Podcasts about ADC

Dr. Linda Duska and Dr. Kathleen Moore discuss key studies in the evolving controversy over radical upfront surgery versus neoadjuvant chemotherapy in advanced ovarian cancer. TRANSCRIPT Dr. Linda Duska: Hello, and welcome to the ASCO Daily News Podcast. I am your guest host, Dr. Linda Duska. I am a professor of obstetrics and gynecology at the University of Virginia School of Medicine.  On today's episode, we will explore the management of advanced ovarian cancer, specifically with respect to a question that has really stirred some controversy over time, going all the way back more than 20 years: Should we be doing radical upfront surgery in advanced ovarian cancer, or should we be doing neoadjuvant chemotherapy? So, there was a lot of hype about the TRUST study, also called ENGOT ov33/AGO-OVAR OP7, a Phase 3 randomized study that compares upfront surgery with neoadjuvant chemotherapy followed by interval surgery. So, I want to talk about that study today. And joining me for the discussion is Dr. Kathleen Moore, a professor also of obstetrics and gynecology at the University of Oklahoma and the deputy director of the Stephenson Cancer Center, also at the University of Oklahoma Health Sciences.  Dr. Moore, it is so great to be speaking with you today. Thanks for doing this. Dr. Kathleen Moore: Yeah, it's fun to be here. This is going to be fun. Dr. Linda Duska: FYI for our listeners, both of our full disclosures are available in the transcript of this episode.  So let's just jump right in. We already alluded to the fact that the TRUST study addresses a question we have been grappling with in our field. Here's the thing, we have four prior randomized trials on this exact same topic. So, share with me why we needed another one and what maybe was different about this one? Dr. Kathleen Moore: That is, I think, the key question. So we have to level-set kind of our history. Let's start with, why is this even a question? Like, why are we even talking about this today? When we are taking care of a patient with newly diagnosed ovarian cancer, the aim of surgery in advanced ovarian cancer ideally is to prolong a patient's likelihood of disease-free survival, or if you want to use the term "remission," you can use the term "remission." And I think we can all agree that our objective is to improve overall survival in a way that also does not compromise her quality of life through surgical complications, which can have a big effect. The standard for many decades, certainly my entire career, which is now over 20 years, has been to pursue what we call primary cytoreductive surgery, meaning you get a diagnosis and we go right to the operating room with a goal of achieving what we call "no gross residual." That is very different – in the olden days, you would say "optimal" and get down to some predefined small amount of tumor. Now, the goal is you remove everything you can see.  The alternative strategy to that is neoadjuvant chemotherapy followed by interval cytoreductive surgery, and that has been the, quote-unquote, "safer" route because you chemically cytoreduce the cancer, and so, the resulting surgery, I will tell you, is not necessarily easy at all. It can still be very radical surgeries, but they tend to be less radical, less need for bowel resections, splenectomy, radical procedures, and in a short-term look, would be considered safer from a postoperative consideration. Dr. Linda Duska: Well, and also maybe more likely to be successful, right? Because there's less disease, maybe, theoretically. Dr. Kathleen Moore: More likely to be successful in getting to no gross residual. Dr. Linda Duska: Right. Yeah, exactly. Dr. Kathleen Moore: I agree with that. And so, so if the end game, regardless of timing, is you get to no gross residual and you help a patient and there's no difference in overall survival, then it's a no-brainer. We would not be having this conversation. But there remains a question around, while it may be more likely to get to no gross residual, it may be, and I think we can all agree, a less radical, safer surgery, do you lose survival in the long term by this approach? This has become an increasing concern because of the increase in rates of use of neoadjuvant, not only in this country, but abroad. And so, you mentioned the four prior studies. We will not be able to go through them completely. Dr. Linda Duska: Let's talk about the two modern ones, the two from 2020 because neither one of them showed a difference in overall survival, which I think we can agree is, at the end of the day, yes, PFS would be great, but OS is what we're looking for. Dr. Kathleen Moore: OS is definitely what we're looking for. I do think a marked improvement in PFS, like a real prolongation in disease-free survival, for me would be also enough. A modest improvement does not really cut it, but if you are really, really prolonging PFS, you should see that-  Dr. Linda Duska: -manifest in OS. Dr. Kathleen Moore: Yeah, yeah. Okay. So let's talk about the two modern ones. The older ones are EORTC and CHORUS, which I think we've talked about. The two more modern ones are SCORPION and JCOG0602. So, SCORPION was interesting. SCORPION was a very small study, though. So one could say it's underpowered. 170 patients. And they looked at only patients that were incredibly high risk. So, they had to have a Fagotti score, I believe, of over 9, but they were not looking at just low volume disease. Like, those patients were not enrolled in SCORPION. It was patients where you really were questioning, "Should I go to the OR or should I do neoadjuvant? Like, what's the better thing?" It is easy when it's low volume. You're like, "We're going." These were the patients who were like, "Hm, you know, what should I do?" High volume. Patients were young, about 55. The criticism of the older studies, there are many criticisms, but one of them is that, the criticism that is lobbied is that they did not really try. Whatever surgery you got, they did not really try with median operative times of 180 minutes for primary cytoreduction, 120 for neoadjuvant. Like, you and I both know, if you're in a big primary debulking, you're there all day. It's 6 hours. Dr. Linda Duska: Right, and there was no quality control for those studies, either. Dr. Kathleen Moore: No quality control. So, SCORPION, they went 451-minute median for surgery. Like, they really went for it versus four hours and then 253 for the interval, 4 hours. They really went for it on both arms. Complete gross resection was achieved in 50% of the primary cytoreduced. So even though they went for it with these very long surgeries, they only got to the goal half the time. It was almost 80% in the interval group. So they were more successful there. And there was absolutely no difference in PFS or OS. They were right about 15 months PFS, right about 40 months OS.  JCOG0602, of course, done in Japan, a big study, 300 patients, a little bit older population. Surprisingly more stage IV disease in this study than were in SCORPION. SCORPION did not have a lot of stage IV, despite being very bulky tumors. So a third of patients were stage IV. They also had relatively shorter operative times, I would say, 240 minutes for primary, 302 for interval. So still kind of short. Complete gross resection was not achieved very often. 30% of primary cytoreduction. That is not acceptable. Dr. Linda Duska: Well, so let's talk about TRUST. What was different about TRUST? Why was this an important study for us to see? Dr. Kathleen Moore: So the criticism of all of these, and I am not trying to throw shade at anyone, but the criticism of all of these is if you are putting surgery to the test, you are putting the surgeon to the test. And you are assuming that all surgeons are trained equally and are willing to do what it takes to get someone to no gross residual. Dr. Linda Duska: And are in a center that can support the post-op care for those patients. Dr. Kathleen Moore: Which can be ICU care, prolonged time. Absolutely. So when you just open these broadly, you're assuming everyone has the surgical skills and is comfortable doing that and has backup. Everybody has an ICU. Everyone has a blood bank, and you are willing to do that. And that assumption could be wrong. And so what TRUST said is, "Okay, we are only going to open this at centers that have shown they can achieve a certain level of primary cytoreduction to no gross residual disease." And so there was quality criteria. It was based on – it was mostly a European study – so ESGO criteria were used to only allow certified centers to participate. They had to have a surgical volume of over 36 cytoreductive surgeries per year. So you could not be a low volume surgeon. Your complete resection rates that were reported had to be greater than 50% in the upfront setting. I told you on the JCOG, it was 30%. Dr. Linda Duska: Right. So these were the best of the best. This was the best possible surgical situation you could put these patients in, right? Dr. Kathleen Moore: Absolutely. And you support all the things so you could mitigate postoperative complications as well. Dr. Linda Duska: So we are asking the question now again in the ideal situation, right? Dr. Kathleen Moore: Right. Dr. Linda Duska: Which, we can talk about, may or may not be generalizable to real life, but that's a separate issue because we certainly don't have those conditions everywhere where people get cared for with ovarian cancer. But how would you interpret the results of this study? Did it show us anything different? Dr. Kathleen Moore: I am going to say how we should interpret it and then what I am thinking about. It is a negative study. It was designed to show improvement in overall survival in these ideal settings in patients with FIGO stage IIIB and C, they excluded A, these low volume tumors that should absolutely be getting surgery. So FIGO stage IIIB and C and IVA and B that were fit enough to undergo radical surgery randomized to primary cytoreduction or neoadjuvant with interval, and were all given the correct chemo. Dr. Linda Duska: And they were allowed bevacizumab and PARP, also. They could have bevacizumab and PARP. Dr. Kathleen Moore: They were allowed bevacizumab and PARP. Not many of them got PARP, but it was distributed equally, so that would not be a confounder. And so that was important. Overall survival is the endpoint. It was a big study. You know, it was almost 600 patients. So appropriately powered. So let's look at what they reported. When they looked at the patients who were enrolled, this is a large study, almost 600 patients, 345 in the primary cytoreductive arm and 343 in the neoadjuvant arm. Complete resection in these patients was 70% in the primary cytoreductive arm and 85% in the neoadjuvant arm. So in both arms, it was very high. So your selection of site and surgeon worked. You got people to their optimal outcome. So that is very different than any other study that has been reported to date. But what we saw when we looked at overall survival was no statistical difference. The median was, and I know we do not like to talk about medians, but the median in the primary cytoreductive arm was 54 months versus 48 months in the neoadjuvant arm with a hazard ratio of 0.89 and, of course, the confidence interval crossed one. So this is not statistically significant. And that was the primary endpoint. Dr. Linda Duska: I know you are getting to this. They did look at PFS, and that was statistically significant, but to your point about what are we looking for for a reasonable PFS difference? It was about two months difference. When I think about this study, and I know you are coming to this, what I thought was most interesting about this trial, besides the fact that the OS, the primary endpoint was negative, was the subgroup analyses that they did. And, of course, these are hypothesis-generating only. But if you look at, for example, specifically only the stage III group, that group did seem to potentially, again, hypothesis generating, but they did seem to benefit from upfront surgery.  And then one other thing that I want to touch on before we run out of time is, do we think it matters if the patient is BRCA germline positive? Do we think it matters if there is something in particular about that patient from a biomarker standpoint that is different? I am hopeful that more data will be coming out of this study that will help inform this. Of course, unpowered, hypothesis-generating only, but it's just really interesting. What do you think of their subset analysis? Dr. Kathleen Moore: Yeah, I think the subsets are what we are going to be talking about, but we have to emphasize that this was a negative trial as designed. Dr. Linda Duska: Absolutely. Yes. Dr. Kathleen Moore: So we cannot be apologists and be like, "But this or that." It was a negative trial as designed. Now, I am a human and a clinician, and I want what is best for my patients. So I am going to, like, go down the path of subset analyses. So if you look at the stage III tumors that got complete cytoreduction, which was 70% of the cases, your PFS was almost 28 months versus 21.8 months. Dr. Linda Duska: Yes, it becomes more significant. Dr. Kathleen Moore: Yeah, that hazard ratio is 0.69. Again, it is a subset. So even though the P value here is statistically significant, it actually should not have a P value because it is an exploratory analysis. So we have to be very careful. But the hazard ratio is 0.69. So the hypothesis is in this setting, if you're stage III and you go for it and you get someone to no gross residual versus an interval cytoreduction, you could potentially have a 31% reduction in the rate of progression for that patient who got primary cytoreduction. And you see a similar trend in the stage III patients, if you look at overall survival, although the post-progression survival is so long, it's a little bit narrow of a margin.  But I do think there are some nuggets here that, one of our colleagues who is really one of the experts in surgical studies, Dr. Mario Leitao, posted this on X, and I think it really resonated after this because we were all saying, "But what about the subsets?" He is like, "It's a negative study." But at the end of the day, you are going to sit with your patient. The patient should be seen by a GYN oncologist or surgical oncologist with specialty in cytoreduction and a medical oncologist, you know, if that person does not give chemo, and the decision should be made about what to do for that individual patient in that setting. Dr. Linda Duska: Agreed. And along those lines, if you look carefully at their data, the patients who had an upfront cytoreduction had almost twice the risk of having a stoma than the patients who had an interval cytoreduction. And they also had a higher risk of needing to have a bowel resection. The numbers were small, but still, when you look at the surgical complications, as you've already said, they're higher in the upfront group than they are in the interval group. That needs to be taken into account as well when counseling a patient, right? When you have a patient in front of you who says to you, "Dr. Moore, you can take out whatever you want, but whatever you do, don't make me a bag." As long as the patient understands what that means and what they're asking us to do, I think that we need to think about that. Dr. Kathleen Moore: I think that is a great point. And I have definitely seen in our practice, patients who say, "I absolutely would not want an ostomy. It's a nonstarter for me." And we do make different decisions. And you have to just say, "That's the decision we've made," and you kind of move on, and you can't look back and say, "Well, I wish I would have, could have, should have done something else." That is what the patient wants. Ultimately, that patient, her family, autonomous beings, they need to be fully counseled, and you need to counsel that patient as to the site that you are in, her volume of disease, and what you think you can achieve. In my opinion, a patient with stage III cancer who you have the site and the capabilities to get to no gross residual should go to the OR first. That is what I believe. I do not anymore think that for stage IV. I think that this is pretty convincing to me that that is probably a harmful thing. However, I want you to react to this. I think I am going to be a little unpopular in saying this, but for me, one of the biggest take-homes from TRUST was that whether or not, and we can talk about the subsets and the stage III looked better, and I think it did, but both groups did really well. Like, really well. And these were patients with large volume disease. This was not cherry-picked small volume stage IIIs that you could have done an optimal just by doing a hysterectomy. You know, these were patients that needed radical surgery. And both did well. And so what it speaks to me is that anytime you are going to operate on someone with ovary, whether it be frontline, whether it be a primary or interval, you need a high-volume surgeon. That is what I think this means to me. Like, I would want high volume surgeon at a center that could do these surgeries, getting that patient, my family member, me, to no gross residual. That is important. And you and I are both in training centers. I think we ought to take a really strong look at, are we preparing people to do the surgeries that are necessary to get someone to no gross residual 70% and 85% of the time? Dr. Linda Duska: We are going to run out of time, but I want to address that and ask you a provocative question. So, I completely agree with what you said, that surgery is important. But I also think one of the reasons these patients in this study did so well is because all of the incredible new therapies that we have for patients. Because OS is not just about surgery. It is about surgery, but it is also about all of the amazing new therapies we have that you and others have helped us to get through clinical research. And so, how much of that do you think, like, for example, if you look at the PFS and OS rates from CHORUS and EORTC, I get it that they're, that they're not the same. It's different patients, different populations, can't do cross-trial comparisons. But the OS, as you said, in this study was 54 months and 48 months, which is, compared to 2010, we're doing much, much better. It is not just the surgery, it is also all the amazing treatment options we have for these patients, including PARP, including MIRV, including lots of other new therapies. How do you fit that into thinking about all of this? Dr. Kathleen Moore: I do think we are seeing, and we know this just from epidemiologic data that the prevalence of ovarian cancer in many of the countries where the study was done is increasing, despite a decrease in incidence. And why is that? Because people are living longer. Dr. Linda Duska: People are living longer, yeah. Dr. Kathleen Moore: Which is phenomenal. That is what we want. And we do have, I think, better supportive care now. PARP inhibitors in the frontline, which not many of these patients had. Now some of them, this is mainly in Europe, will have gotten them in the first maintenance setting, and I do think that impacts outcome. We do not have that data yet, you know, to kind of see what, I would be really interested to see. We do not do this well because in ovarian cancer, post-progression survival can be so long, we do not do well of tracking what people get when they come off a clinical trial to see how that could impact – you know, how many of them got another surgery? How many of them got a PARP? I think this group probably missed the ADC wave for the most part, because this, mirvetuximab is just very recently available in Europe. Dr. Linda Duska: Unless they were on trial. Dr. Kathleen Moore: Unless they were on trial. But I mean, I think we will have to see. 600 patients, I would bet a lot of them missed the ADC wave. So, I do not know that we can say we know what drove these phenomenal – these are some of the best curves we've seen outside of BRCA. And then coming back to your point about the BRCA population here, that is a really critical question that I do not know that we're ever going to answer. There have been hypotheses around a tumor that is driven by BRCA, if you surgically cytoreduced it, and then chemically cytoreduced it with chemo, and so you're starting PARP with nothing visible and likely still homogeneous clones. Is that the group we cured? And then if you give chemo first before surgery, it allows more rapid development of heterogeneity and more clonal evolution that those are patients who are less likely to be cured, even if they do get cytoreduced to nothing at interval with use of PARP inhibitor in the front line. That is a question that many have brought up as something we would like to understand better. Like, if you are BRCA, should you always just go for it or not? I do not know that we're ever going to really get to that. We are trying to look at some of the other studies and just see if you got neoadjuvant and you had BRCA, was anyone cured? I think that is a question on SOLO1 I would like to know the answer to, and I don't yet, that may help us get to that. But that's sort of something we do think about. You should have a fair number of them in TRUST. It wasn't a stratification factor, as I remember. Dr. Linda Duska: No, it wasn't. They stratified by center, age, and ECOG status Dr. Kathleen Moore: So you would hope with randomization that you would have an equal number in each arm. And they may be able to pull that out and do a very exploratory look. But I would be interested to see just completely hypothesis-generating what this looks like for the patients with BRCA, and I hope that they will present that. I know they're busy at work. They have translational work. They have a lot pending with TRUST. It's an incredibly rich resource that I think is going to teach us a lot, and I am excited to see what they do next. Dr. Linda Duska: So, outside of TRUST, we are out of time. I just want to give you a moment if there were any other messages that you want to share with our listeners before we wrap up. Dr. Kathleen Moore: It's an exciting time to be in GYN oncology. For so long, it was just chemo, and then the PARP inhibitors nudged us along quite a bit. We did move more patients, I believe, to the cure fraction. When we ultimately see OS, I think we'll be able to say that definitively, and that is exciting. But, you know, that is the minority of our patients. And while HRD positive benefits tremendously from PARP, I am not as sure we've moved as many to the cure fraction. Time will tell. But 50% of our patients have these tumors that are less HRD. They have a worse prognosis. I think we can say that and recur more quickly. And so the advent of these antibody-drug conjugates, and we could name 20 of them in development in GYN right now, targeting tumor-associated antigens because we're not really driven by mutations other than BRCA. We do not have a lot of things to come after. We're not lung cancer. We are not breast cancer. But we do have a lot of proteins on the surface of our cancers, and we are finally able to leverage that with some very active regimens. And we're in the early phases, I would say, of really understanding how best to use those, how best to position them, and which one to select for whom in a setting where there is going to be obvious overlap of the targets. So we're going to be really working this problem. It is a good problem. A lot of drugs that work pretty well. How do you individualize for a patient, the patient in front of you with three different markers? How do you optimize it? Where do you put them to really prolong survival? And then we finally have cell surface. We saw at ASCO, CDK2 come into play here for the first time, we've got a cell cycle inhibitor. We've been working on WEE1 and ATR for a long time. CDK2s may hit. Response rates were respectable in a resistant population that was cyclin E overexpressing. We've been working on that biomarker for a long time with a toxicity profile that was surprisingly clean, which I like to see for our patients. So that is a different platform. I think we have got bispecifics on the rise. So there is a pipeline of things behind the ADCs, which is important because we need more than one thing, that makes me feel like in the future, I am probably not going to be using doxil ever for platinum-resistant disease. So, I am going to be excited to retire some of those things. We will say, "Remember when we used to use doxil for platinum-resistant disease?" Dr. Linda Duska: I will be retired by then, but thanks for that thought. Dr. Kathleen Moore: I will remind you. Dr. Linda Duska: You are right. It is such an incredibly exciting time to be taking care of ovarian cancer patients with all the opportunities.  And I want to thank you for sharing your valuable insights with us on this podcast today and for your great work to advance care for patients with GYN cancers. Dr. Kathleen Moore: Likewise. Thanks for having me. Dr. Linda Duska: And thank you to our listeners for your time today. You will find links to the TRUST study and other studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to 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. Linda Duska  @Lduska Dr. Kathleen Moore Follow ASCO on social media:     @ASCO on X (formerly Twitter) ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures of Potential Conflicts of Interest:    Dr. Linda Duska:   Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma  Research Funding (Inst.): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Ludwig Institute for Cancer Research, Leap Therapeutics  Patents, Royalties, Other Intellectual Property: UptToDate, Editor, British Journal of Ob/Gyn  Dr. Kathleen Moore: Leadership: GOG Partners, NRG Ovarian Committee Chair Honoraria: Astellas Medivation, Clearity Foundation, IDEOlogy Health, Medscape, Great Debates and Updates, OncLive/MJH Life Sciences, MD Outlook, Curio Science, Plexus, University of Florida, University of Arkansas for Medical Sciences, Congress Chanel, BIOPHARM, CEA/CCO, Physician Education Resource (PER), Research to Practice, Med Learning Group, Peerview, Peerview, PeerVoice, CME Outfitters, Virtual Incision Consulting/Advisory Role: Genentech/Roche, Immunogen, AstraZeneca, Merck, Eisai, Verastem/Pharmacyclics, AADi, Caris Life Sciences, Iovance Biotherapeutics, Janssen Oncology, Regeneron, zentalis, Daiichi Sankyo Europe GmbH, BioNTech SE, Immunocore, Seagen, Takeda Science Foundation, Zymeworks, Profound Bio, ADC Therapeutics, Third Arc, Loxo/Lilly, Bristol Myers Squibb Foundation, Tango Therapeutics, Abbvie, T Knife, F Hoffman La Roche, Tubulis GmbH, Clovis Oncology, Kivu, Genmab/Seagen, Kivu, Genmab/Seagen, Whitehawk, OnCusp Therapeutics, Natera, BeiGene, Karyopharm Therapeutics, Day One Biopharmaceuticals, Debiopharm Group, Foundation Medicine, Novocure Research Funding (Inst.): Mersana, GSK/Tesaro, Duality Biologics, Mersana, GSK/Tesaro, Duality Biologics, Merck, Regeneron, Verasatem, AstraZeneca, Immunogen, Daiichi Sankyo/Lilly, Immunocore, Torl Biotherapeutics, Allarity Therapeutics, IDEAYA Biosciences, Zymeworks, Schrodinger Other Relationship (Inst.): GOG Partners

Send us a textGood morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a host of transformative events reshaping the landscape, from strategic acquisitions and funding infusions to regulatory maneuvers and scientific breakthroughs.Johnson & Johnson has taken a decisive step in its oncology strategy with the $3 billion acquisition of Halda's cell death technology. This acquisition, focusing on the "hold and kill" bifunctional small molecule platform, is poised to enhance J&J's prostate cancer pipeline significantly. It underscores J&J's commitment to expanding its oncology portfolio through innovative platforms designed to improve therapeutic outcomes. The move highlights a broader industry trend toward personalized medicine and targeted cancer therapies, which are becoming pivotal in improving patient care.In another domain of cancer treatment, Nuvalent has unveiled promising Phase 1/2 data for its candidate neladalkib, which could position the company as a formidable competitor to Pfizer's established lung cancer drug, Lorbrena. The promising data might expedite regulatory discussions with the FDA, potentially leading to an accelerated approval process. This development illustrates the competitive landscape in oncology, where firms strive to introduce novel therapies with improved efficacy and safety profiles.The field of antibody-drug conjugates (ADCs) is also experiencing significant advancements. A San Diego-based biotech has secured $120 million in funding to develop a best-in-class ADC formula, with support from Merck & Co. This initiative aims to refine the precision and efficacy of ADCs by delivering cytotoxic agents directly to cancer cells while minimizing collateral damage to healthy tissues. Such innovations are crucial as they represent a new frontier in targeted cancer therapy.In terms of financial activities, Artios Pharma's successful $115 million Series D funding round is set to bolster its clinical efforts in exploring DNA damage response inhibitors for cancer treatment. These inhibitors target cancer cells' ability to repair DNA damage, holding potential for more effective therapies against resistant cancer types. Meanwhile, Sofinnova Partners' €650 million raise for biotech and medtech investments amid a volatile economic environment underscores continued investor confidence in life sciences despite market uncertainties.Bayer is making strategic moves in China by opening an incubator in Beijing. This facility will host local biopharma companies such as Suzhou Puhe Biopharma and Beijing Youngen Technology, fostering innovation and collaboration within China's burgeoning biotech landscape. Such initiatives reflect global efforts to leverage regional strengths and foster cross-border collaborations.On the operational side, Nxera Pharma is restructuring its workforce by laying off 15% of its staff as part of a strategic pivot towards profitability. This decision mirrors broader industry trends where companies refocus resources on core projects to streamline operations and enhance financial stability.A recent study has highlighted the impact of NIH grant cuts on clinical trials across the United States. Over 383 trials involving more than 74,000 patients have been disrupted due to funding terminations under the current administration. This situation raises concerns about the sustainability of clinical research funding and its implications for ongoing medical advancements.Jazz Pharmaceuticals has reported practice-changing Phase 3 results for its HER2-targeted drug Ziihera for gastroesophageal adenocarcinoma. These findings reaffirm Jazz's confidence in positioning Ziihera as a preferred first-line treatment option for HER2-positive cancers, poSupport the show

Send us a textIn this episode of ADC's Parenting Adult Children podcast, host James Moffitt is joined by John Fela and Katy Moffitt to discuss the challenges and experiences of parenting children with disabilities. John shares his journey as a parent of a nonverbal autistic son, highlighting the fears and realities of finding suitable care and community for his child. Katy, with her extensive experience in special education, adds insights into the educational needs and social dynamics of children with disabilities. The conversation delves into the importance of community support, the role of churches in disability ministry, and the need for awareness and acceptance in society.Keywordsparenting, disability advocacy, autism, special education, community support, church ministry, awareness, acceptance, nonverbal communication, special needsTakeawaysJohn Fela describes himself as the 'Swiss Army knife of disability advocacy.'John's son, Chris, is nonverbal and autistic, requiring specialized care.Katy has over 25 years of experience in special education.The importance of finding a supportive community for families with disabilities.Challenges in finding suitable educational and living environments for children with disabilities.The role of churches in providing support and inclusion for families with disabilities.John emphasizes the need for awareness and acceptance in society.The fear of the future and loneliness as a parent of a child with disabilities.The significance of communication tools like TouchChat for nonverbal individuals.John's advocacy work includes writing, speaking, and creating support groups for fathers.Title OptionsNavigating Disability Advocacy with John FelaParenting Challenges: A Journey with John and KatyBuilding Community Support for Special Needs FamiliesThe Role of Churches in Disability MinistryJohn Fela: A Voice for Disability AdvocacyUnderstanding Autism: Insights from John FelaSpecial Education and Parenting: Katy's PerspectiveCreating Inclusive Communities for DisabilitiesJohn Fela's Advocacy JourneySupporting Nonverbal Communication in AutismSound bitesSwiss Army knife of disability advocacyFear of the future and lonelinessImportance of community supportRole of churches in inclusionAwareness and acceptance in societyNonverbal communication toolsChallenges in special educationBuilding support groups for fathersNavigating disability advocacyCreating inclusive communitiesChapters00:00:00 Introduction and Guest Introductions00:00:00 John Fela's Advocacy Journey00:00:00 Parenting a Nonverbal Autistic Child00:00:01 Educational and Living Challenges Listen here for our sponsors list. Many thanks to them for helping to underwrite the costs of producing this podcast. Support the showSocial Media Links https://www.youtube.com/@JamesMoffitt https://www.instagram.com/parentingadultchildren125/ https://www.tiktok.com/@chiefpropellerhead ABC's of Parenting Adult Children Facebook Page https://www.facebook.com/profile.php?id=61581576308055 r/parentingadultchildren Feel free to subscribe to these channels and share the links with your social media portals.

Esportmaníacos 2421: En el programa de hoy hemos hablado de cómo progresa el mercado europeo. Flakked dejará de ser el ADC de Team Heretics, dejando el equipo tras tres años de prestar sus servicios. Movistar KOI ha fichado a Alphari como assistant coach para reforzar el cuerpo técnico y por otro lado, tenemos muchas noticias sobre el mercado asiático, haciendo especial hincapié en T1. APÓYANOS AQUÍ https://www.patreon.com/Esportmaniacos https://www.twitch.tv/esportmaniacos 🔁Nuestras redes🔁 https://twitter.com/Esportmaniacos https://www.tiktok.com/@esportmaniacos 💙Referido de AMAZON: https://amzn.to/36cVx3g 00:00:00 - Intro 00:19:20 - Nerf a Neeko, ¿y a las skins de T1? 00:25:35 - ¿Renovará Doran con T1? 00:40:10 - KT Rolster podría perder a su roster 00:45:15 - Más rumores de la offseason asiática 00:56:08 - KOI Alphari 01:18:45 - Flakked deja Heretics 01:45:30 - Mikyx ofreció su proyecto a Fnatic (y le dijeron que no)

Phelim Warren is not only a mega-talented musician, he's also a sports fanatic whose positivity flows into his beloved Shamrock Rovers. A brilliant volunteer, Phelim joins to discuss his work with ADC commentary, Rovers and the League of Ireland - and a personal battle that brought out the very best in him. Phelim has an angel on his shoulder.

Huit danseuses et danseurs plus la chanteuse Billie Bird et la DJ Mânaa pour emporter le public dans une formidable tempête de joie. Avec sa troupe de bleu vêtue, la chorégraphe Géradine Chollet célèbre le collectif et le lien. Cette baleine fait un job formidable. A voir à Vidy-Lausanne jusquʹau 9 novembre. Puis à lʹADC de Genève du 13 au 15 novembre. Chronique de Thierry Sartoretti.

Aleluya: vuelve al estudio Álex Vicente, la voz de ADC y de nuestras conciencias. Hablamos de Taylor Swift y de su era showgirl, que más bien parece su era fantasía tradwife. Pero, básicamente, hablamos con y de nuestra showgirl, Noelia Ramírez, que publica libro. ‘Nadie me esperaba aquí' era un ensayo sobre el desclasamiento al que se le cruzó el duelo, un texto hondo y vibrante que abre nuevas lecturas sobre la muy universal experiencia de no pertenecer del todo a ningún lugar.

In this week's episode of Dividend Talk, we're back with a jam-packed Dividend Announcements & Earnings deep dive.We kick things off with PayPal initiating its first-ever dividend (welcome to the club, Monkey!), Hershey holding flat to stay off the aristocrat chopping block, and a wild stat on revenue-per-employee (OnlyFans crushes tech giants at $37.6M per head). Then it's over to dividend hikes from Iberdrola (+8.2%), Rockwell Automation, AbbVie, and ExxonMobil, before diving into earnings: Nestlé's volume rebound in China, Schneider Electric riding data-center tailwinds, Altria's cash-rich but growth-poor reality, UnitedHealth's margin squeeze, T. Rowe Price outflows, and Shell's $10B FCF buyback machine.In the Q&A, we tackle benchmarking vs. S&P 500, dollar-cost-averaging into falling knives, estate tax broker moves, covered-call ETFs, Finnish gems, Evolution's permanent pivot, and stock-specific takes on Novo Nordisk, APD, Qualcomm, and more.SEE YOU ON THE INSIDE!!Tickers discussed: PYPL, HSY, GOOGL, MSFT, EBAY, AMZN, IBM, MCD, IEP, IBDR.MC, MUM.DE, SIE.DE, APD, LIN, NOVO-B.CO, EVO.ST, QCOM, ARE, ADC, MO, BATS.L, PM, UNH, TROW, SHEL, XOM, TTE, ITW, ABT, ADP, SCHN.PA, ROC.AX, NOVN.SW, NESN.SW, MCD, APH, DHR, TXN, VFC, RELAS, VWS.CO, WSO, GRG.LJoin us:[Facebook] – Https://www.facebook.com/groups/dividendtalk[Twitter] – @DividendTalk_ , @European_DG[Discord] – https://discord.gg/nJyt9KWAB5[Premium Services] – https://dividendtalk.eu/download-your-free-samples/[Malmo Meetup] – https://t.co/STgV1nMWKj

On today's episode, Dr. Tabby Khan, senior director of analytics for Komodo Health, spoke about their newest data analysis measuring age and insurance disparities in antibody-drug conjugate, or ADC, treatment rates in patients with metastatic breast cancer. The analysis was in partnership with the Tigerlily Foundation, a national breast cancer advocacy organization, in celebration of the 40th anniversary of Breast Cancer Awareness Month.

Election season is usually a time of open contests, new ambitions and fresh starts.But what happens when the gate to politics is closed  not by law, but by those in power?On Monday, October 28, 2025, veteran politician Sule Lamido arrived at the headquarters of Peoples Democratic Party in Abuja. He came prepared to purchase the nomination and expression-of-interest forms to contest for the party's national chairmanship. Instead, he walked away without them  denied access to the very entry ticket to the race.Why was Lamido shut out?What is the party's justification?And what does this shut-out tell us about democracy and internal party rule in Nigeria?This is what we are discussing in today's episode of Nigeria Daily.

Election day a moment that should define the futuretoo often turns into a market square.Whispers behind polling booths… folded notes exchanged for a quick thumbs-up…bags of rice delivered hours before the ballot box opens.Votes the very foundation of democracy are being sold to the highest bidder.But what does the law actually say about this dangerous practice?Who is breaking the law the buyer, the seller, or both?And what is being done to stop politicians from turning our votes into commodities?This is what we're discussing in today's episode of Nigeria Daily.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Recent developments in these industries underscore a period of significant scientific progress, regulatory maneuvers, and strategic investments.One notable event was AstraZeneca and Daiichi Sankyo's success at the European Society for Medical Oncology Congress 2025. Their antibody-drug conjugate, Datroway, demonstrated superior efficacy compared to Gilead's Trodelvy in the first global head-to-head trial involving Trop2-targeted therapies. This reflects the increasing focus on antibody-drug conjugates as precision medicine tools that offer targeted treatment options with potentially improved outcomes over traditional chemotherapy.In a move highlighting the ongoing trend of bolstering domestic production capacities, Merck is making a substantial $3 billion investment in a small molecule drug plant in Virginia. This is part of a broader $70 billion commitment to expand manufacturing and R&D capabilities in the U.S. Such strategic investments are crucial for maintaining competitive advantage and ensuring drug availability while meeting rising demands and streamlining supply chains.Turning to regulatory updates, the FDA has approved Amgen and AstraZeneca's Tezspire for chronic rhinosinusitis with nasal polyps. This marks Tezspire's second indication, following its initial approval for severe asthma in 2021. The expanded approval showcases the drug's versatility and represents a strategic push to enhance its market presence against competitors like Dupixent.In oncology, Merck's Keytruda and Astellas/Pfizer's Padcev have made headlines with compelling results in muscle-invasive bladder cancer. The combination therapy reduced the risk of death by 50%, reinforcing Keytruda's position as a cornerstone immunotherapy across multiple cancer types. This result not only augments treatment options but also signifies the potential for combination regimens to enhance patient outcomes.Roche has expanded the indication of its aging oncology drug Gazyva to treat lupus nephritis, demonstrating strategic repurposing efforts to extend the lifecycle of existing therapies. While this expansion into autoimmune diseases comes late in Gazyva's lifecycle, it highlights a growing trend of capitalizing on established drugs for new therapeutic areas.AstraZeneca and Daiichi Sankyo's Enhertu showed robust efficacy in early breast cancer treatment, potentially reshaping therapeutic strategies by offering new hope for early intervention. Similarly, Novartis' Pluvicto demonstrated promise in slowing hormone-sensitive prostate cancer progression, underscoring the potential of radioligand therapies in oncology.However, not all developments have been positive. AstraZeneca faced setbacks when its Imfinzi and Lynparza combination failed to meet survival goals in ovarian cancer, underscoring the challenges inherent in oncology drug development and the stringent benchmarks set by regulatory authorities like the FDA.The industry is also witnessing significant advancements in next-generation ADCs, as evidenced by Tubulis' 59% response rate in early clinical trials, which has attracted substantial investor interest. Additionally, Grail's Galleri cancer blood test is progressing towards FDA review with enhanced performance data, potentially revolutionizing cancer screening and early detection practices.These scientific and regulatory milestones are complemented by strategic investments in bioconjugation technologies. Cohance Life Sciences' $10 million investment in NJ Bio to enhance GMP bioconjugation capabilities exemplifies this trend. Such investments are crucial for advancing ADC development, which remains a focal point for innovative cancer therapies.Overall, these developments reflect a dynamic phase for the pharmaceutical and biotech sectors characterized by signSupport the show

Hear experts Matthieu Culié and Alessandro Agosti as they discuss how Olon stands out in a competitive landscape through its fully integrated end-to-end ADC manufacturing expertise, global operations, impurity control and strategic facilities.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we'll delve into a series of remarkable advancements and strategic movements shaping the landscape of healthcare. Let's start with a recent spotlight on the European Society for Medical Oncology Congress 2025, where key clinical trial outcomes have emerged, potentially reshaping future treatment protocols.AstraZeneca made waves with its Phase 3 trial results for Imfinzi, a PD-L1 inhibitor, in high-risk non-muscle invasive bladder cancer. The findings suggest that Imfinzi stands strong against Pfizer's PD-1 candidate, Sasanlimab. This is particularly noteworthy as bladder cancer has historically had limited non-invasive treatment options. The implications for patient care are substantial, providing hope for improved management of this form of cancer and possibly influencing treatment standards.Meanwhile, Eli Lilly's Verzenio marked another success at the ESMO Congress with its overall survival win in early breast cancer cases. This victory enhances Verzenio's standing within the CDK4/6 inhibitor class, suggesting increased adoption in clinical settings. The demonstration of extended survival benefits not only strengthens Verzenio's competitive position but also contributes to setting a new standard of care in early breast cancer treatment.On the regulatory front, Sanofi encountered mixed outcomes from the European Medicines Agency's Committee for Medicinal Products for Human Use. While Rezurock was not recommended as a third-line treatment for chronic graft-versus-host disease, this decision underscores the stringent regulatory processes companies navigate despite existing market success in other regions like the U.S.In a significant move by the FDA to expedite drug approvals, nine companies including Merck KGaA and Regeneron received priority review vouchers. These vouchers allow a shortened review timeline, reflecting an ongoing trend towards accelerating drug availability to address unmet medical needs swiftly.In terms of strategic developments, EMD Serono—Merck KGaA's U.S. branch—has unveiled a major discount initiative for its IVF treatments on the TrumpRx platform. This aligns with broader efforts to make fertility treatments more accessible amidst rising demand and economic pressures.The metabolic dysfunction-associated steatohepatitis (MASH) arena is also witnessing robust interest with over $10 billion recently reported in mergers and acquisitions. This surge indicates confidence among Big Pharma players in MASH as a lucrative therapeutic field ripe for innovation and development.In response to competitive pressures and operational challenges, Kezar Life Sciences is preparing for layoffs following the FDA's decision to cancel a critical meeting related to its R&D program. This situation illustrates the volatile dynamics within biotech firms where regulatory decisions can significantly impact corporate strategies and workforce stability.Overall, these developments reflect an industry characterized by rapid innovation, strategic realignments, and an evolving regulatory framework. The implications for patient care are substantial as these scientific advancements promise enhanced treatment options across various therapeutic areas.Switching gears to scientific developments, Bristol Myers Squibb has reported promising results from early-stage trials of its EGFRxHER3 antibody-drug conjugate. Demonstrating a 55% overall response rate, this positions BMS to potentially gain a competitive edge in the ADC market—a sector valued for targeting cancer cells while minimizing side effects on healthy tissues.Strategic partnerships continue to shape industry growth and innovation. Roche has secured a deal with Hansoh Pharmaceutical worth up to $1.45 billion for global rights to an experimental ADC outside Greater China. SimilSupport the show

This week's EYE ON NPI is as mysterious and powerful as the extra-dimensional being from Star Trek (https://en.wikipedia.org/wiki/Q_(Star_Trek)) - it's the new Arduino UNO Q (https://www.digikey.com/en/product-highlight/a/arduino/uno-q-microcontroller-board) microcontroller board, released as part of the Qualcomm/Arduino acquisition announcement (https://www.qualcomm.com/news/releases/2025/10/qualcomm-to-acquire-arduino-accelerating-developers--access-to-i). This Uno-shaped board is packed with both an STM32 microcontroller and a Qualcomm Dragonwing microprocessor so you get the best-of-both-worlds: 3.3V/5V logic compatibility with timers and ADCs, plus a full Debian install and AI support for running local vision models. We last checked in on Arduino we were reviewing their new announcements based on a partnership with Renesas: the Arduino Nano R4 SoC (https://www.youtube.com/watch?v=QLAI41ZfCfw) which is a miniaturized version of the UNO R4 (https://www.youtube.com/watch?v=uw0EU8urz5M). These boards feature an Arm microcontroller, with lots of fun on-board accessories like an LED grid, Qwiic connector, and WiFi/Bluetooth module. These boards represented a bump in capabilities over the classic UNO R3 (https://www.digikey.com/en/products/detail/arduino/A000073/3476357) but are still under-powered compared to the 'Portenta' line (https://www.digikey.com/en/products/detail/arduino/ABX00045/15294134). So, when we see the Arduino UNO Q (https://www.digikey.com/short/qc9d09fm) is a merging of three separate 'strands' of Arduino development history. One, it's shaped and has hardware-compatibility with the classic UNO which has been their mainstay for decades. Two, it has the powerful microcontroller type that the Pro line features. And three, it revives some of the Linux-based boards that Arduino had previously released like the Yun (https://www.digikey.com/en/products/detail/arduino/A000008/4486331), Tian (https://docs.arduino.cc/retired/boards/arduino-tian/) and Tre (https://docs.arduino.cc/retired/boards/arduino-tre). What sets the Q apart is that this time instead of being just a chip-supplier partnership, Arduino has been acquired as a subsidiary of Qualcomm (https://www.qualcomm.com/news/releases/2025/10/qualcomm-to-acquire-arduino-accelerating-developers--access-to-i) which means that there's going to be first-class engineering support for the onboard Dragonwing processor. Speaking of, let's take a look at the hardware included in the new Q! There's two chipsets on each board: the big processor is a Qualcomm Dragonwing™ QRB2210 (https://www.digikey.com/en/products/detail/qualcomm/QRB-2210-0-NSP752-TR-00-0/27904331) - 64-bit System-on-Chip with 4 × Arm Cortex-A53 running at 2.0 GHz and Adreno 702 GPU running at 845 MHz for 3D graphics. This chip runs mainline Debian OS with upstream support so you can configure a kernel and distribution image without needing patches. Arduino and Qualcomm distribute their own ready to go image too (https://docs.arduino.cc/tutorials/uno-q/update-image/). This chip has modern A/V support with both CSI camera and DSI MIPI display capability to match. Those high speed connects are available on the dual 60-pin bottom connects - while there isn't a sub-connect board right now, it's likely that Arduino will develop one soon. Meanwhile, you can use their documentation (https://docs.arduino.cc/hardware/uno-q/) such as STEP and Gerber files if you want to start adding a direct-plug integration into your hardware now. The second chipset is a STM32U585 Arm Cortex-M33 with 2 MB Flash, 786 kB SRAM and running at 160 MHz - it runs the Arduino Core via Zephyr OS and from the block diagram, looks like it communicates with the main core via UART and SPI. The STM is what handles GPIO, PWM, ADC, DAC, timers, etc since it is 3.3V logic and has some 5V logic-level compatibility. The main headers on the Arduino - and some of the bottom extra headers - expose the STM logic so you can connect standard sensors, OLEDs, relays etc. While there are some GPIO from the Dragonwing also available, they're 1.8V logic and are already allocated in the Linux Device tree. The Arduino UNO Q (https://www.digikey.com/short/qc9d09fm) is available for pre-order right now from DigiKey for a door-busting $44! We've already put in our order, and we'll do a project to check it out as soon as it arrives. After you get your pre-order in, check out some of the projects that have already been published to get a sense of the Q's capabilities like this MAME emulation arcade cabinet (https://projecthub.arduino.cc/jcarolinares/arduino-uno-q-arcade-cabinet-machine-39dd38) or face-recognition car (https://www.youtube.com/watch?v=EGDxAXpH_Ag). You can start dreaming of what you'll be able to do with a full computer + microcontroller board that fits where your old UNO R3 would fit, while you wait for the shipping notification.

What happens when the most complex molecules in biotech meet the organizational challenge of managing 300+ analytical scientists? The answer lies not just in the science, but in building systems that turn technical complexity into reliable delivery.In Part 2 of our deep dive with Amanda Hoertz, VP of Analytical and Formulation Sciences at KBI Biopharma, we shift focus from the molecular intricacies of ADCs to the operational mastery required to scale analytical development across multiple sites. Amanda reveals how her team achieves consistency across hundreds of scientists while maintaining the agility to pivot priorities in real time when critical programs need emergency support.This isn't just about managing people; it's about architecting systems that preserve institutional knowledge, accelerate method transfer, and deliver results when regulatory deadlines loom.What you'll discover:Seamless Project Handoffs Without Knowledge Loss: How KBI's stable team assignments eliminate the costly learning curves that plague most CDMO relationships, ensuring your molecule expertise stays with your program from development through commercial manufacturing.Organizational Scale Without Operational Chaos: The decision tree and layered reporting structure that allows 200+ analysts at a single site to function as a coordinated force, capable of rapid reprioritization and flood-level resource deployment when programs reach critical status.Digital Transformation That Actually Works: Beyond the automation buzzwords, Amanda walks through the practical realities of LIMS/ELN implementation, audit-compliant systems, and machine learning databases that transform raw data into defensible, actionable insights for complex biologics.Whether you're evaluating how analytical capabilities scale with program complexity, or seeking practical insights into leading technical teams through digital transformation, this episode delivers the operational intelligence that separates successful ADC programs from expensive failures.Connect with Amanda Hoertz:LinkedIn: www.linkedin.com/in/amanda-hoertz-3aba605KBI Biopharma: www.kbibiopharma.comKBI Portal: www.standalone.kbi.bioNext step:Book a 20-minute call to help you get started on any questions you may have about bioprocessing analytics: https://bruehlmann-consulting.com/call

In recent months, the People's Democratic Party (PDP) has witnessed a string of high-profile defections to the ruling All Progressives Congress (APC).From governors to lawmakers, political bigwigs are switching sides leaving many Nigerians wondering if the PDP, once Africa's largest political party, is losing its grip.Is the PDP truly on the verge of extinction, or are these defections part of a broader political realignment ahead of 2027?Join us on this episode of Nigeria Daily as we unpack the forces reshaping Nigeria's opposition politics.

Featuring an interview with Dr Laura Huppert, including the following topics: General overview of antibody-drug conjugate (ADC) structure and function; mechanisms of resistance to ADCs (0:00) Preventing and managing toxicities associated with trastuzumab deruxtecan (5:44) Selecting between sacituzumab govitecan and datopotamab deruxtecan for patients with metastatic breast cancer; common toxicities associated with these 2 agents (9:30) Potential use of ADCs in the first line for metastatic triple-negative breast cancer (mTNBC) (16:13) Case: A woman in her mid 40s with mTNBC receives sacituzumab govitecan and pembrolizumab in the first-line setting (18:25) CNS penetration and activity of ADCs in the treatment of breast cancer (22:27) Use of trastuzumab deruxtecan for HER2-ultralow mTNBC; promising trials of ADCs and other therapies for mTNBC (24:24) Treatment options in the second line and beyond for patients with HR-positive mBC that is HER2-negative, HER2 low or HER2 ultralow (27:05) Case: A woman in her late 50s with HR-positive, HER2-low mBC experiences disease progression on multiple lines of therapy (30:51) Ongoing evaluation of ADCs in the localized disease setting (35:42) Novel therapeutic approaches for leptomeningeal disease in patients with breast cancer (38:38) CME information and select publications

What if the key to unlocking ADC manufacturing success lies in abandoning the platform mindset entirely?Antibody-drug conjugates represent biotech's most promising weapon against cancer: precision-targeted therapeutics that deliver cytotoxic payloads directly to tumor cells while sparing healthy tissue. But beneath the clinical promise lies a manufacturing reality that's rewriting the rules of bioprocess development, demanding analytical strategies that most CDMOs simply aren't equipped to handle.In this deep-dive episode, David Brühlmann sits down with Amanda Hoertz, Vice President of Analytical and Formulation Sciences at KBI Biopharma, where she oversees 300+ scientists across the mammalian network. Amanda's team has cracked the code on some of the industry's most challenging ADC programs, achieving a remarkable 93% batch success rate by rejecting cookie-cutter approaches in favor of molecule-specific development strategies.What you'll discover:The Platform Fallacy: Why treating ADCs like standard monoclonals is costing companies millions and months of development time, and the bespoke analytical framework that's changing everything.Cytotoxic Payload Management: From free drug analysis to employee safety protocols, Amanda reveals the hidden complexities of handling molecules designed to kill cells, including the specialized facilities and analytical methods required for GMP manufacturing.Charge Heterogeneity Mastery: The analytical method that "keeps Amanda up at night," and the development strategies her team uses to achieve robust separation and qualification across multiple sites and analysts.This episode delivers the technical depth and strategic insights that bioprocess engineers need to navigate ADC development successfully. Whether you're evaluating CDMO partnerships, optimizing analytical methods, or scaling complex conjugates, Amanda's proven strategies will transform your approach to these game-changing therapeutics.Ready to master the analytical complexities that make or break ADC programs?Connect with Amanda Hoertz:LinkedIn: www.linkedin.com/in/amanda-hoertz-3aba605KBI Biopharma: www.kbibiopharma.comKBI Portal: www.standalone.kbi.bioNext step:Book a 20-minute call to help you get started on any questions you may have about bioprocessing analytics: https://bruehlmann-consulting.com/call

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      

Synopsis: Few biotechs can pull off what Syndax Pharmaceuticals has achieved — two first-in-class oncology drug launches, built entirely through strategic in-licensing and disciplined execution. In this episode, host Alok Tayi sits down with Michael Metzger, Chief Executive Officer of Syndax, to explore how the company identified breakthrough assets, advanced them through development, and successfully commercialized them within a span of just a few years. Metzger unpacks Syndax's distinctive model — leveraging external innovation, rapid clinical validation, and precision in go-to-market strategy — to create measurable patient and shareholder value. From the first menin inhibitor approved in acute leukemia to a novel CSF1R antibody reshaping GVHD and fibrosis care, Syndax's portfolio embodies science that scales. The conversation offers an insider's perspective on risk management, deal-making, data-driven decision-making, and why speed to market has become the new differentiator in biotech. A must-listen for investors, executives, and founders navigating the complexities of growth in a capital-intensive industry. Biography: Michael A. Metzger is a seasoned biopharmaceutical executive with extensive leadership experience in company building, operations, and strategic transactions across the life sciences industry. He currently serves as the Chief Executive Officer of Syndax Pharmaceuticals, a publicly traded oncology company, a role he assumed in 2022. Prior to this, Michael served as President and Chief Operating Officer of Syndax from 2015 and has been a member of the company's Board of Directors since 2019. Previously, Michael held leadership roles at Regado Biosciences, Inc, where he served as President and CEO and guided the company through a successful merger with Tobira Therapeutics. He also served as Executive Vice President and COO at Mersana Therapeutics, Inc., where he oversaw key strategic initiatives in ADC development for oncology. Earlier in his career, Michael held senior roles in business development and M&A at Forest Laboratories, LLC, contributing to its transformation ahead of its acquisition by Allergan plc. He also held leadership positions at Onconova Therapeutics, Inc., and was a Managing Director at MESA Partners, Inc., a healthcare-focused venture capital firm. Michael has served on several public and private company boards, including CTI BioPharma Corp., acquired by SOBI AB in 2023, and continues to be active in guiding innovative biotech organizations. Michael holds a B.A. from George Washington University and a M.B.A. in Finance from the NYU Stern School of Business.

In this episode of the Mic On Podcast, the host, Seun Okinbaloye, speaks with former Senior Political Assistant to Atiku Abubakar, Demola Olarewaju about Nigeria's 2027 political landscape.Mr Olarewaju, who resigned from the PDP, says the party is “no longer fit for purpose” and pitches the ADC as the real opposition force, especially on a potential Atiku–Obi ticket. He calls Tinubu a “political strategist” but says the president is beatable if opposition groups unite.On Lagos politics, Mr Olarewaju rejected the talk of Seyi Tinubu's governorship ambition, arguing that the state needs inclusive leadership beyond oligarch families.Guest:Mr Demola OlarewajuSenior Political Assistant to Atiku Abubakar

As Nigeria gears up for the next general election, a heated debate is brewing. Supporters of former President Goodluck Jonathan are rallying behind his potential return to the presidency, citing his experience and leadership skills. However, others are raising constitutional concerns, arguing that a third term would be barred by the country's laws. The debate is sparking intense discussions across the nation, with legal experts, politicians, and ordinary citizens weighing in on the matter. As the country navigates this complex issue, questions about the rule of law, political precedent, and the will of the people are coming to the fore. Can Goodluck Jonathan's supporters convince the nation that he's the right leader for the job, or will the constitutional concerns prevail? The answer remains to be seen, but one thing is certain  this debate will continue to shape Nigeria's political landscape in the months to come."

We break down Pobelter's thoughts on the ADC role and discuss how OP support is.Join an academy for coaching and guides: https://wtl.lol/thinkchallJoin our free community with courses: https://wtl.lol/skool

Editor-in-Chief of the Archives of Disease in Childhood, Dr. Nick Brown, and Senior Editor of ADC, Dr. Rachel Agbeko bring you the monthly Atoms - the highlights of the October 2025 issue. Read it on the Archives of Disease in Childhood website: https://adc.bmj.com/content/110/10/i        Please listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify to get episodes automatically downloaded to your phone and computer. And if you enjoy the podcast, please leave us a review at https://podcasts.apple.com/gb/podcast/adc-podcast/id333278832

Featuring an interview with Prof Peter Schmid, including the following topics: Response to immunotherapy in breast cancer subtypes (0:00) Tolerability of TROP2 antibody-drug conjugates (ADCs) for metastatic breast cancer (mBC) (3:51) Approaches to therapy for patients with HR-negative HER2-low and HER2-ultralow mBC (13:03) ADC structure and treatment-related adverse events (19:02) Available data from the Phase III ASCENT-04 trial evaluating sacituzumab govitecan with pembrolizumab as first-line therapy for patients with PD-L1-positive advanced triple-negative breast cancer (23:06) Novel ADCs and bispecific antibodies under investigation for mBC (28:30) Comparing datopotamab deruxtecan and sacituzumab govitecan for HR-positive disease (33:01) Clinical investigator perspectives on the Phase III DESTINY-Breast09 trial evaluating first-line trastuzumab deruxtecan with or without pertuzumab versus THP (docetaxel/rastuzumab/pertuzumab) for HER2-positive mBC (35:06) CME information and select publications

Suite retour sur mon son trop bas, j'ai fait de mon mieux en post production pour corriger le problème Tolkraft lance sa maison d'édition pour publier la Licorne d'Abondance, un scénario one shot modulaire medfan compatible avec la 5ème édition à venir en financement participatif le 22/09/2025 sur gameontabletop Pour occasion, il est venu présenter son parcours et son projet (désolé pour les soucis techniques rencontrés, oui encore, je sais) scénarios med fan gratuitshttps://www.drivethrurpg.com/fr/publisher/18585/Dendrobat-Prod?langues=40031-francais&src=fid40031 Scénarios "trhiller / AdC" primés aux Uto : Un prophète dans JdR Mag n° 35 (primé en 2015) Un été en hiver dans Casus Belli n° 25 (primé en 2016) Les 3 autres n'ont pas été publiés

In this episode of the Mic On Podcast, Seun Okinbaloye sits with former Kogi State Deputy Governor Edward Onoja, who opens up on his political journey, his rift with ex-Governor Yahaya Bello, and his role in national politics.Onoja recalls Bello urging him to contest the 2023 primaries only to withdraw support at the last minute, a move he calls “shocking” but says he has forgiven. He defends the Bello administration's record in Kogi, from civil service reforms to new hospitals and institutions, while stressing that he takes “credit and blame” for its legacy.In national politics, Onoja dismisses claims of northern resentment toward Tinubu, calling himself a “foot soldier” for the president's reelection and pledging to build unity even with opposition figures. But he waves off coalition parties like the ADC as unserious, insisting his loyalty rests with the APC.Guest:Chief Edward Onoja(Former Deputy Governor, Kogi State / Governing Member, South East Development Commission)

Send us a textPeaches and Aaron are back swinging at the nonsense. From Special Warfare's assessment model to Air Force Academy cadets racking up predatory loans, this episode rips into leadership fails, lazy commanders who hand out paperwork like candy, and the lost art of spot corrections. We go from stories of LOCs, LORs, and mustache games with Rangers, to watching Army football drop a quarter million dollars just to get smoked by Tarleton State. Oh, and Peaches gets dragged through camp in just a towel because Rangers can't handle beards. Add in college football meltdowns, fantasy league punishments, and some blistering hot takes on what “leadership” actually means—you've got a mix of cringe, comedy, and brutal honesty that only Ones Ready delivers.⏱️ Timestamps: 00:00 – Intro & Special Warfare assessment truth bombs 01:15 – Operator Training Summit Nashville & gear talk 03:10 – Booties in the pool: stop training slick 04:45 – AOCs gone wild with paperwork 07:00 – Progressive discipline vs lazy leadership 10:20 – Why real mentorship beats LOR inflation 12:50 – Spot corrections, life problems, and actually helping airmen 17:30 – Setting boundaries and predictable leadership 23:10 – Smoke sessions, “don't tell dad,” and better discipline tools 25:30 – Peaches' LOC story that turned his career around 29:30 – Pushing boundaries vs working the system 33:00 – Rangers, beards, and the towel walk of shame 36:00 – Mustache game rules and how to win (or lose) 40:00 – Always rebuttal your paperwork (and call ADC, not your buddy) 41:30 – The insane $416K Academy disenrollment bill 47:00 – The infamous Manitou Incline & OTS candidate pain fest 54:00 – Army football pays $250K to lose to Tarleton State 56:10 – Air Force uniforms: actually fire this year 01:02:00 – Bama gets stomped, SEC fan tears taste delicious 01:03:50 – Peaches unveils the Fantasy Loser Belt 01:04:55 – Wrap up & call-to-actions

Featuring an interview with Dr Jacob Sands, including the following topics: Management of Adverse Events of Special Interest Associated with Datopotamab Deruxtecan (Dato-DXd) (0:00) Heist RS et al. Clinical management, monitoring, and prophylaxis of adverse events of special interest associated with datopotamab deruxtecan. Cancer Treat Rev 2024;125:102720. Abstract  Sands J et al. Analysis of drug-related interstitial lung disease (ILD) in patients (pts) treated with datopotamab deruxtecan (Dato-DXd). ASCO 2024;Abstract 8623. Intracranial Efficacy of Dato-DXd for Previously Treated Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) with Actionable Genomic Alterations in the TROPION-Lung05 Study (7:23) Lisberg A et al. Intracranial efficacy of datopotamab deruxtecan (Dato-DXd) in patients (pts) with previously treated advanced/metastatic non-small cell lung cancer (a/m NSCLC) with actionable genomic alterations (AGA): Results from TROPION-Lung05. ASCO 2024;Abstract 8593.  Clinical Evidence Supporting the Combination of Dato-DXd with Immune Checkpoint Inhibition for Advanced NSCLC (12:12) Bessede A et al. TROP2 is associated with primary resistance to immune checkpoint inhibition in patients with advanced non-small cell lung cancer. Clin Cancer Res 2024;30(4):779-85. Abstract Levy BP et al. TROPION-Lung02: Datopotamab deruxtecan (Dato-DXd) plus pembrolizumab (pembro) with or without platinum chemotherapy (Pt-CT) as first-line (1L) therapy for advanced non-small cell lung cancer (aNSCLC). ASCO 2025;Abstract 8501. Waqar SN et al. First-line (1L) datopotamab deruxtecan (Dato-DXd) + rilvegostomig in advanced or metastatic non-small cell lung cancer (a/mNSCLC): Results from TROPION-Lung04 (cohort 5). ASCO 2025;Abstract 8521. Current and Future Development of Antibody-Drug Conjugates in the Treatment of Lung Cancer (17:11) Tawfiq RK et al. Targeting lung cancer with precision: The ADC therapeutic revolution. Curr Oncol Rep 2025;27(6):669-86. Abstract CME information and select publications

In this podcast, experts Aditya Bardia, MD, MPH, FASCO; and Erika P. Hamilton, MD, discuss recent efficacy and safety data of TROP2-targeted antibody-drug conjugate (ADC) plus immune checkpoint inhibitor combinations for advanced triple-negative breast cancer (TNBC).

Have you ever felt the presence of a loved one after they passed? Was it just your imagination… or could it have been a sacred message from the other side? In this soul-stirring episode of The Abundance Journey, Elaine welcomes the radiant and deeply wise Purnima Sinha, a wellness and spiritual life coach with over 50 years of meditation practice and profound experience in after-death communication, mystical encounters, and soul-to-soul connection. Together, Elaine and Purnima explore:· How to recognize signs and messages from loved ones who have crossed over· Why intention and energy are the keys to unlocking Divine guidance· The role of self-love, forgiveness, and surrender in profound healing· How grief, loss, and even pain can become portals to spiritual connection and abundance This conversation will remind you that love never dies, that you are always supported, and that the Divine is inviting you into a deeper partnership with every breath. About the Guest:(bio, personal links, resource links)Purnima has been trained in Ultra Transcendental Meditation- Surat Shabd Yoga. Purnima practiced meditation for over 50 years. Purnima does private sessions. Purnima has Certificates in LifeStyle Medicine and Meditation & Psychotherapy from the Harvard School of Medicine in Boston. Purnima has presented in IANDS conference a few times and is part of Healing Circle also.Purnima has worked in the healthcare system and county wellness program since 2009 as a Wellness and Meditation/Spiritual Life Coach. Purnima has ADC, OBE, STE, Mystical experiences and shared death experiences all her life. Purnima has helped many patients during their transition. She has been interviewed by JeffMara podcast about after-death communication and an IANDS podcast by Betty Guadagno about ADC how to Let Go Finally. Purnima's article got published in Eckhart Tolle (Power Of NOW and A New Earth) newsletter about healing.Her motto is Self Care = Self LoveAbout the Host, Elaine Starling: (bio, personal links, resource links)An international TEDx speaker, bestselling author, coach and mentor, Elaine Starling is recognized for her video show and podcast, The Abundance Journey. Known as The Abundance Ambassador, Elaine helps high-achieving women stop proving and start receiving by aligning with Divine guidance. Through her coaching, podcast, and The Soul Aligned Life Process™, Elaine empowers women to embody their worth, speak their truth, and create deeply fulfilling relationships—from the inside out.Elaine Starling Social Media Links:Facebook: https://www.facebook.com/elaine.abundance Linkedin: https://www.linkedin.com/in/elainestarling/YouTube: https://www.youtube.com/channel/UC3eXgwdMYYzLicCEcB1DdrgTEDx Talk, “Abundance Is a Choice” https://youtu.be/tMQ0D4sfEysWebsite: www.TheAbundanceJourney.com5 Steps to Activate Your Abundance Universal Book Link:

In this special WCLC 2025 episode of Lung Cancer Considered, hosts Dr. Narjust Florez and Dr. Stephen Liu discuss highlights from the conference. Dr. Susan Scott discusses EGFR mutant NSCLC and results from PALOMA-2 and subcutaneous amivantamab. Dr. Wenfeng Fang discusses Iza-Bren (BL-D01D1), a first-in-class EGFR x HER-3 biospecific ADC linked to a novel topoisomerase I inhibitor payload, with promising preliminary activity in EGFR positive previously treated NSCLC. Dr. Biagio Ricciuti shares his insights from WCLC 2025, including the FLAURA-2 OS readout, the HARMONi trial in EGFR positive NSCLC, and his research in the use of immunotherapy in early-stage lung cancer.

@phoenix_agenda and @nigeriasbest had a one to one chat after a long summer break.They discussed:1. President Tinubu's trips to Brazil and Japan.2. Wike says Rivers State of Emergency should end 18th September 3. INEC begins Continuous Voter Registration exercise4. President Tinubu goes to Europe on 10 day Annual Leave 5. Attack on Gbadebo Rhodes-Vivour's defection ceremony to ADC

Dr. Pedro Barata and Dr. Rana McKay discuss the integration of innovative advances in molecular imaging and therapeutics to personalize treatment for patients with renal cell and urothelial carcinomas. TRANSCRIPT Dr. Pedro Barata: Hello, I'm Dr. Pedro Barata, your guest host of By the Book, a podcast series featuring insightful conversations between authors and editors of the ASCO Educational Book. I'm a medical oncologist at University Hospitals Seidman Cancer Center and an associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also an associate editor of the ASCO Educational Book. Now, we all know the field of genitourinary cancers (GU) is evolving quite rapidly, and we have new innovations in molecular imaging as well as targeted therapeutics. Today's episode will be exploring novel approaches that are transforming the management of renal cell and urothelial carcinomas and also their potential to offer a more personalized treatment to patients. For that, joining for today's discussion is Dr. Rana McKay, a GU medical oncologist and professor at University of California San Diego. Dr. McKay will discuss her recently published article titled, “Emerging Paradigms in Genitourinary Cancers: Integrating Molecular Imaging, Hypoxia-Inducible Factor-Targeted Therapies, and Antibody-Drug Conjugates in Renal Cell and Urothelial Carcinomas.”  Our full disclosures are available in the transcript of this episode.  And with that, Rana McKay, great to have you on the podcast today. Dr. Rana McKay: Oh, thank you so much, Dr. Barata. It's really wonderful to be here with you. So, thanks for hosting. Dr. Pedro Barata: No, thanks for taking the time, and I'm looking forward to this conversation. And by the way, let me start by saying congrats on a great article in the Educational Book. Really super helpful paper. I'm recommending it to a lot of the residents and fellows at my own institution. I would like to first ask you to kind of give our listeners some context of how novel approaches in the molecular imaging as well as targeted therapeutics are actually changing the way we're managing patients with GU, but specifically with renal cell carcinoma and urothelial carcinoma. So, what are the areas you would call out as like being big areas for innovation in this context, and why are they important? Dr. Rana McKay: Very good question. And I think this is really what this article highlights. It highlights where are we going from an imaging diagnostics standpoint? Where are we going from a therapeutic standpoint? And I think if we have to step back, from the standpoint of diagnostics, we've seen PET imaging really transform diagnostics in prostate cancer with the advent of PSMA PET imaging, and now PSMA PET imaging is used as a biomarker for selection for theranostics therapy. And so, we're starting to see that enter into the RCC landscape, enter into the urothelial cancer landscape to a lesser extent. And I think it's going to potentially be transformative as these tools get more refined. I think when we think about therapeutics, what's been transformative most recently in the renal cell carcinoma landscape has been the advent of HIF2α inhibition to improve outcomes for patients. And we have seen the approval of belzutifan most recently that has reshaped the landscape. And now there's other HIF2α inhibitors that are being developed that are going to be further important as they get refined. And lastly, I think when we think about urothelial carcinoma, the greatest transformation to treatment in that context has been the displacement of cisplatin and platinum-based chemotherapy as a frontline standard with the combination of enfortumab vedotin plus pembrolizumab. And we've seen antibody-drug conjugates really reshape treatment and tremendously improve outcomes for patients. So, I think those are the three key areas of interest. Dr. Pedro Barata: So with that, let's focus first on the imaging and then we'll get to the therapeutic area. So, we know there's been a paradigm shift, really, when prostate-specific targets emerged as tracers for PET scanning. And so, we now commonly use prostate-specific membrane antigen, or PSMA-based PET scanning, and really transform how we manage prostate cancer. Now, it appears that we're kind of seeing a similar wave in renal cell carcinoma with the new radiotracer against the target carbonic anhydrase IX. What can you tell us about this? And is this going to be available to us anytime soon? And how do you think that might potentially change the way we're managing patients with RCC today? Dr. Rana McKay: First, I'll step back and say that in the context of PSMA PET imaging, we have actually been able to better understand RCC as well. So, we know that PSMA is expressed in the neovasculature of tumors, and it can actually be used to detect renal cell carcinoma tumors. It has a detection rate of about 84% when used for detection. And so, you know, I don't think it's just restricted to carbonic anhydrase IX, but we will talk about that. So, PSMA expressed in the neovasculature has a detection rate of around 84%, particularly if we're looking at clear cell RCC. CAlX is overexpressed in clear cell RCC, and it's actually used in diagnosing renal cell carcinoma when we think of CAlX IHC for diagnosing clear cell RCC. And now there are CAlX PET tracers. The first foray was with the ZIRCON study that was actually an interestingly designed study because it was designed to detect the likelihood of PET imaging to identify clear cell RCC. So, it was actually used in the early diagnostics setting when somebody presents with a renal mass to discriminate that renal mass from a clear cell versus a non-clear cell, and it was a positive study. But when I think about the potential application for these agents, you know, I think about the entire landscape of renal cell carcinoma. This is a disease that we do treat with metastasis-directed therapy. We have certainly seen patients who've undergone metastasectomy have long, durable remissions from such an approach. And I think if we can detect very early onset oligometastatic disease where a metastasis-directed therapy or SABR could be introduced - obviously tested in a trial to demonstrate its efficacy - I think it could potentially be transformative. Dr. Pedro Barata: Wonderful. It's a great summary, and I should highlight you are involved in some of those ongoing studies testing the performance of this specific PET scanning for RCC against conventional imaging, right? And to remind the listeners, thus far, for the most part, we don't really do FDG-PET for RCC. There are some specific cases we do, but in general, they're not a standard scanning. But maybe that will change in the future. Maybe RCC will have their own PSMA-PET. And to your point, there's also emerging data about the role of PSMA-PET scanning in RCC as well, as you very elegantly summarized. Wonderful. So, let me shift gears a little bit because you did, in your introduction, you did highlight a novel MOA that we have in renal cell carcinoma, approved for use, initially for VHL disease, and after that for sporadic clear cell renal cell carcinoma. We're talking about hypoxia-inducible factor 2-alpha inhibitors, or HIF2α inhibitors, such as belzutifan. But there's also others coming up. So, as a way to kind of summarize that, what can you tell us about this breakthrough in terms of therapeutic class, this MOA that got to our toolbox of options for patients with advanced RCC? Tell us a little bit what is being utilized currently in the management of advanced RCC. And where do you see the future going, as far as, is it moving early on? Is it getting monotherapy versus combinations? Maybe other therapies? What are your thoughts about that? What can you tell us about it? Dr. Rana McKay: Belzutifan is a first-in-class HIF2α inhibitor that really established clinical validation for HIF2α as a therapeutic target. When we think about the activity of this agent, the pivotal LITESPARK-005 trial really led to the approval of belzutifan in patients who were really heavily pretreated. It was patients who had received prior IO therapy, patients who had received prior VEGF-targeted therapy. And in the context of this study, we saw a median PFS of 5.6 months, and there did seem to be a tail on the curve when you looked at the 12-month PFS rate with belzutifan. It was 33.7% compared to 17.6% with everolimus. And then when we look at the response rate, it was higher with belzutifan on the order of 22-23%, and very low with everolimus, as we've previously seen. I think one of the Achilles heels of this regimen is the primary PD rate, which was 34% when used in later line. There are multiple studies that are testing belzutifan in combination across the treatment landscape. So, we have LITESPARK-011, which is looking at the combination of belzutifan plus lenvatinib in the second-line setting. We've got the MK-012 [LITESPARK-012] study, which is looking at belzutifan in various combinations in the frontline setting. So there is a combination with IO plus belzutifan. And so this is also being looked at in that context. And then we also have the LITESPARK-022 study, which is looking at pembrolizumab with belzutifan in the adjuvant setting. So there's a series of studies that will be exploring belzutifan really across the treatment landscape. Many of these studies in combination. Additionally, there are other HIF2α inhibitors that are being developed. We have casdatifan, which is another very potent HIF2α inhibitor. You know, I think pharmacologically, these are different agents. There's a different half-life, different dosing. What is going to be the recommended phase 3 dose for both agents, the EPO suppression levels, the degree of EPO suppression, and sustainability of EPO suppression is very different. So, I think we've seen data from casdatifan from the ARC-20 trial from monotherapy with a respectable response rate, over 30%, primary PD rate hovering just around 10%.  And then we've also seen data of the combination of casdatifan with cabozantinib as well that were recently presented this year. And that agent is also being tested across the spectrum of RCC. It's being looked at in combination with cabozantinib in the PEAK-1 study, and actually just at the KCRS (Kidney Cancer Research Summit), we saw the unveiling of the eVOLVE-RCC trial, which is going to be looking at a volrustomig, which is a PD-1/CTLA-4 inhibitor plus casdatifan compared to nivo-ipi in the frontline setting.  So, we're going to see some competition in this space of the HIF2α inhibitors. I think when we think of mechanism of action in that these are very potent, not a lot of off-target activity, and they target a driver mutation in the disease. And that driver mutation happens very early in the pathogenesis. These are going to be positioned much earlier in the treatment landscape. Dr. Pedro Barata: All these studies, as you're saying, look really promising. And when we talk about them, you mentioned a lot of combinations. And to me, when I think of these agents, it makes a lot of sense to combine because there's not a lot of overlapping toxicities, if you will. But perhaps for some of our listeners, who have not used HIF2α inhibitors in practice yet, and they might be thinking about that, what can you tell us about the safety profile? How do you present it to your patients, and how do you handle things like hypoxia or anemia? How do you walk through the safety profile and tolerability profile of those agents like belzutifan? Dr. Rana McKay: I think these drugs are very different than your traditional TKIs, and they don't cause the classic symptoms that are associated with traditional TKIs that many of us are very familiar with like the rash, hand-foot syndrome, hypertension, diarrhea. And honestly, these are very nuanced symptoms that patients really struggle with the chronicity of being on a chronic daily TKI. The three key side effects that I warn patients about with HIF2α inhibitors are: (1) fatigue; (2) anemia; and (3) hypoxia and dysregulation in the ability to sense oxygen levels. And so, many of these side effects - actually, all of them - are very dose-dependent. They can be very well-managed. So, we can start off with the anemia. I think it's critically important before you even start somebody on belzutifan that you are optimizing their hemoglobin and bone marrow function. Make sure they don't have an underlying iron deficiency anemia. Make sure they don't have B12 or folate deficiency. Check for these parameters. Many patients who have kidney cancer may have some hematuria, other things where there could be some low-level blood loss. So, make sure that those are resolved or you're at least addressing them and supplementing people appropriately. I monitor anemia very closely every 3 to 4 weeks, at least, when people start on these medications. And I do initiate EPO, erythropoietin, should the anemia start to worsen. And I typically use a threshold of around 10g/dL  for implementing utilization of an EPO agent, and that's been done very safely in the context of the early studies and phase 3 studies as well. Now, with regards to the hypoxia, I think it's also important to make sure that you're selecting the appropriate individual for this treatment. People who have underlying COPD, or even those individuals who have just a very high burden of disease in their lung, lymphangitic spread, pleural effusions, maybe they're already on oxygen - that's not an ideal candidate for belzutifan. Something that very easily can be done in the clinic before you think about initiating somebody on this treatment, and has certainly been integrated into some of the trials, is just a 6-minute walk test. You know, have the patient walk around the clinic with one of the MAs, one of the nurses, put the O2 sat on [measuring oxygen saturation], make sure they're doing okay. But these side effects, like I said, are very dose-dependent. Typically, if a patient requires, if the symptoms are severe, the therapy can be discontinued and dose reduced. The standing dose is 120 mg daily, and there's two dose reductions to 80 mg and 40 mg should somebody warrant that dose modification. Dr. Pedro Barata: This is relatively new, right? Like, it was not that we're used to checking oxygen levels, right? In general, we're treating these patients, so I certainly think there's a learning curve there, and some of the points that you highlight are truly critical. And I do share many of those as well in our practice. Since I have you, I want to make sure we touch base on antibody-drug conjugates as well. It's also been a hot area, a lot of developments there. When I think of urothelial carcinoma and renal cell carcinoma, I see it a little bit different. I think perhaps in urothelial carcinoma, antibody-drug conjugates, or ADCs, are somewhat established already. You already mentioned enfortumab vedotin. I might ask you to expand a little bit on that. And then in renal cell carcinoma, we have some ADCs as well that you include in your chapter, and that I would like you to tell us what's coming from that perspective. So, tell us a little bit about how do you see ADCs in general for GU tumors, particularly UC and RCC? Tell us a little bit about the complexity or perhaps the challenges you still see. At the same time, tell us about the successes. Dr. Rana McKay: Stepping back, let's just talk about like the principles and design of ADCs. So, most ADCs have three components. There's a monoclonal antibody that typically targets a cell surface antigen, which is conjugated by a linker, which is the second component, to a payload drug. And typically, that payload drug has been chemotherapy, whether it be topoisomerase or whether it be MMAE or other chemotherapeutic. We can start in the RCC space. There's been multiple antibody-drug conjugates that have been tested. There's antibody-drug conjugates to CD70, which is expressed on clear cell RCC. There's been antibody-drug conjugates to ENPP3, which is also expressed on RCC. There's antibody-drug conjugates to CDH6. And they have different payloads, like I said, whether it be topoisomerase I or other microtubule inhibitors. Now, when we think about kidney cancer, we don't treat this disease with chemotherapy. This disease is treated with immunotherapy. It is treated with treatments that target the VEGF pathway and historically has not been sensitive to chemo. So, I think even though the targets have been very exciting, we've seen very underwhelming data regarding activity, and in some context, seen increased toxicity with the ADCs. So, I think we need to tread lightly in the context of the integration and the testing of ADCs in RCC. We just came back from the KCRS meeting, and there was some very intriguing data about a c-Kit ADC that's being developed for chromophobe RCC, which is, you know, a huge unmet need, these variant tumors that really lack appropriate therapeutics. But I just caution us to tread lightly around how can we optimize the payload to make sure that the tumor that we're treating is actually sensitive to the agent that's targeting the cell kill. So, that's a little bit on the ADCs in RCC. I still think we have a long way to go and still in early testing. Now, ADCs for UC are now the standard of care. I think the prototypical agent, enfortumab vedotin, is a nectin-4-directed ADC that's conjugated to an MMAE payload and was the first ADC approved for advanced urothelial, received accelerated approval following the EV-201 trial, which was basically a multicenter, single-arm study that was investigating EV in cisplatin-ineligible patients with advanced urothelial carcinoma, and then ultimately confirmed in the EV-301 study as well. And so, that study ended up demonstrating the support superiority of EV from an overall survival standpoint, even PFS standpoint. Building on that backbone is the EV-302 study, which tested EV in combination with pembrolizumab versus platinum-based chemotherapy in the frontline setting. And that was a pivotal, landmark study that, like I said, has displaced platinum therapy as a frontline treatment for people with advanced urothelial carcinoma. And when we think about that study and the median overall survival and just how far we've come in urothelial cancer, the median OS with EV-pembro from that trial was 31 and a half months. I mean, that's just incredible. The control arm survival was 16 and a half months. The hazard ratio for OS, 0.47. I mean this is why when this data was presented, it was literally a standing ovation that lasted for several minutes because we just haven't seen data that have looked that good. And there are other antibody-drug conjugates that are being tested. We've all been involved in the saga with sacituzumab govitecan, which is a trophoblast cell surface antigen 2 (Trop-2) targeted ADC with a topoisomerase I payload. It was the second ADC to receive approval, but then that approval was subsequently withdrawn when the confirmatory phase 3 was negative, the TROPiCS-04 trial. So, approval was granted based off of the TROPHY-U-01, single-arm, phase 2 study, demonstrating a response rate of around 28% and a PFS of, you know, about 5 and a half months. But then failure to show any benefit from an OS standpoint. And I think there's a lot of controversy in the field around whether this agent still has a role in advanced urothelial carcinoma. And I think particularly for individuals who do not have molecular targets, like they're not HER2-amplified or have HER2-positivity or FGFR or other things like that. Dr. Pedro Barata: Fantastic summary, Rana. You were talking about the EV, and it came to mind that it might not be over, right, for the number of ADCs we use in clinical practice in the near future. I mean, we've seen very promising data for ADC against the HER2, right, and over-expression. It also can create some challenges, right, in the clinics because we're asking to test for HER2 expression. It's almost like, it's not exactly the same to do it in breast cancer, but it looks one more time that we're a little bit behind the breast cancer field in a lot of angles. And also has vedotin as a payload. Of course, I'm referring to disitamab vedotin, and there's very elegant data described by you in your review chapter as well. And it's going to be very interesting to see how we sequence the different ADCs, to your point as well. So, before we wrap it up, I just want to give you the opportunity to tell us if there's any area that we have not touched, any take-home points you'd like to bring up for our listeners before we call it a day. Dr. Rana McKay: Thank you so much. I have to say, you know, I was so excited at ASCO this year looking at the GU program. It was fantastic to see the progress being made, novel therapeutics that really there's a tremendous excitement about, not just in RCC and in UC, but also in prostate cancer, thinking about the integration of therapies, not just for people with refractory disease that, even though our goal is to improve survival, our likelihood of cure is low, but also thinking about how do we integrate these therapies early in the treatment landscape to enhance cure rates for patients, which is just really spectacular. We're seeing many of these agents move into the perioperative setting or in combination with radiation for localized disease. And then the special symposium on biomarkers, I mean, we've really come a long, long way. And I think that we're going to continue to evolve over the next several years. I'm super excited about where the field is going in the treatment of genitourinary malignancies. Dr. Pedro Barata: Oh, absolutely true. And I would say within the Annual Meeting, we have outstanding Educational Sessions. And just a reminder to the listeners that actually that's where the different teams or topics for the Educational Book chapters come from, from actually the educational sessions from ASCO. And your fantastic chapter is an example of that, right, focusing on advanced GU tumors. So, thank you so much, Rana, for taking the time, sharing your insights with us today on the podcast. It was a fantastic conversation as always. Dr. Rana McKay: My pleasure. Thanks so much for having me, Dr. Barata. Dr. Pedro Barata: Of course.  And thank you to our listeners for your time today. You will find the link to the article discussed today in the transcript of this episode. I also encourage you to check out the 2025 ASCO Educational Book. You'll find an incredible wealth of information there. It's free, available online, and you'll find, hopefully, super, super important information on the key science and issues that are shaping modern oncology, as we've heard from Dr. McKay and many other outstanding authors. So, thank you, everyone, and I hope to see you soon. 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. Pedro Barata @PBarataMD Dr. Rana McKay @DrRanaMcKay Follow ASCO on social media:        @ASCO on X (formerly Twitter)        ASCO on Bluesky       ASCO on Facebook        ASCO on LinkedIn        Disclosures:     Dr. Pedro Barata: Stock and Other Ownership Interests: Luminate Medical Honoraria: UroToday Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck  Dr. Rana McKay: Consulting or Advisory Role: Janssen, Novartis, Tempus, Pfizer, Astellas Medivation, Dendreon, Bayer, Sanofi, Vividion, Calithera, Caris Life Sciences, Sorrento Therapeutics, AVEO, Seattle Genetics, Telix, Eli Lilly, Blue Earth Diagnostics, Ambrx, Sumitomo Pharma Oncology, Esiai, NeoMorph, Arcus Biosciences, Daiichi Sankyo, Exelixis, Bristol Myers Squibb, Merck, Astrazeneca, Myovant Research Funding (Inst.): Bayer, Tempus, AstraZeneca, Exelixis, Bristol Myers Squibb, Oncternal Therapeutics, Artera    

In this episode of the Mic On Podcast, Seun Okinbaloye sits with political commentator Henry Shield, who delivers a blistering take on Nigeria's opposition.Shield brands the PDP “a dead party,” predicts a split between Nyesom Wike's camp and its traditional bloc, and accuses its leaders of selling out to the APC. He singles out Bauchi Governor Bala Mohammed as “walking alone” in trying to revive the party.Looking to 2027, Shield warns that without unity between Jonathan, Atiku, and Obi, President Tinubu will win again. He called the ADC the only party with “a slim chance” and says the next election would be “a war of everything.”Guest:Mr Henry Shield(Leadership & Accountability Advocate, Political Commentator).

Editor-in-Chief of the Archives of Disease in Childhood, Dr. Nick Brown, and Senior Editor of ADC, Dr. Rachel Agbeko bring you the monthly Atoms - the highlights of the September 2025 issue. Read it on the Archives of Disease in Childhood website: https://adc.bmj.com/content/110/9/i       Please listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify to get episodes automatically downloaded to your phone and computer. And if you enjoy the podcast, please leave us a review at https://podcasts.apple.com/gb/podcast/adc-podcast/id333278832

ChatGPT hier, Co-Pilot daar. Elke organisatie wil wel ‘iets met AI'. Maar veel initiatieven verzanden in vrijblijvende probeersels. De IT-afdeling rommelt wat aan, de directie wacht af, en ondertussen blijft echte transformatie uit.Elianne Anemaat, AI specialist bij ADC, ziet het dagelijks gebeuren. Zij helpt organisaties bij het verantwoord én effectief invoeren van AI. Niet door er wat tools doorheen te drukken, maar door strategie en structuur aan te brengen. Zij stelt vragen als: Wat wil je bereiken? Wat past bij jouw organisatie? En: durf je als leider zélf het voortouw te nemen?In deze aflevering leer je:Waarom “We gebruiken Co-Pilot” net zo nietszeggend is als “We doen iets met internet”Hoe je van AI een hefboom maakt, in plaats van een speeltjeWaarom leiderschap essentieel is, ook als je geen techneut bent“Je wint of je leert. Het is pas falen als je niks doet met de uitkomst.”Ben jij ook klaar met die AI-proefballonnen en wil je écht stappen zetten in je organisatie? Luister DenkTank, de podcast van DenkProducties.Meer weten?- Meld jouw AI charity project aan zodra de inschrijving open gaat bij ADC (website en LinkedIn)- Kom naar Amsterdam Business Forum en bezoek de AI Deepdive van ADC. Inschrijven doe je op denkproducties.nl

Are you looking to save time, make money, and start winning with less risk? Then head to https://www.ovtlyr.com.The stock market is sending some serious warning signs right now. If you've been trying to buy the dip, dollar cost averaging your way down, or chasing every bounce, you're probably feeling the pain. This video breaks down why sitting on the sidelines can sometimes be the smartest trade, how to recognize trend shifts before they smack you in the face, and where the real opportunities might show up next.We dive deep into the importance of having a rules-based plan, why consistency and discipline matter more than hype, and how the OVTLYR signals are pointing to some major shifts under the surface. From market breadth and fear vs. greed readings to sector breakdowns and individual stock setups, this is your chance to see exactly what's happening behind the curtain.One of the big takeaways here: you don't have to catch every move. Winners average winners, losers average losers. If the market is running hot with greed, that's often when a snapback is lurking around the corner. Understanding when to sit out and when to strike is what separates disciplined traders from gamblers.Inside this session, we cover:➡️ Why dollar cost averaging in a downtrend can turn into a costly mistake➡️ The power of “sit out” trades and why cash is sometimes the best position➡️ Key lessons from OVTLYR's nine-signal system and how fewer signals can actually lead to more trades➡️ What market breadth, sector rotations, and fear/greed indicators are flashing right now➡️ Stock-specific breakdowns, including Nvidia ahead of earnings, sector leaders, and a few surprising setups in utilities, staples, and communicationsYou'll also see how order blocks reveal where buyers keep getting trapped, why some charts scream “strong buy” while others are flashing “GTFO,” and how expected moves in the options chain can set realistic expectations for volatility. Whether it's Nvidia, Palantir, Duke Energy, or lesser-known tickers like ADC, BZ, and GFL, the same rules apply: risk comes first, profits follow.This isn't about gambling on earnings or hoping for miracle rebounds. It's about protecting your capital, waiting for high-probability setups, and trading with confidence when the odds are finally stacked in your favor. If you've ever been burned holding through a big report, or found yourself stuck in a sideways chop, this breakdown is going to help you see the market differently.Remember, the market doesn't care about opinions—it only cares about price, trend, and momentum. Learn how to read those signals, avoid common traps, and put yourself in a position to win more and risk less.If you're serious about trading smarter, stick around until the end. There's money to be made, but only if you follow your plan, stay disciplined, and keep risk management front and center.Gain instant access to the AI-powered tools and behavioral insights top traders use to spot big moves before the crowd. Start trading smarter today

Antibody-drug conjugates (ADCs) are a relatively new type of medicine for breast cancer. Enhertu (chemical name: fam-trastuzumab-deruxtecan-nxki) and Dato-DXd (brand name: Datroway) are two ADCs used to treat breast cancer. Dr Benjamin Schrank and colleagues have developed a new type of ADC that combines an antibody with a toxin — called an antibody-toxin conjugate — that teaches the immune system to recognize and attack cancer cells. Listen to the episode to hear Dr. Schrank explain: the antibody and the toxin component of the medicine how the new medicine works possible side effects next steps for the research Episode image photo credit: The University of Texas MD Anderson Cancer Center

This week on Dividend Talk, Derek is joined by Jeremy from Dividend Stockpile to explore some of the biggest Megatrends shaping our investing future. We cover the opportunities and risks in infrastructure, clean energy, technology, and healthcare, and how dividend investors can position themselves for the next decade and beyond.You'll hear about recent dividend news from Interface (TILE) and Agree Realty (ADC), how US and European infrastructure approaches differ, why utilities like Iberdrola (IBE.MC) and Enel (ENEL.MI) stand out, and how tech giants Meta (META), Alphabet (GOOG), and Microsoft (MSFT) fit into the AI megatrend. We also look into healthcare innovation, options income strategies, and favourite finance content creators.Tickers Mentioned: TILE, ADC, O, BAM, BIP, NEE, DUK, ED, IBE.MC, ENEL.MI, ABB, DG.PA, META, GOOG, MSFT, GE, CWEN, ASML.AS, SAP, MDT, MRK, ABBV, NVO, LLY, ROG.SW, SNY, SYK, ABT, BDX, RMD, STRCChapters:00:00 – Introduction & Guest Welcome02:52 – Company News: Interface & Dividend Increases05:41 – Agree Realty & REIT Quality08:43 – Understanding Megatrends11:51 – Infrastructure as a Megatrend29:06 – Clean Energy Transition39:31 – The Rise of Technology & AI46:51 – Healthcare Opportunities01:04:06 – Options Income Strategies & High Yield Ideas01:20:06 – Favorite Finance Content Creators & Closing RemarksGet a free sample of our premium dividend newsletter! Stay ahead of the market with in-depth stock analysis here: https://dividendtalk.eu/download-your-free-samples/ Stay Updated:Twitter - @DividendTalk_Twitter - @European_DGIJoin our Facebook Community - Dividend Talk Facebook GroupJoin our Discord group - https://discord.gg/nJyt9KWAB5

This week on EYE ON NPI we're featuring some open source hardware from one of our favorite hardware manufacturers! It's the Arduino Nano R4 System on Module (https://www.digikey.com/en/product-highlight/a/arduino/nano-r4) a miniaturized version of the Arduino UNO R4 and Minima (https://blog.adafruit.com/2023/07/27/eye-on-npi-arduino-uno-r4-minima-and-uno-r4-wifi-boards-digikey-arduino-digikey-adafruit/) versions we covered on EYE ON NPI about two years ago! taking a cue from popular 'castellated single side' PCB proto boards on the market, the Nano comes in two options, one with headers (https://www.digikey.com/en/products/detail/arduino/ABX00143/26766495) for easy installation into existing Arduino Nano expansion kits or breadboards, and one with reflowable castellations (https://www.digikey.com/en/products/detail/arduino/ABX00142/26766490) The Arduino Nano (https://www.digikey.com/en/products/detail/arduino/A000005/2638989) is second only to the UNO as the definitive Arduino board that 'everyone got started with'. Many folks would start with the chunky UNO and then migrate to the Nano to get something that plugs into a breadboard for compact assembly. With a USB connector on one end, button and LEDs and programming header on the top, this board powered tens of thousands of builds. So it's not surprising that Arduino iterated on this design with a wide variety of chips like the RP2040 (https://www.digikey.com/en/products/detail/arduino/ABX00052/14123941) and ESP32 (https://www.digikey.com/en/products/detail/arduino/ABX00092/21219771) The latest generation is the Renesas RA4M1 series - which updates the original ATmega328 8-bit microcontroller to a beefy Cortex M4 with FPU. You get 48MHz clock, 256KB of Flash, 32KB of SRAM, ADC, DAC, CAN, captouch and other extras. The FPU in particular makes it a nice upgrade to the cortex M0/M0+. The best part is that with the 5V logic support of the R7FA4M1AB3CFM (https://www.digikey.com/en/products/detail/renesas-electronics-corporation/R7FA4M1AB3CFM-AA0/10447195), it makes for a great drop-in replacement when a 3V logic chip like the RP2040/ESP32 won't work as well. Plus you get lots of nice linear ADCs, the RP2040 only has 4 and the ESP32's are non-linear and sometimes don't work when WiFi is active. We also love that they added a Qwiic (https://www.sparkfun.com/qwiic) connector on the end! We use this for all our Stemma QT sensors, and between the many companies that have joined in the ecosystem there are easily a thousand different ons/displays/accessories that can plug in directly for instant expansion. If you want to get the latest Nano from the manufacturer of genuine Arduino boards, DigiKey is a authentic distributor and has tons of the Arduino Nano R4 (https://www.digikey.com/short/3brjrnjp) in stock right now for (https://www.digikey.com/en/products/detail/arduino/ASX00061/26744081) immediate shipment! Pick from the castellated flat or soldered-header variety, and don't forget to also grab some Arduino Nano accessories to get your design prototyped fast. Order today and your Nano will fly out of the DigiKey warehouse and arrive at your doorstep by tomorrow morning.

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“Colorectal cancer treatment is not just about eliminating a disease. It's about preserving life quality and empowering patients through every phase. So I think nurses are really at the forefront that we can do that in the oncology nursing space. So from early detection to survivorship, the journey is deeply personal. Precision medicine, compassionate care, and informed decision-making are reshaping outcomes. Treatment's just not about protocols. It's about people,” ONS member Kris Mathey, DNP, APRN-CNP, AOCNP®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about colorectal cancer treatment.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 1.0 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the treatment of colorectal cancer. Episode Notes  Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities Episode 153: Metastatic Colorectal Cancer Has More Treatment Options Than Ever Before ONS Voice articles: Colorectal Cancer Prevention, Screening, Treatment, and Survivorship Recommendations Genetic Disorder Reference Sheet: Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer) How Liquid Biopsies Are Used in Cancer Treatment Selection Oncology Drug Reference Sheet: 5-Fluorouracil Oncology Drug Reference Sheet: Oxaliplatin What Is a Liquid Biopsy? Clinical Journal of Oncology Nursing article: Colorectal Cancer in Young Adults: Considerations for Oncology Nurses Oncology Nursing Forum article: Neurotoxic Side Effects Early in the Oxaliplatin Treatment Period in Patients With Colorectal Cancer ONS Colorectal Cancer Learning Library ONS Biomarker Database (filtered by colorectal cancer) ONS Peripheral Neuropathy Symptom Interventions American Cancer Society colorectal cancer resources CancerCare Colorectal Cancer Alliance Colorectal Cancer Resource and Action Network Fight Colorectal Cancer National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Colorectal cancer has several different types, but there is one that dominates the landscape, and that is adenocarcinoma. So I think most of us have heard that. It's fairly common, and it accounts for about 95% of all colorectal cancers. It begins in the glandular cells lining the colon or rectum and often develops from polyps, in particular adenomatous polyps.” TS 1:41 “One of the biomarkers that we'll most commonly hear about is KRAS or NRAS mutations. This indicates tumor genetics, and these mutations suggest resistance to our EGFR inhibitors such as cetuximab. BRAF mutation or V600E is a more aggressive tumor subtype, and those may respond to our BRAF targeted therapy. … And then our MSI-high or MMR-deficient—microsatellite instability or mismatch repair deficiency—that really predicts an immunotherapy response and may indicate Lynch syndrome, which is a huge genetic component that takes a whole other level of counseling and genetic testing with our patients as well.” TS 6:02 “Polypectomy or a local excision—that removes our small tumors or polyps during that colonoscopy. And that's what's used for those stage 0 or early stage I cancers. A colectomy removes part or all of the colon. This may be open or laparoscopic. It can include a hemicolectomy, a segmental resection, or a total colectomy, so where you take out the entire part of the colon. A proctectomy removes part or all of the rectum. This may include a low anterior resection, also known as an LAR … or an abdominal perineal resection, which is an APR. … Colostomy or ileostomy—that diverts the stool to an external bag via stoma. Sometimes this is temporary or permanent depending on the type of surgery.” TS 14:11 “We'll have our patients say, ‘Hey, I want immunotherapy therapy. I see commercials on it that it works so well.' We have to make sure that these patients are good candidates for it, also that we're treating them adequately. We need to make sure that they have those biomarkers, so as I mentioned, the MSI-high or MMR tumors. Our MSS-stable tumors—they may benefit from newer combinations or clinical trials. Metastatic disease—immunotherapy may be used alone or with other treatments. And then in the neoadjuvant setting, some trials are really showing promising results using immunotherapy prior to surgery.” TS 25:38 “Antibody-drug conjugates are really an exciting frontier in all cancer treatments as well as colorectal cancer treatment. This is used mainly for patients with advanced or treatment-resistant disease, and these therapies combine the targeted power of monoclonal antibodies with the cell-killing ability of potent chemotherapy agents. They're still on the horizon for the most part in colorectal cancer. However, there is only one approved antibody-drug conjugate, or ADC, at this time, and that's trastuzumab deruxtecan, or Enhertu. That's approved for any solid tumor, such as colorectal cancer with HER2 IHC 3+. So again, looking back at that pathology in those markers, making sure that you have that HER2 mutation and that IHC.” TS 35:00 “There are a few myths going around about colorectal cancer treatment that can lead to confusion or even delayed care. One myth is only older men get colorectal cancer. As you heard me talk in my previous podcast on screening, unfortunately, this isn't necessarily true. Colorectal cancer affects both men and women and our cases in the younger population are rising. So our screening guidelines have changed to age 45 because we are seeing it in the younger population.” TS 45:54

In this special episode of Dividend Talk, we tackle one of the most frustrating topics for European investors: dividend withholding tax. Our guest is Thomas Rappold, founder of Divizend.com, a platform built to automate and simplify dividend tax reclaims for retail investors. Thomas shares how his own investing struggles led him to build the company, and how Divizend is helping thousands of investors recover lost income from foreign dividends.We discuss:​What dividend withholding tax is (and why it's such a headache)​Why most investors miss out on reclaiming what's rightfully theirs​The upcoming EU-Faster regulation and digital tax residency certificates​The role of brokers, the EU Commission, and what's changing by 2028​Practical steps for reclaiming your foreign dividend taxes​Why dividend investors need to push for change and how Divizend is giving us a voice​Thomas also shares his unique investing mindset (yes, he owns both Palantir and Lindt!) and replaces a stock in our Dividend Growth Community Portfolio.

Welcome back to The Dive Driven by Kia! Kobe, Azael and Meteos look ahead to 4 more years of T1 Faker before breaking down 4 opening week sweeps in the LTA North. After the break, we look ahead to this weekend's matchups as chosen by the teams themselves. Finally, Patch 25.15 is live! The crew discusses Braum nerfs, the state of ADC and more.Timestamps:0:00 - Intro & Faker Re-signs to T18:15 - Travis Gafford Steps Away12:37 - LTA Split 3 Format17:13 - Team Liquid vs 100 Thieves Review34:23 - Shopify Rebellion vs Dignitas Review45:21 - Cloud9 vs Lyon Review53:51 - FlyQuest vs Disguised Review1:01:56 - Week 2 Matches Preview1:11:18 - Patch 25.151:19:48 - ADC & Balance Debate 

Welcome back to another episode of The Dive Driven by Kia. Champion designer Riot Yelough joins Kobe and Meteos to give some behind-the-scenes intel on the new ADC champ Yunara. Kobe pitches us on his Yunara build (Hullbreaker, Hexplate, Hurricane) and we go over expectations for Yunara in pro play. Will we see Yunara on the LTA stage this weekend? Plus, we break down Patch 25.14, 100 Thieves' last dance, LTA North roster changes and power rankings for Split 3.Finally, make sure to grab tickets for LTA Split 3! Tickets are still available for Opening Week and throughout the entire split, including the LTA Championship in Texas. This Saturday at the Riot Games Arena in LA enjoy a Spirit Blossom themed Opening Day tailgate after the games where you can get a free Spirit Blossom Teemo skin, win prizes, buy some merch (including the exclusive LTA Poro), meet the teams, enjoy free food and more!Purchase your tickets for LTA's Split 3 here: https://www.tixr.com/groups/ltanorth/events/2025-lta-north-split-3-mastercard-opening-week-day-1-150643And get your tickets to the LTA Championship here: https://www.ticketmaster.com/league-of-legends-tickets/artist/2144001Timestamps:0:00 - Introduction with Yunara's Designer Riot Yelough4:54 - Initial Reactions with Yunara's Launch13:23 - Yunara's Itemization22:57 - Thoughts on Yunara in Pro Play33:38 - Evolution of Skill Expression37:57 - Favorite Moments from MSI41:50 - Fantasy is Back42:58 - Patch 25.1455:23 - 100T's Exit from the LTA1:04:53 - LTA Roster Changes1:21:29 - Power Rankings

The boys discuss the ADC role, League Trivia, MSI, and more on episode 698 of Leaguecast! Email us - mail@leaguecastpodcast.com   Support us - https://www.patreon.com/leaguecast  Tweet us - https://twitter.com/leaguecast   Facebook - https://www.facebook.com/Leaguecast/   Join Our Discord - https://discord.gg/leaguecast  Visit our Website - https://leaguecastpodcast.com/

NetScaler ADC and NetScaler Gateway Security Bulletin for CVE-2025-6543 Citrix patched a memory overflow vulnerability leading to unintended control flow and denial of service. https://support.citrix.com/support-home/kbsearch/article?articleNumber=CTX694788 Remote code execution in CentOS Web Panel - CVE-2025-48703 An arbitrary file upload vulnerability in the user (not admin) part of Web Panel can be used to execute arbitrary code https://fenrisk.com/rce-centos-webpanel Gogs Arbitrary File Deletion Vulnerability Due to the insufficient patch for the CVE-2024-39931, it's still possible to delete files under the .git directory and achieve remote command execution. https://github.com/gogs/gogs/security/advisories/GHSA-wj44-9vcg-wjq7 Let s Encrypt Will Soon Issue IP Address-Based Certs Let s Encrypt is almost ready to issue certificates for IP address SANs from Let's Encrypt's production environment. They'll only be available under the short-lived profile (which has a 6-day validity period), and that profile will remain allowlist-only for a while. https://community.letsencrypt.org/t/getting-ready-to-issue-ip-address-certificates/238777