the potential synergy between perhaps suppressing an irAE and augmenting antitumor activity, which I think is very interesting. Am I on the right track with that? Dr Pauline Funchain: I think so, but you will find that a lot of people will not even go there because they are worried about how much immunosuppression you are going to cause. I am at heart a geneticist, but I think an immunologist will happily tell you that the immune system is very complex. There are multiple pathways, and these drugs do not all target the same immune pathways. So if we understand a little bit more about the pathways we are targeting and pick apart the pathways that are really, really tumor relevant and the other pathways that are not tumor relevant, you may be able to piece together a better marriage of tumor response and irAE control. Dr Monty Pal: Kind of on this topic, and again, leaning on your background in genetics, where are we in terms of predicting these irAEs? I mean, you would think the holy grail would be picking out a snip or something of this for it, right, that could potentially identify that patient who is going to get Triple-M or, you know, at the very least a significant high-grade irAE event. Are we anywhere closer to that in 2025? Dr Pauline Funchain: There have been data published. There have been some big GWAS studies. All of the effect sizes are pretty small. So there are some prediction algorithms, but none of them are clinically useful. And I think when you look at the odds ratios, they will increase risk by maybe 20%. I think one of the things that we found in a very small series and supported anecdotally is something as easy as family history of autoimmune disease is probably more predictive at this point than any of those types of markers. I think we will get there, but we are not anywhere near where we would like to be. Things like TMB also, actually, there is some good data about higher TMB, higher risk of irAE too. Dr Monty Pal: Interesting. I see all this data coming through, IL-8 polymorphisms, etc. And I just wondered if any of that was ready for prime time. But I mean, this is a good message for the practicing clinician. Sounds like we are not quite there yet. And I could probably keep you on for another entire podcast to talk about this topic, but let us see if we can at least skim the surface. I never thought I would see the day when BiTEs and CAR-Ts were entering into my kidney cancer practice, but in fact, it is really become central to a lot of our clinical trials in RCC these days. I would be lying if I did not say that I was not struggling with the toxicities and so forth associated with these drugs. Can you give us a quick primer, maybe just good resources that people can go to for managing toxicity with BiTEs and with CAR and with some of these novel therapeutic modalities that we are using in the oncology clinics? Dr Pauline Funchain: I know there is a recently published toxicity manual for BiTEs in hematologic malignancies, I think it was in Blood. CAR-T is covered in many irAE guidelines. So ASCO guidelines actually has a CAR-T [cell therapy guideline], and I would be remiss not to point out that actually ASCO has a, I am a little biased, but a wonderful guideline on irAE that is actually being updated as we speak. We are hoping for publication next year. I find the format of that, there are many guidelines out there, actually. There is ASCO, SITC, ESMO has a guideline for irAE, but I find the formatting of the ASCO guideline to be much easier to flip through during clinic, just because of the visual format of the tables. But that is going to be updated next year. And with CAR-T, there is now multiple publications also in terms of guidelines. But what I will say about bispecifics and CAR-T, so they have very similar toxicities in terms of the cytokine release and also with the ICANS, so the neurotoxicity. But what we have been finding that is really interesting with BiTEs and CAR-T, and actually even with TIL, cytokine release is very similar to some of the IL-2 toxicities but not identical that we see with TIL treatment. But now we are starting to see overlap. So patients who have been treated with immunotherapy and then go on to get a bispecific or then go on to get TIL, so I have seen some colitises that have occurred after the fact. Some of the newer CAR-Ts without checkpoint have been causing some really interesting, probably not in a good way, but interesting biologically, colitises that are really refractory. So we are starting to see some overlap, and again, I think this field is just evolving constantly. Dr Monty Pal: Yeah, no, I almost think I need to go back to that fellowship that you and I did together 20 years ago and, you know, and see if I could repeat some coursework on CAR-T management.  You know, Pauline, I could probably keep you on the horn for hours, but this has just been terrific. Thank you so much for sharing all of your insights with us today on the ASCO Daily News Podcast. Dr Pauline Funchain: Thank you for the invitation. It was wonderful to talk about this, and it was wonderful to catch up a little bit, Monty. Dr Monty Pal: Same here, same here. And thanks to our listeners too. If you value the insights you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:      Dr. Monty Pal    @montypal   Dr. Pauline Funchain @FunchainMD Follow ASCO on social media:       @ASCO on Twitter      ASCO on Bluesky     ASCO on Facebook       ASCO on LinkedIn     Disclosures: Dr. Monty Pal:     Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview    Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical    Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis    Dr. Pauline Funchain: Consulting or Advisory Role: Merck, Replimune, Sanofi/Regeneron, Immunocore, Tempus Research Funding (Inst.): Pfizer, Bristol-Myers Squibb, IDEAYA Biosciences, Linnaeus Therapeutics Travel, Accommodations, Expenses: Merck

When your child struggles with OCD, it's natural to want to ease their distress, but those well-meaning “helping” moments can actually feed OCD's control. In this episode, Natasha breaks down how to pull back accommodations safely and effectively, without creating unnecessary conflict or fear.You'll learn:What OCD accommodations really are and how they sneak into daily routinesWhy reducing them helps your child gain long-term confidenceHow to involve your child in the processWhat to do (and not do) when emotions run highHow to stay consistent and supportive as your child builds resiliencePulling back OCD accommodations isn't about being tough — it's about helping your child take their power back from OCD, one small step at a time.Get in-depth OCD support in my FREE parenting series starting this week. You can register at www.ATparentingsurvivalseries.comLinks mentioned in the show:Get a PDF handout of today's episodeSPACE Treatment Study Guide CourseEli Lebowitz's book Breaking Free of Child Anxiety and OCD & Alec Pollard's book When a Love On Won't Seek Mental Health TreatmentSPACE Treatment website, Alec Pollard's website, YouTube video on compulsive reassurance, YouTube video on compulsive confessing, Podcast on developing effective incentive plans***This podcast episode is sponsored by NOCD. NOCD provides online OCD therapy in the US, UK, Australia and Canada. To schedule your free 15 minute consultation to see if NOCD is a right fit for you and your child, go to https://go.treatmyocd.com/at_parentingThis podcast is for informational purposes only and should not be used to replace the guidance of a qualified professional. Parents, do you need more support?

Welcome back to the Bar Exam Toolbox podcast! Today, we're speaking with Chris Fromm - National Director of Curriculum and Assessment at Themis Bar Review - about strategies for tackling multiple-choice questions on the bar exam, including the upcoming NextGen format. We discuss how to manage your time effectively, leverage practice tools, and seek support during the challenging bar prep period. Note: This episode is sponsored by Themis Bar Review – the gold standard in bar exam preparation. With this special promotion, you can save $1,000 on any 2026 Themis Bar Review course using the code BAREXAMTB1000 at checkout. (This offer is valid until December 1st, 2025.) In this episode, we discuss: Why are multiple-choice questions stress-inducing for many people? Tips for approaching multiple-choice questions on the bar exam Effective time management and scheduling Turning to your support network for help Accommodations and focus strategies Six-option questions on the NextGen exam Resources: Themis Bar Review (https://www.themisbar.com/) Podcast Episode 18: Strategies for Mastering the MBE (https://barexamtoolbox.com/podcast-episode-18-strategies-for-mastering-the-mbe/) Podcast Episode 244: Spaced Repetition and Memorization During Bar Prep (w/Gabe Teninbaum) (https://barexamtoolbox.com/podcast-episode-244-spaced-repetition-and-memorization-during-bar-prep-w-gabe-teninbaum/) Podcast Episode 261: Quick Tips – Bar Exam Accommodations Basics (https://barexamtoolbox.com/podcast-episode-261-quick-tips-bar-exam-accommodations-basics/) Practice a Full Bar Exam Session – Go for the Gold (https://barexamtoolbox.com/practice-a-full-bar-exam-session-go-for-the-gold/) How to Plan Your Bar Exam Study Day for Maximum Success (https://barexamtoolbox.com/how-to-plan-your-bar-exam-study-day-for-maximum-success/) Manage Expectations Before Bar Prep Begins: Keeping Friends & Family on Your Side (https://barexamtoolbox.com/manage-expectations-before-bar-prep-begins-keeping-friends-family-on-your-side/) Download the Transcript (https://barexamtoolbox.com/episode-332-mastering-bar-exam-multiple-choice-questions-w-chris-fromm-from-themis/) If you enjoy the podcast, we'd love a nice review and/or rating on  Apple Podcasts (https://itunes.apple.com/us/podcast/bar-exam-toolbox-podcast-pass-bar-exam-less-stress/id1370651486) or your favorite listening app. And feel free to reach out to us directly. You can always reach us via the contact form on the Bar Exam Toolbox website (https://barexamtoolbox.com/contact-us/). Finally, if you don't want to miss anything, you can sign up for podcast updates (https://barexamtoolbox.com/get-bar-exam-toolbox-podcast-updates/)! Thanks for listening! Alison & Lee

Professor Yana Rodgers, Rutgers University and Professor Jennifer Cohen, Miami University discuss their collaborative research about Long COVID, disability and accommodation. Their research examines the prevalence of Long COVID across different demographic groups, and the extent with which workers with impairments associated with Long COVID have benefitted from remote work. People with pre-existing disabilities, women, sexual and gender minorities, individuals without college degrees and Hispanic people are more likely to experience Long COVID. These groups are also more likely to be clustered in jobs less amenable to remote work. Rodgers and Cohen suggest other types of accommodations for employers to consider, including flexible scheduling and task-sharing that re-evaluates essential job functions.

In this podcast recorded at our recent Corporate Labor and Employment Counsel Exclusive® seminar, Tae Phillips (shareholder, Birmingham), Jim Paul (shareholder, St. Louis/Tampa), and Scott Kelly (shareholder, Birmingham) continue their discussion of the EEOC's evolving enforcement priorities—this time addressing religious discrimination, harassment, and accommodations in the workplace. Jim (who is co-chair of the firm's Disability Access Practice Group) examines recent trends, including the rise in religious accommodation requests, the impact of federal executive orders, and the challenges employers face in navigating religious and political overlap in employee requests. The conversation highlights the complexities of accommodating diverse religious beliefs while maintaining compliance with Title VII of the Civil Rights Act and fostering a respectful work environment.

The Push-Pull of ADHD and Autism: Stretching Without Breaking In this candid conversation, Patricia Young (she/her) and B Lourenco (she/her) dive deep into the realities of living with ADHD, autism, and other forms of neurodivergence. They explore the push-pull between self-accommodation and stretching ourselves, how shame and internalized ableism impact daily life, and what it means to create realistic support systems at home, in relationships, and in the workplace. Expect raw honesty, relatable stories, and practical insights for navigating neurodivergent life. WHAT YOU'LL HEAR IN THIS EPISODE · The ongoing "driver's seat battle" between ADHD and autism. · The push-pull between making accommodations and stretching ourselves beyond comfort. · Parenting a neurodivergent young adult while balancing when to push and when to allow rest. · Task initiation struggles — from making banana bread to cooking meals. · Body doubling as a powerful tool to reduce shame and spark motivation. · The "crisper/rotter" effect — guilt over wasted food and executive dysfunction. · Financial and practical impacts of task initiation challenges. · How privilege plays into having options like prepared or frozen meals when cooking feels impossible. · The cost of pushing through fatigue and flares with conditions like POTS and MCAS. · "Future me" thinking — and the difficulties neurodivergent folks have with impermanence. · Shame as the "ice cream scoop" on top of disability struggles. · Why diagnosis matters: language helps reduce shame and prevent repeating harmful patterns. · How powerlessness, and an attempt to gain autonomy can show up in small, reactive choices (like leaving a Facebook group). · Sensory sensitivities in family systems — how lack of accommodations can lead to dysfunction. · Practical accommodations for noise-sensitive parents and their kids. · Workplace challenges: 40-hour weeks, return-to-office pressures, and capitalism's rigidity. · Creative problem-solving in disabled and neurodivergent communities. · The deep fear of being uncared for and alone if we can't keep up. · Hyper-independence and isolation in the ADHD/autistic community. · Internalized ableism and the "shoulds" that drive shame and burnout. · Neurodivergence as a dynamic disability — what's possible one day isn't always possible the next. · Radical acceptance as a path toward reducing judgment and finding relief. SOUND BITES · "It begs the question of, okay, is that okay? Can we just say that's how it is?" – B Lourenco · "Instead of putting our energy into addressing the gap, folks will take the great divide and then put a scoop of shame on top of it." – B Lourenco · "All the terrible things that we tell ourselves… if I didn't have that awareness, I'd just keep repeating these patterns." – Patricia Young · "In order to truly accommodate ourselves, we have to acknowledge that it's as hard as it is and that we're as disabled as we are." – B Lourenco · "Sometimes I have to ask myself, what if what you're going through is exactly where you need to be?" – Patricia Young SENSITIVITY IS NOTHING TO APOLOGIZE FOR; IT'S HOW YOUR BRAIN IS WIRED You are not broken. You were shaped by systems that weren't built for you. You deserve rest, joy, and support exactly as you are. TOPICS COVERED (please adjust for addition of introduction) 00:00 Navigating Neurodivergence: A Personal Journey 02:59 Understanding Accommodations: Balancing Needs and Expectations 05:48 The Push-Pull of Task Initiation and Self-Care 08:33 Shame and Support: The Role of Community 11:35 The Impact of Environment on Neurodivergent Individuals 14:26 Workplace Challenges: The Struggle for Accommodations 17:16 Building Bridges: Community and Creative Solutions 20:00 Radical Acceptance: Embracing Our Reality 22:48 The Journey of Self-Discovery and Identity 25:42 The Dynamic Nature of Neurodivergence 29:02 Finding Joy in the Present Moment 31:47 The Bigger Picture: Building a Better Future 34:47 Conclusion: Resources and Future Endeavors PODCAST HOST Patricia Young (she/her) was a Licensed Clinical Social Worker for over 17 years, but she is now exclusively providing coaching. She knows what it's like to feel like an outcast, misfit, and truthteller. Learning about the trait of being a Highly Sensitive Person (HSP), then learning she is AuDHD with a PDA profile, OCD and RSD, helped Patricia rewrite her history with a deeper understanding, appreciation, and a sense of self-compassion. She created the podcasts Unapologetically Sensitive and Unapologetically AuDHD to help other neurodivergent folks know that they aren't alone, and that having a brain that is wired differently comes with amazing gifts, and some challenges. Patricia works online globally working individually with people, and she teaches Online Courses for neurodivergent folks that focus on understanding what it means to be a sensitive neurodivergent. Topics covered include: self-care, self-compassion, boundaries, perfectionism, mindfulness, communication, and creating a lifestyle that honors you Patricia's website, podcast episodes and more: www.unapologeticallysensitive.com PODCAST GUEST B Lourenco, MA, LMHC (she/her) is a licensed mental health counselor, educator, advocate, and activist. B has been working in community support for nearly 20 years and is committed to social change on all system levels. Seeing mental health advocacy as a way to serve the community, she earned a Master of Arts degree in Clinical Psychology, with a Systems Emphasis, in 2015 and began her private practice, B Lourenco Therapy in 2017. B has also worked in the public school system, providing support to students with behavioral issues that made attending school challenging for them. Highly trained in Applied Behavior Analysis (ABA), B became a district-wide expert in supporting neurodivergent students. It was during this work that she began to be critical of the medical models of support for neurodivergence, including ABA. Making the shift from the medical to the Neurodiversity-affirming model has allowed her to finally identify her own neurodivergence, including Autism and ADHD. Combining her lived experience of neurodivergence, along with years of anti-oppression work, B is passionate about helping others untangle themselves from harmful practices and align themselves with those that instead support marginalized communities. In addition to CE events for healthcare providers, she has also been a speaker on panels and podcasts, and also facilitates community based workshops. https://www.blourencotherapy.com LINKS Cascadia Training: https://cascadia-training.com Imani Barbarin—crutches_and_spice IG https://www.instagram.com/crutches_and_spice/ To write a review in itunes: click on this link https://itunes.apple.com/us/podcast/unapologetically-sensitive/id1440433481?mt=2 select "listen on Apple Podcasts" chose "open in itunes" choose "ratings and reviews" click to rate the number of starts click "write a review" Website--www.unapologeticallysensitive.com Facebook-- https://www.facebook.com/Unapologetically-Sensitive-2296688923985657/ Closed/Private Facebook group Unapologetically Sensitive-- https://www.facebook.com/groups/2099705880047619/ Instagram-- https://www.instagram.com/unapologeticallysensitive/ Youtube-- https://www.youtube.com/channel/UCOE6fodj7RBdO3Iw0NrAllg/videos?view_as=subscriber Tik Tok--https://www.tiktok.com/@unapologeticallysensitiv Unapologetically AuDHD Podcast-- https://unapologeticallysensitive.com/unapologeticallyaudhd/ e-mail-- unapologeticallysensitive@gmail.com Show hashtag--#unapologeticallysensitive Music-- Gravel Dance by Andy Robinson www.andyrobinson.com

I've had so many jobs over the years — from babysitter to office administrator — and I didn't know until much later that my struggles in certain environments were connected to being autistic. In this episode, I talk about what it means to navigate workplaces that aren't built for neurodivergent minds, and how universal design could change everything. This is about moving from just "accommodating" us to truly including us.Watch this episode on YouTube.If you'd like to know more about topics discussed in this episode, check out:"Workplace Accommodations and Neurodiversity" by Susanne Bruyère and Adrienne Colella (chapter in Neurodiversity and Work: Employment, Identity, and Support Networks for Neurominorities edited by Eric Patton and Alecia Santuzzi)"Accommodations vs Universal Design" by CultureAlly"Autistic Adults' Views and Experiences of Requesting and Receiving Workplace Adjustments in the UK" by Jade Davies et al.Universal Design: Creating Inclusive Environments by Edward Steinfeld and Jordana Maisel"How Can the Work Environment Be Redesigned to Enhance the Well-Being of Individuals With Autism?" by Michał Tomczak"Autism and the Right to a Hypersensitivity-Friendly Workspace" by Bouke de Vries"'It's Like a Ramp for a Person in a Wheelchair': Workplace Accessibility for Employees With Autism" by Michal Waisman-Nitzan et al.  Theme music: "Everything Feels New" by Evgeny Bardyuzha. All episodes written and produced by Kristen Hovet.Send in your questions or thoughts via audio or video recording for a chance to be featured on the show! Email your audio or video clips to otherautism@gmail.com through WeTransfer. Buy me a coffee!Buy The Other Autism merch. Use code FREESHIP for free shipping on orders over $75 USD! The views, opinions, and experiences shared by guests on this podcast are their own and do not necessarily reflect those of the host or production team. The content is intended for informational purposes only and should not be taken as medical or professional advice. Please consult with a qualified healthcare provider before making any decisions related to your health, fitness, or wellness.

In this episode, Hailey shares a few cozy county escapes across Wisconsin! As summer fades and Wisconsin's landscapes shift into shades of gold and red, it's the perfect time to sneak away. Dreaming of mornings on the lake, nights under the stars, or waking up to the sound of farm animals? Every corner of Wisconsin has a stay perfect for you! From treetop hideaways to historic inns, here are a few handpicked spots where fall feels extra special.The Bobber is brought to you by Something Special from Wisconsin: https://www.somethingspecialwi.com/Read the blog here: https://discoverwisconsin.com/cozy-county-escapes-september-stays-across-wisconsin/Bayfield County: https://www.wicounties.org/counties/bayfield-county/; BoulderRidge Tree House: https://www.bayfield.org/listing/boulderridge-tree-house/409/; Lake Superior Sea Caves: https://www.nps.gov/apis/learn/nature/caves.htm; Apple Hill Orchard: https://www.applehillorchard.com/; Hillcrest Orchards: http://www.hillcrestorchards.net/; Bayfield Apple Festival: https://www.bayfield.org/bayfield-apple-festival/; La Crosse County:https://www.wicounties.org/counties/la-crosse-county/; Rainbow Ridge Farms: https://www.rainbowridgefarms.com/; Brown County: https://www.wicounties.org/counties/brown-county/; The Astor House Bed & Breakfast: https://astorhouse.com/; Lambeau Field: https://www.packers.com/lambeau-field/; Fox River State Trail: https://dnr.wisconsin.gov/topic/parks/foxriver; LoCo WisCo: https://www.locowisco.com/; Bhava Coffee: https://www.bhavacoffee.com/; Walworth County: https://www.wicounties.org/counties/walworth-county/; Lake Geneva Lodge: https://genevalakelodge.com/; Geneva Lake Shore Path: https://www.visitlakegeneva.com/things-to-do/shore-path/; Lake Geneva Cruise Line: https://www.cruiselakegeneva.com/; Geneva Lakes Antique and Classic Boat Show: https://www.genevalakesboatshow.com/; Pier 290: https://pier290.com/The Bobber: https://discoverwisconsin.com/the-bobber-blog/The Cabin Podcast: https://the-cabin.simplecast.com. Follow on social @thecabinpodShop Discover Wisconsin: shop.discoverwisconsin.com. Follow on social @shopdiscoverwisconsinDiscover Wisconsin: https://discoverwisconsin.com/. Follow on social @discoverwisconsinDiscover Mediaworks: https://discovermediaworks.com/. Follow on social @discovermediaworksWisconsin Counties Association: https://www.wicounties.org/

For this episode of the show, we are joined by Amy Cushner! Amy has dedicated more than 30 years to the Shelton School and a lifetime to advocating for neurodivergent individuals, infusing passion, humor, and wisdom into every stage she graces. From classrooms in Dallas to conferences in China, she has become a sought-after voice championing inclusive, strengths-based approaches across both education and business.. In this episode, Amy breaks down the important differences between accommodations, modifications, and remediation in the education system, explaining how these terms are often used interchangeably but have distinct purposes that can significantly impact a child's learning journey. Amy discusses the historical context, which traces back to Thomas Jefferson's vision for public education and the challenges of the "Goldilocks effect," ensuring the right fit for every student. She highlights why it's so important to understand the “magic number” that determines when remediation is provided, highlighting that the need for support does not disappear just because a student falls short of the threshold. Amy stresses the importance of understanding important distinctions as they have major implications for a student's educational journey, particularly when it comes to college and career choices, and she also emphasizes the crucial role of early intervention and the empowerment of students to self-advocate, using visual cues and clear communication about their accommodations. Throughout our conversation, Amy shares some valuable insights and practical advice for parents and educators, highlighting the need for a collaborative approach and the recognition that every child's learning journey is unique.  Show Notes: [3:21] - Amy Cushner traces public education's evolution from Jefferson to modern challenges in individualized learning. [6:54] - Students often get accommodations when remediation or intervention is truly required. [7:12] - Amy criticizes rigid “magic number” cutoffs for remediation, calling them unfair and financially motivated. [9:13] - Accommodations, Amy explains, provide classroom access without altering expectations or content. [11:18] - Amy contrasts accommodations with modifications, which lower expectations to match processing or cognitive challenges. [13:54] - Amy highlights knowing accommodation vs. modification and likens it to learning another country's customs. [15:12] - Remediation can help develop missing skills caused by neurological learning differences, not intellectual deficits. [17:31] - Research shows us that remediation builds entirely new neural pathways, effectively rewiring students' brains. [20:17] - When schools won't fund remediation, parents have to seek external diagnoses and licensed therapists. [23:19] - Hear how true remediation requires trained therapists. [26:45] - Remediation needs to be paired with accommodations like audiobooks for full access. [27:39] - Amy explains how modifications alter curriculum expectations, influencing future school and college options. [30:02] - Amy suggests that teachers can use accommodations across the board to help build learning from the ground up. [32:32] - Starting instruction too high frustrates students, while accommodations let them build confidence gradually. [34:59] - Educational advocates help parents navigate laws, testing, and school obligations, helping to ease parental burdens. [38:10] - Timely intervention prevents years of lost learning caused by eligibility cutoffs. [41:21] - Amy encourages early remediation and teaching children to self-advocate for their accommodations. [44:29] - Honest conversations can help kids avoid developing inaccurate, damaging narratives about struggles. [45:48] - Amy reframes nonstandard brains as strengths that offer unique ways of seeing the world. [47:02] - What is the best way to get in touch with Amy Cushner? Links and Related Resources: “How to Initiate a Special Education Assessment” Episode 109: “IEP and 504 Plan Q&A with Vickie Brett and Amanda Selogie” Episode 164: “5 Keys to Productive IEPs with April Rehrig” Episode 218: “Understanding IEPs and 504 Plans: Which One Is Right for Your Child? - Marisol Chianello”   Connect with Us: Get on our Email List Book a Consultation Get Support and Connect with a ChildNEXUS Provider Register for Our “When Struggles Overlap” Live Webinar Email Dr. Wilson: drkiwilson@childnexus.com    Connect with Amy Cushner: Amy's LinkedIn Page Phone: 972-855-8949 Email: amy@aceservice.org   

In this episode of Ogletree Deakins' Litigation Lens podcast series, shareholders Michael Nail (Greenville) and Fiona Ong (Baltimore) dissect a Seventh Circuit Court of Appeals case concerning an accommodation request brought under the Rehabilitation Act. The speakers explain why the Seventh Circuit found the employer's alternative accommodation reasonable in a case involving a VA hospital employee's request for parking and scooter storage amid COVID-19-related entrance changes. Michael and Fiona—emphasize that accommodations must be effective, not perfect—and cover the interactive process, changing accommodations without proving undue hardship, and damages considerations.

Frommer's Author David McElhenny joined Pauline Frommer to discuss the culinary specialties of different Japanese regions, walking vacation opportunities that mirror the Camino de Santiago experience, ways to experience Japan's sizzling pop culture, and some strategies for saving money on a Japanese vacation.Takeaways:Transportation in country is one of the highest costs travelers face, but buying a Japan Rail Pass may save you money. A look at its pros and cons.Accommodations can also take a bite out of the budget, so we discussed what capsule hotels are like, plus the more conventional but still affordable options most travelers prefer. Japan's culinary offerings are diverse and budget-friendly. We took a look at convenience store meals, Tokyo's Ramen scene, and the foods eaten in a region of Japan that has the most centenarians. Visiting off-the-beaten path Japan will get you out into some stunning nature areas, and into communities that really need the tourist business.The Frommer's Travel Podcast was named one of the 13 best for travel by the New York Times. It is hosted by Pauline Frommer, the Publisher of the Frommer's guidebooks and Frommers.com, with new episodes issued weekly.Mentioned in this episode:Check out the Smart Travel PodcastThis week's show is supported by the new Smart Travel Podcast. Travel smarter — and spend less — with help from NerdWallet. Check out Smart Travel at the Link below:Smart Travel Podcast

Interviewees: Matthew Sullivan, PhD, Assistant Director of Disability Resources, Washington University School of Medicine in St. Louis Suchita “Suchi” Rastogi, PhD. MPH Candidate, University of Illinois Chicago; CEO, Disability in Medicine Mutual Mentorship Program Interviewer: Lisa Meeks, PhD, MA, Guest Editor, Academic Medicine Supplement on Disability Inclusion in Undergraduate Medical Education Description: In this episode of Stories Behind the Science, Dr. Lisa Meeks talks with Matt Sullivan (Washington University School of Medicine) and Suchita “Suchi” Rastogi (UIC; DM3P) about their paper, “Standardized Language for Clinical Accommodations in U.S. Undergraduate Medical Training: Results From a National Modified Delphi Consensus Study,”part of the Academic Medicine supplement on Disability Inclusion in UME. Their conversation explores how a grassroots idea—born from students' lived experiences and practitioners' urgent need for clarity—grew into the first national, evidence-based language guide for clinical accommodations. Together, they unpack how a modified Delphi process brought students, Disability Resource Professionals, and leaders together to build consensus around the precise language that transforms intention into implementation. The trio discuss how language and word choices can make the difference between support and confusion, and how transparent, shared language strengthens trust and access for all. Dr. Meeks, Sullivan, and Rastogi also reflect on the collaborative model that made this project possible—one that centers disabled voices, encourages vulnerability in leadership, and demonstrates how clarity in communication is the foundation of equity. Listeners will come away with practical takeaways for institutions and leaders: audit your accommodation templates, build structured partnerships between DRPs and Student Affairs, and engage students as co-creators in designing accessible clinical environments. Transcript: https://docs.google.com/document/d/1ooJ5TP8V8s4t35EECoWHNTta7qqwbKlx-Fgu_WIiPG4/edit?usp=sharing Bios: Matt Sullivan PhD Dr. Sullivan is the Assistant Director of Disability Resources, At Washington University in St. Louis, and serves as DR's liaison to WashU's School of Medicine, acting as the primary contact for SoM faculty/staff, students, and prospective students.  In this role, Matt works closely with all parties to create an accessible and inclusive educational environment for disabled students pursuing their degrees within Health Sciences and Medicine. Dr. Sullivan is a research-oriented practitioner dedicated to promoting disability awareness and inclusion within the higher education environment.  In his student affairs roles, Dr. Sullivan has experience providing leadership and direction for a variety of programs and services in the areas of disability, testing, tutoring, Supplemental Instruction, and academic coaching.  Working in the field of disability services for more than a decade, Matt has dedicated his time and energy to the education and development of students, faculty, and staff surrounding the intersectionality of disability with race, culture, gender, and other prominent identity factors. Suchita “Suchi” Rastogi PhD Suchi is an MPH student at the University of Illinois Chicago and CEO of the Disability in Medicine Mutual Mentorship Program (DM3P). A former MD-PhD student at Stanford University, she advocates for accessible medical education and leads community-based efforts to promote disability inclusion and peer mentorship. As a South Asian disability activist, she values health equity and compassionately designed systems that serve all people with dignity. She believes everyone deserves respect, access to material resources, and psychosocial support. These values compel her to improve healthcare and public health infrastructure for disabled patients, increase disability representation in medicine, and shift attitudes towards persons with disability. To accomplish this, she 1) run a mentorship program (DM3P) for healthcare professionals with disability, 2) conducts disability health equity research, and 3) advocates for evidence-based policies that center accessibility. Key Words: Clinical accommodations · Disability inclusion · Medical students · Disability Resource Professionals ADA Resources: Article from Today's Talk: Dhanani Z, Rastogi S, Sullivan M, Betchkal R, Poullos P, Meeks LM. Standardized Language for Clinical Accommodations in U.S. Undergraduate Medical Training: Results From a National Modified Delphi Consensus Study.Academic Medicine. 2025;100(10S):S92–S97. DOI: 10.1097/ACM.0000000000006150 Read the full article here → Equal Access for Students with Disabilities: The Guide for Health Science and Professional Education (2nd Ed). Meeks LM, Jain NR, & Laird EP. Springer Publishing, 2020. Read here → The Docs With Disabilities Podcast: https://www.docswithdisabilities.org/docswithpodcast

This week, Dave welcomes back his good friend Jeff Copper of DIG Coaching for a vital discussion tailored for the busy professional navigating life with ADHD. Many with ADHD excel at problem-solving for others, but often struggle to implement those same solutions for themselves. This episode dives into the concept of executive function impairment and introduces a new approach. Jeff shares how this model provides a simple, actionable, and universal accommodation to help mitigate the challenges of ADHD and burnout. Tune in to understand why direct communication is the most basic, yet often overlooked, tool for achieving clarity with Adult ADHD. Key Discussion Points ADHD and Problem Solving: Individuals with ADHD are often excellent problem solvers and "connect the dots" better than others, but struggle to apply these skills to their own lives. The Role of Executive Functions: ADHD is defined as an executive function impairment, meaning the "mind tools" used for problem-solving (planning, organizing, decision-making) are less efficient, requiring much greater effort in some cases. Strategies vs. Execution: Having a plan or strategy isn't enough; the difficulty lies in the execution which requires intensive use of executive functions. Cognitive Ergonomics from the Inside Out: Jeff Copper's model posits that direct communication (talking things through in real-time) is a universal accommodation for ADHD. Communication as an Accommodation: Language evolved to solve shared problems, making direct, collaborative conversation the most fundamental form of problem-solving. People with ADHD simply need this accommodation more. The Power of Clarity: The majority of procrastination is rooted in ambiguity, which direct communication is designed to resolve. **Do you want to work with Dave one-on-one? Go to www.overcomingdistractions.com and book an introductory Zoom chat. Or go directly to Dave's calendar; https://calendly.com/davidgreenwood1/15min  

As tensions arise between the US and China over critical minerals, could Australia be the key player to reshape the balance? Private credit under the microscope as investors dive in, and regulators ponder what to do next. Women seek better understanding around menopause in the office. Gold price defies gravity again. And the ASX wipes off all the gains it made towards records. Interviews with: Robert Makdissi, Investment Manager at Akambo & Kathryn Carter, MyPause Health founder Email us your thoughts to moneynews@nine.com.au Hosted by: Tom StoreySee omnystudio.com/listener for privacy information.

Dr. Monty Pal and Dr. Fumiko Chino discuss several of the top abstracts presented at the 2025 ASCO Quality Care Symposium, including research on federally funded clinical trials and financial reimbursement for trial participation. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I am your host, Dr. Monty Pal. I am a medical oncologist, professor, and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. Today, we are highlighting key abstracts that were presented at the 2025 ASCO Quality Care Symposium. I am delighted to be joined today by the chair of this year's meeting, Dr. Fumiko Chino. Dr. Chino is an associate professor in radiation oncology at MD Anderson Cancer Center with a research focus on access, affordability, and equity. She is also a consultant editor of JCO Oncology Practice and the host of the Put into Practice podcast. I have got to listen to that.  Dr. Chino, welcome, and thanks so much for being on the podcast today. Dr. Fumiko Chino: I am overjoyed to be here, and absolutely, you should take a listen. Dr. Monty Pal: Definitely. And FYI for listeners, our full disclosures are all available in the transcript of this episode, so do have a look if you are inclined. Now, we have really seen some fantastic advances in health services and quality and supportive care, digital health, and beyond. There are some great abstracts that were presented at this year's meeting. I have actually picked a couple that I am particularly interested in and that I believe you share my interest in as well.  So, the first is an abstract actually from my friends at SWOG (Abstract 94). So, this was a terrific abstract from Joe Unger and Michael LeBlanc and Dawn Hershman. And this, I think, really hits on a very, very key issue right now, which is the benefit of federally funded trials. Do you mind just kind of spelling out some of the observations from what I think is a really brilliant piece of work? Dr. Fumiko Chino: Absolutely, and I think Dr. Unger's work is really important for our current funding environment. I think that this research is really essential to do to show the role of federal sponsorship in the design and conduct of clinical trials. Because what they did was really look at a landscape analysis over the last 20 years looking at funding and were able to show quite clearly that federal funding really matters for advancing the science in cancer care. So what they showed was that the federal funding was more commonly essential for early-stage clinical trials, so those phase 1, phase 2 trials that really help advance the science. And that federal funding was really essential for multimodality drug combinations, combinations with drug and surgery, combinations with drug and radiation. Those trials were much more likely to be federal funded. And then the last thing is that they showed that the patients that are, I think, the largest at risk for gaps in care who really need the advancements in science that keep U.S. health care amazing and wonderful and world-leading, so the kids, the pediatric patients, the patients with rare cancers, and the patients actually that could benefit from de-escalation or right-sizing of treatment, they were also all more likely to have federal funding. So I think this research that was presented really shows that if, unfortunately, current status of restricted federal funding continues, that we are going to lose out in terms of the next generation of cancer cures, cancer de-escalations, and the type of combination treatments that make advancements in science. Dr. Monty Pal: Indeed. You know, I always point to Joe Unger's paper, and I think it is in JAMA Oncology, right, that showed life-years gained from NCI trials. It is such an important piece of work. I think this is a really nice complement to that, isn't it, to show the specific areas that otherwise would be, am I right in saying, kind of largely untouched? Dr. Fumiko Chino: I think you are right in that what we know from what industry will sponsor versus what the federal government will sponsor, that the federal government really helps make up the gap to really make those advancements that save lives, that lead to more birthdays, that advance our knowledge and our capacity for providing more cures and more successful futures for our patients. I always like pointing to the de-escalation research, which is, and this is not to dig pharma, but no pharmaceutical company is going to run a trial that says you can give less of their drug, right? It just does not make sense for the business end of the science. And so, thinking about how to right-size treatments, how to do more with less, that really is the purview of the federal government. Dr. Monty Pal: Absolutely. Absolutely.  I am going to shift gears here and bring up another abstract that I found to be quite intriguing, and this relates to reimbursement of expenses, et cetera, for clinical trials. This is an abstract from Courtney Williams and team. It brings to mind the importance, I think, of recognizing the hardships that patients take on by clinical trials, but I also would love for you to comment on that sort of fine line between reimbursement for expenses and then, you know, sort of undue enticement. It is a challenging balance there. But give me your reflections on this abstract. Dr. Fumiko Chino: Absolutely. You are speaking about Dr. Williams' Abstract 93 from the Alabama group, and Alabama actually has this incredible group of health services researchers which is, are doing really important work in this space. What this trial shows is that, you know, it is a small pilot study, it is 30-something patients that received some support primarily for their travel and additional expenses related to their clinical trial participation for breast cancer. It showed that the money helps, and I think what we all know is that it is expensive to participate in clinical trials. It requires additional visits. It often requires some significant travel burden for our patients, and I do not feel that money reimbursement for clinical trial expenses is an inducement. Nobody participates in a clinical trial to get the money for their gas, right? We know that our patients are making some pretty significant sacrifices in order to participate in clinical trials, and what this type of program does is just actually reimburse them for their outlaying of funds.  And I loved this trial because the patients were actually given $1,000 a month for the first 4 months of their trial participation, and what the study showed is that the patients were using it for things like travel-related food, for things like transportation, caregiver expenses, or even some of their out-of-pocket medical expenses like cost sharing or prescriptions. And that they said that overall, the reimbursement really made a difference in terms of their capacity for staying on the clinical trial. Because we know our clinical trials really are not able to enroll the full diversity of patients that often have a disease, and that the patients that are at biggest risk for a health care disparity or a gap in care are also the least likely to enroll in a clinical trial.  Programs like this are an essential part of showing how financial toxicity can be overcome with pretty straightforward assistance to patients to help reimburse them for the things that they are already taking out of their pocket, for parking costs, for that $10 soup that they buy at the cancer center, for those additional expenses that we are, unfortunately, putting on them. Dr. Monty Pal: Very well said. And you know, I have started to dabble in clinical trials looking at CAR T-cell therapies for kidney cancer, and I have to tell you, it is just insane the amount of cost that a patient would have to take on to comply with the stipulations for some of these novel therapies. We require that they stay within 30 minutes of the facility for 28 days, and unless we are compensating for some of that, I mean, how can one afford a hotel stay that is that long? I mean, it is just, it is unprecedented, and it would certainly provide a huge barrier to many patients who would otherwise enroll. Really well said. I also wanted to bring up another financially driven topic, and treating renal cell, again, I would say the vast majority, 90% plus of my patients in clinic are on oral drug therapies. And I cannot tell you how often a patient will show up in my practice and say, "Doc, I have got 15 days out of this 30-day prescription left. What do I do with it?" You know, or some come with pill bottles from a deceased loved one. And it is so frustrating to say, "Take it to the pharmacy and they will just get rid of it for you." But sounds like there is an abstract from Dr. Mackler, Abstract 102, that seems to address this topic quite well. Am I right? Dr. Fumiko Chino: Absolutely. This presentation, I was the most excited about seeing because this group, which helps run a cancer drug repository, theirs is called YesRx, presented their data from the last approximately two years of running this repository, and they were able to show incredible benefit for their patients in Michigan. And it is a really straightforward program. It is run by pharmacists. It has support from the legislation in Michigan. And what they were able to show is that they repurposed medications that would otherwise have been discarded. They delivered them directly to the oncologist, which then actually dispersed them to the patients. They helped 1,000 patients in less than two years. They saved them millions of dollars, over $15 million presented in the abstract. And it is just a win-win-win because I know that patients actually, and sometimes patient caregivers, they feel very sad to have spent a lot of money out of pocket for their medication, and then if they have a dose reduction or, obviously, you know, if the surviving spouse then has to get rid of their medication, just dispose of them, it is very disheartening. And this is a way of kind of reclaiming power for patients. So they were able to accept donations from all over the state of Michigan and then also help over 1,000 patients. And so, it is a phenomenal program. Dr. Monty Pal: Just wild when I came across the dollar amounts, right, that they were saving. It just, it seems like a place that, you know, we just have to look, as cancer centers, right, and really take this on. Just brilliant. On that same theme of cost savings and so forth, you know, I think there has been a lot of focus on what recent policies have done in the context of us having access to therapies and so forth. And one of the topics that has come up is the Inflation Reduction Act and how changes pertaining to the IRA have really played a role in one's ability to take on some of these expensive prescriptions. And I believe John Lin and colleagues tackled that issue in Abstract 97. Could you comment on that, Fumiko? Dr. Fumiko Chino: Absolutely. Dr. Lin is one of my colleagues here at MD Anderson, so I know him very well, and he has been doing really phenomenal work over the last several years with looking at drug affordability and access. And what his analysis shows is that for patients, after the Inflation Reduction Act's cap on out-of-pocket expenses, is that it really did show that out-of-pocket expenses decreased. So what the Inflation Reduction Act did is that it eliminated the 5% co-insurance and placed this $2,000 cap on out-of-pocket expenses. And what that led to for these patients that were not able to have the low-income subsidy is that there were lower costs, and that there was a lower rate of drug abandonment, meaning that the prescription was not refilled. There was also a lower rate of unfilled prescriptions as well. And I think that it shows that health policy really can improve access to care. I think the flip side of the fact that the IRA, this policy, really did seem to help people is that what his research showed is that actually, even with the benefits of this cap, is that actually it is still really high in terms of the rate of people who are not able to fill their prescriptions or that completely abandon them over time. And that unfortunately, even with this change, that over half of people without the low-income subsidy were potentially not getting the full benefit of their medications because they were not able to afford them. And so I think it really kind of highlights that we still need to do more work about making drugs affordable. Dr. Monty Pal: Indeed, indeed. And I mean, in a setting like this, I mean, I think it is important to recognize that $2,000 is a lot, it is a big chunk of change, right, for a lot of families in the U.S. What do you think of the prospect of, like, decreasing that cap? Is that something that from a policy standpoint you would be supportive of? Dr. Fumiko Chino: Well, so something that is a real option for patients on Medicare is there is something called the Medicare Prescription Payment Plan, and what it allows you to do is actually prorate the $2,000 over the whole year. And so instead of having to pay $2,000 as soon as you fill your prescription, because you are going to have, if you have an expensive medication, it is essentially you have to pay the $2,000 in January, right? It allows you to prorate it, so essentially $170 a month, and that comes to you as like a regular bill. And I think that as rolled out as part of the IRA is a really lovely way of thinking about how do we make these payments more stable over time, so it is not a huge hit sort of at the beginning of the year. And I think that alone actually can make a difference in terms of trying to help make sure that people can actually get their medications. Dr. Monty Pal: That is an excellent tip. Excellent tip.  We are going to shift gears entirely. We have been talking a lot about the dollars and cents of things and talk about an abstract from Sophia Smith and colleagues. So this is Abstract 550 at your meeting. And this hinged on a program of sorts to deal with post-traumatic stress disorder. We do not often think about PTSD in the vernacular for oncology patients, but indeed, I mean, it is something that they must face, especially in the context of long-term survivorship. Can you talk a little bit about Dr. Smith's abstract? Dr. Fumiko Chino: Absolutely. I love this work from Dr. Smith, who is at Duke. She worked with Dr. Applebaum, who was my old colleague at Memorial Sloan Kettering. And this group of researchers really is trying to figure out how to best support people into survivorship so that they can actually thrive. And their patient population for this work was actually people who received stem cell transplant, and they focused on people who had PTSD symptoms. And what they were able to show through this SMART design, which is essentially this serial, multiple randomized trial, so everyone got randomized upfront to either usual care or this app, so this digital app that actually helped coach people through cancer distress. And then for the people who were non-responders, they were then additionally randomized to either the app plus coaching or a therapist versus the cognitive behavioral therapy or CBT.  And what they were able to show is that, number one, anyone who had the app seemed like they did better than those who did not start the path with the app. But then the additional help of either the therapist or the coach or the CBT made additional benefit over time. And so, I think this shows a really nice stepped care, which is you can potentially have some right-sizing of treatments cost saving, if we sort of give everyone the app, which is, I think, overall pretty low cost. And that for the people who do not get the full benefit from the app, then you can think about these maybe more tailored approaches, the therapist, the coach, the CBT, but that some people actually just respond to the app. And I think it allows us to, again, right-size the care for our patients. And I think it is really innovative to think about how technology can help improve access to care in the setting of something like PTSD. Dr. Monty Pal: Brilliant summary. Brilliant summary.  Gosh, it looks like such an exciting meeting this year. Congratulations on a terrific program for the ASCO Quality Care Symposium. I know you played a huge role in developing it, and thanks for sharing your insights on the ASCO Daily News Podcast. Dr. Fumiko Chino: No, I really appreciate you having me. ASCO Quality is my favorite meeting of the year. You know, it is really a phenomenal meeting, and I am so excited for next year in Boston in 2026. Dr. Monty Pal: Awesome. And thanks to our listeners too. You are going to find links to all the abstracts that we discussed today in the transcript of this episode. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. More on today's speakers: Dr. Sumanta (Monty) Pal  @montypal Dr. Fumiko Chino @fumikochino Follow ASCO on social media: @ASCO on Twitter ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures of Potential Conflicts of Interest: Dr. Monty Pal:     Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis Dr. Fumiko Chino:  Consulting or Advisory Role: Institute for Value Based Medicine Research Funding: Merck

On this episode of The Steve Dangle Podcast, 00:00 Leafs beat the Preds 54:45 A great Ducks giveaway 1:02:30 Rangers lose at home again 1:11:00 The Sharks owner speaks 1:25:30 A Sharks giveaway 1:28:00 Adam's Pittsburgh fat guy corner 1:42:00 Accommodations for NHLers at the Olympics Donate to Steve's Easter Seals page: https://eastersealsontario.akaraisin.com/ui/lindros2025/p/078df4e3c0c444d59a551259d78a749e Donate to Adam's Easter Seals page: https://eastersealsontario.akaraisin.com/ui/lindros2025/p/12938347f56e4b2eab06c3a423a727f6 Donate to Jesse's Easter Seals page: https://eastersealsontario.akaraisin.com/ui/lindros2025/p/f58403a20caa4b47a17e19cf86c198d9 Visit this episode's sponsors: Grab a pack today.  Visit your local Tim Hortons, or download the Tims App, to start collecting Tim Horton's NHL Hockey Trading Cards. Grab your EXCLUSIVE NordVPN Deal by going to https://nordvpn.com/dangle to get a Huge Discount off your NordVPN Plan + 4 additional months on top! It's completely risk-free with Nord's 30-day money-back guarantee! Hope in Every Step is more than a walk — it's a movement. Held this year at Spencer Smith Park in Burlington on November 1st, the event brings our community together to stand against gender-based violence. Visit https://hope-in-every-step.raiselysite.com/donate for more information. Join us at The Rec Room: https://sdpn.ticketspice.com/sdp-x-the-rec-room Join Drew & Stew Pick Em' ➡️ https://app.sparc.fun/point-spread/dspe Check out https://sdpn.ca/events to see The Steve Dangle Podcast live! Subscribe to the sdpn YouTube Channel: https://www.youtube.com/@sdpn?sub_confirmation=1Join - SDP VIP: YouTube: https://www.youtube.com/channel/UC0a0z05HiddEn7k6OGnDprg/join Apple Podcasts: https://apple.co/thestevedanglepodcast Spotify: https://podcasters.spotify.com/pod/show/sdpvip/subscribe - Follow us on Twitter: @Steve_Dangle, @AdamWylde, & @JesseBlake Follow us on Instagram: @SteveDangle, @AdamWylde, & @Jesse.BlakeJoin us on Discord: https://discord.com/invite/MtTmw9rrz7 For general inquiries email: info@sdpn.ca Reach out to https://www.sdpn.ca/sales to connect with our sales team and discuss the opportunity to integrate your brand within our content! Learn more about your ad choices. Visit megaphone.fm/adchoices

In this week's episode of Special Education for Beginners, we're continuing our October series all about writing IEPs that are clear, meaningful, and truly connected.So far this month, we've talked about how your Present Levels (PLAAFPs) act as the blueprint of the IEP and how to use that information to write strong, measurable goals. Now we're moving one step further — connecting those goals to the services, accommodations, and supports that make them work in practice.If you've ever caught yourself copying last year's IEP just to “save time,” you're not alone. But today, we're hitting reset and walking through five simple steps to make sure every service and accommodation in your IEP is backed by data and directly connected to your student's current needs.In this episode, you'll learn:✅ How to use data from the Present Levels to guide your decisions✅ What questions to ask yourself before adding or adjusting services✅ How to ensure every support ties back to an IEP goal✅ Why alignment matters for both compliance and student success✅ Tips for knowing when it's time to remove outdated accommodations or servicesPlus, I'm sharing how AI tools can actually help you pull out student strengths and needs more efficiently — without replacing your professional judgment. If you want to try this for yourself, check out my resource Using AI to Write IEPs: Identifying Strengths and Needs, which walks you step-by-step through how to use AI responsibly to analyze data and identify key areas for growth. And if you're looking for more support with goal writing, my IEP Goal and PLAAFP Forms are designed to simplify the process while keeping your writing precise, professional, and personalized.

Accommodating neurodiversity doesn't have to mean resentment or burnout. In this episode, we explore how a neurodiverse relationship can thrive when both partners learn to balance self-accommodation and mutual respect. Coaches Jeremy & Charity Rochford show how neurodivergent partners can self-accommodate (not outsource to neurotypical spouses) and how neurotypical partners can set boundaries that protect their own bandwidth. You'll learn concrete tools—transition buffers, noise strategies, visual timers—and how a shared relationship system replaces score-keeping with reciprocity. If you've been told to “just run” from a neurodiverse relationship, this episode offers a smarter path. Jeremy (autistic) & Charity (neurotypical) (hosts of the NeuroFam podcast) join Jodi to show how reframing autism/ADHD from problem to predictable pattern unlocks real solutions. We dig into practical rituals that improve connection without enmeshment, plus we explore why “effort is invisible” and how accommodations can increase connection instead of being sacrifices for either partner. Jeremy explains his “software upgrade” mindset (strengthening theory of mind/executive function like training a muscle), while Charity shares how compassion + structure reduce resentment. You'll leave with scripts, rituals, and a way to accommodate needs without erasing yourself. 00:00 – Welcome to Season Five 01:00 – Meet Jeremy & Charity 04:45 – Autism isn't the problem: Updating the ‘80s narrative 09:40 – How kid diagnoses led to adult discoveries (and relief) 14:20 – Compassion shifts: Seeing sensory overload vs. “too much” 18:30 – “Software upgrades”: Building empathy & executive function 22:10 – Accommodations that work: Earbuds, car rules, visual timers 29:10 – Resentment vs reciprocity: Why effort is invisible 33:00 – Build a marriage system: Make expectations explicit 35:20 – Accommodate without erasing yourself (Disney example)

Parents often rely on their usual parenting strategies to help their child with OCD — but those same strategies can actually backfire. In this episode, I break down the most common approaches parents try and explain why they don't work when it comes to OCD.If you've ever felt stuck, repeating the same things without progress, this episode will help you understand why and what to do differently.To get the PDF handout that supplements this episode go to www.natashadaniels.com/episode440✨ Get 50% off all my courses and workshops until December 18, 2025 11:59pm in honor of OCD Awareness Week. Go to AT Parenting Survival School and use the coupon code OCDAWARENESS2025.Links mentioned in podcast:Podcast: Validation vs Accommodations in OCDPodcast: Developing Effective Incentive PlansReel: Distraction vs Refocusing***This podcast episode is sponsored by NOCD. NOCD provides online OCD therapy in the US, UK, Australia and Canada. To schedule your free 15 minute consultation to see if NOCD is a right fit for you and your child, go tohttps://go.treatmyocd.com/at_parentingThis podcast is for informational purposes only and should not be used to replace the guidance of a qualified professional.Parents, do you need more support?

Thanks for joining me, Holly Blanc Moses - The Mom/Neurodivergent Therapist, on The Autism ADHD Podcast. Is a neurodivergent student in your life struggling at school?  You're not alone—and there ARE supports that actually work. In this episode, I'm breaking down 5 game-changing school accommodations based on what parents, therapists, and educators are searching for most: communication supports, sensory regulation, executive functioning help, and more. These aren't vague suggestions—they're real examples you can implement in the classroom, recommend in evaluations, or request in IEP and 504 meetings. These 5 supports help in the areas of communication, regulation, executive functioning, writing, social interaction and mental health!  Perfect For: Parents preparing for IEP or 504 meetings and advocating for your child's needs. Therapists identifying school supports that will help clients emotionally, socially and academically. Educators looking for practical classroom strategies that work.  

This week on the Power of Owning Your Career Podcast, host Simone Morris welcomes Charlotte Dales, co-founder and CEO of Inclusively, for a lively and insightful discussion on charting your own course and building inclusive workplaces. Charlotte shares her remarkable journey—from banking at Deutsche Bank to starting successful companies and sparking positive change after being inspired by her cousin's achievements. Tune in for actionable tips on handling rejection, planning bold career moves, leveraging technology for growth, and embracing a mindset that keeps you in the driver's seat—no matter where you're starting from. Episode Highlights & Timestamps: [00:00] Intro to Charlotte & Overview of Inclusively [00:03] Charlotte's early career aspirations and pivot to finance [00:07] If your career were a book—Charlotte's title & philosophy [00:08] The formula for owning your career: key ingredients and mindsets [00:10] Stories of rejection, resilience, and not taking no for an answer [00:17] Strategies for self-advocacy and pitching yourself [00:19] Game-changing career resources (including Blinkist & AI) [00:22] Realizing you're in the driver's seat: the London story [00:23] Charlotte's parting words on perseverance and choice [00:24] How to connect with Charlotte and Inclusively Learn More & Get Involved: Learn more about host Simone E. Morris: LinkedIn Apply or recommend a guest: Become a Guest on the Show Looking for career support from Simone? Visit 52 Tips for Owning Your Career Connect with Charlotte: Inclusively: Website Charlotte Dales on LinkedIn: LinkedIn Follow & Subscribe: Follow us on social @simonemorrisent for updates & success tips! Subscribe for more inspiring guests and actionable career episodes.

Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma.  The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation.  And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point.  Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival.  Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect.  And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored.  And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival.  So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient.  Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity.  And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease.  So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology.  Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca      

Beau Martonik heads to Nebraska for an early-season deer camp with Thomas & Nate Krick (Identical Draw), Ben Dettamanti (Shed Crazy), Joel Burham (Whitetail Fit), and Josh Ilderton (The Untamed). The crew dives into what makes deer camp special—camaraderie, laughs, and lessons learned along the way. From spider stick pranks and quicksand mishaps to scouting strategies and close encounters, this episode of the East Meets West Hunt podcast captures the spirit of chasing whitetails together. Topics: 00:00:00 - Intro 00:04:11 – Introductions 00:06:30 – The Idea Behind This Camp 00:11:13 – Ben's Whitetail Perspective 00:13:07 – Spider Stick Shenanigans 00:15:25 – The Food Sources Debate 00:21:05 – The Quicksand Experience 00:23:41 – The Last Stand 00:29:07 – Ben's Shed Tour 00:32:05 – Nate's Buck 00:51:03 – Guest Switch - Josh Ilderton and Joel Burham 00:55:21 – Camp Life and Accommodations 01:00:22 – Hunting Timber vs. Agriculture 01:15:31 – Evening Strategies 01:22:36 – Wrapping Up the Adventure Resources: Joel Burham (Whitetail Fit) - YouTube and IG Identical Draw - YouTube and IG The Untamed - YouTube and IG Shed Crazy - YouTube and IG Instagram:   ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@eastmeetswesthunt⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@beau.martonik⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook:   ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠East Meets West Outdoors⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Shop Hunting Gear and Apparel: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eastmeetswesthunt.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ YouTube: Beau Martonik - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCQJon93sYfu9HUMKpCMps3w⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Partner Discounts and Affiliate Links: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.eastmeetswesthunt.com/partners⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Amazon Influencer Page ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/beau.martonik⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Monty Pal and Dr. Matteo Lambertini discuss a compelling global study on the clinical behavior of breast cancer in young BRCA1 and BRCA2 carriers, the association of pre-diagnostic awareness of BRCA status with prognosis, and the importance of identifying healthy people who are at risk of carrying the BRCA1/2 pathogenic variants. TRANSCRIPT Dr. Monty Pal: Well, hello everyone, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist, professor, and vice chair of medical oncology at the City of Hope Comprehensive Cancer Center in Los Angeles. Now, when we think about genetic testing, whether for patients diagnosed with breast cancer or for other family members of them, it seems to be widely underutilized. Today, we're going to be discussing a recently published study in the Journal of Clinical Oncology that reported on the clinical behavior of breast cancer and specifically young BRCA1 and BRCA2 carriers, and the association of pre-diagnostic awareness of BRCA status with prognosis. I thought this was just a fascinating piece, and I honestly couldn't wait to have this conversation. It's a really compelling paper that highlights the importance of identifying healthy people who are at risk of carrying the BRCA1/2 pathogenic variants, and really the need for genetic counseling and testing to inform people about early detection that could lead to a better prognosis. I'm really delighted to welcome the study's lead author, Dr. Matteo Lambertini. He really needs no introduction. He's very well known in the breast cancer world for his amazing contributions to fertility in the context of breast cancer, to pregnancy in the context of breast cancer, and genetic testing. He's an associate professor at the University of Genova, and a breast cancer medical oncologist at the San Martino Polyclinic Hospital in Genova, Italy.  Dr. Lambertini, thank you so much for joining us today. Dr. Matteo Lambertini: Thank you very much, Dr. Pal. It's a great pleasure. Dr. Monty Pal: Oh, thanks. And just FYI, if you're listening in and you want to hear our disclosures, they're all listed at the transcript of this podcast.  So, I poured through this paper [Clinical Behavior of Breast Cancer in Young BRCA Carriers and Prediagnostic Awareness of Germline BRCA Status] yesterday, Dr. Lambertini, and first of all, congratulations on this study. This was a huge international multicenter effort, 4,752 patients. How did you pool all these patients with young breast cancer? Dr. Matteo Lambertini: Thanks a lot for the question. Yes, this was an effort made by several centers all over the world. The main idea behind the creation of this network that we have named as BRCA BCY Collaboration, was to get as many data as possible in a sort of niche patient population in the breast cancer field, meaning women diagnosed with breast cancer at the age of 40 years or younger, and all of them being BRCA carriers. We know that around, in the Western world, around 5% of breast cancer cases are being diagnosed under the age of 40 years, and among them around 10-15% are BRCA carriers. So, I would say it's a relatively rare patient population where we did not have a lot of evidence to support our choices in terms of counseling on treatment, prevention, and oncofertility as well. That was the idea behind the creation of this network that includes many centers. Dr. Monty Pal: Yeah. You know, what's so interesting about this is that you sort of draw this line between patients who have BRCA testing at the time of diagnosis and then BRCA testing earlier in their course and then leading to a diagnosis perhaps. And I think that's where really sort of the dichotomy in outcome sits. Can you maybe elaborate on this and tell us about timing of genetic testing in this study and what that meant ultimately in terms of prognosis? Dr. Matteo Lambertini: In this specific analysis from this large network, including almost 5,000 women with breast cancer diagnosed at the age of 40 years or younger and being a BRCA carrier, we looked specifically into the timing of genetic testing because this is a retrospective study and the criteria for inclusion are those that I have just mentioned, so diagnosis at a young age plus carrying germline BRCA pathogenic or likely pathogenic variant. In this analysis, we have looked into the time the patient has got the genetic testing and particular we focused on two populations: those that were diagnosed, knowing already to be a BRCA carrier, and those that got tested after being diagnosed with breast cancer. And the main findings from this analysis have been that knowing to be a BRCA carrier was associated with a lower stage at the time of diagnosis, meaning more T1 tumors, so a tumor less than 2 cm, more node-negative disease, and this translated into less aggressive treatment, so less often axillary dissection, less often use of chemotherapy and anthracycline-based chemotherapy. And even more importantly, we have seen a better overall survival for those patients that were diagnosed already knowing to be BRCA carriers as compared to those tested after breast cancer diagnosis. These results after adjusting for all the confounding, stage, treatment and so on, there was not significant anymore, meaning that it's not the timing of test per se that is probably leading to a better survival, but it is the fact that knowing to be a BRCA carrier would likely translate into having access to all the preventive measures that we have in this setting and this will translate into an overall survival benefit, so in terms of saving more lives in young BRCA carriers. Dr. Monty Pal: I think it's such an important point, and it's one that I think might sound implicit, right, but it needs to be proven, I think, through a study like this. You know, the fact that finding this early, identifying the mutation, doing enhanced screening, and so forth, is really going to lead to superior clinical outcomes. One of the things that I think many people puzzle over, including myself, is what to do? I personally occasionally will see BRCA altered patients in the context of prostate cancer. But that's a very different population of individuals, right? Typically older men. In young females with BRCA mutation, I guess there's a specific set of considerations around reproductive health. You'd already highlighted preventive strategies, but what sorts of things should we be talking about in the clinics once a patient's diagnosed and once perhaps their breast cancer diagnosis is established? Dr. Matteo Lambertini: Yes, exactly. Knowing to be a BRCA carrier has a lot of implications from prevention to treatment to survivorship issues including reproductive counseling. And this is important not only for the patient that has been diagnosed with breast cancer but also for all the family members that will get tested and maybe identify with this sort of genetic alteration before diagnosis of cancer. Why this is important is because we have access to very effective preventive measures, a few examples: MRI screening, which starts at a very young age and normally young women don't have an effective screening strategy outside the BRCA field. Also, primary preventive measures, for example, risk-reducing surgery. These women are known to have a high risk of breast cancer and high risk of ovarian cancer. So the guidelines are suggesting to undergo risk-reducing salpingo-oophorectomy at a young age, so 35 to 40 years in BRCA1 carrier, 40 to 45 years in BRCA2 carrier. And also risk-reducing mastectomy should be discussed because it is a very effective way to prevent the occurrence of breast cancer. And in some situations, including the setting that we are talking about, so young women with breast cancer, BRCA carrier, also risk-reducing mastectomy has shown to improve overall survival.  On the other side, once diagnosed with breast cancer, nowadays knowing to be or not a BRCA carrier can make a difference in terms of treatment. We have PARP inhibitors in the early setting, in the adjuvant setting as well as in the metastatic setting. And in terms of survivorship implication, one of the critical aspects for young women is the oncofertility care which is even more complicated when we talk about BRCA carriers that are women candidates for gynecological surgery at a very young age. So this sort of counseling is even more complicated. Dr. Monty Pal: One of the other things, and this is subtle in your paper and I hope you don't mind me bringing it up, is the difference between BRCA1 and BRCA2. It really got me thinking about that because there are differences in phenotype and manifestation. Do you mind just expanding on that a little bit for the audience because I think that's a really important reminder that you brought up in the discussion? Dr. Matteo Lambertini: The difference between BRCA1 and BRCA2 carriers has been known that there are different phenotypes of breast cancer that are more often diagnosed in these two different populations. Normally BRCA1 carriers have a higher likelihood to develop a triple negative breast cancer as compared to BRCA2 carriers, more likely to develop a hormone receptor-positive HER2-negative disease. In this study, again, a specific population of young women with breast cancer, we have seen the same findings, mostly triple negative disease in BRCA1 carrier, mostly luminal-like disease in BRCA2 carrier. But what's novel or interesting from this study is to look also at the age at the time of diagnosis of this disease. And particularly in BRCA1 carriers, we should be sort of more careful about diagnosis of breast cancer and also other primary tumors including ovarian cancer because the risk of developing these malignancies is higher even at a younger age as compared to BRCA2 carriers. And this has implications also in the primary and secondary prevention that we were talking about earlier. Dr. Monty Pal: Oh, interesting. I guess the fundamental question then from your paper becomes, how do we get at the right patients for screening for BRCA1 and BRCA2? And I realize our audience here is largely oncologists who are going to be listening to this podcast, oncology providers, MDs, nurses, etc. But maybe speak for a moment to the general practitioner. Are there things that, for instance, a general practitioner should be looking for to say, “Wait a minute, this patient's high risk, we should consider BRCA1, BRCA2 testing or germline screening”? Dr. Matteo Lambertini: Yes, it's a very important question for the breast cancer community. After the updated ASCO guideline, the counseling is way easier because right now the age cutoff goes up to 65 years, meaning that all the patients diagnosed with breast cancer below the age of 65 years should be tested these days. And then above the age of 65, there are different criteria like triple-negative disease or family history. From a general practitioner standpoint, it's of course a bit more difficult, but knowing particularly the family history of the person that they have in front will be crucial to know if there are cases of breast cancer diagnosed at a young age, maybe triple-negative cases, knowing cases of ovarian cancer in first-degree relatives or pancreatic cancer in first-degree relatives, and of course cases of prostate cancer as well. So, I would say probably mostly the family side will be important from a general practitioner perspective.  From an oncology one, the other point that I think is important to stress also based on the data that we have shown in this publication is that having a case of breast cancer known to carry a BRCA pathogenic or likely pathogenic variant. It means that all the people around this case should get tested and if found to be BRCA carrier and healthy carrier, these people should also undergo the primary and secondary prevention strategies because this is very critical also to improve their outcomes and try to avoid the developing of breast or ovarian cancer, but also in the case of diagnosis of this disease, a diagnosis at an earlier stage, as we have seen in this paper. Dr. Monty Pal: Brilliant. I'm going to diverge from our list of questions here and close by asking a question that I have at the top of my mind. You're very young. I know our podcast listeners can't see you, but you're very, very young. Dr. Matteo Lambertini: Thank you. Thank you for that. Not so young but yeah. Dr. Monty Pal: You have nearly 300 papers. Your H-index is 67. You've already made these seminal contributions, as I outlined it from the outset, regarding fertility, regarding use of GnRH analogs, regarding pregnancy and breast cancer. What are you studying now? What are you really excited about right now that you're doing that you think might potentially be practice changing? Give us a little teaser. Dr. Matteo Lambertini: Yeah. Thanks a lot, Dr. Pal. Receiving this compliment from you is fantastic. So, thanks a lot for that. From my side, in terms of my research, I've been interested in the field of breast cancer in young women since the start of my training. I've had very good mentors from Italy, from Europe, from the U.S. I'm still interested in this field, so I think we still have a lot to learn to try to improve the care of young women with breast cancer. For example, the oncofertility care, which is something I worked a lot over the past years. Now with all the new treatment options, there's a sort of new chapter of oncofertility counseling. So, what's the impact of immunotherapy? What's the impact of the new targeted agents?  More on the genetic aspects, now we know that there's not only BRCA1 or BRCA2. There are a lot of other different genes that may increase the risk of breast cancer and other malignancies. And also for these genes, we really don't have a lot of evidence to counsel women on prognosis, treatment, prevention strategy. So we need to learn way more for this special patient population that are quite rare, and so we really need a multicenter academic effort to try to give some evidence in this field. Dr. Monty Pal: Yeah. It's tough because these are rare circumstances, but, you know, I think that you've done really well to sort of define some collective experiences that I think really define therapy. I mean, I just remember when I was in training 25 years ago, just reading through textbooks where all the experience around breast cancer and pregnancy was really just very sort of anecdotal almost, you know? And so it's great to see that the state of the science has moved forward.  Well, gosh, I really enjoyed our conversation today. I think your study really reminds us how powerful genetic information is in terms of improving outcomes. And, you know, hopefully this will lead some individuals to perhaps test more broadly in appropriate settings. So, thank you so much, Matteo, for joining us today with your fantastic insights on the ASCO Daily News Podcast. Dr. Matteo Lambertini: Thank you very much, Dr. Pal. It's a real pleasure. Dr. Monty Pal: And thanks to our listeners too. You'll find a link to Dr. Lambertini's study in the transcript of this episode. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks a ton. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:    Dr. Sumanta (Monty) Pal  @montypal  Dr. Matteo Lambertini @matteolambe   Follow ASCO on social media:     @ASCO on Twitter    ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Monty Pal:   Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview  Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical  Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis  Dr. Matteo Lambertini: Consulting or Advisory Role: Roche, Novartis, Lilly, AstraZeneca, Pfizer, MSD, Exact Sciences, Gilead Sciences, Seagen, Menarini, Nordic Pharma Speakers' Bureau: Takeda, Roche, Lilly, Novartis, Pfizer, Sandoz, Ipsen, Knight Therapeutics, Libbs, Daiichi Sankyo, Gilead Sciences, AstraZeneca, Menarini, AstraZeneca, Menarini Research Funding (Inst.): Gilead Sciences Travel, Accommodations, Expenses: Gilead Sciences, Daiichi Sankyo Europe GmbH, Roche

In this JCO Article Insights episode, Dr. Ece Cal interviews Dr. Martin Wermke, author of the JCO article, "Phase I Dose-Escalation Results for the Delta-Like Ligand 3/CD3 IgG-Like T-Cell Engager Obrixtamig (BI 764532) in Patients With Delta-Like Ligand 3+ Small Cell Lung Cancer or Neuroendocrine Carcinomas." TRANSCRIPT The disclosures for guests on this podcast can be found in the transcript. Dr. Ece Cali: Welcome to this episode of JCO Article Insights. This is Dr. Ece Cali, JCO editorial fellow, and today I am joined by Dr. Martin Wermke, Professor for Experimental Cancer Therapy at Dresden University of Technology, to discuss the manuscript “Phase 1 Dose-Escalation Results for the Delta-Like Ligand 3/CD3 IgG-like T-Cell Engager Obrixtamig in Patients with DLL3+ Small Cell Lung Cancer or Neuroendocrine Carcinomas.” Obrixtamig is a bispecific T-cell engager that binds to DLL3 on tumor cells and CD3 on T-cells. This manuscript presents the phase 1A dose escalation results of Obrixtamig in patients with DLL3+ small cell lung cancer and neuroendocrine carcinomas. In this study, 168 patients were treated with Obrixtamig across four different dosing regimens. 49% of the patients had small cell lung cancer, 42% had extrapulmonary neuroendocrine carcinoma, and 8% had large cell neuroendocrine carcinoma of the lung. Patients received a median of two prior lines of therapy. 33% of the patients had brain metastases at baseline. Of note, this trial did not mandate baseline brain imaging. Maximum tolerated dose was not reached. 88% of the patients experienced a treatment-related adverse event, however, only 3.6% of the patients had to discontinue treatment due to treatment-related AEs, and dose reduction due to treatment-related AEs was documented in 2.4% of the patient population. Similar to the other DLL3-targeted bi-therapies, the most common adverse events included CRS in 57%, dysgeusia in 23%, and pyrexia in 21% of the patients. CRS events were mostly mild. They occurred more frequently in the first two to three doses. 9% of the patients experienced ICANS, of which 3% were graded as Grade 3 or higher. And let's review the efficacy results. Responses were only seen in patients who received 90 microgram per kg or more once weekly or once every three weeks dosing. The objective response rate in patients who received an effective dose was 28%. If we review by tumor type, 21% of the small cell lung cancer patients, 27% of the extrapulmonary neuroendocrine carcinoma patients, and 70% of the large cell neuroendocrine carcinoma patients had objective response. Median duration of response was 8.5 months, though this data is immature due to short follow-up. Dr. Wermke, DLL3-targeted bispecific T-cell engagers are reshaping the treatment landscape of small cell lung cancer. This trial investigates Obrixtamig in other high-grade neuroendocrine tumors as well. Can you put this trial into context for us and explain why it may represent an important step forward? Dr. Martin Wermke: Yeah, thank you for providing me with the opportunity to discuss our data today. I think the data with Obrixtamig in small cell lung cancer are largely similar to what has been observed with other bispecific T-cell engagers such as tarlatamab with respect to the response rate and duration. It has, however, been to be mentioned that BI 1438001 had a bit more liberal inclusion criteria than other trials around. You already mentioned the fact that we allowed the inclusion of patients without mandatory brain imaging, which led to some patients having their brain mets been diagnosed during the treatment with obrixtamig and then adding to the progressive disease patients. That is something which was not the case with the tarlatamab trials where you really had to have a brain imaging before, and in the Phase 1 trial you were even required to treat the brain mets before you included the patient. So it is a bit different, more poorest patient population. I think the trial adds on existing data by being the first trial to also include non-SCLC neuroendocrine carcinoma of other origin, for example from the gastrointestinal tract, and also by including large cell neuroendocrine carcinoma of the lung, which is a really hard to treat pulmonary neoplasm which currently lacks any standardized treatment. So that is really a step forward which we will build on in the future. Dr. Ece Cali: And one thing I would note in this trial, only patients with tumor expressing DLL3 were enrolled. Can you tell us a little bit more about this target, DLL3 in the context of neuroendocrine tumors, and does DLL3 expression predict clinical outcomes after treatment with DLL3 BiTEs, or do we actually need other predictive biomarkers for these novel agents? Dr. Martin Wermke: Yeah, thank you. That's a pretty interesting question. First of all, DLL3 is an atypical notch ligand, which is expressed by the majority of neuroendocrine carcinomas, virtually absent on healthy adult tissues. Therefore, turning it really into a bona fide target for T-cell engaging therapies, pretty low risk for on-target off-tumor side effects. We found that in all the patients we screened, we had an expression rate of about 94% in small cell lung cancer, 80% of large cell neuroendocrine carcinoma of the lung were positive, and also about 80% of the extrapulmonary neuroendocrine carcinoma. So it's really a high prevalence. So the fact that we only included DLL3+ tumors still means we included most of the patients that presented with these diseases. I think at the moment there are no data suggesting a clear-cut association between DLL3 expression levels and outcome on DLL3 CD3 T-cell engagers. There's also not a lot published. If you want to find this out for tarlatamab, you have to look into their patent to really see the data, but it's not clear-cut and I'm sure we need other markers to complement that. And I think what probably plays a major role is intrinsic T-cell fitness. So the question how really diseased your T-cells are, how old you are, because age also correlates with the fitness of the immune system, and other patient characteristics such as tumor burden, we've seen all across the board that the higher the tumor burden, the lower the rate of prolonged response is in such trials. And I also think we need to focus on other components of the tumor microenvironment. So see how high the T-cell infiltration with obrixtamig is and how abundant suppressive elements like regulatory T-cells or myeloid-derived suppressive cells are. That is work which is currently being done. Data are emerging, but I don't think that at the moment we have any clear biomarker helping us to select who should not receive DLL3 T-cell engagers. Dr. Ece Cali: Those are great points and there is a lot we need to learn about how to use these novel agents in the future. I'd like to highlight the results in large cell neuroendocrine carcinoma of the lung. The response rate in this group was remarkably high at 70%. Though we should note the small sample size of only 14 patients in this trial. After first line chemoimmunotherapy, current approved options for this population have very modest clinical activity. Given these trial results, how do you envision the field moving forward for patients with large cell neuroendocrine carcinoma? Dr. Martin Wermke: Yeah, I think LCNEC is really an area which urgently needs further improvement of therapeutic standards. At the moment, as I said, there is no real standard. We are usually extrapolating from results we have in small cell lung cancer or non-small cell lung cancer, but I don't think we have too many prospective trials really informing this. Of course, 14 patients is a small sample size, but I think it's still fair to say that we can claim that DLL3 T-cell engagers are not doing worse in LCNEC than they do in SCLC. And that's why I think we really need to move forward clinical trials that are specifically targeting this population. Although I fear a bit that, given the rareness of this disease and the aggressiveness of its phenotype, that this is probably not the main focus of the pharmaceutical industry. So I think it's up to us academic investigators to really come up with investigator-initiated trials trying to fill the knowledge gaps we have here. Dr. Ece Cali: And one more thing that I want to talk about is the accessibility for these drugs. These novel agents are showing real promise in improving outcomes for patients with high-grade neuroendocrine tumors, an area where progress has been limited until very recently. However, as DLL3 BiTEs become more widely used, issues of logistics and access come into sharper focus. With unique toxicities and the specialized monitoring, their use is restricted to certain centers. Looking ahead, what kinds of strategies could help mitigate some of these adverse events or make these treatments more broadly available? Dr. Martin Wermke: Yeah, I think if you look at countries like the United States where tarlatamab has already been approved, we can see how the management strategies are evolving. I've heard about a colleague equipping their patients with thermometers and a pill of Dexamethasone, alongside with a temperature control protocol and clearly instructing them, "If you measure a temperature above a certain level then start taking the Dexamethasone and come back to our office and we're going to take care of you." I think that's one way to move forward. I think we are lucky in a way that CRS usually manifests within the first 24 hours. This was the same in our study, like in the tarlatamab studies. So we really know when the time of trouble is for our patients. And in this time, I think we need to instruct the patients to stay close to the hospital. I don't think we need to hospitalize all of them, but we probably need them to stay in a nearby hotel to be able to reach the emergency room if needed in a short period of time. And I think we can also learn in this strategy how to manage bispecific antibodies from the experience our colleagues in hematology had because they have been using bispecific T-cell engagers for quite some years right now and they developed strategies and networks that were able to successfully treat these patients also on an outpatient basis. And I think that is clearly an experience we need to follow, acknowledging that we are talking about diseases which are much more frequent than the standard hematology indications. Dr. Ece Cali: Thank you so much, Dr. Wermke, for this informative discussion and for sharing your perspective on this evolving field. Dr. Martin Wermke: Yeah, thank you for providing me with the opportunity to talk about data. It was really great being able to share that, and I really think that we are just at the beginning of a new exciting area for the treatment of neuroendocrine carcinomas, and I think much improvement is yet to come for our patients. Dr. Ece Cali: Yes, that's really exciting. And thank you everyone for listening to JCO Article Insights. Please come back for more interviews and article summaries and be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on this podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Dr. Martin Wermke's Disclosures Honoraria: Lilly, Boehringer Ingelheim, SYNLAB, Janssen, Merck Serono, GWT, Amgen, Novartis, Pfizer,  BMS GmbH & Co. KG, Regeneron, MJH/PER, Takeda Consulting or Advisory Role: Bristol-Myers Squib, Novartis, Lilly, Boehringer Ingelheim, ISA Pharmaceuticals, Amgen, immatics, Bayer, ImCheck therapeutics, AstraZeneca, Tacalyx, Regeneron, Daiichi Sankyo Europe GmbH, Zymeworks, PharmaMar, Iovance Biotherapeutics, T-Knife, Genentech Research Funding: Roche Patents, Royalties, Other Intellectual Property Travel, Accommodations, Expenses: Pfizer, Bristol-Myers Squibb, AstraZeneca,  Amgen,  GEMoaB, Sanofi/Aventis, immatics,  Merck Serono, Janssen Oncology, Iovance Biotherapeutics, Daiichi Sankyo Europe GmbH"

Interviewees: Kirsten Brown, PhD Assistant Professor of Health Professions Education at the Uniformed Services University of the Health Sciences; as a short disclaimer, Kirsten's views do not represent the official policy or position of her employer.  Dionna Bidny, MD, MMUS  a first-year resident in Physical Medicine and Rehabilitation at the University of Pittsburgh Medical Center, currently completing her Transitional Year; and Abby Konoposky, PhD Senior Director of Medical Education Research in the Department of Psychiatry at Northwell Health. Interviewer:  Lisa Meeks, PhD, MA, Guest Editor, Academic Medicine Supplement on Disability Inclusion in UME. Description: This episode of Stories Behind the Science brings you an intimate conversation with Dr. Kirsten Brown (Uniformed Services University of the Health Sciences), Dr. Dionna Bidny (University of Pittsburgh Medical Center), and Dr. Abby Konopasky (Northwell Health), co-authors of Disability in Undergraduate Medical Education in the United States: A Scoping Review, part of the Academic Medicine supplement on Disability Inclusion in Undergraduate Medical Education. Drawing from over 80 publications, their study traces how disability in medical education has too often been framed through deficit and legal models, while leaving intersectionality and the voices of disabled learners largely absent. Together, we explore why this framing matters, what the literature reveals about gaps and progress, and how a critical perspective can re-shape the field. Our guests share the personal and professional motivations behind this ambitious review, the surprises and challenges they encountered, and their hopes for how this work can serve as both roadmap and catalyst. Whether you are a researcher, faculty member, disability resource professional, or student, this episode offers insights into the state of the field and inspiration for charting new directions. Resources and links to the open-access article, Disability Resource Hub, and related tools are in the show notes. Transcript: https://docs.google.com/document/d/1iUYE0Q-2TA1flXiMU6rum1S3dO-obE5DoA9J0mFmHlE/edit?usp=sharing Bios:   Kirsten Brown, PhD Dr. Kirsten Brown's research examines the intersection of disability, power, and social systems. Her work has appeared in the Journal of College Student Development, the Journal of Diversity in Higher Education, and Journal of Higher Education. She co-authored the book Disability in Higher Education: A Social Justice Approach. Dr. Brown prepared this chapter during non-work hours as an independent scholar and this publication did not receive funding from the federal government. The views expressed are solely those of the author and do not represent the official policy or position of the Uniformed Services University of the Health Sciences, the Henry M. Jackson Foundation for the Advancement of Military Medicine, the Department of Defense, or the U.S. Government.  Abigail Konopasky, PhD Abigail Konopasky holds doctorates in educational psychology from George Mason University and in linguistics from Princeton University. She is currently an Associate Professor and Director of Medical Education Research and Scholarship in the Psychiatry Department at Northwell Health. She conducts critical qualitative and mixed methods research in health professions education, with a focus on equity, Black feminism, and critical disability studies using functional linguistic and narrative methods and theories of agency. She serves on the editorial boards of Teaching and Learning in Medicine, Perspectives on Medical Education, and Advances in Health Sciences Education. Dionna Bidny, MD, MMus  Dionna is a first year resident at the University of Pittsburgh Medical Center in Physical Medicine and Rehabilitation (currently  in her  Transitional Year). She has a BS in biomedical engineering and an  MMus in Musicology; she incorporated her interest in accessibility in arts, sports, and healthcare spaces through research during both degrees. In medical school, she continued to study and lecture in the space of disability  justice and its intersections with art, identity,  and healthcare experience, all  while navigating  chronic illness and pursuit of her own  accommodation and access needs. In residency, she aims to continue her work in accessibility within arts and sports through community engagement and engineering innovation. Key Words:   Disability in medical education Undergraduate medical education (UME) Disability inclusion Scoping review Academic Medicine supplement Deficit model vs. asset model Legal framing of disability Intersectionality in medicine Disabled learners' voices Critical perspectives in medical education Equity in medical training Accommodations in medical education Disability justice Ableism in medicine Representation in health professions Research roadmap Diversity and inclusion in medicine Disability studies in medical education Inclusive curriculum Systemic barriers in medical education Resources:  Article from Today's Talk Maggio, Lauren A. PhD; Brown, Kirsten R. PhD; Costello, Joseph A. MSIS; Konopasky, Aaron PhD, JD; Bidny, Dionna MD, MMus; Konopasky, Abigail PhD. Disability in Undergraduate Medical Education in the United States: A Scoping Review. Academic Medicine 100(10S):p S64-S73, October 2025. | DOI: 10.1097/ACM.0000000000006154 https://journals.lww.com/academicmedicine/fulltext/2025/10001/disability_in_undergraduate_medical_education_in.5.aspx   The Docs With Disabilities Podcast https://www.docswithdisabilities.org/docswithpodcast

Ben and Nate tackle another common misconception: "I have accommodations, so I should finish the section." They remind listeners to slow down if their accuracy is low, no matter how much time they have.Read more on our website. Email daily@lsatdemon.com with questions or comments. Watch this episode on YouTube!

Dr. Monty Pal and Dr. Mina Sedrak discuss the science behind cancer treatment-induced accelerated aging and the development of drug therapies and technologies aimed at helping older patients and cancer survivors. TRANSCRIPT Transcript: Cancer and Aging: Researching the Path to Longer, More Vibrant Lives Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I am Dr. Monty Pal. I am a medical oncologist and professor and vice chair of medical oncology here at the City of Hope Comprehensive Cancer Center. I am also host of this podcast. Today, we are going to be talking to somebody that I consider to be my little brother, if you will, in oncology, Mina Sedrak. Mina is an expert in the area of cancer and aging, which really includes the development of drug therapies and technologies that help enable older adults and survivors to live longer, healthier, and more vibrant lives. I am really excited to chat with him. He is an expert not just in cancer and aging but also breast cancer. He was my former colleague here at City of Hope before he moved over to the UCLA Jonsson Comprehensive Cancer Center, where he is an associate professor and director there of the Cancer and Aging Program. Dr. Sedrak's research involves mechanisms behind cancer treatment-induced accelerated aging and really aims to take this science into more of a therapeutic direction, which I am super, super excited about.  Mina, thanks so much for joining us today, and just FYI for our listeners, we have all of our disclosures in the transcript of this episode. Dr. Mina Sedrak: Thank you, Monty. Thank you, Dr. Pal, for having me. I am really excited to be here. Dr. Monty Pal: I feel like we have to go on a first-name basis here with how well we know each other. So Mina, you and I together have witnessed this evolution in cancer and aging. I mean, both of us worked together here with just a legendary figure in the field of geriatric oncology, I will call it, Dr. Arti Hurria, mentor to me, mentor to you, mentor to so many. Can you give us a sense of where cancer and aging has gone since the time that you and I started here together at City of Hope? Dr. Mina Sedrak: Dr. Hurria and her collaborators, Dr. [Willliam] Dale and Dr. [Supriya] Mohile, they were like huge pioneers in the field. They were one of the very first people to highlight the importance of looking at older adults beyond just their chronological age and their comorbidities and moving us beyond just seeing patients and making decisions using what we call the eyeball test. "Oh, this person looks fit or not fit, frail or robust," to really using objective measures to assess our patient's health status and incorporate that assessment into our evaluation of the treatment, prognostication, and discussions with our patients throughout the cancer continuum. And so that is what geriatric oncology has and continues to be, and it is a huge, important part. And their work has laid the foundation to show that when we look at our patients beyond just their chronological age and we look at their functional age, and we do these objective assessments, we can gain much more deeper information to tailor the treatment for our patient that is sitting in front of us, rather than do a prescriptive treatment or over- or undertreatment in that population. So that is sort of where the field is growing, and a lot of the work now is, how do we implement that? How do we put that into clinical practice? Dr. Monty Pal: Well, let me kind of spearhead that discussion, right? I have these moments when I go to the ASCO Annual Meeting – I remember this happened to me a while ago when Dr. Jennifer Temel presented that terrific work around early palliative care interventions, right? Or it even happened to me this year, right, when Dr. Christopher Booth presented the CHALLENGE trial around exercise and colon cancer. You know, these amazing, I am going to say simple, they are not simple, but they are simple interventions relative to, you know, some of the complex drugs and mechanisms that we are using nowadays that really help outcomes for our cancer patients. The big question becomes, how do you implement, right? But my understanding is that there are easy ways for us to take tools in cancer and aging and sort of plug them into our daily practice. Am I right about that? Dr. Mina Sedrak: Yes, and that is something that they are – the Cancer and Aging Research Group, which was founded by Dr. Hurria and now is co-led by Dr. Dale, Dr. Mohile, and Dr. [Heidi] Klepin, they have been incredible at really trying to develop practical tools, like the Practical Geriatric Assessment, which is now endorsed by the ASCO and other NCCN guidelines. And so, there are tools that are becoming more and more practical to help incorporate that into clinic.  Now, what might be practical in a resource-intensive setting may not be practical in some of the limited resources, whether it is rural and/or other countries where the resources may be more limited. So that is why Cristiane Bergerot, Enrique Soto, and others have been really working hard. There was actually a really beautiful paper that was just published in the Journal of Global Oncology, where they have shown that there are guidelines [ASCO Geriatric Assessment Global Guideline] about how to implement these tests, these tools, these assessments in clinical practice, even in different resource settings. So I think we are going to get to the future where this is much more – it is definitely important, but it is much more easily ‘incorporatable' into our practice. Dr. Monty Pal: Yeah, you know how close I am to Cris, and I was so proud when I saw that paper come out. That was really exciting. You know, I skimmed it. I have to tell you, I did not get into the weeds, but it was apparent to me that, you know, some of these geriatric oncology tools are things that, you know, I could probably plug and play into my practice where I am double- and triple-booked over, you know, most slots, right? I mean, I could still probably afford a little bit of time or maybe have, like, a nurse or an extender kind of help participate in the evaluation process. I thought that was, yeah, really, really interesting. Dr. Mina Sedrak: I will just say that at UCLA, we are working with Dr. Arash Naeim, who is a geriatric oncologist, and he has developed an AI platform where the assessments can be done by an AI computer. So it is like talking to your ChatGPT. They can talk to you, and for a few minutes, they will ask you the questions. So you do not even have to fill it out on a piece of paper. You could give the patient a little iPad, put them in a private room while they are waiting for their doctor, and get the results, and it is right there for you. And so, we have been trying to think about how can technology help with the completion of the assessment, at least doing that? And I think it is actually, it has been very cool. We did a pilot study. He is writing that up, and we are going to continue to do some of this exciting work. How do we think about AI in the context of this? And, you know, older adults, they are not like what they used to be. A lot of older adults are very familiar with and comfortable with phones and computers and iPads, much more so today than they were even at the time when Dr. Hurria was alive. Dr. Monty Pal: That is so interesting. You mentioned this, the AI approach is something I have been thinking about in this context because what if, for instance, you know, we have got video monitors all over our hospital, right? What if you are actually just taking a look at that patient as they make their way towards your clinic? Capture that video, use an AI algorithm to say, "Hey, you know, the timed get-up-and-go test in this patient is not particularly good based on what I am seeing here," right? There are so many ways that you could, you know, stir the pot and come up with creative ways to get these tests done. Dr. Mina Sedrak: That's right. And Arash is looking at also sensors. So he has some studies where he is putting sensors inside people's homes, where they would put them, like, on top of an Alexa app or the equivalent. A lot of people have these apps, and basically, they can sense how you are moving around and what you are doing, just movement-wise. And then they can collect that information to gain information about your life beyond just what we are seeing in the 20-minute visit in the clinic. Even when I do a walk test where I get gait speed or physical performance, short physical performance battery, the chair sit-up, those are oftentimes a single, cross-sectional, static measure. But what about the dynamic ability of capturing what has been happening for the last 7 days? What has been happening for the last 25 days between the visits, between the cycles of chemotherapy? And could that inform how I make decisions when I see patients and who do I need to target and identify? And so, we are very excited because really at UCLA, Arash is leading the technology efforts and thinking about implementation of these important measures and these important tools but leveraging new technology. And we do not want to be behind; we want to be ahead of the game. Dr. Monty Pal: I love that idea because there is a Hawthorne effect, isn't there, where you observe a process, and it naturally gets better. I mean, when you ask that patient to get up in the clinic and move, they are probably functioning to the best of their abilities, but we could probably learn a lot from just watching how fast that patient picks up a remote control at home. Some simple movement like that that is volitional would probably help out a ton. And I got to tell you, it is so funny when you mention Arash Naeim's name. I distinctly remember him serving as an attending on the wards when he was brand new at UCLA on faculty when I was a resident there. And his dad is a legendary hematopathologist, right? Dr. Mina Sedrak: I did not know that. Dr. Monty Pal: Yeah, yeah. Faramarz Naeim wrote the book on a lot of heme-path malignancies. Incredible guy. Very, very storied hematopathologist at UCLA.  I could probably go on this topic forever, but in the interest of time, I am going to shift to something that again, I could probably talk about forever, which is this area of senescence that you are involved in. You know, you had mentioned this to me, I am going to say during your outro from City of Hope and towards your transition to UCLA, it is such an exciting area. I mean, understanding the actual biologic process of aging and using those underpinnings to really sort of tailor therapy. So tell us where the state of the science is there with this body of work that you are doing. Dr. Mina Sedrak: As I said before, we have tools now to assess patients and to then do something about the deficits. So if a patient is falling, what we do is we refer them to physical therapy where they can do fall precautions and strength training to give them the information. But all of these supportive care interventions are very important. They are great. But they oftentimes are not targeting the root cause of why they are happening. And so that is really where I have been very interested in, how can we understand why is it that something like chemotherapy or immunotherapy is causing a decline in cognitive function or a decline in physical function? And so that has really led us to think about geriatric oncology rather than a discipline of older adults, but to think about aging as a physiologic process. We are all aging. As every day goes by, we are aging. And what that means is that our bodies are accumulating damage, the cells are being exposed to various stressors, and the repair mechanisms are declining. And as we get older, it is really more damage and less repair mechanism at the cellular molecular level. And it turns out that these processes of how our cells repair and respond to damage are fundamental processes of biological aging. And there has been a large amount of preclinical and now really exciting clinical work to show that there are hallmarks that could be used to assess the rate of which we age by looking at these processes. And that includes things like epigenetics, telomeres, inflammation, and something called ‘cellular senescence.' And we have been interested in my lab in senescence because it is a unique process that has an important role in aging, but it also has a really important role in cancer. Senescence is a cell state. Cells, when they are stressed, they respond to entering this state of senescence. The stress could come from anything. It could come from an oncogene activation. It could come from a reactive oxygen species. It could come from a direct damage to the cell. But it is a cell state, just like apoptosis, necrosis. Senescence is a state in which the cell, in response to that stressor, undergoes an arrest from the G to the S phase. And that arrest is oftentimes associated with a resistance to apoptosis. So then the cell does not die, but it is alive, and it remains metabolically active. And in fact, downstream pathways of these cell cycle inhibition of this G-to-S phase lead to the increase of these transcription factors in the chromatin and lead to the development of these pro-inflammatory factors. So these cells, which can occur in various tissues in the body, can continue to live despite having developed these changes, and then they secrete these proinflammatory molecules like cytokines, chemokines, metalloproteinases, all of these, which are called the senescence-associated secretory phenotype, or SASP. And as we age, we accumulate more and more of these cells, and our bodies are no longer able – our immune system, like macrophages and T cells – are no longer able to remove them effectively. And as we accumulate them in various organs, these organs release a lot of inflammatory cytokines, and the chronic inflammation in that tissue leads to the tissue being damaged, and it does not work as well, and then it starts to decline in function. And that is believed to be how senescence plays a role in aging. It is the accumulation of senescent cells that occurs with increased damage and then the repair mechanism of clearing these cells effectively, which then leads to build up of inflammation and chronic inflammation leads up to damage in multiple tissues. Dr. Monty Pal: This concept to me is fascinating. And I guess the big question is – senescence is bad, right – is it not reasonable to think that this body of research, I mean, if you are able to sort of have a meaningful impact on senescence, it could have implications well beyond oncology. Is that fair? You really could extend lifespan all around. Is that reasonable to think, all-cause mortality? Dr. Mina Sedrak: One hundred percent. And that is what they have been shown in animal models. And the reason senescence is exciting is because it turns out that you can target these cells and you can induce apoptosis of these cells, but it requires active targeting of various pathways, but it can occur. And when it does, and it is done either genetically or pharmacologically in mice, we see that the mice can reverse damage. So if you take an old mouse and you genetically engineer it to remove senescent cells, that mouse will go from being frail to fit. And if you take a young mouse and you induce senescent cells at a high rate and you accumulate them in that mouse, that mouse, even though it is young, will become frail.  So that has really led to this exciting opportunity of, can we translate this finding that we are seeing in animals and in in vivo cells, cell cultures, into humans? And could that have a benefit beyond just one disease? Could it have a benefit in multiple diseases? And not just really longevity, which I think it would be great, but what people are really looking for is, how do we live healthy as we get older? How do we move the curve so that people are not developing chronic diseases in their 60s, but they are developing them in their 80s towards shortening the period of their life with disability rather than what we have currently, which is people are living to 70s, the average life expectancy is in the mid-70s, but they are spending 10 or 11 years in disability of that life. And so, how could we reduce that time frame? Dr. Monty Pal: This is brilliant, Mina. And for our audience, this compelling dialogue that we have had here thankfully is translating to funding for Mina's work. He just scored in the second percentile for his NIH R01 based on this topic. We are so, so proud of you. I mean, it is just remarkable work. It is not easy in the current climate to get funding, and a second percentile score is just absolutely wonderful. You know, Mina, I could probably go on with you for a couple more hours here talking about your work in cancer and aging. I think I am going to have to have you back on the podcast here. But a million thanks for sharing your thoughts here today on the ASCO Daily News Podcast.  And thanks to our listeners too. If you value the insights that you heard today on the ASCO Daily News Podcast, please do not forget to rate, review, and subscribe wherever you get your podcasts. Thanks, Mina. Dr. Mina Sedrak: Thank you so much. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:     Dr. Sumanta (Monty) Pal   @montypal  Dr. Mina Sedrak @minasedrakmd   Follow ASCO on social media:      @ASCO on Twitter     ASCO on Bluesky    ASCO on Facebook      ASCO on LinkedIn      Disclosures:     Dr. Monty Pal:    Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview   Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical   Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis   Dr. Mina Sedrak: Patents, Royalties, Other Intellectual Property: Up-to-Date

Food allergy accommodations don't stop at the classroom door—they extend into workplaces, public spaces, and even stadiums. But what rights do you actually have? Today, we're joined by FAACT's General Counsel, Amelia Smith, JD, to break it all down and help you understand your civil rights.Resources to keep you in the know:FAACT's Accommodations Resource CenterFAACT's Civil Rights Advocacy Resource CenterFAACT's Local ResourcesContact Amelia Smith, JD: Amelia.Smith@FoodAllergyAwareness.orgYou can find FAACT's Roundtable Podcast on Apple Podcasts, Pandora, Spotify, Podbay, iHeart Radio, or wherever you listen to podcasts.Follow us on Facebook, Instagram, BlueSky, Threads, LinkedIn, Pinterest, TikTok, and YouTube.Sponsored by: DBV TechnologiesThanks for listening! FAACT invites you to discover more exciting food allergy resources at FoodAllergyAwareness.org!

Leah Stiegler, a seasoned labor attorney from Woods Rogers, delves into the complexities of modern workplace dynamics. From handling toxic personalities to navigating the intricacies of non-compete agreements, Leah offers invaluable insights for employers. She discusses the importance of maintaining a psychologically safe environment and the role of documentation in protecting both employees and employers. Leah also touches on the ethical use of AI in workplace management, emphasizing transparency and responsible practices. Tune in to learn how to manage workplace challenges effectively and keep your organization legally compliant. Whether you're dealing with workplace toxicity or exploring AI's role in sales, Leah's expertise is a must-listen for all managers. "I would say that the best advice I can give on that is for managers to address concerns early on, to hear someone out regardless of whether they think the concern is ridiculous or whether they know that the person is wrong about their perception, whatever it may be." - Leah Stiegler KEY TAKEAWAYS: -How can managers handle false allegations without appearing retaliatory? -The importance of handling workplace HR legal issues promptly -The latest unusual workplace HR trends and accommodations, including furries, litter boxes and other requests -Non-Compete agreements -What to do about workplace romances and the various dynamics and scenarios of those -AI, technology forensic data, social media posts legal latest #HR #humanresources #businesslaw #law #lawyer #laborlaw #laborattorney #HRattorney #workplaceaccommodations CONNNECT WITH LEAH STIEGLER www.woodsrogers.com https://www.linkedin.com/in/leah-stiegler-28aa7a62/ https://www.linkedin.com/company/woodsrogers/ Connect with Manage Smarter         Website: https://salesfuel.com/manage-smarter/·         LinkedIn: https://www.linkedin.com/in/audreystrong/                                                 LinkedIn: https://www.linkedin.com/in/cleesmith/ X Audrey https://x.com/tallmediamaven Lee  https://x.com/cleesmith  Connect with SalesFuel·         Website:  https://salesfuel.com/·         X: https://x.com/SalesFuel·         Facebook: https://www.facebook.com/salesfuel/ Learn more about your ad choices. Visit megaphone.fm/adchoices

(00:00) Path to Medicine and Representation(10:45) Navigating Challenges in Pre-Med Studies(17:10) Navigating Learning Differences and Accommodations(29:09) Journey to Medical School Acceptance(35:27) Perseverance in the Journey to MedicineAt 17, Katya's life took an unexpected turn when a spark for dermatology lit up her path away from fashion. Join us as Katya shares her unique journey through the world of medicine, a path filled with challenges, self-discovery, and unyielding determination. Hear how her mother's insight into the demand for dermatologists and the experience of shadowing a physician of color solidified her commitment to a field where representation and cultural competence are crucial. Katya's story sheds light on the underrepresentation of Latino physicians in the U.S. and highlights the vital role of family and community support in overcoming self-doubt.The academic journey wasn't smooth sailing for Katya, who faced hurdles at Princeton that tested her resolve. Discover how initial setbacks and lower-than-expected grades fueled her imposter syndrome, propelling her to reevaluate her approach to premed studies. Through strategically pausing her coursework and immersing herself in diverse academic experiences abroad, Katya not only enhanced her college journey but also prepared for future medical school applications. Her candid discussion reveals the power of friendships, therapy, and core values in navigating the demanding world of premed, and serves as a guide for those facing similar battles.Listen as Katya recounts the emotionally charged process of medical school applications, drawing parallels to the unpredictability of dating. From receiving just one interview invite to the thrill of an acceptance call from Stanford on her birthday, her journey is a testament to perseverance against all odds. Katya opens up about learning differences and the significance of accommodations, breaking down the stigma and proving that success is within reach for those who seek the support they need. Her story is a beacon of hope for aspiring medical students, reinforcing that with grit and determination, even the most formidable barriers can be overcome.

Syria: And Israel accommodations. Ahmad Sharawi, FDD https://apnews.com/article/syria-israel-diplomacy-conflict-us-e3fd86d0e2a011e6eba6dea8977bc084

#thePOZcast is proudly brought to you by Fountain - the leading enterprise platform for workforce management. Our platform enables companies to support their frontline workers from job application to departure. Fountain elevates the hiring, management, and retention of frontline workers at scale.To learn more, please visit: https://www.fountain.com/?utm_source=shrm-2024&utm_medium=event&utm_campaign=shrm-2024-podcast-adam-posner.Thanks for listening, and please follow us on Insta @NHPTalent and www.youtube.com/thePOZcastFor all episodes, please check out www.thePOZcast.com  SummaryIn this episode, Adam Posner interviews Charlotte Dales, co-founder and CEO of Inclusively, a platform dedicated to creating equitable workplaces. Charlotte shares her journey from finance to founding Inclusively, inspired by her cousin Cameron's achievements despite challenges. The conversation delves into the importance of workplace accommodations, the role of anonymity in fostering inclusion, and the need for data-driven insights to bridge gaps in employee support. Charlotte discusses the pivot from a hiring platform to a focus on retention and the future of work, emphasizing skills-based hiring and authentic DEI practices. She also offers advice for aspiring founders on balancing personal and professional life while defining success beyond financial metrics.Takeaways: - Inclusively aims to create equitable workplaces through technology.- Charlotte's inspiration came from her cousin Cameron's journey.- Accommodations in the workplace can significantly impact employee success.- Anonymity in requesting support is crucial for employee comfort.- Data-driven insights help align employee needs with company offerings.- The business model pivoted from hiring to retaining talent.- Skills-based hiring complements the need for accommodations.- Authenticity in DEI practices is essential for real impact.- Balancing work and personal life can enhance productivity.- Success is defined by the positive impact on future generations.Chapters00:00 Introduction to Inclusively and Its Mission02:59 Charlotte's Journey: From Finance to Founding Inclusively06:03 Inspiration from Family: Cameron's Story08:55 The Importance of Accommodations in the Workplace11:51 The Role of Anonymity in Workplace Inclusion14:47 Bridging the Gap: Data-Driven Insights for Employers17:57 Pivoting the Business Model: From Hiring to Retaining Talent20:54 The Future of Work: Skills-Based Hiring and Inclusion24:00 Navigating the DEI Landscape: Authenticity vs. Performative Actions26:58 Advice for Aspiring Founders: Balancing Life and Work29:42 Defining Success: Beyond Numbers and Exits 

Happy Birthday to Bryan! Fresh off his first week at the Edinburgh Fringe, Bryan tells us about the hustle it takes to perform at the world's largest performing arts festival. Erin saw the musical Some Like It Hot and has now been inspired to sign up for tap classes. Bryan explains the UK's Online Safety Act which now requires people to upload personal documents in order to view adult websites. Erin calls out Superintendent of Public Instruction Ryan Walters for watching porn during a work meeting, and celebrates Rhode Island for being the first state to provide workplace accommodations for menopause. For tickets to Bryan's show visit www.bryansafi.comSee omnystudio.com/listener for privacy information.