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Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "The Wolf, the Duck and the Mouse" by Mac Barnett! With a unique artsyle and a cute story.As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Dr. Beckett compares grilling and steak grading to sports card grading, noting that both rely on labels and subjective “eye appeal” but can still disappoint. He explains how chefs and buyers judge ingredients by sight, how steaks are graded (prime/choice) yet may not taste like their grade, and how it's hard to “return the evidence” after eating. Comparing a cheaper USDA prime New York strip from Tom Thumb versus his usual Central Market purchase, he felt the steak tasted about a full grade lower despite looking similar. Beckett discusses trust in grading within limits, consistency, batch rhythm, pricing differences by venue, and parallels to card alteration and the need for truthful labeling, concluding that grading matters but isn't perfect and that collectors gravitate to trusted graders. 00:44 Foodie Grilling Mindset 00:57 Steak Grading Meets Cards 01:58 Sending Back Mistakes 02:48 Bargain Prime Experiment 06:23 Subjective Value and Trust 08:53 How Graders Get Rhythms 10:12 Mint to Black Label Steaks 10:50 Alterations and Disclosure
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
HER Style Podcast | Buy Less, Shop Smarter, Build a Wardrobe You Love
Have you ever tried something on and bought it just because it fit? Maybe part of you knew the color wasn't quite right or it wasn't the exact thing you were hoping to find. But you couldn't bring yourself to keep up the search? Or you genuinely didn't have time to keep looking? Often, those are the pieces that end up sitting in your closet for months because even though it technically fit your figure, it didn't fit your life, your style, or the way you wanted to feel. If you've ever struggled with that, then today's episode is for you. We're going to talk about why fit is only one piece of the style puzzle, the seven things that matter just as much as fit when you're evaluating clothes, why so many women settle for "good enough" pieces, and how to know whether something is truly worth bringing home. Because if your goal is to build a wardrobe you genuinely love, then you cannot let fit alone be the final say. You can do so much better than that, my friend. And in this episode, we're raising the bar and equipping you to stop settling and start making smarter buying decisions. So go refill your mug and settle in. I can't wait for you to hear this one. FREE 5-MIN PERSONAL STYLE QUIZ: https://herstylellc.com/quiz HER STYLE ON INSTAGRAM: https://www.instagram.com/heatherriggsstyle/ JOIN THE WAITLIST FOR HER STYLE COLLECTIVE: https://herstylellc.com/collective Related Episodes: 286 – Shopping for Your Real Life (Not the Fantasy One in Your Head) 129 – Which Style Foundation Is the MOST Important? The Style, Fit, and Color Debate! 104 – Alterations 101: What's Possible, How Much It Costs, and Where To Find a Good Tailor
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "The Sun is Late and so is the Farmer" by Phillip C. Stead. A cute adventure before the morning sun rises.As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I'm reading the first entry of The Meditations of Marcus Aurelius. For those unfamiliar, this is an often cited book as a strong Stoic philosophy, and while do agree, I also feel like a lot of the Meditations has been taken out of context and, ironically, not meditated upon in the way a true Stoic should. It's an interesting read even for those uninterested in Stoicism, and I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hello there! This idea came because I wanted to read a bit about fossils and to share how you can learn from old outdated books. So I put both ideas together, and here we are! I have planned a full six weeks of uploads EVERY DAY (except weekends) and I'm looking forward to all the dinosaur info!In my opinion, It's a little dry to be honest, but I loved this stuff as a kid and I hope someone listening enjoys it too. Plus we still have our regular content for ya'll to enjoy! - Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "The Night of the Hedgehog" by Tanya Rosie. Hedgehogs are so cute! This book has sweet illustrations of the cutest little hedgehogs, you realy should check it out.As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Dr. Lyudmila Bazhenova joins the podcast to share the update to the living guideline on stage IV NSCLC without driver alterations. Dr. Bazhenova discusses the evidence reviewed for both non-squamous NSCLC, including the POD1IM-304 and BAP BRAIN trials, and squamous cell NSCLC, including the HARMONi-6 trial. She shares how these results impacted the clinical practice guideline, what they mean for patients receiving immunotherapy and chemotherapy, and where the panel is waiting for additional evidence to clarify the role of therapeutic options. Dr. Bazhenova encourages listeners to stay tuned for future updates to the living guideline after publication of data from the 2026 ASCO Annual Meeting. Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer without Driver Alterations, ASCO Living Guideline Version 2026.3.1" LINK TO FULL TRANSCRIPT
Dr. Joshua Reuss returns to the podcast to discuss the update to the living guideline on stage IV NSCLC with driver alterations. The conversation focuses on new cancer treatment strategies for patients with advanced NSCLC and EGFR mutations, including classical EGFR alterations (exon 19 deletions, exon 21 L858R substitution) and rarer alterations (exon 20 insertion mutations). Dr. Reuss discusses results from clinical trials, including MARIPOSA and CHRYSALIS-2 and how these impacted first-line and subsequent line treatment recommendations. He looks to the future on what new evidence and potential updates are in the pipeline for this living guideline. Read the full living guideline "Therapy for Stage IV Non-Small Cell Lung Cancer with Driver Alterations, ASCO Living Guideline Version 2026.3.1" LINK TO FULL TRANSCRIPT
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I will read you a bit of the classic writing that is actually pretty interesting and fun to read. This is The Apology of Socrates, written by his student Plato. Socrates was a great philosopher, who very much annoyed everyone. Everyone except his students at least. The Apology, is an apology in the classical sense meaning a defense of, so this is Socrates defending himself in the Athenian court of Law, with his life on the line. I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "I Will Read to You" by Gideon Sterer. This is a cute bedtime story for all the little monsters out there!As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I will read you a bit of the classic writing that is actually pretty interesting and fun to read. This is The Apology of Socrates, written by his student Plato. Socrates was a great philosopher, who very much annoyed everyone. Everyone except his students at least. The Apology, is an apology in the classical sense meaning a defense of, so this is Socrates defending himself in the Athenian court of Law, with his life on the line. I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "A Mischief of Mice" by Christie Matheson. Did you know any of these animal group names? My favorite is an Unkindness of Ravens.As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I will read you a bit of the classic writing that is actually pretty interesting and fun to read. This is The Apology of Socrates, written by his student Plato. Socrates was a great philosopher, who very much annoyed everyone. Everyone except his students at least. The Apology, is an apology in the classical sense meaning a defense of, so this is Socrates defending himself in the Athenian court of Law, with his life on the line. I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book for you and she is very excited to read to you today! Today we have Caitlin who will be reading "Brindlefox" by John Sandford. What is a lazy fox to do?As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I will read you a bit of the classic writing that is actually pretty interesting and fun to read. This is The Apology of Socrates, written by his student Plato. Socrates was a great philosopher, who very much annoyed everyone. Everyone except his students at least. The Apology, is an apology in the classical sense meaning a defense of, so this is Socrates defending himself in the Athenian court of Law, with his life on the line. I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
Hope you are having a lovely day! Today Ms. Caitlin has a cute kids book and she is very excited to read to you today! Today we have Caitlin who will be reading "Buffalo Fluffalo and Puffalo" by Bess Kalb. A cute sequeal to her favorite!As always this book was selected from our library! Kids and Parents can read along with us, in this read aloud story time! Be sure to check out your local Library to check out what books they may have! If you prefer E-Books, sign into the Hoopla or Libby app using your Library Card and follow along from there!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365Original background track is Concerto for Two Violins by Bach.Alterations were made by us to make it fit the length of our content.Brought to you from the Pike-Amite-Walthall Library system.#library #books #pawlskids #kidsstorytime
Glad to have you listening with us today! I've been interested in reading the Harvard Classics, and plan to share a few stories from each volume as I go. This is Volume one, containing multiple ancient philosophies, and here we will focus on one in particular. Today I will read you a bit of the classic writing that is actually pretty interesting and fun to read. This is The Apology of Socrates, written by his student Plato. Socrates was a great philosopher, who very much annoyed everyone. Everyone except his students at least. The Apology, is an apology in the classical sense meaning a defense of, so this is Socrates defending himself in the Athenian court of Law, with his life on the line. I hope you enjoy!We hope you enjoy this sneak peak, and as always if you enjoy the story then we invite you to visit your local library and ask them to reserve it for you! If you can't find it at your library, then you will want to follow my Project Gutenberg guide, so please check it out to learn more!- Check out the Library Systems official website where you can find links to free resources, school and career guides, and news about our upcoming events! https://www.pawls.org/ -Follow us on YouTube and enjoy our backlog of digital story hours and other great content! https://www.youtube.com/@pawls365 Original background track is The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle, music from the freemusicarchive.orghttps://freemusicarchive.org/music/Doctor_Turtle/none_given_1561/Doctor_Turtle_-_You_Um_Ill_Ah1/The Talons Of Adventure, The Antlers Of Romance by Doctor Turtle is licensed under a Attribution 4.0 International License.Alterations were made by us to make it fit the length of our content.#library #books #pawlskids #kidsstorytime
In this Supplement Ingredient Series episode, Nurse Doza breaks down glutathione — the master antioxidant your liver makes to fight inflammation, detox your body, and protect your brain. With roughly 1 in 4 people worldwide carrying a fatty liver, most are running on low reserves. Learn why glutathione is non-negotiable for energy, performance, and recovery — plus how to get your own vial to use at home. Featured Partner: SHED SHED delivers practitioner-grade glutathione in a vial you can use at home — the same master antioxidant Nurse Doza has administered through thousands of injections and IVs in clinical practice. Because the liver's ability to produce glutathione drops when it's fatty, inflamed, or overworked, supplementing directly is often the fastest way to restore energy, mental clarity, and detoxification pathways — exactly the mechanism discussed in this episode.
On this Make A Difference Minute, you'll hear a simple but powerful reminder from Cynthia Jones, who is battling cancer. In the middle of her fight, she shares what matters most now. Every day is precious. Take a moment to listen, reflect, and consider how you can support her journey. This MADM is brought to you by CoraNation Tailoring & Alterations, proudly supporting stories and the people who make our communities strong. Real stories. Real people. Real impact. News That Unites!™️
On this Monday edition of Sid & Friends in the Morning, Sid recaps yesterday's Sunday afternoon action at Augusta National Golf Club down in Georgia, where Rory McIlroy secured his second consecutive Green Jacket, winning the 2026 Masters Tournament at twelve under par. In other news of the day, Mayor Mamdani celebrates his first 100 days in office, Eric Swalwell suspends his run for California Governor after multiple sexual assault allegations get tossed his way, and President Trump announces that he'll be taking the initiative in the Strait of Hormuz with a blockade taking effect this morning. Bruce Blakeman, Craig Carton, Darryl Strawberry, Ellie Cohanim, Joe Hathaway, John Catsimatidis & Randy Fine join Sid on this Monday installment of Sid & Friends in the Morning. Learn more about your ad choices. Visit megaphone.fm/adchoices
On this Make A Difference Minute, I'm joined by Dr. George Ackerman, founder of Together for Sharon, a movement created in memory of his mother, Sharon, who lost her battle with Parkinson's disease. One of the biggest misconceptions about Parkinson's is that it only affects the elderly. The reality is, it doesn't discriminate. People are being diagnosed younger than ever, even in their 20s. George shares what families face that often goes unseen, and why awareness matters now more than ever. From personal loss to a global mission, his message is clear. The more we come together, the closer we get to stopping this disease. This MADM is brought to you by CoraNation Tailoring & Alterations, proudly supporting stories and the people who make our communities strong. Real stories. Real people. Real impact. News That Unites!™️
What does it really take to build a thriving bridal alterations business from the ground up? In this episode, Nadine sits down with Rachel Natali of Change of a Dress Alterations who shares how she went from bartending and working multiple side jobs to hitting six figures and buying her dream home—all in just a few years.Rachel opens up about the wins, the hard moments, and the mindset shifts that changed everything. If you've ever wondered when it's time to take the leap, how to charge what you're worth, or how to grow without losing yourself in the process, this episode is for you. In this episode:How Rachel discovered bridal alterations through a chance encounter What she learned from working for someone else before going solo—the good, the bad, and what NOT to doThe brave decision to start a business in a brand new state where she knew absolutely no oneHow to know when it's actually time to take the leap and quit your side jobsThe real story of hiring help when you're scared you can't afford it (spoiler: you probably can)Money mindset shifts: why being money-motivated isn't greedy—it's empoweringWhat it really took to hit six figures as a bridal seamstress Why you should never feel bad about charging what you're worthThe offer Rachel turned down (and why working in-house for a bridal shop isn't always the dream it seems)How to set boundaries with bridal shops while still maintaining great relationshipsRachel's next chapter: hiring a team, paying off debt, and living life on her own termsConnect with Rachel: Website: https://changeofadressalterations.com/Instagram: https://www.instagram.com/changeofadressalterations/ Connect with Nadine:Check out the exclusive private podcast series, Fitting Packages 101: https://enchanting-sun-77080.myflodesk.com/privatepodcastBecome a member: https://secretsofabridalseamstresspodcast.com/membershipInstagram: https://www.instagram.com/secretsofabridalseamstress/TikTok: https://www.tiktok.com/@nadinebozemanYouTube: https://www.youtube.com/@secretsofabridalseamstress
Today on the 5: The newest release of DLSS has generated a lot of discussion, and with very good reason. DLSS5 crosses an important line by opening the door to changing the nature of graphics in video games that could easily have a significant impact on how players react to them. This is exactly the thing that many people have been concerned would happen, and they're clearly not happy about it.
Our brains are engines of imagination—an “idea organ” that has transformed both our species and the planet. Genevieve Konopka, Chair of the Department of Neurobiology in the David Geffen School of Medicine at UCLA, asks how genes drive the development of the cell types that build the human brain and give rise to cognition, and how cognitive behavior emerges from evolutionarily adapted genomic programs. Because the human brain is comprised of heterogenous cell types, she examines gene expression patterns and chromatin states within specific cell types to gain insights into brain evolution and the development of cognitive disorders. Using single cell genomics to compare human and nonhuman primate brains, her work uncovers human brain innovations, including changes in the proportions of immature oligodendrocytes in the neocortex. She recapitulates this result in vitro using stem cell derived models from humans and nonhuman primates, highlighting the intersection of cellular genomics with brain evolution and function. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Science] [Show ID: 41298]
Our brains are engines of imagination—an “idea organ” that has transformed both our species and the planet. Genevieve Konopka, Chair of the Department of Neurobiology in the David Geffen School of Medicine at UCLA, asks how genes drive the development of the cell types that build the human brain and give rise to cognition, and how cognitive behavior emerges from evolutionarily adapted genomic programs. Because the human brain is comprised of heterogenous cell types, she examines gene expression patterns and chromatin states within specific cell types to gain insights into brain evolution and the development of cognitive disorders. Using single cell genomics to compare human and nonhuman primate brains, her work uncovers human brain innovations, including changes in the proportions of immature oligodendrocytes in the neocortex. She recapitulates this result in vitro using stem cell derived models from humans and nonhuman primates, highlighting the intersection of cellular genomics with brain evolution and function. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Science] [Show ID: 41298]
CARTA - Center for Academic Research and Training in Anthropogeny (Video)
Our brains are engines of imagination—an “idea organ” that has transformed both our species and the planet. Genevieve Konopka, Chair of the Department of Neurobiology in the David Geffen School of Medicine at UCLA, asks how genes drive the development of the cell types that build the human brain and give rise to cognition, and how cognitive behavior emerges from evolutionarily adapted genomic programs. Because the human brain is comprised of heterogenous cell types, she examines gene expression patterns and chromatin states within specific cell types to gain insights into brain evolution and the development of cognitive disorders. Using single cell genomics to compare human and nonhuman primate brains, her work uncovers human brain innovations, including changes in the proportions of immature oligodendrocytes in the neocortex. She recapitulates this result in vitro using stem cell derived models from humans and nonhuman primates, highlighting the intersection of cellular genomics with brain evolution and function. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Science] [Show ID: 41298]
Our brains are engines of imagination—an “idea organ” that has transformed both our species and the planet. Genevieve Konopka, Chair of the Department of Neurobiology in the David Geffen School of Medicine at UCLA, asks how genes drive the development of the cell types that build the human brain and give rise to cognition, and how cognitive behavior emerges from evolutionarily adapted genomic programs. Because the human brain is comprised of heterogenous cell types, she examines gene expression patterns and chromatin states within specific cell types to gain insights into brain evolution and the development of cognitive disorders. Using single cell genomics to compare human and nonhuman primate brains, her work uncovers human brain innovations, including changes in the proportions of immature oligodendrocytes in the neocortex. She recapitulates this result in vitro using stem cell derived models from humans and nonhuman primates, highlighting the intersection of cellular genomics with brain evolution and function. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Science] [Show ID: 41298]
Our brains are engines of imagination—an “idea organ” that has transformed both our species and the planet. Genevieve Konopka, Chair of the Department of Neurobiology in the David Geffen School of Medicine at UCLA, asks how genes drive the development of the cell types that build the human brain and give rise to cognition, and how cognitive behavior emerges from evolutionarily adapted genomic programs. Because the human brain is comprised of heterogenous cell types, she examines gene expression patterns and chromatin states within specific cell types to gain insights into brain evolution and the development of cognitive disorders. Using single cell genomics to compare human and nonhuman primate brains, her work uncovers human brain innovations, including changes in the proportions of immature oligodendrocytes in the neocortex. She recapitulates this result in vitro using stem cell derived models from humans and nonhuman primates, highlighting the intersection of cellular genomics with brain evolution and function. Series: "CARTA - Center for Academic Research and Training in Anthropogeny" [Science] [Show ID: 41298]
SummaryThis episode features a lively panel discussion on healthcare documentation, compliance risks, and best practices. The experts share insights on managing documentation delays, metadata analysis, contract oversight, and the impact of AI in healthcare record-keeping.key topicsRisks of documentation modificationMetadata analysis in auditsContract oversight and complianceAI in healthcare documentationTakeawaysAltering original medical records can escalate legal issues.Metadata analysis is crucial in fraud detection.Effective contract management prevents costly mistakes.AI in documentation requires careful oversight.
On this Make A Difference Minute, 17-year-old business owner Elli Tomlin of Elli Beans Coffee in Rogersville shares what entrepreneurship has taught her about leadership and self-discipline. From early mornings to real responsibility, Elli talks about the habits, mindset, and accountability it takes to run a business while still in high school. Her perspective is a reminder that leadership is not about age. It is about ownership, consistency, and showing up when it matters. Sponsor: CoraNation Tailoring & Alterations
On this MADM, Josey Trawick shares a little bit about himself as he battles chronic myelogenous leukemia, vision loss, Meniere's Disease, and multiple mental health challenges that have left him unable to work. Listen & share. Donate: gofundme.com/support-josey-trawicks-journey-to-stability Sponsor: CoraNation Tailoring & Alterations
On this Make A Difference Minute, I'm reminding listeners that one of the most meaningful things we can do is let people know they are not alone. Many carry silent burdens and feel unseen, even while surrounded by others. This segment encourages presence, compassion, and small acts of connection that can make a lasting difference. Sponsor: CoraNation Tailoring & Alterations
On this Make A Difference Minute, Chambers Ricketts shares a father's perspective after bringing his son, Ethan, home following his diagnosis of Polymicrogyria (PMG). Sponsor: CoraNation Tailoring & Alterations
Dr. Joshua Reuss is back on the podcast to discuss the full update to the living guideline on stage IV NSCLC without driver alterations. He discusses the new evidence and how this impacts the latest recommendations on first-line and subsequent therapeutic options. Dr. Reuss emphasizes the need for shared decision-making between clinicians and patients. He shares ongoing research that the panel will review in the future for further updates to this living guideline, and puts the updated recommendations into context for clinicians treating patients with stage IV NSCLC. Read the full living guideline update "Therapy for Stage IV Non-Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2026.3.0" at www.asco.org/thoracic-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-02825 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I am interviewing Dr. Joshua Reuss from Georgetown University, co-chair on "Therapy for Stage IV Non-Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2026.3.0." It is great to have you back on the show today, Dr. Reuss. Dr. Joshua Reuss: Happy to be here, Brittany. Brittany Harvey: Just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Reuss who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. Dr. Reuss, this living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer without driver alterations is updated on an ongoing basis. So, what prompted this latest update to the recommendations? Dr. Joshua Reuss: Our committee is tasked with making routine updates to the living guidelines and really keeping them living, right? So, evaluating new data as it is coming in to see, is this practice changing? Is this data that should inform and potentially alter our guideline recommendations so that practitioners and other care providers could really make the best treatment decisions for their patients? So that is something that happens on a more routine basis, but periodically, we are tasked with performing a more comprehensive update of our guideline where we really evaluate every one of our point recommendations, the data associated with these recommendations, to be sure that these are up to date, these are comprehensive, and to see if we need to alter anything in the language of these updates. Brittany Harvey: Excellent. Thank you for providing that background. And yes, this is truly a comprehensive update that goes through all the latest literature. Given that, I would like to review what has changed and what is new in the recommendations. So, what are the updated recommendations on first-line therapy for patients with stage IV non-small cell lung cancer without driver alterations? Dr. Joshua Reuss: So there are two main guidelines that we recommend from this panel. One is a driver mutation-positive guideline and the other is a driver mutation-negative guideline. And I think on first blush, one might look at kind of the recent flurry of approvals and new data and say, well, all the excitement, you know, is in the driver mutation-positive guideline. But I would say that the driver mutation-negative guideline is equally as important and really has several unique challenges associated with it. You know, first and foremost is that there are really a multitude of regimens that can be considered for any one patient. And how to choose between one can be quite difficult and a stressful challenge that clinicians can have, particularly since there are really no randomized studies comparing these regimens in a head-to-head fashion. In addition, you know, these guidelines are really broken down by two key factors. One is disease histology, so namely squamous versus non-squamous histology. And the other is PD-L1 status, broken down into one of three tertiles: PD-L1 high, which is greater than or equal to 50% expression; PD-L1 low, which is 1% to 49% expression; and then PD-L1 negative or unknown. So what you are really looking at, if you do that math, is really six unique patient subpopulations where we need to make a recommendation on one of the multitude of treatment regimens that is approved. And what that means is you are oftentimes really looking at subset and sub-subset level data to help inform clinicians in their treatment decision making, which can be quite challenging because as those small subsets of data is more and more parsed, there are many confounders that can be interjected there. And so I think the committee is tasked with really quite a challenge in terms of how to really communicate and broadcast that data in a way that informs clinicians in making a decision on what is the right treatment for their patient. Brittany Harvey: Absolutely. It can be challenging to interpret that subgroup data across several different studies that are reporting on different regimens and different outcomes. And I appreciate you mentioning the driver mutation-positive guideline as well. Listeners can check out the companion episode with Dr. Puri for more information on what is changed in the driver mutation-positive guideline. Based on that primer, what is new for first-line therapy for patients with stage IV non-small cell lung cancer without driver alterations? Dr. Joshua Reuss: Even though I will say there is not a lot of new trial data that was incorporated into this guideline, there were some updates and just some meaningful long-term data that we incorporated. I think first and foremost, there is a new top-level recommendation in this guideline pertaining to molecular testing, which is absolutely critical in both the driver mutation-positive and driver mutation-negative space. I think we tend to think that, oh, well, molecular testing really only pertains to then finding a driver mutation. But the lack of a mutation is absolutely critical as well, right? Because that is what leads us down the mutation-negative pathway. We also need this molecular testing to assess PD-L1 status. We are seeing emerging data on molecular mutations that might confer resistance to certain immunotherapy-based strategies. So the committee felt strongly that a recommendation on molecular testing is critical to include in both the driver mutation-positive guideline and the driver mutation-negative guideline. I will also say that we are now seeing five and six-year updates from some of the landmark trials of immunotherapy in driver mutation-negative non-small cell lung cancer. It is really incredible to see that in some of these trials, we are seeing very impressive durability of the treatment in the patient subsets that we are commenting on. In others, perhaps that durability is less clear, and I think that leads to challenges in making a recommendation on any one particular regimen. And I think that is nowhere more clear than in the squamous subset. I think that was one perhaps subtle change that is in this guideline where, particularly in the PD-L1 negative squamous population, the committee felt that no one regimen really was worthy of standing above the others. Sometimes I think it is important to really champion one unique regimen if we feel that the data is there to support it. But I think it is equally important to list multiple regimens where the data is less clear. I think another point is that while perhaps there were no new regimens that we have added or that led to other clear changes in the prioritization of one regimen over another, there are other unique data subsets that I think come into play in making a decision and that really are important when looking at the discussion on any one recommendation from this guideline. For example, we know there is emerging data on perhaps the significance of molecular alterations in KEAP1 or STK11 and how that might influence frontline decision-making. You know, there is not a prospective phase III trial in this population, but I think we still need to use that data in certain scenarios to make recommendations for a particular patient. Another example of a trial that, again, did not change our recommendations, but I think one can incorporate in their decision making is the KEYNOTE-598 trial. Now, this is not a new study, but what it studied was pembrolizumab versus pembrolizumab plus ipilimumab in a PD-L1 high subset, and found that the addition of ipilimumab to pembrolizumab in the PD-L1 high population did not significantly improve clinical efficacy. And so while pembrolizumab plus ipilimumab is not an approved regimen, it is hard to extrapolate that to our combination treatments that are approved. I think some clinicians might find that data valuable when making a frontline treatment decision on a patient who has PD-L1 high status. So a bit of a whirlwind tour, but I think there are still multiple factors that went into this guideline that are important to review when making treatment decisions for any one patient. Brittany Harvey: Absolutely. I think what you just mentioned in having that upfront molecular testing is really key for individualized patient care. And the evidence summaries that you provide in addition to the recommendations are really important for clinicians to be able to refer to as they are making decisions in their clinic. So then beyond those changes for first-line therapy, what is updated for second-line and subsequent therapies? Dr. Joshua Reuss: For second-line and subsequent therapies, we did see one new treatment recommendation join these ranks, and that was telisotuzumab vedotin. Telisotuzumab vedotin, quite a mouthful. That is an antibody-drug conjugate. I like to think of that as smart chemotherapy, targeted chemotherapy, where you are trying to utilize some aspect of a marker that is selectively expressed or overexpressed on the cancer surface to then shepherd in the anticancer molecule, a highly potent chemotherapeutic in the case of currently approved antibody-drug conjugates, to exert antitumor killing effect. So in this case, the antibody-drug conjugate telisotuzumab vedotin targets MET overexpression. So telisotuzumab is an antibody targeting MET, and that is conjugated to an MMAE highly potent chemotherapeutic payload called vedotin. So we know MET can be selectively expressed and overexpressed in non-small cell lung cancer in both driver mutation-positive and mutation-negative subsets. The data that led to this approval was from the phase II LUMINOSITY trial which evaluated telisotuzumab vedotin, or Teliso-V, in many subsets. But the subset that really showed promise and was expanded was the EGFR wild-type, non-squamous, non-small cell lung cancer population with MET overexpression. And so in 78 patients with high levels of expression, the response rate here was 34.6%, median progression-free survival of 5.5 months, and a median overall survival of 14.6 months. With an overall acceptable safety profile; grade 3 or higher adverse events, neuropathy was perhaps the most common at 7%, also increased ALT at 3.5%, and pneumonitis at 2.9%. Now this was phase II data that led to an accelerated approval. There is an ongoing phase III study randomizing patients with high expression to Teliso-V versus docetaxel. That is the phase III TeliMET study. But it is nice that we now have another option for patients, perhaps a more biomarker-directed option with, again, this MET overexpression. And again, it further reinforces the importance of molecular testing in patients with traditionally driver mutation-negative non-small cell lung cancer, whether that is upfront or at progression, and in particular utilizing immunohistochemistry to assess MET expression in these patients. And this does join another ADC that we had previously made an update in our recommendation, which is trastuzumab deruxtecan, which is approved for those patients with HER2-overexpressing non-small cell lung cancer. So just again to reiterate the importance of molecular testing in patients both at the outset of their treatment and upon progression on frontline therapy. Brittany Harvey: Definitely. It is great to have this new antibody-drug conjugate join the treatment options, and as you mentioned, very important in this case to have that molecular testing done at the outset and at progression. So then in your view, what should clinicians know as they implement this living guideline, and how do these changes impact patients with non-small cell lung cancer? Dr. Joshua Reuss: Because there are so many different regimens that one can consider for any one patient, I think it is easy to become overwhelmed and stress on, "Am I making the right choice for my patient?" And I think one of the key take home points is that in many cases, there is no one right regimen. And I think one has to weigh several factors. It is the treatment schedule. It is the toxicity profile. It is the molecular profile of the patient. It is the patient preference. You know, there are so many factors here. And I would like to draw the reader and viewer's attention to an important section of these guidelines, particularly the Patient and Clinician Communication section, where we have a box focused on discussion points between patients and clinicians, which I think focuses on several of the high-level points that one can emphasize in making these decisions, ranging on things from: what are the goals of the treatment? What are the risks and benefits to any one approach? What are comorbidities that should be factored in? Common concerns, toxicity management, clinical trial consideration. All of these factors that I think are incredibly important in making that frontline treatment decision and implementing a regimen that both the clinician and, more importantly, the patient feels comfortable with. Brittany Harvey: It is really important that there is shared decision-making in these scenarios. And I think that patient-clinician communication section can tease out some of those preferences from the patient end and talk through the risks and benefits of different regimens as well. As we mentioned at the top of this episode, this guideline is a living guideline and updated on an ongoing basis. So what is the panel examining and keeping an eye on for future updates to this guideline? Dr. Joshua Reuss: So I think there are a lot of exciting new therapies and more up-to-date trials that we are anxiously awaiting the results of on our committee, and I think the oncology community in general is awaiting the results of. When we will have these results, I think, is a bit of an open-ended question, but I can give some insight on several of the trials that our committee is really keeping a close eye on. One that we have mentioned for several guideline iterations is the ECOG-ACRIN INSIGNA trial. This is a phase III clinical trial comparing pembrolizumab versus pembrolizumab plus carboplatin and pemetrexed chemotherapy in PD-L1 positive, non-squamous, non-small cell lung cancer. We talk about there being different regimens that can be considered in PD-L1 positive and PD-L1 high subsets, namely immunotherapy alone or immunotherapy plus chemotherapy, but there is no direct head-to-head comparison here. So this trial hopefully will answer that question. It has now finished accrual. There are other very interesting molecules and trials. I think another interesting compound is ivonescimab. This is a PD-1/VEGF bispecific antibody that is currently approved in China as monotherapy in patients with PD-L1 positive non-small cell lung cancer based off of the HARMONi-2 trial, where the progression-free survival of this bispecific antibody, ivonescimab, appeared superior to pembrolizumab. And we are looking closely at ongoing trials to see if these results will be replicated in an ex-China population. And if so, I think it could have a real impact and change on our guidelines. Still other very interesting things. There are obviously confirmatory studies for antibody-drug conjugates, such as the TeliMET study that I alluded to earlier, and many promising antibody-drug conjugates, both bispecific and trispecific antibody-drug conjugates, that hopefully can inform practice. And then there are several unique subsets of populations that I think we now are utilizing data on to make decisions, but a lot of that is retrospective in small subsets where we do not have that prospective data. And there are several trials ongoing in some of these subsets to try to gain clarity on what regimen may be the best for patients. One example is the phase III TRITON trial, which is looking at comparing CTLA-4 containing regimen, particularly the POSEIDON regimen of durvalumab plus tremelimumab and chemotherapy, versus the KEYNOTE-189 regimen, which is pembrolizumab plus carboplatin and pemetrexed, in patients with non-squamous, non-small cell lung cancer that have alterations in either KRAS, KEAP1, and/or STK11. There is a lot of both preclinical and clinical data to suggest that patients with these alterations in STK11 and KEAP1 may be more resistant to a PD-1 based treatment approach, and perhaps the incorporation of CTLA-4 can lead to a more meaningful response in this unique subset. Obviously, that data, it is retrospective, it is in small subsets. And when you add in a CTLA-4 molecule, you are also introducing greater risk for toxicity. So this trial is going to be very important in elucidating: is there a benefit in that unique subset? Does that data that we see retrospectively in this small subset hold true when evaluated in a prospective fashion? So while our guideline, our most recent comprehensive panel update, may not have had a lot of new data in it that has influenced frontline treatment decision-making, I think the future is bright and there are a lot of novel studies and novel treatments on the horizon that will hopefully improve the outcomes for our patients. Brittany Harvey: Absolutely. We will look forward to the results of those ongoing trials to provide more options and particularly clarity for patients with non-small cell lung cancer and to inform this guideline and its many updates to come. So I want to thank you so much for your work to rapidly and continuously update this guideline, and thank you for your time today, Dr. Reuss. Dr. Joshua Reuss: Thank you so much. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines App available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.
Dr. Sonam Puri discusses the full update to the living guideline on stage IV NSCLC with driver alterations. She shares a new overarching recommendation on biomarking testing and explains the new recommendations and the supporting evidence for first-line and subsequent therapies for patients with stage IV NSCLC and driver alterations including EGFR, MET, ROS1, and HER2. Dr. Puri talks about the importance of this guideline and rapidly evolving areas of research that will impact future updates. Read the full living guideline update "Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2026.3.0" at www.asco.org/thoracic-cancer-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/thoracic-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-02822 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Sonam Puri from Moffitt Cancer Center, co-chair on "Therapy for Stage IV Non-Small Cell Lung Cancer with Driver Alterations: ASCO Living Guideline, Version 2026.3.0." It's great to have you here today, Dr. Puri. Dr. Sonam Puri: Thanks, Brittany. Brittany Harvey: And then just before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Puri, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to dive into the content that we're here today to talk about, Dr. Puri, this living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer with driver alterations is updated on an ongoing basis. So, what data prompted this latest update to the recommendations? Dr. Sonam Puri: So Brittany, non-small cell lung cancer is one of the fastest-moving areas in oncology right now, particularly when it comes to targeted therapy for driver alterations. New data are emerging continuously from clinical trials, regulatory approvals, real-world experience, which is exactly why these are living guidelines. The goal is to rapidly integrate important advances as they happen, rather than waiting for years for a traditional update. Since the last full update of the ASCO Stage IV Non-small Cell Lung Cancer Guideline with Driver Alterations published in 2024, there have been seven new regulatory approvals and changes in first-line therapy for some driver alterations. [This version] of the "Stage IV Non-small Cell Lung Cancer Guidelines with Driver Alterations" represents a full update, which means that the panel reviewed and refreshed every applicable section of the guideline to reflect the most current evidence across therapies including sequencing and clinical decision-making. This is to ensure that clinicians have up-to-date practical guidelines that keep pace with how quickly the field is evolving. Brittany Harvey: Absolutely. As you mentioned, this is a very fast-moving space and this full update helps condense all of those versions that the panel reviewed before into one document, along with additional approvals and new trials that you reviewed during this time period. So then, the first aspect of the guideline is there's a new overarching recommendation on biomarker testing. Could you speak a little bit to that updated recommendation? Dr. Sonam Puri: Yeah, definitely. So the panel has discussed and provided recommendations on comprehensive biomarker testing and its importance in all patients diagnosed with non-small cell lung cancer. Ideally, biomarker testing should include a broad-based next-generation sequencing panel, rather than single-gene tests, along with immunohistochemistry for important markers such as PD-L1, HER2, and MET. These results really drive treatment decisions, both in frontline settings for all patients diagnosed with non-small cell lung cancer and in subsequent line settings for patients with non-small cell lung cancer harboring certain targetable alterations. Specifically in the frontline setting, it helps determine whether a patient should receive upfront targeted therapy or immunotherapy-based approach. We now have strong data that shows that complete molecular profiling results before starting first-line therapy is associated with better overall survival and actually more cost-effective care. Using both tissue and blood-based testing can improve likelihood of getting actionable results in a timely way, and we've also provided guidance on platforms that include RNA sequencing, which are specifically helpful for identifying gene fusions that might be otherwise missed with other platforms. On the flip side, outside of a truly resource-limited setting, single-gene PCR testing really should not be routine anymore. This is what the panel recommends. It's less sensitive and inefficient and increases the risk of missing important actionable alterations. Brittany Harvey: Understood. I appreciate you reviewing that recommendation. It really helps identify critical individual factors to match the best treatment option to each individual patient. So then, following that recommendation, what are the updated recommendations on first-line therapy for patients with stage IV non-small cell lung cancer with a driver alteration? Dr. Sonam Puri: Since the last full update in 2024, there have been four additional interim updates which were published across 2024 and 2025. Compared to the last version, there have been several updates which have been included in this full update. One of the most important shifts has been in first-line treatment of patients with non-small cell lung cancer harboring the classical, or what we call as typical, EGFR mutation. The current version of the recommendation is based on the updated survival data from the phase III FLAURA2 and MARIPOSA studies, based on which the panel recommended to offer either osimertinib combined with platinum-pemetrexed chemotherapy or the combination of amivantamab plus lazertinib in the first-line treatment of classical EGFR mutations. And these recommendations, as I mentioned, are grounded in the results of the FLAURA2 and MARIPOSA trials, both of which demonstrated improvement in progression-free survival and overall survival compared to osimertinib alone in patients with common EGFR mutations. That being said, the panel actually spent significant time discussing the toxicities associated with these treatments as well. These combination approaches come with higher toxicity, longer infusion time, increased treatment frequency. So while combination therapy is now recommended as preferred, the panel has recommended that osimertinib monotherapy remains a reasonable option, particularly for patients with poor performance status and for those who are not interested in treatment intensification after knowing the risks and benefits. Brittany Harvey: Absolutely. It's important to consider both those benefits and risks of those adverse events that you mentioned to match appropriately individualized patient care. So then, beyond those recommendations for first-line therapy, what is new for second-line and subsequent therapies? Dr. Sonam Puri: So this is a section that saw several major updates, particularly again in the EGFR space. The first was an update on treatment after progression on osimertinib for patients with classical EGFR mutation. Here the panel recommends the combination of amivantamab plus chemotherapy, and this recommendation was based on the phase III MARIPOSA-2 trial, which compared amivantamab plus chemotherapy with chemotherapy alone with progression-free survival as the primary endpoint. The study met its primary endpoint, showing an improvement in median PFS with the combination of amivantamab plus chemotherapy compared to chemotherapy alone. And as expected, the combination was associated with higher toxicity. So, although the panel recommends this regimen, the panel emphasizes that patients should be counseled on the side effects which may be moderate to severe with the combination therapy approach. In addition, a new recommendation was added for patients who are not candidates for amivantamab plus chemotherapy. In those cases, platinum-based chemotherapy with or without continuation of osimertinib may be offered, and the option of continuing osimertinib with chemotherapy was recommended and supported by data from a recently presented phase III COMPEL study, which randomized 98 patients with EGFR exon 19 deletion or L858R-mutated advanced non-small cell lung cancer who had experienced no CNS progression on first-line osimertinib, and these patients were randomized to receive platinum-pemetrexed chemotherapy with osimertinib or placebo. Although this study was small, it demonstrated a PFS benefit with continuation of osimertinib with chemotherapy, and this approach may be appropriate for patients without CNS progression who prefer or require alternatives to more intensive treatment strategies. Next was an update on options for patients with EGFR-mutated lung cancer after progression on osimertinib and platinum-based chemotherapy. Here the panel recommended that for patients whose disease has progressed after both osimertinib and platinum-based chemotherapy, a new drug known as datopotamab deruxtecan can be offered as a treatment option. And this treatment recommendation was based on evaluation of pooled data from the TROPION-Lung01 and TROPION-Lung05 study, in which in the pooled analysis about 114 patients with EGFR-mutant non-small cell lung cancer were treated with Dato-DXd, 57% of whom had received three or more prior lines of treatment, and what was observed was an overall response rate of 45% with a median duration of response of 6.5 months. So definitely promising results. Next, we focused on updates to subsequent therapy options for patients with another type of EGFR mutation known as EGFR exon 20 insertion mutations. In this section, the panel added sunvozertinib as a subsequent line option after progression on platinum-based chemotherapy with or without amivantamab. Sunvozertinib is an oral, irreversible, and selective EGFR tyrosine kinase inhibitor with efficacy demonstrated in the phase II WU-KONG6 study conducted in Chinese patient population. In this study, amongst 104 patients with platinum-pretreated EGFR exon 20 mutated non-small cell lung cancer, the observed response rate was 61%. Staying in the EGFR space, the panel added a recommendation for patients with acquired MET amplification following progression on EGFR TKI therapy. In these situations, the panel recommended that treatment may be offered with osimertinib in combination with either tepotinib or savolitinib. As our listeners may know, MET amplification occurs in approximately 10% to 15% of patients with EGFR-mutated non-small cell lung cancer when they progress on third-generation EGFR TKIs, and detection of MET amplification is done with various methods, such as tissue-based methods like FISH, NGS, and IHC, as well as ctDNA-based NGS with variable cut-offs. Over the last few years, several studies have informed this recommendation. I'm going to be discussing some of them. In the phase II ORCHARD trial, 32 patients with MET-amplified non-small cell lung cancer after progression on first-line osimertinib were evaluated, where the combination of osimertinib plus savolitinib achieved an overall response rate of 47% with a duration of response of 14.5 months. More recently, the phase II SAVANNAH trial reported outcomes in 80 patients with MET-amplified tumors after progression on osimertinib, and in this patient population, the combination of savolitinib and osimertinib achieved an overall response rate of 56% with a median PFS of 7.4 months. And lastly, the phase II single-arm INSIGHT 2 trial assessed the efficacy of osimertinib plus tepotinib in patients with advanced EGFR-mutant non-small cell lung cancer who had disease progression following first-line osimertinib therapy. And in this study, in a cohort of 98 patients with MET-amplified tumors confirmed by central testing, the overall response rate with the combination was 50% with a duration of response of 8.5 months. So definitely informing this guideline recommendation. Next, we had an update on recommendation in patients with ROS1-rearranged non-small cell lung cancer. For patients with ROS1-rearranged non-small cell lung cancer, the panel recommended specifically for patients who progressed after first-line ROS1 TKIs, the addition of taletrectinib as a new option alongside repotrectinib. And this recommendation was based on analysis of the results of the TRUST-I and TRUST-II studies, which showed that amongst 113 tyrosine kinase inhibitor-pretreated patients, taletrectinib achieved a confirmed overall response rate of 55.8% with a median duration of response of 16.6 months and a median PFS of 9.7 months, a very promising agent. Finally, for patients with HER2 exon 20 mutated non-small cell lung cancer, the panel added two new oral HER2 tyrosine kinase inhibitors, zongertinib and sevabertinib, as options in addition to T-DXd and after exposure to T-DXd. These recommendations are based on early phase data from two trials: the phase I Beamion LUNG-01 study, which evaluated zongertinib, and the phase I/II SOHO-01 study that evaluated sevabertinib. In this study, zongertinib demonstrated an overall response rate of 71% in previously treated patients, with an overall response rate of 48% amongst patients who had received prior HER2-directed ADCs including T-DXd. Sevabertinib in its early phase study showed an overall response rate of 64% in previously treated but HER2 therapy-naive patients, and an overall response rate of 38% in patients previously exposed to HER2-directed therapy. The panel believes that both agents had manageable toxicity profile and represent meaningful new options for this patient population. Brittany Harvey: Certainly, it's an active space of research, and I appreciate you reviewing the evidence underpinning all of these recommendations for our listeners. So, it's great to have these new options for patients in the later-line settings. And given all of these updates in both the first and the later-line settings, what should clinicians know as they implement this latest living guideline update, and how do these changes impact patients with non-small cell lung cancer? Dr. Sonam Puri: Some great questions, Brittany. I think for clinicians when implementing this update, I think about two practical steps. First is reiterating the importance of comprehensive biomarker testing. That is the only way to identify key drivers and resistance mechanisms that we are now targeting. And second, picking a first-line strategy that balances efficacy and toxicity and patient preference for your specific patient. I think informed decision-making, shared decision-making is more important than any time right now. It has always been important, but definitely very important now. For patients, this guideline brings recommendations on more personalized treatment options for both first-line and post-progression settings, which potentially means better outcomes. But it is also very important for our patients to continue to have informed conversations about side effects, time commitment, and what matters most to them with their providers. The panel in this version of the guideline specifically acknowledges the real-world barriers that prevent patients from receiving guideline-concordant therapy, including challenges with access to comprehensive molecular testing and treatment availability, and the panel emphasizes on the importance of shared decision-making, and we provide practical discussion points to help clinicians navigate these conversations with the patient. In addition, the panel has also addressed common real-world clinical complexities, such as treating elderly or frail patients, managing multiple chronic conditions, considerations around pregnancy and fertility, and certain disease scenarios such as oligoprogression or oligometastatic disease. And where available, the guideline summarizes this existing data to support informed individual decision-making in these complex situations. Brittany Harvey: Shared decision-making is really paramount, especially with all of the options and weighing the risks and benefits and considering the individual circumstances of each patient that comes before a clinician. We've talked a lot about all of the new studies that the panel has reviewed, but what other studies or areas of research is the panel examining for future updates to this living guideline as it continues to be updated on an ongoing basis? Dr. Sonam Puri: Yes, definitely, so much to look forward to, right? Looking ahead, the panel is closely monitoring several rapidly evolving areas that are likely to shape future updates of the guideline. This includes emerging data from ongoing later-phase studies, particularly the studies that are evaluating these new targeted agents moving to earlier lines of therapy, alongside studies evaluating additional combination strategies or more refined approaches to treatment sequencing. We're also closely watching advances in biomarker testing, the evolving understanding of resistance mechanisms, development of new targets, and promising therapeutic agents. I think ultimately the living guideline exists to help clinicians and patients navigate this rapidly evolving field, and we would like to ensure that scientific advances are rapidly translated into better, more personalized patient care. Brittany Harvey: Definitely. We'll look forward to those updates from those ongoing trials and future areas of research that you mentioned to provide better options for patients with non-small cell lung cancer and a driver alteration. So I want to thank you so much for your work to rapidly and continuously update this guideline, and thank you for your time today, Dr. Puri. Dr. Sonam Puri: Thanks so much. Thanks so much for the opportunity. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. There's also a companion episode with Dr. Reuss on the related living guideline on stage IV non-small cell lung cancer without driver alterations that listeners can find in their feeds as well. And if you've enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. 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.
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Episode 305 is the eighteenth episode of our mini-series on the Tippit murder. David Belin, the celebrated Warren Commission attorney called it the "Rosetta Stone" of the JFK assassination. It may very well be just that...but for other reasons! In this eighteenth episode, we tell the story of one of the most blatant evidence tampering episodes within the case. And perhaps one of the most blatant ever in any such high profile case. The police logs that officially capture the conversations and the exact time in which they occur were uniquely suited to pinpoint the time of Tippit's death, and thus prove or disprove Oswald's ability to even be at the scene of the crime in time to commit the murder. When it became clear that this information was going to prove the authorities wrong, they altered the transcripts and obfuscated other evidence contained in those logs in order to conceal the fact that many officers were in the Oak Cliff area even when they had no business being there. The combination of these changes were not only designed to shut door the on the case and ensure that Oswald was to be identified as the killer, but they also avoided the obvious questions of a wider conspiracy that may have involved a number of individuals within the Dallas Police Department. Yes…there is a grave possibility that the true "Rosetta Stone" of November 22nd, 1963, might just lie in the quiet Dallas suburb of Oak Cliff, waiting for us to finally put the pieces together. This is a wander I've created especially for you…and of all the wanders you have taken with me, this may be the most thrilling of all! And don't worry, as the fall winds turn cooler, we will all be vacationing once again, in Mexico…I think you know what I mean by that. But our new wander takes precedent. As we wind down the Tippit series, I hope that you will enjoy these last few episodes of what is one of the most riveting aspects of the JFK assassination story.
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