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Nikki made it back from her trip after a TWENTY FIVE HOUR DELAY, so we wanted to know what your worst delay was. Plus, Marcus Mumford met his wife Carey Mulligan when they were kids at camp and reconnected later in life, which made us go "Awwwww!" So we asked you when you met your spouse and when you actually got married! Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Wendy Mateo, Director of The Brief and Wondrous Life of Oscar Wao at the Goodman Theatre chats with Chris of The Morning Mix about the production, rehearsal process, and theater in Chicago.For tickets and information on The Brief and Wondrous Life of Oscar Wao, click HERE.Listen to The Morning Mix weekdays from 5:30am - 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Nikki's flight home from vacation got cancelled so it's an impromptu Dude's Day! Chris and Whip asked about the strangest reason you got dumped and it turns out men do believe in the power of dreams. Also, in today's weekend oopsie Lexi gives us a follow up from last Friday's Good News! Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The sun came out and it's supposed to be 60 degrees in Chicago making it a gorgeous Friday in February to hear some GOOD NEWS! And there's so much more to celebrate including a brand new Bruno Mars album that Chris's mom absolutely loves (seriously, we called her to ask). Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

A historical, philosophical, psychological and theological view of the word "conscience," lays the foundation for the message. God used the famine in Israel and placed Joseph's brothers and father in a state of need, lack, or want and are crying out to God for help, in this time, God is closest to us.  Genesis 45:5 VF-1811 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

Coach Caroline and Coach Valerie answer a great membership Zoom question: why do drills feel amazing in a Zoom practice but not translate to outdoor runs? In this episode we explain the difference between "in-place" drill conditioning and running practice, why doing too much outside too soon can undermine progress, and how to treat running like an interval-style practice — work, reset, drill, then continue. You'll get practical steps for stopping and resetting mid-run, why small intentional pauses improve form and endurance, how walk-breaks differ from resets, and real member examples that show steady progress. Also learn how our gait analysis and membership feedback accelerate your improvement and why treating runs like practice makes your outdoor sessions feel as crisp as your best Zoom drills.Chapters: 00:00:24 – 00:01:10 | Intro & membership Zoom: the question that started this episode 00:01:10 – 00:02:30 | Why drills feel better in the Zoom room: in-place vs. outdoor effort 00:02:30 – 00:04:00 | Treat your run like practice: stop, reset, drill, repeat 00:04:00 – 00:05:30 | Conditioning vs technique: why fitness isn't always the limiter 00:05:30 – 00:06:40 | Walk breaks vs resets: Jeff Galloway, walk-run history, and Coach Valerie's approach 00:06:40 – 00:08:10 | Practical run-practice plan: intervals, short drills, progressive distance 00:08:10 – 00:09:09 | Closing: membership value, gait analysis vs membership pricing, how to get startedWhere to find us: ▶️ Free 30-Day RunRX Reboot — Skill, Strength & Self-Care https://www.youtube.com/watch?v=a0N-GZ0AosI&list=PLDPcF8ZrDdILC8bYyn2zR-4xvqKRzp2re▶️ Join the RunRX Membership https://runrx.fit/join-runrxstrongWebsite: https://runrx.fit App: RunRx Academy — available on Apple App Store and Google Play (search "RunRx Academy") Support email: support@runrx.fit

Chris and Whip hold it down today while Nikki is out and they're giving you a reason to brag about your husbands. Plus, we find out the treasures you found in someone else's trash. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Iron entered into Joseph's soul, and the promise of the Lord severely tested him. God uses our trials, like Joseph's, for His purpose. Psalm 105:17 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

Send a textWelcome to Episode 367 of the Chasing Daylight Podcast! This week, we are joined by a special guest, Jacob Safar, the creator and developer of Grassy.If you've ever wanted a dedicated platform just to nerd out about golf courses, Grassy is exactly what you've been looking for. Jacob breaks down how he built this iOS-exclusive social platform to help golfers track their travels, rank their favorite courses, and build their ultimate bucket lists.In this episode, we cover:What is Grassy? Think of it like a restaurant review app or "Letterboxd," but specifically curated for golfers to share course photos and reviews.The Origin Story: Jacob explains how he developed the first version of the app in less than three weeks out of a coffee shop.App Features vs. On-Course Tracking: We discuss why Grassy focuses on the off-course social and discovery experience rather than competing with live GPS trackers like 18Birdies.Future Updates: We brainstorm some new features live on the show, from adding a Chasing Daylight group ranking page to a "Pokedex" for golf courses and AI caddy recommendations.Massive Giveaway: Jacob shares details on the current Grassy app giveaway, including a Callaway Quantum Max driver and over $500 in PGA Superstore and Grassy gift cards! Make sure to hit that like button, share this episode, and go download Grassy on the Apple App Store today! https://www.grassy.golf/Special thank goes out to our show sponsors:

Dr Mary Talley Bowden joins The Jeff Dornik Show to break down her legal battle against the Texas Medical Board after it issued a public reprimand for her good faith effort to administer Ivermectin to a dying COVID patient under a court order. The Board ignored medical expert testimony, disregarded due process, and punished her despite her reliance on judicial authority and legal counsel. Attorney General Ken Paxton has now intervened to defend Dr Mary Talley Bowden's constitutional rights and refuse representation of the Texas Medical Board in her case. The discussion also examines RFK Jr's first year leading HHS, the reality of MAHA, and the continued presence of COVID shots on the market amid reports of disease, disability, and death without accountability.SPONSORSupermassive Black Coffee is crafted from organic, gourmet beans fire-roasted in an antique Victorian-era roaster, delivering the rich, smooth, non-acidic taste that reminds you this is how coffee was always meant to be. Use code JEFF50 for 50% off your first order. https://supermassiveblackcoffee.com/?ref=JEFFFollow Dr Mary Talley Bowden on Pickax - https://pickax.com/mdbreatheFollow Jeff Dornik on Pickax - https://pickax.com/jeffdornikTune into The Jeff Dornik Show LIVE daily at 1pm ET on Rumble. Subscribe on Rumble and never miss a show. https://rumble.com/c/jeffdornikPickax is officially live, and we are building what Big Tech refused to build, a platform where creators own their voice, their audience, and their future without algorithms manipulating reach or silencing truth. Download Pickax today in the Google Play Store and Apple App Store and join a movement where technology serves people, freedom, and real human connection. https://pickax.com/?referralCode=y7wxvwq&refSource=copy

Dr. Lakshmi Rajdev and Dr. Manish Shah join the podcast to discuss the updated guideline on immunotherapy and targeted therapy in unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. They share first-line and subsequent-line recommendations for both gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma based on actionable biomarkers including PD-L1 expression, MMR and/or MSI, CLDN18.2 expression, and HER2 status. They note the importance of the algorithms and tables in the guidelines that provide visual illustrations and quick reference guides of the evidence-based recommendations. They also comment on ongoing and recently presented trials that may impact future guidelines in this space. Read the full guideline, "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update" at www.asco.org/gastrointestinal-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/gastrointestinal-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-25-02958      Timestamps ·       00:00 – 02:15 Introduction and Overview ·       02:16 - 08:20 First-line treatment for patients with pMMR/MSS, HER2-negative gastroesophageal adenocarcinoma ·       08:21 –10:29 First-line treatment for patients with pMMR/MSS, HER2-positive gastroesophageal adenocarcinoma ·       10:30 – 14:39 First-line treatment for patients with dMMR/MSI-H, gastroesophageal adenocarcinoma ·       14:40 – 18:03 First-line treatment for ESCC ·       18:04 – 22:04 Second- and third-line therapy for gastroesophageal adenocarcinoma and ESCC ·       22:05 – 24:38 Importance of guideline ·       24:39 – 27:45 Outstanding questions and future research   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. Lakshmi Rajdev from the Icahn School of Medicine at Mount Sinai and Dr. Manish Shah from Weill Cornell Medicine, co-chairs on "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update." Thank you for being here today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you for having us. It is wonderful. Brittany Harvey: And then 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. Rajdev and Dr. Shah, who have 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 what we are here today to talk about, Dr. Shah, I would like to start first with what prompted the update to this guideline, which was previously published in 2023, and what is the scope of this updated guideline? Dr. Manish Shah: Yes, terrific. So even in the last few years, the pace of drug development in gastroesophageal cancers has just been astounding. So, what prompted this guideline is actually the practice-changing results for a new biomarker, CLDN18.2 hat was based on the GLOW and SPOTLIGHT studies, as well as a practice-changing study in HER2-positive disease where we added pembrolizumab to trastuzumab and chemotherapy for tumors that are HER2-positive and PD-L1 CPS 1 or greater. And then there were also new studies and new approvals in esophageal squamous cell cancer that you will hear about as well. So there were several studies, overall more than 5,000 patients were reported on, and that led to several new therapies, new indications, and it really necessitated this guideline. Brittany Harvey: Excellent. It is great to hear about all of these exciting updates in this space. So then to next review the key recommendations of this guideline by clinical question that the expert panel addressed. So, Dr. Rajdev, what is the recommended first-line treatment for patients with proficient mismatch repair, microsatellite stable, HER2-negative gastroesophageal adenocarcinoma? Dr. Lakshmi Rajdev: Thank you for that question. So historically, we have sort of used fluoropyrimidine and platinum doublets, which yielded a survival of about one year. More recently, immunotherapy and targeted therapy options have improved outcomes in patients with advanced esophageal and gastric adenocarcinoma, as well as squamous cell carcinoma. Patients with gastric and GE junction adenocarcinoma have a high rate of actionable alterations, so it is imperative that physicians test the following biomarkers upfront so that it can help guide therapy. The markers recommended by the ASCO panel are HER2, MMR or MSI, CLDN18.2, and PD-L1. And also, it was recommended to use NGS if feasible in this patient population. HER2, as we know, is expressed in about 15% to 25% of patients; PD-L1 expression occurs in about 80% of patients; MSI-high, deficient MMR is present in about 5% to 8% of patients; and CLDN18.2 expression is present in about 40% of patients. There is, of course, biomarker overlap. About 13% to 22% of CLDN18.2 patients are also PD-L1 positive. For patients with pMMR or microsatellite stable HER2-negative disease with PD-L1 expression greater than 1 and absence of CLDN18.2, the panel recommended a first-line therapy with fluoropyrimidine and platinum-based therapy in combination with immunotherapy. These recommendations stem from large phase 3 trials, and the agents approved in the United States are pembrolizumab, nivolumab, and tislelizumab. It has been shown that immunotherapy benefit is greater in patients with higher PD-L1 expression, and it is not possible to comment on the individual PD-L1 cutoff scores and sort of identify the optimal PD-L1 cutoff score that sort of balances benefits and harms. But what is recommended is that immunotherapy-based treatments can be offered in patients with a CPS score of greater than 1. With regard to the choice of immunotherapy agents, that is pembrolizumab, nivolumab, or tislelizumab, these agents are considered to have similar efficacy, and the selection of an agent could be based on dosing schedule, cost considerations, toxicity, and the method of administration. Typically, clinicians should avoid withholding the start of chemotherapy while awaiting biomarker testing, depending on the clinical scenario. Now, for patients with pMMR microsatellite stable disease that is HER2-negative with PD-L1 expression less than 1 and positive CLDN18.2 expression, zolbetuximab-based treatments or in combination with chemotherapy is recommended, and this is based on two global phase III randomized controlled trials, the GLOW and the SPOTLIGHT. And across both studies, the hazard ratio for the overall survival was 0.78, and similarly, there was also an improvement in progression-free survival favoring the zolbetuximab group compared to the chemotherapy group alone. An important note is that nausea, vomiting is commonly associated with zolbetuximab-based treatments, and the panel recommended prophylactic antiemetics, adjusting zolbetuximab infusion rates, pausing infusion temporarily, using non-prophylactic antiemetics, and hydration intravenously prior to discontinuation of zolbetuximab-based chemotherapy. So effective handling of the GI-related symptoms with zolbetuximab is recommended prior to discontinuation of therapy. Now, for patients with pMMR microsatellite stable HER2-negative gastric, GE junction adenocarcinoma with PD-L1 expression greater than 1 and CLDN18.2 positivity, the ones with the dual expression with CLDN18.2 as well as PD-L1 chemotherapy, the choice of therapy can be based on the degree of PD-L1 expression, the toxicity profile, the burden of symptoms, and the anticipated improvement in symptoms associated with response to treatment, the patient comorbidities, the prior medical and treatment history. So this decision needs to be made on a case-by-case basis, and these are some of the factors that we suggested that could potentially influence the choice of therapy. For patients with pMMR microsatellite stable disease that is HER2-negative and a PD-L1 expression less than 1 and an absence of CLDN18.2 expression, first-line therapy with fluoropyrimidine and platinum-based chemotherapy is recommended. So you can see we have segmented out patients based on PD-L1 expression, pMMR and microsatellite stable disease expression, and also based on CLDN expression. Brittany Harvey: Absolutely. And that first point you noted, I think is really important, that biomarker testing is really critical for treatment decision-making in this space. So then the next subgroup of patients that the panel looked at, Dr. Shah, what first-line therapy is recommended for patients with proficient mismatch repair, microsatellite stable, HER2-positive gastroesophageal adenocarcinoma? Dr. Manish Shah: So this was an update from a few years ago. So we have known for 15 years now that if you are HER2-positive, you should get trastuzumab plus chemotherapy. That was based on the ToGA trial. And the update now is based on a trial called KEYNOTE-811, where it examined the addition of pembrolizumab to trastuzumab and chemotherapy versus trastuzumab and chemotherapy, and there was a progression-free and overall survival benefit. And again, here, the biomarkers are important. If your CPS PD-L1 is less than 1, we would not recommend Pembrolizumab in that setting, so you would still get trastuzumab and chemotherapy. But if it is 1 or greater, the PD-L1 CPS score, then we do recommend pembrolizumab unless there is a contraindication to immunotherapy. The take-home message really is from the onset of diagnosis, please check your biomarkers. And I will just, it is worth repeating, it is important to check your PD-L1 status, HER2 status, mismatch repair status, and CLDN18.2 status. And then the optimal therapy, and it is outlined in the publication, is really biomarker-driven. We know that if we are able to hit the target that is overexpressed, we are going to have a better outcome. And Dr. Rajdev did mention where there is overlap, there can be a lack of data, and that is where we are with both PD-L1 positive and CLDN positive. Here we do have data in HER2-positive cases where if you are both HER2-positive and PD-L1 positive, you would combine trastuzumab and pembrolizumab for the best outcomes. Brittany Harvey: Understood. I really appreciate you detailing what is most important for each individual biomarker combination that patients may have. So then following that, Dr. Rajdev, what does the expert panel recommend for first-line treatment for patients with esophageal squamous cell carcinoma that is not amenable to definitive chemoradiation? Dr. Lakshmi Rajdev: There are three phase III randomized clinical trials that have influenced practice in patients with esophageal squamous cell carcinoma examining the benefit of immunotherapy in this patient population. The RATIONALE-306 was a randomized trial of tislelizumab plus chemotherapy with platinum and fluoropyrimidine or paclitaxel versus placebo with chemotherapy. And then you have the KEYNOTE-590, which compared pembrolizumab plus chemotherapy versus chemotherapy alone. And then you have CheckMate-648, which included comparisons of nivolumab plus chemotherapy versus nivolumab plus ipilimumab or chemotherapy. And the primary endpoints for these studies were overall survival, and they did look at subgroups with PD-L1 expression. They used TPS score greater than 1% in CheckMate-648 and PD-L1 CPS greater than 10 in KEYNOTE-590. The bottom line is that the overall hazard ratio for overall survival across this patient population was 0.72. So clearly, there is benefit in patients that express PD-L1 CPS greater than 1 for benefit for the addition of immunotherapy. Now, the benefit again in patients with a PD-L1 expression less than 1 remains limited, and so the panel has made a recommendation for using immunotherapy in combination with platinum-based chemotherapy in patients with a PD-L1 greater than 1. Again, we know that it is hard to make recommendations on what PD-L1 cutoffs are recommended in this patient population, meaning that should it be limited to patients with a PD-L1 of 1 to 4 or greater than 10? I think that the general consensus that has been gleaned from the data is that the higher the PD-L1 expression, the greater the benefit. I do want to comment on another option that is available in patients with squamous cell carcinoma compared to adenocarcinoma, and that is the combination of nivolumab and ipilimumab. Now, in CheckMate-648, nivolumab with ipilimumab was also recommended as a treatment option in patients that have a PD-L1 score of greater than 1. There was a survival benefit demonstrated with this combination compared to chemotherapy alone. And an important observation in this study is that, although there was a slightly increased rate in early death, but there was really no significant difference in PFS and OS compared to chemotherapy alone. Importantly, the treatment appeared to be pretty well tolerated by the study population. There was a notable difference in the objective response rate, which was 35% in the nivolumab plus ipilimumab group compared to patients receiving nivolumab and chemotherapy, where it was 53%. So superiority is, so the importance of chemotherapy in patients with esophageal squamous cell carcinoma is to be noted. However, there is no difference in overall survival and progression-free survival when using the combination of nivolumab and ipilimumab, and thus it affords a chemotherapy-free option for this patient population with esophageal squamous cell carcinoma and a CPS with a score of greater than 1. Brittany Harvey: Understood. I appreciate you reviewing the evidence underpinning those recommendations as well. So then the next patient population that the guideline panel addressed, what first-line therapy is recommended for patients with deficient mismatch repair, microsatellite instability-high, gastroesophageal adenocarcinoma or esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: The rate of MSI-high expression is about 3% to 7% across different studies. Now, the KEYNOTE-158 was a tumor-agnostic study in patients with non-colorectal cancers, and again, the problem with the MSI-high population, given that it is so rare, the numbers in the individual studies are fairly small. But consistent outcomes do emerge, indicating high response to immunotherapy. So in KEYNOTE-158, a response rate of about 46% was noted. The number of patients was small, it was about 24. In CheckMate-649, which is a study of chemotherapy plus or minus nivolumab in patients with advanced gastric adenocarcinoma, there was again a very small number of patients, and patients that were MSI-high or deficient MMR did experience substantial benefits with the addition of immunotherapy, with hazard ratios in the order of about 0.38. In KEYNOTE-062, again, it was a very small number of patients, again about 6% or so, and similar to CheckMate-649, a substantial benefit was noted in combination with chemotherapy, but also there were benefits noted with pembrolizumab alone. The RATIONALE-305 again was a study of tislelizumab in combination with chemotherapy and similarly showed benefits to the combination of chemotherapy plus immunotherapy in this patient population. I think that we are all aware of the dramatic benefits of immunotherapy in this particular subset of patients, deficient MMR MSI-high, and also we have seen in CheckMate-649 they did have a subset of patients that received nivolumab and ipilimumab. And in this patient population, they noted unstratified hazard ratio of 0.28. So I think that the overall consensus is that immunotherapy is a very important treatment modality in patients with deficient MMR MSI-high disease, given that a lot of the trials in gastroesophageal adenocarcinoma have utilized chemotherapy-based options, that is certainly a recommendation of the panel to use chemotherapy in combination with immunotherapy. However, on a case-by-case basis, the panel recommended immunotherapy alone as well, and given the high response rates noted in trials across different diseases as well as noted in this disease as well. Brittany Harvey: Certainly. And I appreciate you both for reviewing these first-line recommendations. So moving to later lines of therapy, Dr. Rajdev, what recommendations did the expert panel make for second or third-line therapy for gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: So, I think that the RAINBOW trial that investigated the utility of the addition of ramucirumab as second-line therapy has been around since 2014, and those results have led to the addition of ramucirumab to taxane-based therapy in the second-line setting. Based on the utilization of oxaliplatin and platinum-based therapy in the front-line setting, there may be patients that have an underlying neuropathy, and so we wanted to really include treatment options for this patient population so that an agent that is less neurotoxic could also be recommended in combination with ramucirumab. The RAMIRIS trial is one such trial where ramucirumab was combined with FOLFIRI, and it demonstrated benefit in combination with ramucirumab. So we have listed that as a potential treatment option for patients in the second-line setting who may have an underlying neuropathy or even for whatever reason that based on the toxicity profile, that needs to be the preferred option by a physician, that recommendation is new from the older guidelines that we have. With regard to the utility of PD-1 inhibitors, there really has been no benefit noted in the second-line setting with regard to overall survival or progression-free survival, so no recommendation is made for that option. I think an important study that has been recently presented is the DESTINY-Gastric04 trial, which really has been practice-changing and has led to the recommendation for trastuzumab deruxtecan in patients that have HER2-positive metastatic gastric or GE junction adenocarcinoma. Now, this is a phase III trial in patients who retained HER2-positive disease after progressing on front-line trastuzumab-based treatments, and the comparator for this trial was trastuzumab deruxtecan versus ramucirumab plus paclitaxel. There was significant improvement and progression-free survival in patients that received trastuzumab deruxtecan. The patients that were excluded from the trial are patients that have pulmonary problems, interstitial lung disease; that is one of the toxicities of this particular agent, and close monitoring and prompt initiation of therapy such as glucocorticoid treatment in patients who develop this toxicity was also highlighted by the panel. So to summarize, the new guidelines highlight the possibility of FOLFIRI plus ramucirumab as a second-line option and then trastuzumab deruxtecan as a later-line option in patients that still retain HER2 expression. And that is very important because the trial did retest patients whether they expressed HER2. As we know, in a substantial number of patients, there is downregulation of HER2, and there is emerging data that the benefit for subsequent HER2-directed therapies is best noted in patients that still retain HER2 expression. Brittany Harvey: Great. So as our listeners have heard, there are many recommendations and new treatment options for advanced gastroesophageal cancer. Dr. Shah, earlier you highlighted the importance of biomarker testing, but I would like to hear in your view, what is the importance of this guideline and how will it impact both clinicians and patients with gastroesophageal carcinoma? Dr. Manish Shah: So as we have discussed throughout this podcast, the treatment for gastroesophageal cancer, both adenocarcinoma and squamous cell cancer, is increasingly complex, increasingly biomarker-driven. And I think the value of the guideline is to place all of that into context. So it provides the data for why certain biomarkers are important, what therapies should be indicated. Not only that, but if you are able to review the guideline, it provides the details of each of these studies and summarizes them in a meta-analysis fashion to sort of give you the context, because sometimes the individual studies can be maybe a little bit discordant or confusing and the guideline attempts to harmonize all that. And then also, I think the tables are very, very interesting because they give you actual numbers in terms of how many patients over a thousand would this benefit or how many patients over a thousand would this cause harm in terms of nausea, vomiting, or other things like that. So it gives you context for helping clinicians and patients weigh the potential benefits of the novel treatment strategies against the potential adverse events. And then finally, the guideline does also provide an algorithm that you are able to follow based on the biomarkers, and those are in figures 4 and 5. So I think overall, it is a very comprehensive guideline. It intends to make more manageable a very complex subject, and you know, I really encourage our listeners to review it after listening to the podcast. Dr. Lakshmi Rajdev: If I can add to that, I think that what is also really good about the guidelines is there are quick summaries. So if someone is busy in the clinic, of course, there is the opportunity to review the data supporting the guidelines in great depth in the manuscript, but what is also really good is that there are good summaries. In the event that you are very busy, you can easily identify what the recommendations should be for that particular patient based on these summaries. Brittany Harvey: Absolutely. Listeners are encouraged to review the full guideline, including those tables and figures that may be more helpful when they are looking for something quick to look at in the clinic as well. So, as you both mentioned, there have been a number of recent practice-changing trials in this area. So I imagine there is still a lot of ongoing research as well. So Dr. Shah, what are the outstanding questions regarding treatment options for patients with locally advanced unresectable, advanced, or metastatic gastroesophageal carcinoma? Dr. Manish Shah: I think we touched upon it a little bit. The guidelines are based on the data available, and they are primarily examining one novel therapy with chemotherapy in a specific biomarker population. But as you know, the biomarkers are not either/or; you are not either CLDN18.2 positive or PD-L1 positive. A portion of patients could have dual biomarkers, and you know, I think that we are generating data on how to manage those patients. At the recent GI Symposium in January this year, the ILUSTRO trial was presented by Dr. Shitara, which looked at combining zolbetuximab and chemotherapy with immunotherapy for dual-positive biomarkers, and that is leading to a phase III study that has begun to enroll. So unanswered questions are: how do we manage dual-positive biomarkers? The other thing that was mentioned is that the current data for mismatch repair deficiency involve chemotherapy plus immunotherapy. Only squamous cell cancer is there a study with a positive non-chemotherapy kind of backbone, that is CheckMate-648 that Dr. Rajdev mentioned. As we move forward, it will be good to get data on non-chemotherapy options in certain biomarker-positive populations. And then finally, another update, which is likely to be practice-changing, is the HERIZON-GEA-01 study that looked at zanidatamab, which is another biparatopic antibody that targets HER2, and that is likely to change practice. And as that data gets published, we may look to even do a rapid update for the current immunotherapy and targeted therapy guideline that is just being published. Dr. Lakshmi Rajdev: So, if I can add to that, there are numerous ADCs that look very interesting. There are bispecific antibodies; in fact, the zanidatamab is a bispecific antibody showing improved activity in patients with HER2-positive disease. So I think there are studies from Asia looking at CLDN CAR T-based therapies. So, I think that there are a lot of novel agents and a lot of excitement in the field. We know that the bemarituzumab study, unfortunately, the FGFR2 inhibitor failed to demonstrate any benefit, but I think that there are other agents that are being explored, so there are newer targets, newer agents, ADCs, bispecifics that could potentially change the field in the future. Brittany Harvey: Yes, we will look forward to the data to address these unanswered questions and new agents and inform future guideline updates. So, I would like to thank you both for all of your work to review the evidence here and update this important guideline, and for your time today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you. 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/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is 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.

All the way from the North Shore Center for the Performing Arts, it's The Morning Mix Live On Stage: The Podcast! Enjoy all of your favorite moments from The Morning Mix in front of a live theatre audience. This episode was recorded live on Thursday, February 19th.Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

We made it to hump day and we are ready to hear about the epic fights you've had with your siblings, more importantly, why are twins always beefing? And an executive was talking about red flags for potential job candidates so we had to know, what are some red flags you have for executives when hunting for a job? Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Temptation is subtle, persistent, convenient and aggressive. Referencing many scriptures it is demonstrated that God Has equipped us, through His word, to combat temptation of the flesh. The Pattern set by Joseph is the illustration . When temptation came he responded fast, he remained faithful and he fled from it. Genesis 39 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

Dr. Bishal Gyawali and Dr. Tessa Cigler share the new, comprehensive, evidence-based update of the ASCO guideline on the use of hematopoietic colony-stimulating factors in patients with cancer. They discuss recommendations on primary prophylaxis, secondary prophylaxis, and treatment of febrile neutropenia along with stem cell mobilization, efficacy, safety, duration, dosing, and administration of CSFs – including biosimilars. They highlight where it is appropriate to use a CSF, and importantly, when not to use a CSF. They touch on the significance of individual patient considerations and cost implications, and future work to refine the risk factors for the development of complications of febrile neutropenia. Read the full guideline, "White Blood Cell Growth Factors: ASCO Guideline Update" at www.asco.org/supportive-care-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/supportive-care-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-25-02938     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. Bishal Gyawali from Queen's University in Kingston, Ontario, Canada, and Dr. Tessa Cigler from Weill Cornell Medicine in New York, New York, co-chairs on "White Blood Cell Growth Factors: ASCO Guideline Update." Thank you for being here today, Dr. Gyawali and Dr. Cigler. Dr. Bishal Gyawali: Thank you very much for having me. It's a pleasure. Dr. Tessa Cigler: Hi there. Nice to be here as well. Brittany Harvey: Great. And then 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. Cigler and Dr. Gyawali, who have 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 I'd like to dive into the guideline that we're here today to talk about. So first, what prompted an update to this guideline on the use of hematopoietic colony-stimulating factors in patients with cancer, and what is the scope of this updated guideline? Dr. Bishal Gyawali: The last version of the guidelines from ASCO on this topic was back in 2015, so it has been more than a decade since ASCO had a guideline on the use of G-CSF in patients with cancer receiving treatment. So it was due for an update because there has been a lot more evidence based on not necessarily new drugs, but evidence for proper timing of these agents and the duration of these agents, as well as there have been a lot of new biosimilars, and there are questions about are these biosimilars equivalent or how do we choose among these different options. One is that content of the evidence that has evolved over time in the last decade, but also I think the last time we had these guidelines, the ASCO guidelines were not incorporated to have those evidence GRADE tables. So the quality of the ASCO guidelines itself has evolved over the years, so we wanted to have a new version of the guideline that includes not only the new evidence, but also contains those evidence GRADE tables that will help to quantify the benefits. And so I think it was high time, and even more than that, the newer ASCO guidelines for any guideline, they also include considerations of cost, access, equity, and all these factors that were not included in the previous version of the guideline. So I think it's only natural that with time the guideline should also evolve. Dr. Tessa Cigler: I agree completely, and just as a framework, as we all know, neutropenia and its complications, including febrile neutropenia and infections, are still an important toxicity of many myelosuppressive chemotherapies. And these neutropenic complications do require prompt evaluation and treatment and often hospitalization, and we know that hematopoietic colony-stimulating factors, which I'm going to refer to as growth factors, can reduce the duration and severity of neutropenia and the risk of febrile neutropenia, so it remains an important topic in the practice of clinical oncology. Brittany Harvey: Absolutely. It's an important topic for both clinicians and for patients who are receiving treatment for their cancer. And as you said, there was a substantial amount of literature to review here and updating everything to be in line with the GRADE evidence rating system, so there was a lot of work that you both put into this. So then next, I'd like to review the key recommendations of this guideline by clinical question. So first, what factors did the expert panel identify that should influence the decision to administer primary prophylaxis of febrile neutropenia with a CSF? Dr. Bishal Gyawali: Yeah, so I think that constitutes one of the most important recommendations in our guidelines about primary prophylaxis with G-CSF. And this is important because not only it's about when to use it, it's also about when not to use it, as in the ASCO "Choosing Wisely" campaign has also made some recommendations about this. So our guideline recommendations are also aligned with that. So first of all, we recommend that primary prophylaxis with G-CSF is recommended when the risk of febrile neutropenia because of the chemotherapy regimen is equal to or more than 20% unless an alternative chemotherapy regimen with comparable efficacy and safety that does not need G-CSF is available. And the quality of evidence to make this recommendation is high, so we give a strong strength of recommendation for this. Having said that, even for patients where the risk of febrile neutropenia is not necessarily 20%, it's a little lower, but because of other patient-related factors, the patient is at a higher risk of complications from febrile neutropenia, such as age, comorbidities, and other factors, in such case primary prophylaxis with G-CSF should be offered. And we also make a recommendation that if G-CSF is not affordable or available, then antibiotic prophylaxis can also be offered, but the evidence quality for this is low, and the strength of recommendation is very conditional. A couple of things to highlight here would be that, I think Dr. Cigler can attest to that, we ran into lots of problems about finding the data for the evidence base to say what are the patient-related factors that actually make them at a higher risk of febrile neutropenia, you know, like how did that 20% benchmark come about? Why 20%? Or when we say even if it's less than 20%, if based on other comorbidities, if the risk is higher, we tried to dig into that evidence. For example, we're talking about our "Box 1" in the guideline, what is the evidence for each item we have included under that "Box 1"? And we tried to do a lot of search to find the evidence for that, and some of them do have strong evidence, and that will tie into our future research ideas as well. And some of them actually don't have such solid evidence too, so that was one of the reasons why we ran into lots of problems about how do we quantify whether someone is at a high risk of febrile neutropenia and where that 20% benchmark comes from. Dr. Tessa Cigler: And definitely, because there's not very clear data, our guidelines definitely leave room for physician discretion in all these situations. Brittany Harvey: Absolutely. I find that in a lot of these guidelines the key point is that there's a lot of shared decision-making with patients after talking through what risk factors they may have and what is best for them in their individual clinical scenario. So then moving on to secondary prophylaxis, what factors did the expert panel identify that should influence the decision to administer secondary prophylaxis of febrile neutropenia with a CSF? Dr. Tessa Cigler: So for patients who've already experienced a neutropenic complication from a previous cycle of chemotherapy, the question is which patients should then receive prophylactic G-CSF for subsequent cycles of chemotherapy. And without a lot of evidence again to guide us, the panel really felt strongly that secondary prophylaxis should be used when a treatment delay or when a reduced dose of chemotherapy would be thought to compromise cure rates or survival outcomes. We do note that in many situations, certainly a dose reduction or a delay would be a very reasonable alternative or an additional strategy to G-CSF administration. Dr. Bishal Gyawali: Yeah, I think it's more like if there is going to be compromise in outcomes without using G-CSF, as in if we can't maintain the dose intensity and that's going to lead to inferior outcomes, then we should. But if we can reduce the dose intensity and treatment frequency and still have the same outcomes, then I guess in simple words, we're just trying to say use it when it's absolutely needed, or you can also look into other alternatives that might not need G-CSF but you could maintain the same outcomes. Brittany Harvey: Understood. It's helpful to review those options for clinicians and showing that there's not just one way to address potential neutropenic complications for later cycles of chemotherapy. So then following those recommendations for prophylaxis, what does the expert panel recommend regarding CSFs for the treatment of febrile neutropenia? Dr. Bishal Gyawali: This is an important question because this ties strongly with the "Choosing Wisely" campaign. In other words, primary and secondary prophylaxis we talked about when CSF should be used; here we make a sort of negative recommendation in that we say when CSF should not be used, because this is where we see most overuse or overtreatment with G-CSF. So first, we say that we should not be using a CSF routinely simply because a patient has neutropenia. If they are afebrile but they only have neutropenia, we recommend against using CSF just to boost neutrophil counts; that's not a meaningful metric. Then the second recommendation we make is CSF should not be routinely used as an adjunctive treatment with antibiotic therapy for patients with fever and neutropenia. So the first one was neutropenia, no fever, don't use it. The second one is okay, there is neutropenia and fever, but the treatment for that is use of antibiotic therapy, and so in such situations routinely we should not be using G-CSF just to boost the neutrophil count. And that is tied on to the third recommendation where if the patient has fever and neutropenia but is also at a very high risk for infection-related complications or who have other prognostic factors that we think will lead to poor outcomes for the patient, then in such situations, a CSF can be used as an adjunctive treatment. But we talk about the data in the manuscript, but the data show that the most that this will do is reduce the days of hospitalization by a couple of days. It actually does not have any data that it's going to improve the mortality rates. So as of now, we use the word "may be offered," it's not "should be offered," it's "may be offered" if there are other factors that we think will make the patient at the very poor risk of mortality outcomes, and the evidence quality here therefore is low and our strength of recommendation is conditional. And we also have a box that lists those items that we think might be associated with poor prognosis for the patients, but again the data for those, are they really hard evidence? No. And that is also tied with our future research recommendation that we should study more about these factors that might lead to these poor outcomes. Dr. Tessa Cigler: And again, allowing for discretion of the treating physician. Brittany Harvey: Absolutely. It's just as important to know when not to use CSFs routinely, and those risk factor boxes that you mentioned are available in the full manuscript along with the full list of recommendations, and our listeners can refer to that; a link will be in the show notes of the episode . Dr. Tessa Cigler: Just so you know, the panel, we really discussed those criteria a lot and agonized over them and gave you our best recommendations. Brittany Harvey: Definitely, and it sounds like there was varying degrees of evidence to support a lot of those risk factors, and so it's really important that the evidence supports those, but also there was expert consensus of the panel in reviewing each of those factors individually to come up with recommendations that can be applicable for all clinicians. Dr. Bishal Gyawali: If I may add, we're proud of our panel because I think our panel is quite inclusive of people representing different specialties within cancer care, as in we had radiation oncologist, we had infectious disease expert, pharmacists, and most importantly, we also had patient partners. Brittany Harvey: Absolutely. Having a multidisciplinary panel is really important for each and every guideline. So then, this is probably relevant now, but addressing a few more specific sections addressed in the guideline, what is the role of CSFs as adjuncts to progenitor cell transplantation? Dr. Tessa Sigler: Great question, and so, as solid tumor oncologists, Dr. Gyawali and I really leaned heavily on our hematology experts within the panel. The panel decided that a CSF should be used alone after chemotherapy or in combination with a CXCR4 inhibitor to mobilize peripheral blood progenitor cells. Clearly the choice of mobilization strategy depends on the type of cancer and the type of transplantation. The panel noted that a CSF should be routinely administered after autologous stem cell transplantation to reduce the risk of severe neutropenia, and that a CSF may be administered after allogeneic stem cell transplant to reduce the duration of severe neutropenia. Again, this last recommendation has not a lot of evidence to support it, and so we kind of tempered our language that it may be administered or can be considered based on clinical judgment of the physician and the clinical status of the patient. Brittany Harvey: And that really highlights the need for a multidisciplinary panel, because as you are solid tumor oncologists, you need the hematologists to make recommendations for all sorts of patients and make sure that these guidelines are comprehensive.   So then moving on to another smaller subset population, for patients receiving concomitant chemotherapy and radiation therapy, are CSFs recommended? Dr. Bishal Gyawali: I think there is very little evidence for patients who are receiving radiation therapy alone, so there is no evidence to suggest the use of CSF in patients with radiation therapy alone. The bigger question is in patients who are receiving both chemo and radiation together, chemoradiotherapy. In those patients, up until now, the classical recommendation has been to avoid G-CSF use. I think in our updated guidelines we discuss a couple newer trials that are trying to address this issue, but in the totality of evidence, we still stick with the same recommendation as before, which is CSFs are not recommended in patients receiving concomitant chemotherapy and radiation therapy, especially those involving the mediastinum because the biggest evidence of harm is for these patients. Dr. Tessa Cigler: I agree completely. Brittany Harvey: Definitely. It's important to recognize when that balance of benefits and harms leans more towards harms, and so that this should not be recommended for those patients. So there are several different CSFs that are recommended in the guideline, including biosimilars. So do the recommended CSFs differ in efficacy or safety? Dr. Tessa Cigler: So as supported by evidence, and the panel all agreed, that the various forms of CSFs, including the biosimilars, really have the same evidence for efficacy and for safety, and that the choice of agent really should depend on cost, availability, accessibility, patient convenience, and sometimes disease subtypes and treatment regimens. But, in essence, these can be used interchangeably without concern for efficacy or toxicity differences. Dr. Bishal Gyawali: I completely agree. I think in terms of efficacy outcomes, I don't think there is anything to choose between these agents. The choice between these agents would largely depend on different patient and treatment-related factors: cost, availability, affordability, feasibility. We even discuss things like where does the patient live, as in how frequently the patient can commit to the cancer center, and we also discussed things like even for the daily shots of filgrastim, patients can be taught and they can get it by themselves at home. So we discussed all these factors, but in a nutshell, the choice within these agents primarily depends not on efficacy factors, but simply based on all these other factors that are equally important but which can lead to informed decision-making about what is best for a given patient. But we mention it explicitly that the biosimilars, there is nothing to choose between them, especially the biosimilars; it's about price competition and what you can get at an affordable rate. Brittany Harvey: Understood. It's great to have many different options for patients so that there's something that can work for them based off access, cost, and all these factors that you listed. As you mentioned, it may be easier for some patients to get their treatment at home rather than in clinic, and so having different options and reviewing those with patients is very important. Dr. Bishal Gyawali: As we are having this conversation, I'm thinking that we might be a very unique guideline in that I don't think in many other settings you have this many options that you are asking about, you know, choices between equally good options and making decisions based on cost. I don't think there are any other areas in oncology where we have the privilege of making these decisions based on cost and convenience and all these factors, as well as we might be one of those guidelines where we have, as discussed before, so many recommendations about when not to do things and trying to promote judicial use of treatments. Dr. Tessa Cigler: As you might imagine, our panel discussions were very lively. Dr. Bishal Gyawali: Yes. But Dr. Cigler, do you recall any other guideline where there is so much discussion about when not to use things and how we have so many biosimilar options and we can choose the one that's most appropriate? I don't recall any other. Dr. Tessa Cigler: I agree with you. Brittany Harvey: It's certainly a unique guideline in that regard. So we'll move into the last clinical question that the expert panel addressed. But what does the expert panel recommend for the initiation, duration, dosing, and administration of CSFs? Dr. Bishal Gyawali: Yeah, I think there has been some new data in this regard that were not available in the previous guideline. For example, we have new trials testing a shorter duration of filgrastim injections compared to the standard of care. So we have some data, we call this 'de-escalation of treatment'. So we have more data supporting de-escalation of treatment. We have some data for lower dose of pegfilgrastim, we have data for lower duration of filgrastim, we have also some new data about timing of treatment, as in there has been some newer data presented about the relationship of timing of the drug and the frequency of adverse events from G-CSF such as bone pain. There is also the question about, for patients who don't live near the cancer center, can they get their pegfilgrastim shot on the day of chemo while they are in the cancer center? So all these questions that are very pragmatic and important questions, but were not answered before, we're glad that we had more evidence to talk about all these factors and give a more solid recommendation to our users of the guideline. Brittany Harvey: Definitely. And listeners can review the full list of dosing and administration recommendations in Table 2 in the guideline, and that will be linked in the show notes of the episode. So then I really want to thank you both for reviewing all of these recommendations. There's certainly a large amount of clinical questions and recommendations that you went through. I'd like to next ask, in your view, what is the importance of this updated guideline and how will it impact both clinicians and patients? Dr. Bishal Gyawali: I think the importance of this updated guideline is that, as mentioned before, we talk about newer data that have come up with regards to not just the most important two questions as in when to use it as primary prophylaxis and when to use it as secondary prophylaxis and when to use it as treatment, but also with regards to the duration and timing and dosing and multiple options and how these all factors as well as patient-related factors should be combined to make an informed decision, the most appropriate decision for the patient. And as mentioned before, we have the GRADE tables that were not in the previous version of this guideline. So I think even those users that are familiar with the 2015 guideline, I think they will find very novel content in this new updated guideline, and they will find it useful for their practice. I would encourage the readers to not only read the headlines of the box recommendations, but also read the full text of these guidelines because we have worked really hard to incorporate the latest evidence and also interpret them contextually. The discussion regarding de-escalation, patient considerations, cost implications; usually, people just skip these portions when they read a guideline. But I think these are also one of the most important paragraphs in our guideline, so they have been written with very careful thought, and I think reading the whole guideline is very much worth your time. Dr. Tessa Cigler: As you can imagine, I agree completely, having just spent several months thinking about these guidelines and all their nuances. Brittany Harvey: Certainly, this guideline is definitely a very comprehensive update, and that nuance in the manuscript is really important for clinicians to understand and read through and understand when it's appropriate to make certain decisions. So then to wrap us up, I'd like to ask, what are the outstanding questions and active research areas regarding the use of white blood cell growth factors in patients with cancer? Dr. Tessa Cigler: As you all know from clinical practice and that we've said several times already in this podcast is that the risk factors for the development of complications of febrile neutropenia are still not clearly worked out. And one of the things that is, I think, really needed in clinical practice is the development of predictive algorithms or biomarkers to really allow us to understand who might be more at risk and to allow for the clinician to be able to tailor the use of G-CSF as needed. Brittany Harvey: Yes, and so we'll look forward to future updates in this space to inform new recommendations and an updated guideline in the future. So I want to thank you both so much for your work to develop this comprehensive guideline. It was certainly a lot of effort, and thank you for your time today, Dr. Gyawali and Dr. Cigler. Dr. Tessa Cigler: Oh, my pleasure. It's nice to be here and to speak with you all. Dr. Bishal Gyawali: Yeah, it was great to speak with both of you but also through you to the audience, and we had a great time. Thank you. Brittany Harvey: And then 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/supportive-care-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'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.

Ava Suppelsa joins Chris, Nikki, and Whip of The Morning Mix to chat about her career as a singer/songwriter, working with some of the biggest names in music, and writing the hit song "Better Me For You (Brown Eyes)" with Max McNown!For more from Ava, find her on Instagram HERE.Listen to The Morning Mix weekdays from 5:30am - 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Some fights are worth having and some...aren't. We asked you to tell us about the silliest fights you had with your partner and these did not disappoint. Speaking of fights, things can get thrown in the heat of the moment so we had to ask - what'd you get thrown at you?? Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Looking at the source of Joseph's strength in this familiar story. Despite being sold into slavery by his brothers, falsely accused and hated, he still loved his brothers. Be encouraged by Joseph's example: Hang on to the source of strength despite your circumstances. Genesis 37 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All rights Reserved

Do you ever wish you hit record when your partner starts talking in their sleep? We definitely do, because we heard some crazy things your partners are saying whilst snoozing, and a lot of them are cheese related. Plus, this weekend had a lot of you trippin', stumblin', and slippin' during today's Weekend Oopsie. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Christ's work at the cross is not just one-dimensional. Its effects are continuous, encompassing the whole sum total of what is needed for us to be whole in His presence: both salvation from our sins past, present and future, and healing of our sicknesses and diseases. 1 Peter 2:24-25 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

Message by: Rev. Patrick Ballington.  The Bridge Church is located at 607 Hulsey Road, Cleveland Georgia. The church that "Connects Faith and Life". Download our app by searching "The Bridge Church, Cleveland and Apple App Store or GooglePlay Store. Bridge Streams live Sundays @ 9:00 and 11:00 am. Streaming under CCLI License Number #CSPL072350

The Olympics are coming to a close this weekend, so we had to get the inside scoop from someone with boots on the ground. We talked to Alex Maragos of NBC5 who is covering the Olympics from Milan. We spoke about curling scandals, Nazgul the dog's photo finish, and some very specific...pizza making...if you know what we're saying. Get the inside scoop on everything local and international!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

We're all a little sleepy this Friday after the Morning Mix Live On Stage show last night. If you missed it, you'll be able to catch up when we post it as a podcast. But today, you'll hear what it sounds like when we play Nikki's Thousand Dollar Minute live in front of an audience! Plus, we can all use some GOOD NEWS on this gray, chilly February Friday. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The Mix See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

We are not able to reconcile ourselves to God.  He completely reconciled all things, including us, to Himself by the work of Christ, resulting in peace.  He makes us new creatures on the inside while we are still in the same decaying sinful bodies.  We are being changed from one state to another as we keep faithing: ungodly made godly, sinners made saints, enemies turned allies, aliens brought close, strangers no longer estranged, and far off brought near.  2 Corinthians 5:18-20 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

In this episode of the RunX Podcast Coach Caroline and Coach Valerie explain why short, regular check-ins beat occasional overreach, how simple movement checks and short daily drills prevent injury, and why coaching focuses on your movement — not your clothes or weight. Learn exactly what a coach looks for in a gait check (ears → shoulders → hips → lifted ankle), how private vs community check-ins work, and step-by-step tips for uploading usable video or photos so your coach can help faster. Hear real member examples of how small, repeatable changes turned chronic pain into consistent, pain-free running. Practical, actionable, and grounded in movement skill — this episode gives you the next steps to get back on track today.Chapters:00:00:04 – 00:00:30 | Intro: why check-ins matter and what to expect00:00:30 – 00:01:50 | February check-in season: ebbs, flows, and staying consistent00:01:50 – 00:03:50 | Lurkers vs active members: why lurking still has value and how to convert it into progress00:03:50 – 00:05:45 | How our check-in process works: private check-ins, public community posts, and peer learning00:05:45 – 00:07:45 | What coaches look for in a gait analysis: pose, alignment, and the role of gravity00:07:45 – 00:09:15 | Common self-limiting beliefs (tight hips, "my glutes don't work", leg-length myths) and how movement reframes them00:09:15 – 00:10:45 | Real member stories: targeted feedback that cured plantar pain and enabled a marathon comeback00:10:45 – 00:11:40 | Practical tips: how to record usable video/photos, what to show a coach, and how to describe pain00:11:40 – End | Final encouragement, next steps, and how to get startedWhere to find us:▶️ Free 30-Day RunRX Reboot — Skill, Strength & Self-Carehttps://www.youtube.com/watch?v=a0N-GZ0AosI&list=PLDPcF8ZrDdILC8bYyn2zR-4xvqKRzp2re▶️ Join the RunRX Membershiphttps://runrx.fit/join-runrxstrongWebsite: https://runrx.fitApp: RunRx Academy — available on Apple App Store and Google Play (search "RunRx Academy")Support email: support@runrx.fit

Do you snore? if that's a dealbreaker then you probably want to find out if your future spouse does. And today we got the inside scoop from the Milan-Cortina Winter Olympics from Alex Maragos, NBC Chicago's local reporter0on the ground in Milan. Plus, Chris's Thursday Threestyle is all about the First Fake Spring we've been experiencing these last few gorgeous days. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Sin is a universal disease for mankind, and we are in an ongoing process of coming short of the glory of God. It is only because of Christ's obedience to pay the price for us in His work at the cross that we are able to be in right standing before God. The law had to be there so we would know that there are consequences for sin – the wrath of God – but our salvation does not come through the law. We must trust God and have faith that we are justified once and for all in His work at the cross. Romans 3:21-26 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

A teenager playing beer pong accidentally swallowed a bottle cap so we wanted to know...how'd that get in there?? Plus, Whip pulls a red card on aggressive youth sports parents in today's Hot Take. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Paul is addressing two groups of people, their reaction to the cross and what that reaction produces. Although both products sound static in the English, the Greek reveals both are processes. To those who have rejected Christ, the cross is moronic and has produced the process of perishing. To those who have trusted Christ, the cross is the reality of life eternal that human ability cannot obtain. While the message of the cross creates division, it is also the unifying force of the church, who has become a community of people heralding its message; it is the prototype of what we will become and the solution to all of the problems we face today. 1 Corinthians 1:18 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

In this episode of The Dad Verb Podcast, we discuss screen time with Wyzly app creator and father Adam Adler. Download the App Now! https://www.wyzly.app/ or on the Apple App Store https://apps.apple.com/us/app/wyzly-parental-controls-lock/id6636516313 Follow our special guest Adam Adler: https://www.linkedin.com/in/adamadler-charleston/ Listen on Spotify: https://spoti.fi/3XfpYjR Listen on Apple: https://apple.co/3HLZCzU Listen on Google: https://bit.ly/42uXtSU Follow Muamer Razic (Step Dad): @talesfromdadverb Follow Ben Brown: @mr_mackenzie Follow Andrew Saunders: @saunders.dadverb Follow Nate Klein: @nateklein53 Follow Andrew Tiu: @dad_verb Join our private Discord community for new/expectant dads: https://www.launchpass.com/dad-verb/community-member

In Episode 56 Landon urges us to slow down a bit, to relax. One of the ways in which we accomplish this is to Embrace Life's Undeniables. This is the 4th Key to living fully...excerpted from "The Significant Seven", a 7-part addition to the Heartbeat App. You can get the entire course, including thought provoking insights from Landon and an accompanying exploration workbook, now included in the Heartbeat App. The App is free, and can be downloaded from the Apple App Store or the Google Play Store.

Happy Tuesday, you can do it! Today we learned that sometimes all it takes to successfully embarrass your kids is an inhale and exhale. Plus, we get all the dirty deets on the weirdest requests you got at your job. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Want to increase your organic downloads without spending money on ads? In this video, I break down our proven app store optimization (ASO) framework for 2026. Whether you are an indie developer or managing a big brand, these strategies will help you rank higher on both the Apple App Store and Google Play Store.We cover the exact steps we use at App Masters to help clients find success, from keyword research to conversion rate optimization.In this ASO tutorial, you will learn:✅ The most important ASO ranking factors in 2026✅ How to find low-competition keywords that still drive revenue✅ The do's and dont's of selecting keywords✅ Some Real Case Studies:- $1,600 in revenue in the first 22 days from organic search- $3,000/month purely from long-tail ASO strategy- 90+ #1 keyword rankings using low-traffic terms

The cross cannot remain an event of the past; without the cross, there would be no resurrection. We can either flee from the cross or embrace it as the means of a slow death of our old nature. Christ's death on His cross brought an end to the jurisdiction of the Law. We have union with Christ in death, resurrection, and ascension when we take up our own cross. The cross is where everything begins to be clear about working out our salvation in Christ. VF-2164 Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel.©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

It's that time of year again as the Geek Salad crew waxes nostalgic about the music from 30 years ago. In this installment, they discuss their favorite album releases of the year 1996! Geek Salad is available at www.geeksalad.podbean.com, or can be subscribed to at the iTunes store by using keyword “geek salad.”  Geek Salad is also available on Spotify,iTunes,  iHeart Radio and wherever else you get your podcasts! Also, check out the Podbean App where you can stream and download the entire Geek Salad archive right from your Android or iPhone!  You can get the app at either the Google Play Store or the Apple App Store!  Want Geek Salad swag?  Check out our new store on Tee Public, where you can get t-shirts, mugs, stickers, and so much other stuff!!!  Shop here! Geek Salad episodes are now also available to stream on YouTube.  “Like” and Subscribe to their channel at Geek Salad Podcast at www.youtube.com Contact Geek Salad at geeksaladradio@gmail.com.  Geek Salad is also available on Facebook under the group heading “Geek Salad Podcast.” Check out their website at www.geek-salad.com, and please subscribe to their Blue Sky feed: @geeksaladradio Geek Salad is intended for adult listeners and contains coarse language and profanity.  Listener discretion is advised.  

Today's Chicago Confession had us laughing...contagiously. Plus, from the Olympics to the grocery aisle we found a couple cases of some really cranky Canadians. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The Gospel of John highlights Christ as the Sovereign, Eternal Glory of God; the reigning King who is in control of time. He remained in complete control even to His final cry on the Cross, and He continues to be in control of our lives today.  Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel.©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

Tomorrow is Valentine's Day so today is our day of love!! Plus, we hear all your Good News and find out whether you'd like to name a turd, roach, or rat after your ex. Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

A fresh look at Luke's gospel and the way he highlights Christ's compassion for the least and the worst, not just in His life, but also in His death. Luke Watch, Listen and Learn 24x7 at PastorMelissaScott.com Pastor Melissa Scott teaches from Faith Center in Glendale. Call 1-800-338-3030 24x7 to leave a message for Pastor Scott. You may make reservations to attend a live service, leave a prayer request or make a commitment. Pastor Scott appreciates messages and reads them often during live broadcasts. Follow @Pastor_Scott on Twitter and visit her official Facebook page @Pastor.M.Scott. Download Pastor Scott's "Understand the Bible" app for iPhone, iPad and iPod at the Apple App Store and for Android devices in the Google Store. Pastor Scott can also be seen 24x7 on Roku and Amazon Fire on the "Understand the Bible?" channel. ©2026 Pastor Melissa Scott, Ph.D., All Rights Reserved

In honor of Black History Month, we're revisiting the story of Alberta Jones — Louisville's first Black woman prosecutor and a civil rights trailblazer. On August 4, 1965, Alberta left her home after a late-night phone call. Hours later, her body was found floating in the Ohio River. The investigation was marked by conflicting timelines, missing evidence, and suspects who were never charged. Decades later, police claimed they knew who was responsible — but said they couldn't prosecute. Sixty years later, Alberta Jones' murder remains unsolved. Her story deserves to be remembered. SUPPORT OUR SPONOR EARNIN Download today in the Apple App Store or Google Play Learn more about your ad choices. Visit megaphone.fm/adchoices

Chris, Nikki, and Whip chat with Jim OBrill, Sr. Director of Marketing & Strategy at the Chicago Automobile Trade Association! Don't miss the Chicago Auto Show at McCormick Place through Monday, February 16th. Get your tickets HERE.Listen to The Morning Mix weekdays from 5:30am - 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

We're gearing up for Valentine's Day this weekend with a Thursday Threestyle that puts love and shag carpets front and center. Plus, today's Chicago Confession has us seeing double...in HR...Catch up on everything you missed from today's show on The Morning Mix Podcast!Listen to The Morning Mix weekdays from 5:30am – 10:00am on 101.9fm The Mix in Chicago or with the free Mix App available in the Apple App Store and Google Play.Follow The Mix: The MixstagramGet the Free MIX App: Stream The MixSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.