Podcasts about AstraZeneca

We have a special episode of Raise the Line on tap today featuring the debut of host Dr. Parsa Mohri, who will now be leading our NextGen Journeys series that highlights the fresh perspectives of learners and early career healthcare professionals around the world on education, medicine, and the future of care. Parsa was himself a NextGen guest in 2024 as a medical student at Acibadem University in Turkey. He's now a general physician working in the Adult Palliative Care Department at Şişli Etfal Research and Training Hospital in Istanbul.  Luckily for us, he's also continuing in his role as a Regional Lead for the Osmosis Health Leadership Initiative (OHLI). For his first guest, Parsa reached out to a former colleague in the Osmosis family, Negeen Farsio, who worked with him as a member of OHLI's predecessor organization, the Osmosis Medical Education Fellowship. Negeen is now a graduate student in medical anthropology at Brunel University of London, a degree which she hopes will inform her future work as a clinician. “Medical anthropology is a field that looks at healthcare systems and how human culture shapes the way we view different illnesses, diseases, and treatments and helps you to see the full picture of each patient.” You are sure to enjoy this heartfelt conversation on how Negeen's lived experience as a patient and caregiver have shaped her commitment to mental health and patient advocacy, and how she hopes to marry humanity with medicine in a world that yearns to heal. If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

This episode covers: Cardiology This Week: A concise summary of recent studies What´s new in TAVI?  Digital solutions in arrhythmias Mythbusters - Gratitude is heart healthy Host: Emer Joyce Guests: JP Carpenter, Davide Capodanno, Fleur Tjong Want to watch that episode? Go to: https://esc365.escardio.org/event/2528 Want to watch that extended interview on Digital solutions in arrhythmias, go to: https://esc365.escardio.org/event/2528?resource=interview Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Emer Joyce has declared to have potential conflicts of interest to report: Alnylam, Bayer, Pfizer, Fire-1. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson. Fleur Tjong has declared to have potential conflicts of interest to report: Amsterdam UMC Innovation grant, Heath Holland TKI, Abbott, Dutch Research Council, Boston Scientific.

Host: Emer Joyce Guest: Fleur Tjong Want to watch that extended interview on https://esc365.escardio.org/event/2528?resource=interview Go to: Want to watch that episode? Go to: https://esc365.escardio.org/event/2528 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Emer Joyce has declared to have potential conflicts of interest to report: Alnylam, Bayer, Pfizer, Fire-1. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson. Fleur Tjong has declared to have potential conflicts of interest to report: Amsterdam UMC Innovation grant, Heath Holland TKI, Abbott, Dutch Research Council, Boston Scientific.

Last week, we covered the best investments to preserve your money, but this week we are shifting gears to focus on growth. For retirees, the goal is to have an income that outpaces inflation, and historically, the best way to achieve that is by having 50% to 70% of your portfolio invested in stock funds. In this episode, I break down five specific Exchange Traded Funds (ETFs) that can help you grow your wealth in 2026. I discuss why I prefer ETFs over mutual funds, specifically focusing on cost, transparency, and liquidity, and provide the exact ticker symbols and expense ratios for the funds I use with my own clients to build diversified, growth-oriented portfolios. If you are willing to accept some volatility to achieve higher long-term returns, this episode provides a blueprint for structuring the equity side of your retirement plan.  You will want to hear this episode if you are interested in... [00:00] Top 5 Growth ETFs to Own For 2026. [02:55] Why ETFs are superior to mutual funds. [05:23] The core holding: S&P 500 ETF. [09:28] Capturing extra growth with SPYG. [06:33] Small Cap stocks and the profitability factor. [13:38] Investing in the Developed World ex-US. [15:43] High growth potential in Emerging Markets. Why Choose ETFs? Before diving into specific funds, it is important to understand why Exchange Traded Funds (ETFs) are often a better choice than traditional mutual funds. I prefer them for four main reasons: Cost: ETFs often have significantly lower expense ratios, some less than a tenth of a percent, compared to actively managed funds that can charge up to 2%. Performance: Many active funds struggle to outperform their benchmarks over time. Transparency: You can see exactly what an ETF holds, whereas mutual funds may only report holdings twice a year. Liquidity: You can trade ETFs throughout the day while the market is open, rather than waiting for the market close price required by mutual funds. The US Core: S&P 500 and Growth Variations For the core of a growth portfolio, I look to the S&P 500, which has averaged a 15% return over the last five years. State Street SPDR Portfolio S&P 500 ETF (SPYM/SPSM): This fund tracks the S&P 500 but was created to offer a lower cost (0.02% expense ratio) compared to the original SPY ETF. It is a massive fund with over $100 billion in assets, heavily weighted toward large technology companies like Nvidia, Apple, and Microsoft. S&P 500 Growth ETF (SPYG): If you want to lean more aggressively into growth, this fund tracks S&P 500 companies with high sales growth and momentum. It has a 3-year average return of 29% and a very low expense ratio of 0.04%. Diversifying with Small Caps While the S&P 500 is dominant, it has had "lost decades" in the past where returns were negative. To diversify, I recommend the S&P 600 Small Cap ETF. Unlike the Russell 2000, the S&P 600 index requires companies to be profitable, which filters out lower-quality stocks. Although it has lagged recently, small caps may be poised for a comeback due to economic shifts and tariffs. The expense ratio for this fund is just 0.03%. International Opportunities The US has outperformed international markets recently, but that trend could reverse. Developed World ex-US (SPDW): This fund invests in developed economies like Japan, the UK, and Canada. It offers exposure to major global players like Samsung and AstraZeneca with a low expense ratio of 0.03%. Emerging Markets (SPEM): For higher potential growth, this fund targets countries with rapidly growing GDPs, such as China, Taiwan, and India. These economies have a growing middle class, which can drive corporate earnings. The fund holds major companies like Taiwan Semiconductor and Alibaba. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE  Connect With Morrissey Wealth Management  www.MorrisseyWealthManagement.com/contact   Subscribe to Retire With Ryan

In this episode, I sit down with Gary Stapleton to unpack the complexity of small intestinal bacterial overgrowth and why it is so often overlooked in clinical practice. We discuss the true prevalence of SIBO, how it contributes to both digestive and systemic symptoms, and why accurate diagnosis is essential for meaningful treatment outcomes. Gary shares his expertise on breath testing as the cornerstone of proper SIBO diagnosis. We break down the differences between glucose, lactulose, and fructose substrates, explain when each should be used, and highlight common testing errors that can lead to confusion or misdiagnosis. This portion of the conversation brings clarity to a topic that is frequently misunderstood. We also explore how SIBO overlaps with other gastrointestinal and systemic conditions and why an individualized approach matters. This episode provides a practical framework for understanding SIBO testing and treatment and is essential listening for anyone looking to move beyond trial and error and toward precision based gut health care.   Key takeaways: SIBO is characterized by an abnormal increase of bacteria in the small intestine, often leading to digestive and systemic health issues. Accurate testing and proper preparation are crucial for a reliable diagnosis of SIBO. The choice of substrate (glucose, lactulose, fructose) plays a critical role in breath testing accuracy. Understanding the symptoms and co-occurring conditions of SIBO can guide effective treatment strategies. Collaboration between laboratories and healthcare practitioners is essential for optimal patient care and treatment outcomes.   More About Gary Stapleton:   Gary Stapleton is the founder and Chief Executive Officer of Aerodiagnostics, LLC, where he focuses on advancing diagnostic accuracy and improving clinical decision making in functional and gastrointestinal health. With decades of leadership experience in healthcare diagnostics and pharmaceuticals, Gary brings a deep understanding of how precision testing can transform patient outcomes. Prior to founding Aerodiagnostics, Gary held senior executive roles across major healthcare organizations, including Chief Operating Officer at Calloway Laboratories, Vice President of Sales and Marketing at Bausch & Lomb, and leadership positions at Caris Life Sciences and Lerner Medical Devices. Earlier in his career, he spent 14 years at AstraZeneca, where he played a key role in the launch and commercialization of multiple blockbuster therapies. A former member of the United States Marine Corps, Gary combines disciplined leadership with a passion for innovation in healthcare. He holds an undergraduate degree from Long Island University and an MBA, and founded Aerodiagnostics. Website Instagram Connect with me! Website Instagram Facebook YouTube

New research is transforming the outlook for cervical and uterine cancers -- two of the most serious gynecologic malignancies worldwide – and we'll be hearing from one of the people shaping that progress, Dr. Mary McCormack, on this episode of Raise the Line. From her perch as the senior clinical oncologist for gynecological cancer at University College London Hospitals, Dr. McCormack has been a driving force in clinical research in the field, most notably as leader of the influential INTERLACE study, which changed global practice in the treatment of locally advanced cervical cancer, a key reason she was named to Time Magazine's 2025 list of the 100 most influential people in health. “In general, the protocol has been well received and it was adopted into the National Comprehensive Cancer Network guidelines which is a really big deal because lots of centers, particularly in South and Central America and Southeast Asia, follow the NCCN's lead.”In this conversation with host Michael Carrese, you'll learn about how Dr. McCormack overcame recruitment and funding challenges, the need for greater access to and affordability of treatments, and what lies ahead for women's cancer treatment worldwide. Mentioned in this episode:INTERLACE Cervical Cancer Trial If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/EBAH information, and to apply for credit, please visit us at PeerView.com/AEN865. CME/MOC/EBAH credit will be available until January 4, 2027.Moving Forward in B-ALL: Insights on Modern and Emerging Standards With Off-the-Shelf Bispecific Antibodies In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Acute Lymphoblastic Leukemia. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This episode of TriloTalk explores companion diagnostics and what makes them medical devices. Join Julia Forjanic Klapproth, Senior Partner at Trilogy, Laura Collada, Senior Medical Writing Manager at Trilogy, and Raquel Billiones, Director of Medical Writing at AstraZeneca and learn how in vitro diagnostic tools help pair the right treatment with the right patient and why we can't just test drugs and their companion devices all in one go. Tune in!

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/EBAH/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PWK865. CME/MOC/EBAH/AAPA/IPCE credit will be available until January 4, 2027.Pathways to Personalized Remission in CLL: Leveraging Targeted Standards & Next-Gen Advances for Upfront and Sequential Care In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and CLL Society. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca, BeOne Medicines, and Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/YJT865. CME credit will be available until 30 December 2026.The Challenges of Choice in First-Line EGFRm NSCLC: Practical Guidance on Optimising Treatment Approaches In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/NXT865. CME/MOC/NCPD/AAPA/IPCE credit will be available until January 15, 2027.Dialing Up Precision in HR+, HER2- MBC With New Endocrine Agents, Targeted Therapies, and Combinations: A Framework for Multifactorial Clinical Decisions In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and Living Beyond Breast Cancer. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca, Genentech, a member of the Roche Group, Lilly, and Stemline Therapeutics, a Menarini Company Group.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/EBAH/AAPA information, and to apply for credit, please visit us at PeerView.com/YAZ865. CME/MOC/EBAH/AAPA credit will be available until January 4, 2027.Off the Shelf and in the Clinic for NHL: Leveraging Bispecific Antibody Strategies in DLBCL, FL, and Beyond In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Non-Hodgkin Lymphoma. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Regeneron Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PTK865. CME/MOC/NCPD/AAPA/IPCE credit will be available until January 16, 2027.Forging New Paths With Earlier Use of ADCs in Breast Cancer: From Clinical Breakthroughs to Improved Outcomes In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and GRASP. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete EBAC/CME information, and to apply for credit, please visit us at PeerView.com/WBF865. EBAC/CME credit will be available until December 30, 2026.New Kids on the Block in mHSPC: Personalising Approaches Through Emerging Precision Therapies In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/EBAH/AAPA information, and to apply for credit, please visit us at PeerView.com/GKD865. CME/MOC/EBAH/AAPA credit will be available until January 4, 2027.Redrawing Frontlines in MCL: The Upfront Expansion of BTKi Options & Modern Clinical Decision-making in Newly Diagnosed Disease In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthTree Foundation for Mantle Cell Lymphoma. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure information is available at the beginning of the video presentation.

Dr. Hope Rugo and Dr. Vivek Subbiah discuss innovative trial designs to enable robust studies for smaller patient populations, as well as the promise of precision medicine, novel therapeutic approaches, and global partnerships to advance rare cancer research and improve patient outcomes. TRANSCRIPT  Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center [in Los Angeles]. The field of rare cancer research is rapidly transforming thanks to progress in clinical trials and treatment strategies, as well as improvements in precision medicine and next-generation sequencing that enable biomarker identification. According to the National Cancer Institute, rare cancers occur in fewer than 150 cases per million each year, but collectively, they represent a significant portion of all cancer diagnoses. And we struggle with the appropriate treatment for these rare cancers in clinical practice. Today, I am delighted to be joined by Dr. Vivek Subbiah, a medical oncologist and the chief of early-phase drug development at the Sarah Cannon Research Institute in Nashville, Tennessee. Dr. Subbiah is the lead author of a paper in the ASCO Educational Book titled "Designing Clinical Trials for Patients with Rare Cancers: Connecting the Zebras," a great title for this topic. He will be telling us about innovative trial designs to enable robust studies for small patient populations, the promise of precision medicine, and novel therapeutic approaches to improve outcomes, and how we can leverage AI now to enroll more patients with rare cancers in clinical trials. Our full disclosures are available in the transcript of this episode.  Dr. Subbiah, it is great to have you on the podcast today. Thanks so much for being here. Dr. Vivek Subbiah: Thank you so much, Dr. Rugo, and it is an honor and pleasure being here. And thank you for doing this podcast for rare cancers. Dr. Hope Rugo: Absolutely. We are excited to talk to you. And congratulations on this fantastic paper. It is such a great resource for our community to better understand what is new in the field of rare cancer research. Of course, rare cancers are complex and multifaceted diseases. And this is a huge challenge for clinical oncologists. You know, our clinics, of course, cannot be designed as we are being very uni-cancer focused to just be for one cancer that is very rare. So, oncologists have to be a jack of all trades in this area. Your paper notes that there are approximately 200 distinct types of rare and ultra-rare cancers. And, by definition, all pediatric cancers are rare cancers. Of course, clinical trials are essential for developing new treatment strategies and improving patient outcomes, and in your paper, you highlight some unique challenges in conducting trials in this rare cancer space. Can you tell us about the challenges and how really innovative trial designs, I think a key issue, are being tailored to the specific needs of patients with rare cancer and, importantly, for these trials? Dr. Vivek Subbiah: Rare cancers present a perfect storm of challenges. First, the patient populations are very small, which makes it really hard to recruit enough participants for traditional type trials. Second, these patients are often geographically dispersed across multiple cities, across multiple states, across multiple countries, across multiple zip codes. So, logistics become complicated. Third, there is often limited awareness among clinicians, which delays referrals and diagnosis. Add to that regulatory hurdles, funding constraints, and you can see why rare cancer trials are so tough to execute. To overcome these barriers, we are seeing some really creative novel trial designs. And there are four different types of trial designs that are helping with enrolling patients with rare cancers. The first one is the basket trial. So let us talk about what basket studies are. Basket studies group patients based on shared genetic biomarkers or shared genetic mutations rather than tumor type. So instead of running separate 20 to 30 to 40 trials, you can study one therapy across multiple cancers. The second type of trial is the umbrella trial. The umbrella trials flip that concept of basket studies. They focus on one cancer type but test multiple targeted therapies within it. The third category of innovative trials are the platform studies. Platform trials are another exciting innovation. They allow new treatment arms to be added or removed as the data matures and as the data evolves, making trials more adaptive and efficient. The final category are decentralized tools in traditional trials, which are helping patients participate closer to where they are so that they can sleep in their own bed, which is, I think, a game changer for accessibility.  These designs maximize efficiency and feasibility for rare cancer research and rare cancer clinical trials. Dr. Hope Rugo: I love the idea of the platform trials that are decentralized. And I know that there is a trial being worked on with ARPA-H (Advanced Research Projects Agency for Health) funding in triple-negative breast cancer as well as in lung cancer, I think, and others with this idea of a platform trial. But it is challenged, I think, by precision medicine and next-generation sequencing where some patients do not have targetable markers, or there isn't a drug to target the marker. I think those are almost the same thing. We have really seen that these precision medicine ideas and NGS have moved the needle in helping to identify genetic alterations. This helps us to be more personalized. It actually helps with platform studies to customize trial enrollment. And we hope that this will result in better outcomes. It also allows us, I think, to study drugs even in the early stage setting more effectively. How can these advances be best applied to the future of rare cancers, as well as the challenges of not finding a marker or not having a drug? Dr. Vivek Subbiah: Thank you so much for that question. I think precision medicine and next-gen sequencing, or NGS, are truly the backbone of modern precision oncology. They have transformed how we think about cancer treatment. Instead of treating based on where the tumor originated or where the tumor started, we now look at the genetic blueprint of cancer. The NGS or next-gen sequencing allows us to sequence millions of DNA fragments quickly. Twenty, 30 years ago, they said we cannot sequence a human genome. Then it took almost a decade to sequence the first human genome. Right now, we have academic centers and commercial sequencing companies that are really democratizing NGS across all sites, not just in academic centers, across all the community sites, so that NGS is now accessible. This means that we can identify these actionable alterations like picking needles in haystacks, like NTRK fusions, RET fusions, or BRAF V600E alterations, high tumor mutational burden. This might occur across not one tumor type, across several different tumor types. So for rare cancers, this is critical because some of these mutations often define the best treatment option. Here is why this matters. Personalized therapy, right? Instead of a one-size-fits-all approach, we can tailor treatment to the patient's unique molecular profile. For trial enrollment, this can definitely help because patients can join biomarker-driven trials even if their cancer type is rare or ultra-rare. NGS technology has also helped us in designing rational studies. Many times monotherapy does not work in these cancers. So we are thinking about rational combination strategies. So NGS technology is helping us. Looking ahead, I see NGS becoming routine in clinical practice, not just at major niche academic centers, but everywhere. We will see more tumor-agnostic approvals, more molecular tumor boards guiding treatment decisions in real time. And I think we are seeing an expanded biomarker setup. Previously, we used to have only a few drugs and a handful of mutations. Now with homologous recombination defects, BRCA1/2 mutation, and expanding the HRD and also immunohistochemistry, we are expanding the biomarker portfolio. So again, I personally believe that the future is precision. What I mean by precision is delivering the right drug to the right patient at the right time. And for rare cancers, this isn't just progress. It is survival. And it is maybe the only way that they can have access to these cutting-edge precision medicines. Dr. Hope Rugo: That is so important. You mentioned an important area we will get to in a moment, the tumor-agnostic therapies. But as part of talking about that, do you think that the trials should also include just standard therapies? You know, who do you give an ADC to and when with these rare cancers? Because some of them do not have biomarkers to target and it is so disappointing for patients and providers where you are trying to screen a patient for a trial or a platform trial where you have one arm with this mutation, one arm with that, and they do not qualify because they only have a p53 loss, you know? They just do not have the marker that helps them. But we see this in breast cancer all the time. And it is tough because we don't have good information on the sequencing. So I wonder, you know, just because for some of these rare cancers it is not even clear what to use when with standard treatments. And then that kind of gets into this idea of the tumor-agnostic therapies that you mentioned. There are a lot of new treatments that are being evaluated. We have seen approval of some treatments in the last few years that are tumor-agnostic and based on a biomarker. Is that the best approach as we go forward for rare cancers? And what new treatment options are most exciting to you right now? Dr. Vivek Subbiah: Tumor-agnostic therapies, really close to my heart, are real breakthrough therapies and represent a major paradigm shift in oncology. Traditionally, for the broad listeners here, we are used to thinking about designing clinical trials and therapy like where the cancer originated, breast cancer, kidney cancer, prostate cancer, lung cancer. A tumor-agnostic therapy flips that model. Instead of focusing on the organ, they target the specific genetic alteration or biomarker that drives cancer growth regardless of where the tumor started, regardless of the location of the tumor, regardless of the zip code of the tumor. So why is this so important for rare cancers? Because many rare cancers share molecular features with more common cancers. For instance, NTRK fusion might occur in pediatric sarcoma, a salivary gland tumor, or a thyroid cancer. Historically, each of these would require separate trials, which is nearly impossible, unfeasible to conduct in these ultra-rare cancers like salivary gland cancer or pediatric sarcomas. Tumor-agnostic therapies allow us to treat all those cancers with the same targeted drug if they share that biomarker. Again, we are in 2025. The first tissue-agnostic approval, the historic precedent, was in fact an immunotherapy. Pembrolizumab was approved in 2017, May 2017, as the first immunotherapy to be approved in a tumor-agnostic way for a genomic biomarker, for MSI-High and dMMR cancers. Then came the NTRK inhibitors. So today we have not one, not two, but three different NTRK inhibitors: larotrectinib, entrectinib, and repotrectinib, which show response rates of nearly more than 60 to 75% across a handful of dozens and dozens of cancer types. Then, of course, we have RET inhibitors like selpercatinib, which is approved tissue-agnostic, and pralsetinib, which also shows tissue-agnostic activity across multiple cancers. And more recently, combination therapy with a BRAF and MEK combination, dabrafenib and trametinib, received tumor-agnostic approval for all BRAF V600E tumors with the exception of colorectal cancer. And even recently, you mentioned about antibody drug conjugates. Again, I think we live in an era of antibody drug conjugates. And Enhertu, trastuzumab deruxtecan, which was used first in breast cancer, now it is approved in a histology-agnostic manner for all HER2-positive tumors defined by immunohistochemistry 3+. So again, beyond NGS, now immunohistochemistry for HER2 is also becoming a biomarker. So again, for the broad listeners here, in addition to comprehensive NGS that may allow patients to find treatment options for these rare cancers for NTRK, RET, and BRAF, immunohistochemistry for HER2 positivity is also emerging as a biomarker given that we have a new FDA approval for this. So I would say personally that these therapies are game changers because they open doors for patients who previously had no options. Instead of waiting for years for a trial in their specific cancer type, they can access a treatment based on their molecular profile. I think it is precision medicine at its finest and best. Looking ahead, the third question you asked me is what is exciting going on? I think we will see more of these approvals. My hope is that today, I think we have nine to ten approvals. My hope is that within the next 25 to 50 years, we will have at least 50 to 100 drugs approved in this space based on a biomarker, not based on a location of the tumor type. Drug targeting rare alterations like FGFR2 fusions, FGFR amplifications, ALK fusions, and even complex signatures like high tumor mutational burden. I think we will be seeing hopefully more and more drugs approved. And as sequencing becomes routine, we will identify more patients for these therapies. I think for rare cancers, this is not just innovative approach. This is essential for them to access these novel precision medicines. Dr. Hope Rugo: Yeah, that is such a good point. I do think it is critical. Interestingly in breast cancer, it hasn't been, you know, there is always like two patients in these tumor-agnostic trials, or if that. You know, I think I have seen one NTRK fusion ever. I think that highlights the importance for rare cancers. And you know, I am hoping that that will translate into some new directions for some of our rarer and impossible-to-treat subtypes of breast cancer. It is this kind of research that is really going to make a difference. But what about those people who do not have biomarkers? What if you do not fit into that? Do you think there is a possibility of trying to do treatments for rare cancers in some prospective way that would help with that? You know, it is really a huge challenge. Dr. Vivek Subbiah: Absolutely. I think, you know, you're right, usually many of these rare cancers are driven by specific biomarkers. And again, some of the pediatric salivary gland tumors or pediatric sarcomas like fibrosarcomas, they are pathognomonic with NTRK fusions. And again, given that we have a tumor-agnostic approval, now these patients have access to these therapies. And I do not think that we would have had a trial just for pediatric fibrosarcomas with NTRK fusions. So that is one way. Another way is SWOG, right? The SWOG DART [1609] had this combination dual checkpoint, it was called the DART study dual combination chemotherapy with ipi/nivo. Now here the rare cancer subtype itself becomes a biomarker and they showed activity across multiple rare cancer subtypes. They didn't require a biomarker. As long as it was a rare or ultra-rare cancer, these patients were enrolled into the SWOG DART trial and multiple arms have read out. Angiosarcoma, Kaposi sarcoma, even gestational trophoblastic disease. Again, they have shown responses in these ultra-rare, rare cancers. Sometimes they might be seeing one or two cases a whole year. And I think this SWOG effort, this cooperative group effort, really highlighted the need for such studies without biomarkers as well. Dr. Hope Rugo: That is such a fantastic example of how to try and treat patients in a collaborative way. And in the paper, you also emphasize the need for collaborative research efforts, you know, uniting resource expertise across different ways of doing research. So cooperative groups, advocacy organizations that can really help advance rare cancer research, improve access to new therapies, and I think importantly influence policy changes. I think this already happened with the agnostic approvals. Could you tell us more about that? How can we move forward with this most effectively? Dr. Vivek Subbiah: Personally, I believe that collaboration is absolutely critical and essential for rare cancer research. No single institution, no single individual, or no single state or entity can tackle these challenges alone. The patient populations are small and dispersed. So pooling resources is the only way to run these meaningful trials. Again, it is not like singing, it is like putting a huge, huge, I would say, an opera piece together. It is not a solo, vocal therapy, but rather putting a huge opera piece like Turandot. You know, you mentioned cooperative groups. Cooperative groups, as I mentioned earlier, the SWOG DART program, the ASCO [TAPUR study]. ASCO is doing a phenomenal work of the TAPUR study. Again, this ASCO TAPUR program has enrolled so many patients with rare cancers who otherwise would not have treatment options. NCI-MATCH, the global effort, right? NCI-MATCH and the ComboMATCH are great examples. They bring together hundreds of sites, thousands of clinicians to run large-scale trials that would be impossible for any individual center or institution. These trials have already changed practice. For instance, the DART demonstrated the power of immunotherapy in rare cancers and influenced NCCN guidelines. One of the arms of the NCI-MATCH study from the BRAF V600E arm contributed towards the BRAF V600E tissue-agnostic approval. So, the BRAF V600E tissue-agnostic approval was by a pooled analysis of several studies. The ROAR study, the Rare Oncology Agnostic Research study, the NCI-MATCH dataset of tumor-agnostic cohort, and another pediatric trial, and also evidence from literature and evidence of case reports. And all this pooled analysis contributed to the tissue-agnostic approval of BRAF V600E across multiple rare cancers. There are several patient advocacy organizations which are the real unsung heroes here. Groups like, for instance, we mentioned in the paper, Target Cancer Foundation, don't just raise awareness for rare cancer research, they actively connect patients to trials providing financial, emotional support, and even run their own studies like the TRACK trial. They also influence policy to make access easier. On a global scale, initiatives like DRUP in the Netherlands, the ROME study in Italy, the PCM4EU in Europe are expanding precision medicine across these borders. These collaborations accelerate research, improve trial enrollment, and ensure patients everywhere can have access to these cutting-edge therapies. Again, it is truly a team effort, right? It is a multi-stakeholder approach. Researchers, clinicians, investigators, industry, regulators, academia, patients, patient advocates, and their caregivers all working together. And it takes a village. Dr. Hope Rugo: Absolutely. I mean, what a nice response to that. And I think really exciting and it is great to see your passion about this as well. But it helps all of us, I think, getting discouraged in treating these cancers to understand what is happening moving forward. And I think it is also a fabulous opportunity for our junior colleagues as they rise up in academics to be involved in these international collaborative efforts which are further expanding. One of the things that comes up for clinical trials for patients, and I think it is highlighted with rare cancers because, as you mentioned, people are all over the place, you know, they are so rare. They are all far away. Our patients are always saying to us, "Should I go here for a phase 1 trial?" Can you talk a little bit about how we can overcome these financial and geographic burdens for the patients? You talked about having trials locally, but it is a big financial and just social burden for patients. Dr. Vivek Subbiah: Great point. Financial cost is a major barrier in rare cancer clinical trials. It is a major barrier not just in rare cancer clinical trials, but in clinical trials in general. The economics of rare cancer research are one of the toughest challenges we face. Developing a new drug is already expensive, often billions of dollars. On an average, it takes 2 billion dollars or 2.8 billion dollars according to some data from drug discovery to approval. For rare cancers, the market is tiny, which means the pharmaceutical companies have really little financial incentive to invest. That is why initiatives like the Orphan Drug Act were created to provide tax credits, grants, and market exclusivity to encourage development for rare diseases. Clinical trials themselves are expensive because the small patient populations mean longer recruitment times and higher per-patient costs. Geographic dispersion, as you mentioned, for the patients adds travel, coordination. That is why we need to think out of the box about decentralized trial infrastructure so that we can mitigate some of these expenses. Complex trial designs like basket or platform trials sometimes require sophisticated data systems and regulatory oversight. That is a challenge. And I think some of the pragmatic studies like ASCO TAPUR have overcome those challenges. Advanced technologies like next-gen sequencing and molecular profiling also add significant upfront cost to this. Funding is also limited because rare cancers receive less attention compared to common cancers. Public funding and cooperative group trials help a lot, but I think they cannot cover everything. Patient advocacy organizations sometimes step in to bridge these gaps, but sustainable financing remains a huge challenge. So, the bottom line is without financial incentives and collaborating funding models, many promising therapies for rare cancers would never make it to patients. That is why we need system-wide policy changes, global partnerships, and innovative, effective, seamless trial designs which are so critical so that they can help reduce the cost and make research feasible so that we can deliver the right drug to the right patient at the right time. Dr. Hope Rugo: There is a lot of excitement about the future integration of AI in screening. Just at the San Antonio Breast Cancer meetings, we have a number of different presentations about AI to find markers, even like HER2, and using AI where you would screen and then match patients to clinical trials. Do you have any guidance for the rare cancer community on how to leverage this technology in order to optimize patient enrollment and, I think, identification of the best treatment matches? Dr. Vivek Subbiah: I think artificial intelligence, AI, is a game-changer in the making. Right now, clinical trial is clunky. Matching patients to trial is often manual, time consuming, laborious. You need a lot of personnel to do that. AI can automate this process by analyzing genomic data, medical records, and trial eligibility criteria to find the best matches quickly, accurately, and effectively. For the community, the key is to invest in data standardization and interoperability because AI needs clean, structured data to work effectively. Dr. Hope Rugo: Thank you so much, Dr. Subbiah, for sharing these fantastic insights with us on the podcast today and for your excellent article. Dr. Vivek Subbiah: Thank you so much. Dr. Hope Rugo: We thank you, our listeners, for joining us today. You will find a link to Dr. Subbiah's Educational Book article in the transcript of this episode. And please join us again next month on By the Book for more insightful views on key issues and innovations that are shaping modern oncology.  Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:        Dr. Hope Rugo   @hoperugo   Dr. Vivek Subbiah @VivekSubbiah Follow ASCO on social media:        ASCO on X  ASCO on Bluesky       ASCO on Facebook        ASCO on LinkedIn        Disclosures:       Dr. Hope Rugo:    Honoraria: Mylan/Viatris, Chugai Pharma   Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer   Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx   Dr. Vivek Subbiah: Consulting/Advisory Role: Loxo/Lilly, Illumina, AADI, Foundation Medicine, Relay Therapeutics, Pfizer, Roche, Bayer, Incyte, Novartis, Pheon Therapeutics, Abbvie Research Funding (Inst.): Novartis, GlaxoSmithKline, NanoCarrier, Northwest Biotherapeutics, Genentech/Roche, Berg Pharma, Bayer, Incyte, Fujifilm, PharmaMar, D3 Oncology Solutions, Pfizer, Amgen, Abbvie, Mutlivir, Blueprint Medicines, Loxo, Vegenics, Takeda, Alfasigma, Agensys, Idera, Boston Biomedical, Inhibrx, Exelixis, Amgen, Turningpoint Therapeutics, Relay Therapeutics Other Relationship: Medscape, Clinical Care Options

In der heutigen Folge sprechen die Finanzjournalisten Daniel Eckert und Lea Oetjen über den digitalen Euro, einen Kurssprung bei Sandisk und Trumps Warnung an den Iran. Außerdem geht es um Rheinmetall, Nvidia, Apple, RocketLab, SpaceX, Microsoft, Meta Platforms, Alphabet (Google), Tesla, Amazon, Droneshield, Renk Group, Thyssenkrupp Marine Systems, MiniMax, Zhipu AI, Teamviewer und AstraZeneca. Wir freuen uns an Feedback über aaa@welt.de. Noch mehr "Alles auf Aktien" findet Ihr bei WELTplus und Apple Podcasts – inklusive aller Artikel der Hosts und AAA-Newsletter. Hier bei WELT: https://www.welt.de/podcasts/alles-auf-aktien/plus247399208/Boersen-Podcast-AAA-Bonus-Folgen-Jede-Woche-noch-mehr-Antworten-auf-Eure-Boersen-Fragen.html. Der Börsen-Podcast Disclaimer: Die im Podcast besprochenen Aktien und Fonds stellen keine spezifischen Kauf- oder Anlage-Empfehlungen dar. Die Moderatoren und der Verlag haften nicht für etwaige Verluste, die aufgrund der Umsetzung der Gedanken oder Ideen entstehen. Hörtipps: Für alle, die noch mehr wissen wollen: Holger Zschäpitz können Sie jede Woche im Finanz- und Wirtschaftspodcast "Deffner&Zschäpitz" hören. +++ Werbung +++ Du möchtest mehr über unsere Werbepartner erfahren? Hier findest du alle Infos & Rabatte! https://linktr.ee/alles_auf_aktien Impressum: https://www.welt.de/services/article7893735/Impressum.html Datenschutz: https://www.welt.de/services/article157550705/Datenschutzerklaerung-WELT-DIGITAL.html

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/BQU865. CME/MOC/AAPA/IPCE credit will be available until January 2, 2027.Innovative Approaches in Prostate Cancer: Bridging Genomics and Patient-Centric Treatment In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and ZERO Prostate Cancer. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from Astellas and Pfizer, Inc., AstraZeneca, Bayer HealthCare Pharmaceuticals Inc., Johnson & Johnson, and Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

“The world is a very volatile place, with currently 110 conflicts globally, and yet healthcare staff in the hospitals, even here in London, are not prepared to be the only clinician who can help in a crisis or hostile setting,” says Dr. David Gough, CEO of the David Nott Foundation, which equips providers with the skills and confidence needed to function in war and other extraordinary situations. A former British Army doctor injured in Afghanistan, Gough brings lived experience as well as a background in tech to his current role at the Foundation, which itself is anchored in decades of field work amassed by its namesake, a renowned war surgeon. As Dr. Gough points out to host Lindsey Smith, the cause could be helped by augmenting medical school curricula, but in the meantime, the Foundation is filling the knowledge gap by using prosthetics, virtual reality simulations and cadavers to train a broad swath of health workers including surgeons, anesthetists, and obstetricians. Tune in to this important Raise the Line conversation as Dr. Gough reflects on the strengths and weaknesses of NGOs in doing this work, his plans to expand the Foundation's footprint in the US, and the gratifying feedback he's received from trainees now operating on the frontlines in Ukraine and elsewhere. Mentioned in this episode:David Nott Foundation If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Dr. Monty Pal and Dr. Hope Rugo discuss advances in antibody-drug conjugates for various breast cancer types as well as treatment strategies in the new era of oral SERDs for HR-positive breast cancer. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist and vice chair of academic affairs here at the City of Hope Comprehensive Cancer Center, Los Angeles. Today, I'm thrilled to be joined by Dr. Hope Rugo, an internationally renowned breast medical oncologist and my colleague here at City of Hope, where she leads the Women's Cancers Program and serves as division chief of breast medical oncology. Dr. Rugo is going to share with us exciting advances in antibody-drug conjugates (ADCs) that are expanding treatment options in various breast cancer types. She'll also address some of the complex questions arising in the new era of oral SERDs (selective estrogen receptor degraders) that are revolutionizing treatment in the hormone receptor-positive breast cancer space. Our full disclosures are available in the transcript of this episode.  Dr. Rugo, welcome, and thanks so much for being on the podcast today. Dr. Hope Rugo: Thank you. Pleasure to be here. Dr. Monty Pal: So, I'm going to switch to first names if you don't mind.  The first topic is actually a really exciting one, Hope, and this is antibody-drug conjugates. I don't know if I've ever shared this with you, but I actually started my training at UCLA, I was a med student and resident there, and it was in Dennis Slamon's lab. I worked very closely with Mark Pegram and a handful of others. This is right around the time I think a lot of HER2-directed therapies were really evolving initially in the clinics. Now we've got antibody-drug conjugates. Our audience is well-familiar with the mechanism there but tell us about how ADCs have really started to reshape therapy for HER2-positive breast cancer. Dr. Hope Rugo: Yeah, I mean, this is a really great place to start. I mean, we have had such major advances in breast cancer just this year, I think really changing the paradigm of treating patients. But HER2-positive disease, we've been used to having sequenced success of new agents. And I think the two biggest areas where we've made advances in HER2-positive disease, which were remarkably advanced this year in 2025, have been in antibody-drug conjugates with trastuzumab deruxtecan and with new oral tyrosine kinase inhibitors (TKIs) that have less of a target on EGFR and more on HER2, so they have an overall more tolerable toxicity profile and therefore a potentially better efficacy in the clinic. At least that's what we're seeing with these new strategies that we couldn't really pursue in the past because of toxicities of the oral TKIs. So, although our topic is ADCs, I'm going to include the TKI because it's so important in our thinking about treating HER2-positive disease. In the metastatic setting, we've seen these remarkable improvements in progression-free and overall survival in the second-line setting with T-DXd, or trastuzumab deruxtecan, compared to T-DM1. And then sequencing ADCs with giving T-DXd after T-DM1 was better than an oral tyrosine kinase or a trastuzumab combination with standard chemotherapy. That was DESTINY-Breast03 and DESTINY-Breast02. So, then we've had other trials since then, and T-DXd has moved into the early-stage setting, which I'll talk about in just a moment. But the next big trial for T-DXd in HER2-positive disease was moving it to the first-line setting to supplant what has become an established treatment for now quite a long time: the so-called CLEOPATRA regimen, which used the combined antibodies trastuzumab, pertuzumab with a taxane as first-line therapy. And then we've proceeded on with maintenance with ongoing HP for patients with responding or stable disease. And we'd seen long-term data showing, you know, at 8 years there was a group of patients whose cancers had never progressed and continued improved overall survival. So, T-DXd was studied in DESTINY-Breast09, either alone or in combination with pertuzumab compared to THP. The patient population had received a little bit more prior treatment, but interestingly, not a lot compared to CLEOPATRA. And they designed the trial to be T-DXd continued until progression with or without pertuzumab versus THP, which would go for six cycles and then stop around six cycles, and then stop and continue HP. Patients who had hormone receptor-positive disease could use hormone therapy, and this is one of the issues with this dataset because, surprisingly in this dataset and one other I'll mention, very few patients took hormone therapy. And even in the maintenance trial, the HER2CLIMB-05, less than 50% took hormone therapy as maintenance. This is kind of shocking to me and highlights an area of really important education, that outcome is improved when you add endocrine therapy for hormone receptor-positive HER2-positive metastatic disease in the maintenance phase, and it's a really important part of treatment. But suffice it to say, you know, you're kind of studying continued chemo versus stopping chemo in maintenance. And T-DXd, as we all expected, in combination with pertuzumab was superior to THP in terms of progression-free survival, really remarkably improved. And you could stop the chemo with toxicity, but most people continued it with T-DXd. Again, not a lot of people got hormone therapy, which is an issue, and you stop the chemo in the control arm. So, this has brought up a lot of interest in trying to use T-DXd as an induction and then go to maintenance, much as we do with the CLEOPATRA regimen with hormone therapy. But it brings up another issue. So first, T-DXd is superior; it's a great treatment. Not everybody needs to have it because we don't know whether it's better to give T-DXd first or second with progression - that we need a little bit longer follow-up. But just earlier this week, interestingly, the third week of December, the U.S. FDA approved T-DXd in the DESTINY-Breast09 approach with pertuzumab. So as I mentioned earlier, there was a T-DXd-alone arm; that arm has not yet reported. So very interesting, we don't know if you need pertuzumab or not. So what about the maintenance? That's the other area where we've made a huge advance here. So, we all want to stop chemo and we want to stop T-DXd. You don't want somebody being nauseated for two years while they're on treatment, and also there's a small number of patients with mostly de novo metastatic HER2-positive disease who are cured of their disease. We'd like to expand that, and I think these new drugs give us the opportunity to improve the number of patients who might be cured from metastatic disease. So the first maintenance study we saw was adding palbociclib, the CDK4/6 inhibitor, to endocrine therapy and HP, essentially. There, we had a remarkable improvement in progression-free survival difference of 15.2 months: 29 to 44 months, really huge. At San Antonio this year, we saw data with this oral tyrosine kinase inhibitor tucatinib, already showed it was great in a triplet, but as maintenance in combination with HP, it showed also a remarkable improvement in progression-free survival. But the numbers were all shifted down. So in PATINA, the control arm was in the 24-month range; here it was the tucatinib-HP arm that was in the 25 months and 16 months for control. So there was a differential benefit in ER-negative and ER-positive disease. So I think we're all thinking that our ideal approach moving forward would be to give T-DXd to most patients, we see how they do, and treat to best response. And then, stop the T-DXd, start HP, trastuzumab, pertuzumab for ER-negative, with tucatinib for ER-positive with palbociclib. We also have early data that suggests that both approaches may reduce the development of brain metastases, an issue in HER2-positive disease, and delay time to progression of brain metastases as seen in HER2CLIMB-05 in very early data - small numbers, but still quite intriguing that you might delay progression of brain metastases with tucatinib that clearly has efficacy in the brain.  So, I think that this is a hugely exciting advance for our patients, and these approaches are quickly moving into the early stage setting. T-DXd compared to standard chemo, essentially followed by THP, so a sequenced approach resulted in more pathologic complete responses than a standard THP-AC-type neoadjuvant therapy. T-DXd alone for eight cycles wasn't better, and that's interesting. We still need the sequenced non-cross-resistant chemo. But I think even more importantly, the data from DESTINY-Breast05 looking at T-DXd versus T-DM1 in patients with residual disease after neoadjuvant HER2-targeted therapy showed a remarkable improvement in invasive disease-free survival with T-DXd versus T-DM1, and quite early. It was a high-risk population, higher risk than the T-DM1 trial with KATHERINE, but earlier readout with a remarkable improvement in outcome. We expect to be FDA approved sometime in the first half of 2026. So then we'll get patients who've already had T-DXd who get metastatic disease. But my hope is that with T-DXd, maybe with tucatinib in the right group of patients or even sequenced in very high-risk disease, that we could cure many more patients with early-stage HER2-positive breast cancer and cure a subset, a greater subset of patients with de novo metastatic disease. Dr. Monty Pal: That's brilliant. And you tackled so many questions that I was going to follow up with there: brain metastases, etc. That was sort of looming in my mind. I mean, general thoughts on an ADC versus a TKI in the context of brain mets? Dr. Hope Rugo: Yeah, it's an interesting question because T-DXd has shown quite good efficacy in this setting. And tucatinib, of course, had a trial where they took patients with new brain mets, so a larger population than we've seen yet for the T-DXd trials, and saw that not only did they delay progression of brain metastases and result in shrinkage of existing untreated brain mets, but that patients who develop a new brain met, they could stay on the same assigned treatment. They got stereotactic radiation, and then the patients who were on tucatinib with trastuzumab and capecitabine had a further delay in progression of brain mets compared to those on the placebo arm, even after treatment of a new one that developed on treatment. So, I think it's hard. I think most of us for a lot of brain mets might start with the tucatinib approach, but T-DXd is also a very important treatment. You know, you're kind of trading off a diarrhea, some liver enzyme elevations with tucatinib versus nausea, which you really have to work on managing because it can be long-delayed nausea, and this risk of ILD, interstitial lung disease, that's about 12%, with most but not all trials showing a mortality rate from interstitial lung disease of just under 1 percent. In the early-stage setting, it was really interesting to see that with T-DXd getting four cycles in the neoadjuvant setting, a lot less ILD noted than the patients who got up to 14 cycles, as I think they got a median of 10 cycles in the post-surgical setting, there was a little bit more ILD. But I think we're going to be better and better at finding this earlier and preventing mortality by just stopping drug and treating earlier with steroids. Dr. Monty Pal: And this ILD issue, it always seems to resurface. There are drugs that I use in my kidney cancer clinic, everolimus, common to perhaps the breast cancer clinic as well, pembrolizumab, where I think the pattern of pneumonitis is quite different, right? What is your strategy for recognizing pneumonitis early in this context? Dr. Hope Rugo: Well, it is, and you know, having done the very early studies in everolimus where we gave it in the neoadjuvant setting and we're like, "Hmm, the patient came in with a cough. What's going on?" You know, we didn't know. And you have mouth sores, you know, we were learning about the drug as we were giving it. What we don't do with everolimus and CDK4/6 inhibitors, for example, is grade 1 changes like radiation pneumonitis, we don't stop, we don't treat it. We only treat for symptoms. But because of the mortality associated with T-DXd, albeit small, we stop drug for grade 1 imaging-only asymptomatic pneumonitis, and some of us treat with a half dose of steroids just to try and hasten recovery. We've actually now published or presented a couple of datasets from trials, a pooled analysis and a real-world analysis, that have looked at patients who were retreated after grade 1 pneumonitis or ILD and tolerated drug very well and none of them died of interstitial lung disease, which was really great to see because you can retreat safely and some of these patients stayed on for almost a year benefiting from treatment. So, there's a differential toxicity profile with these drugs and there are risk factors which clearly have identified those at higher risk: prior ILD, for example. A French group said smoking; other people haven't found that, maybe because they smoked more in France, I don't know. And being of Japanese descent is quite interesting. The studies just captured that you were treated in Japan, but I think it's probably being of Japanese descent with many drugs that increases your risk of ILD. And, you know, older patients, people who have hypoxia, those are the patients. So, how do we do this? With everolimus, we don't have specific monitoring. But for T-DXd we do; we do every nine weeks to start with and then every 12 weeks CT scans because most of the events occur relatively early. Somebody who's older and at higher risk now get the first CT at six weeks. Dr. Monty Pal: This is super helpful. And I have to tell you, a lot of these drugs are permeating the bladder cancer space which, you know, is ultimately going to be a component of my practice, so thank you for all this. We could probably stay on this topic of HER2-positive disease forever. I'm super interested in that space still. But let me shift gears a little bit and talk about triple-negative breast cancer and this evolving space of HR-positive, HER2-low breast cancer. I mean, tell us about ADCs in that very sort of other broad area. Dr. Hope Rugo: So triple-negative disease is the absolute hardest subset of disease that we have to treat because if you don't have a great response in the early stage setting, the median survival is very short, you know, under two years for the majority of TNBCs, with the exception of the small percentage of low proliferative disease subsets. The co-question is what do we do for these patients and how do we improve outcome? And sacituzumab govitecan has been one strategy in the later line setting that was shown to improve progression-free and overall survival, the Trop-2 ADC. We had recently three trials presented with the two ADCs, sacituzumab govitecan and the other Trop-2 ADC that's approved for HR-positive disease, datopotamab deruxtecan. And they were studied in the first-line setting. Two trials with SG, sacituzumab govitecan, those trials, one was PD-L1 positive, ASCENT-04. That showed that SG with a checkpoint inhibitor was superior, so pembrolizumab was superior to the standard KEYNOTE-355 type of treatment with either a taxane or gemcitabine and carboplatin with pembrolizumab for patients who have a combined positive score for PD-L1, 10 or greater. So, these are patients who are eligible for a checkpoint inhibitor, and SG resulted in an improved progression-free survival.  The interesting thing about that dataset is that few patients had received adjuvant or neoadjuvant checkpoint inhibitor, which is fascinating because we give it to everybody now. But access is an issue and timing of the study enrollment was an issue. The other thing which I think we've all really applauded Gilead for is that there was automatic crossover. So, you could get from the company, to try and overcome some of the enormous disparities worldwide in access to these life-saving drugs, you could get SG through the company for free once you had blinded independent central review confirmation of disease progression. Now, a lot of the people who got the SG got it through their insurance, they didn't bill the company, but 80 percent of patients in the control arm received SG in the second-line setting. So that impacts your ability to look at overall survival, but it's an incredibly important component of these trials. So then at ESMO, we saw the data from SG and Dato-DXd in the first-line metastatic setting for patients who either had PD-L1-negative disease or weren't eligible for an immunotherapy. For the Dato study, TROPION-Breast02, that was 10 percent of the patients who had PD-L1-positive disease but didn't get a checkpoint inhibitor, and for the ASCENT-03 trial population it was only 1 percent. Importantly, the trials allowed patients who relapsed within a year of receiving their treatment with curative intent, and the Dato study, TB-02, allowed patients who relapsed while on treatment or within the first six months, and that was 15 percent of the 20 percent of early relapsers. The ASCENT trial, ASCENT-03, had 20 percent who relapsed between 6 and 12 months. The drugs were better than standard of care chemotherapy, the ADCs in both trials, which is very nice. Different toxicity profiles, different dosing intervals, but better than standard of care chemotherapy in the disease that's hardest for us to treat. And importantly, when you looked at the subset of early relapsers, those patients also did better with the ADC versus chemotherapy, which is incredibly important. And we were really interested in that 15 percent of patients who had early relapse. I actually think that six months thing was totally contrived, invented, you know, categorization and doesn't make any sense, and we should drop it. But the early relapsers were 15 percent of TB-02 and Dato was superior to standard of care chemo. We like survival, but the ASCENT trial again allowed the crossover to an approved ADC that improved survival and 80 percent of patients crossed over. In the Dato trial, they did not allow crossover, they didn't provide Dato, which isn't approved for TNBC but is for HR-positive disease, and they didn't allow, of course, pay for SG. So very few patients actually crossed over in their post-treatment data and in that study, they were able to show a survival benefit. So actually, I think in the U.S. where we can use approved drugs already before there's a fixed FDA approval, that people are already switching to use SG or Dato in the first-line setting for metastatic TNBC that's both PD-L1 positive for SG and PD-L1 negative for both drugs. And I think understanding the toxicity profiles of the two drugs is really important as well as the dosing interval to try and figure out which drug to use. Dr. Monty Pal: Brilliant. Brilliant. Well, I'm going to shift gears a little bit. ADCs are a topic, again, just like HER2-positive disease we could stay on forever. Dr. Hope Rugo: Huge. Yes. Dr. Monty Pal: But we're going to shift gears to another massive topic, which is oral SERDs. In broad strokes, right, this utilization of CDK4/6 inhibitors in the context of HR-positive breast cancer is obviously, you know, a paradigm that's been well established at this point. Where do we sequence in oral SERDs? Where do they fit into this paradigm? Dr. Hope Rugo: Ha! This is a rapidly changing area; we keep changing what we're saying every other minute. And I think that there are three areas of great interest. So one is patients who develop ESR1 mutations that allow constitutive signaling through the estrogen receptor, even when there's not estrogen around, and that is a really important mutation that is subclonal; it develops under the pressure of treatment in about 40 percent of patients. And it doesn't happen when you first walk in the door. And what we've seen is that oral SERDs as single agents are better than standard single-agent endocrine therapy in that setting. The problem that we've had with that approach is that we're now really interested in giving targeted agents with our endocrine therapies, not just in the first-line setting where CDK4/6 inhibitors are our standard of care with survival benefit for ribociclib and, you know, survival benefit in subsets with other CDK4/6 inhibitors, and abemaciclib with a numeric improvement. So we give it first line. The question is, what do you do in the second-line setting? Because of the recent data, we now believe that oral SERDs should be really given with a targeted agent. And some datasets which were recently presented, which I think have helped us with that, have been EMBER-3 and then the most recently evERA BC, or evERA Breast Cancer, that looked at the oral SERD giredestrant with everolimus compared to standard of care endocrine therapy with everolimus, where 100 percent of patients received prior CDK4/6 inhibitor and showed a marked improvement in progression-free survival, including in the subsets of patients with a short response, 6-12 months of prior response to CDK4/6 inhibitor and in those who had a PIK3CA pathway mutation. The thing is that the benefit looks like it's much bigger in the ESR1 mutant population, although response was better, PFS wasn't better in the wild type. So, we're still trying to figure that out. We also saw EMBER-3 with imlunestrant and abemaciclib as a second line. Not everybody had had a prior CDK4/6 inhibitor; they compared it to imlunestrant alone, but still the data was quite striking and seemed to cross the need for ESR1 mutations. And then lastly, we saw data from the single arms of the ELEVATE trial looking at elacestrant with everolimus and abemaciclib and showed these really marked progression-free survival data, even though single-arm, that crossed the mutation status. At least for the everolimus combination, abemaciclib analysis is still to come in the mutated subgroups. But really remarkable PFS, much longer.  Single-agent fulvestrant after CDK4/6 inhibitor AI has a PFS in like the three-month range and in some studies, maybe close to five months. These are all at 10-plus months and really looking very good. And so those questions are, is it ESR1 mutation alone? Is it all comers? We'd like all comers, right? We believe in the combination approach and we're learning more about combinations with drugs like capivasertib and other drugs as we move forward. Everybody now wants to combine their targeted agent with an oral SERD because they're clearly here to stay with quite remarkable data. The other issue, so the second issue in the metastatic setting is, does it make a difference if we change to an oral SERD before radiographic imaging evidence of progression? And that was the question asked in the SERENA-6 trial where patients had serial monitoring for the presence of ESR1 mutations in ctDNA. And those who had them without progression on imaging could be randomized to switch to camizestrant with the same CDK4/6 inhibitor or stay on their same AI CDK4/6 inhibitor. And they showed a difference in progression-free survival that markedly favored camizestrant. But interestingly, the people who were on the standard control arm had an ESR1 mutation, we think AIs don't work, they stayed on for nine more months. The patients who were on the camizestrant stayed on for more than 16 months. And they presented some additional subset data which showed the same thing: follow-up PFS data, PFS2, all beneficial in SERENA-6 at the San Antonio [Breast Cancer Symposium]. So, we're still a little bit unclear about that. They did quality of life, and pain was markedly improved. They had a marked delayed time to progression of pain in the camizestrant arm. So this is all a work in progress, trying to understand who should we switch without progression to an oral SERD based on this development of this mutation that correlates with resistance. And, you know, it's interesting because the median time to having a mutation was 18 months and the median time to switch was almost 24 months. And then there were like more than 3,000 patients who hadn't gotten a mutation, hadn't switched, and were still okay. So screening everybody is the big question, and when you would start and who you would change on and how this affects outcome. Patients didn't have access to camizestrant in the control arm, something we can't fix but we have experimental drugs. We're actually planning a trial, I hope in collaboration with the French group Unicancer, and looking at this exact question. You know, if you switch and you change the CDK4/6 inhibitor and then you also allow crossover, what will we see? Dr. Monty Pal: We're coming right to the tail end of our time here, and I could probably go on for another couple of hours with you here. But if you could just give us maybe one or two big highlights from San Antonio, any thoughts to leave our audience with here based on this recent meeting? Dr. Hope Rugo: Yeah, I mean, I talked about a lot of those new data already from San Antonio, and the one that I'd really like to mention which I think was, you know, there were a lot of great presentations including personalized screening presented from the WISDOM trial by my colleague Laura Esserman, fascinating and really a big advance. But lidERA was the big highlight, I think, outside of the HER2CLIMB-05 which I talked about earlier in HER2-positive disease. And this study looked at giredestrant, the oral SERD versus standard of care endocrine therapy as treatment for medium and high-risk early-stage breast cancer. And what they showed, which I think was really remarkable with just about a three-year median follow-up, was an improvement in invasive disease-free survival with a hazard ratio of 0.7. I mean, really quite remarkable and so early. It looked as though this was all driven by the high-risk group, which makes sense, not the medium risk, it's too early. And also that there was a bigger benefit in patients who were on tamoxifen compared to giredestrant versus AI, but for both groups, the confidence intervals didn't cross 1. There's even a trend towards overall survival, even though it's way too early. I think that, you know, really well-tolerated oral drug that could improve outcome in early-stage disease, this is the first advance we've seen in over two decades in the treatment of early-stage hormone receptor-positive disease with just endocrine therapy. I think we think that we don't want to give up CDK4/6 inhibitors because we saw a survival benefit with abemaciclib and a trend with giving ribociclib in the NATALEE trial. So we're thinking that maybe one approach would be to give CDK4/6 inhibitors and then switch to an oral SERD or to have enough data to be able to give oral SERDs with these CDK4/6 inhibitors for early-stage disease. And that's all in the works, you know, lots of studies going on. We're going to see a lot of data with both switching 8,000 patients with an imlunestrant switching trial, an elacestrant trial going on, and safety data with giredestrant with abemaciclib and soon to come ribociclib. So, this is going to change everything for the treatment of early-stage breast cancer, and I hope cure more patients of the most common subset of the most common cancer diagnosed in women worldwide. Dr. Monty Pal: Super exciting. It's just remarkable to hear how this has evolved since 25 years ago, which is really the last time I sort of dabbled in breast cancer.  Thank you so much, Hope, for joining us today. These were fantastic insights. Appreciate you being on the ASCO Daily News Podcast and really want to thank you personally for your remarkable contribution to the field of breast cancer. Dr. Hope Rugo: Thank you very much, and thanks for talking with me today. Dr. Monty Pal: You got it. And thanks a lot to our listeners today as well. You'll find links to all the studies we discussed today in the transcript of this episode. Finally, if you value the insights that you hear today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinion of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:   Dr. Monty Pal @montypal Dr. Hope Rugo   @hoperugo Follow ASCO on social media:        ASCO on X  ASCO on Bluesky       ASCO on Facebook        ASCO on LinkedIn        Disclosures:     Dr. Monty Pal:    Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview   Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical   Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis   Dr. Hope Rugo:    Honoraria: Mylan/Viatris, Chugai Pharma   Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer   Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  

This week's Misfit Entrepreneur is John Garrett—a keynote speaker, award winning author, consultant, and the creator of the powerful concept known as "What's Your And?" If you're looking for the X factor in how to build a culture where people actually perform at their best, feel connected, and bring their whole selves to work… John is the guy you need to hear from. John started his career as a CPA before breaking the mold—quite literally—by becoming a nationally touring comedian. And that's what sparked his groundbreaking discovery: people are more than their job titles, and organizations that embrace their employees' outside-of-work passions—what he calls their "Ands"—build stronger cultures, retain talent longer, and unlock levels of performance and engagement most leaders never tap into. He's worked with companies like PwC, AstraZeneca, and Microsoft, and written the bestseller What's Your And? His message is simple but transformative: We perform better when we bring all of who we are to what we do. And for entrepreneurs and business owners looking to build thriving, winning cultures—John's frameworks are pure gold. I've personally spent time with John and seen him present his concepts live. His insights land. His stories resonate. And the applications for leaders are immediate. Show Sponsors: Entrepreneurs, what if there was a way to know you were hiring the best salespeople to drive your business? How much would that help your success? Well, with SalesDrive's DriveTest, you can! Drive is composed of three non-teachable traits shared by all top producers: Need for Achievement, Competitiveness, and Optimism. You can get a FREE DriveTest assessment to help you in your hiring efforts at www.MisfitEntrepreneur.com/SalesDrive 5 Minute Journal: www.MisfitEntrepreneur.com/Journal

Want to come back from JP Morgan with more than just a stack of business cards? In this timely episode, host Elaine Hamm, PhD, sits down with Chris Yochim, a longtime JP Morgan Healthcare Conference insider. With more than three decades of experience leading partnering strategy at AstraZeneca and Zeneca, Chris shares a practical, behind-the-scenes look at how the world's most intense healthcare meeting really works—and how to prepare for it effectively. As JP Morgan approaches, Elaine and Chris break down what “success” looks like for different audiences, from academic tech transfer and startups to investors and large pharma. In this episode, you'll learn: How to define “winning” at JP Morgan based on your role—academic, startup, investor, or industry leader. Why preparation, flexibility, and memorable first impressions matter more than a full calendar of meetings. Practical tips for pitching, following up, and building long-term relationships before, during, and after the conference. Whether this is your first JP Morgan or your tenth, this episode offers actionable advice to help you navigate the chaos, build meaningful connections, and turn conversations into real momentum. Links: Check out the JP Morgan Healthcare Conference 2026. Connect with Chris Yochim and check out NIIMBL and AstraZeneca. Connect with Elaine Hamm, PhD, and learn about Tulane Medicine Business Development and the School of Medicine. Check out EBD Group, RESI, and the Guide to JPM'26 app. Connect with James Zanewicz, JD, LLM, RTTP and Dennis Purcell, MBA. Connect with Ian McLachlan, BIO from the BAYOU producer. Learn more about BIO from the BAYOU - the podcast. Bio from the Bayou is a podcast that explores biotech innovation, business development, and healthcare outcomes in New Orleans & The Gulf South, connecting biotech companies, investors, and key opinion leaders to advance medicine, technology, and startup opportunities in the region.

One on One Video Call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_USTrueLife: Rites of Passage - Episode: The Cultivation of DependenceIn this eye-opening episode of TrueLife: Rites of Passage, host George Monty exposes the dark underbelly of modern dependency engineering—how corporations systematically turn free individuals into captive consumers through biological, psychological, and economic addictions. From pharmaceuticals that hook you for life to hyper-palatable foods and addictive apps, Monty reveals how “customer lifetime value” is just code for human farming, where independence is eroded for perpetual profit.  Monty dives deep into real-world examples: Purdue Pharma's deliberate strategies to create dependence with OxyContin, as uncovered in internal documents  ; Eli Lilly's knowledge of Prozac's permanent neurochemical changes and severe discontinuation syndrome since 1984  ; and the infamous 2018 Goldman Sachs report questioning if “curing patients” is a sustainable business model, favoring chronic treatments instead.   He also uncovers the DSM-5's expansion of mental disorders in 2010, influenced by pharmaceutical ties  ; AstraZeneca's proton pump inhibitors creating “annuity patients” through long-term use  ; and Meta's (Facebook's) 2021 leaked memo admitting Instagram worsens body image issues for 32% of teen girls to keep users hooked.  Beyond drugs, Monty explores food engineering at Frito-Lay, where flavors are lab-designed to mimic cocaine-like dopamine hits  ; Meta's 2017 internal tactics using variable rewards to ensure users return compulsively ; and the shift to subscription models in software and finance that make opting out impossible.This episode challenges listeners to audit their dependencies—medications, apps, subscriptions—and reclaim autonomy. End with a call to action: Research your “needs,” break the hooks, and become unfarmable. Tune in for tomorrow's unmasking of automated compliance.https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.htmlhttps://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/https://www.statnews.com/2019/12/03/oxycontin-history-told-through-purdue-pharma-documents/https://pmc.ncbi.nlm.nih.gov/articles/PMC2622774/https://www.wisnerbaum.com/advocacy_campaigns/ssri-documents/https://www.scribd.com/document/413333146/Eli-Lilly-Prozac-Documents-What-Do-They-Revealhttps://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/https://www.aaup.org/academe/issues/2010-issues-4/diagnosing-conflict-interest-disorderhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3302834/https://www.bradleygrombacher.com/nexium-proton-pump-inhibitor-lawsuit-claims-severe-patient-injurieshttps://www.astrazeneca.com/content/astraz/media-centre/press-releases/2023/astrazeneca-settles-nexium-and-prilosec-product-liability-litigations.htmlhttps://www.theguardian.com/technology/2021/sep/14/facebook-aware-instagram-harmful-effect-teenage-girls-leak-revealshttps://topclassactions.com/lawsuit-settlements/lawsuit-news/frito-lay-sued-over-no-artificial-flavors-claim-on-poppables-snacks/https://www.bakeryandsnacks.com/Article/2025/10/07/pepsico-sued-over-mold-made-citric-acid-in-poppables/ One on One Video call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_US

In this podcast episode, Rami Komrokji, MD, reviews data from select presentations in myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) presented at the ASH 2025 Annual Meeting and shares expert perspectives on the clinical implications of these findings, including:Abstract 910: MANIFEST-2 96-Wk Update: Ruxolitinib + Pelabresib or Placebo in Patients With JAK Inhibitor–Naive MFAbstract 1024: Phase I Trial of INCA033989, a First-in-Class Antibody Targeting Mutant Calreticulin: Safety and Efficacy in Essential ThrombocythemiaAbstract 484: Preliminary Results From 2 Phase I Trials Exploring the Mutant Calreticulin-Specific mAb INCA033989 ± Ruxolitinib in Patients With MFAbstract 235: VERONA: Subgroup Analyses of Venetoclax or Placebo Combined With Azacitidine in Treatment-Naive Higher-Risk MDSAbstract 490: IMerge Post Hoc Analysis: Treatment-Emergent Cytopenias and Response With Imetelstat in Patients With Lower-Risk MDSAbstract 487: Randomized Phase II Trial of Reduced Treatment Durations of Hypomethylating Agents for Lower-Risk MDSPresenter: Rami Komrokji, MDSenior Member, Vice ChairSection Head – Leukemia and MDSDepartment of Malignant HematologyH. Lee Moffitt Cancer CenterProfessor of Oncologic SciencesUniversity of South FloridaTampa, FloridaContent based on an online CME program supported by educational grants from AstraZeneca, BeOne Medicines, Genentech, Geron Corporation, Incyte, Johnson & Johnson, Lilly, and Novartis Pharmaceuticals Corporation.Link to full program: https://bit.ly/48Ye45N Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/KFF865. CME/MOC/NCPD/AAPA/IPCE credit will be available until December 21, 2026.Turning the Tide in Gastric Cancer Management: Integrating Modern Systemic Therapies Across the Disease Continuum for Community-Based Clinicians In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/KFF865. CME/MOC/NCPD/AAPA/IPCE credit will be available until December 21, 2026.Turning the Tide in Gastric Cancer Management: Integrating Modern Systemic Therapies Across the Disease Continuum for Community-Based Clinicians In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/KFF865. CME/MOC/NCPD/AAPA/IPCE credit will be available until December 21, 2026.Turning the Tide in Gastric Cancer Management: Integrating Modern Systemic Therapies Across the Disease Continuum for Community-Based Clinicians In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/KFF865. CME/MOC/NCPD/AAPA/IPCE credit will be available until December 21, 2026.Turning the Tide in Gastric Cancer Management: Integrating Modern Systemic Therapies Across the Disease Continuum for Community-Based Clinicians In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/KFF865. CME/MOC/NCPD/AAPA/IPCE credit will be available until December 21, 2026.Turning the Tide in Gastric Cancer Management: Integrating Modern Systemic Therapies Across the Disease Continuum for Community-Based Clinicians In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by independent educational grants from AstraZeneca and Daiichi Sankyo, Inc.Disclosure information is available at the beginning of the video presentation.

Welcome back to the Ultimate Guide to Partnering® Podcast. AI agents are your next customers. Subscribe to our Newsletter: https://theultimatepartner.com/ebook-subscribe/ Check Out UPX:https://theultimatepartner.com/experience/ https://youtu.be/vEdq8rpBM3I In this data-rich keynote, Jay McBain deconstructs the tectonic shifts reshaping the $5.3 trillion global technology industry, arguing that we are entering a new 20-year cycle where traditional direct sales models are obsolete. McBain explains why 96% of the industry is now surrounded by partners and how successful companies must pivot from “flywheels and theory” to a granular strategy focused on the seven specific partners present in every deal. From the explosion of agentic AI and the $163 billion marketplace revolution to the specific mechanics of multiplier economics, this discussion provides a roadmap for navigating the “decade of the ecosystem” where influence, trust, and integration—not just product—determine winners and losers. Key Takeaways Half of today's Fortune 500 companies will likely vanish in the next 20 years due to the shift toward AI and ecosystem-led models. Every B2B deal now involves an average of seven trusted partners who influence the decision before a vendor even knows a deal exists. Microsoft has outpaced AWS growth for 26 consecutive quarters largely because of a superior partner-led geographic strategy. Marketplaces are projected to grow to $163 billion by 2030, with nearly 60% of deals involving partner funding or private offers. The “Multiplier Effect” is the new ROI, where partners can make up to $8.45 for every dollar of vendor product sold. Future dominance relies on five key pillars: Platform, Service Partnerships, Channel Partnerships, Alliances, and Go-to-Market orchestration. If you're ready to lead through change, elevate your business, and achieve extraordinary outcomes through the power of partnership—this is your community. At Ultimate Partner® we want leaders like you to join us in the Ultimate Partner Experience – where transformation begins. Keywords: Jay McBain, Canalys, partner ecosystem, channel chief, agentic AI, marketplace growth, multiplier economics, B2B sales trends, tech industry forecast, service partnerships, strategic alliances, Microsoft vs AWS, distribution transformation, managed services growth, SaaS platforms, customer journey mapping, 28 moments of truth, future of reselling, technology spending 2025, ecosystem orchestration, partner multipliers. T Transcript: Jay McBain WORKFILE FOR TRANSCRIPT [00:00:00] Vince Menzione: Just up from, did you Puerto Rico last night? Puerto Rico, yes. Puerto Rico. He dodged the hurricane. Um, you all know him. Uh, let him introduce himself for those of you who don’t, but just thrilled to have on the stage, again, somebody who knows more about what’s going on in, in the, and has the pulse on this industry probably than just about anybody I know personally. [00:00:21] Vince Menzione: J Jay McBain. Jay, great to see you my friend. Alright, thank you. We have to come all the way. We live, we live uh, about 20 minutes from each other. We have to come all the way to Reston, Virginia to see each other, right? That’s right. Very good. Well, uh, that’s all over to you, sir. Thank you. [00:00:35] Jay McBain: Alright, well thank you so much. [00:00:36] Jay McBain: I went from 85 degrees yesterday to 45 today, but I was able to dodge that, uh, that hurricane, uh, that we kind of had to fly through the northern edge of, uh, wanna talk today about our industry, about the ultimate partner. I’m gonna try to frame up the ultimate partner as I walk through the data and the latest research that, uh, that we’ve been doing in the market. [00:00:56] Jay McBain: But I wanted to start here ’cause our industry moves in 20 year cycles, and if you look at the Fortune 500 and dial back 20 years from today, 52% of them no longer exist. As we step into the next 20 year AI era, half of the companies that we know and love today are not gonna exist. So we look at this, and by the way, if you’re not in the Fortune 500 and you don’t have deep pockets to buy your way outta problems, 71% of tech companies fail over the course of 10 years. [00:01:30] Jay McBain: Those are statistics from the US government. So I start to look at our industry and you know, you may look at the, you know, mainframe era from the sixties and seventies, mini computers, August the 12th, 1981, that first IBM, PC with Microsoft dos, version one, you know, triggered. A new 20 year era of client server. [00:01:51] Jay McBain: It was the time and I worked at IBM for 17 years, but there was a time where Bill Gates flew into Boca Raton, Florida and met with the IBM team and did that, you know, fancy licensing agreement. But after, you know, 20 years of being the most valuable company in the world and 13 years of antitrust and getting broken up, almost like at and TIBM almost didn’t make payroll. [00:02:14] Jay McBain: 13 years after meeting Bill Gates. Yeah, that’s how quickly things change in these eras. In 1999, a small company outta San Francisco called salesforce.com got its start. About 10 years later, Jeff Bezos asked a question in a boardroom, could we rent out our excess capacity and would other companies buy it? [00:02:35] Jay McBain: Which, you know, most people in the room laughed at ’em at the time. But it created a 20 year cloud era when our friends, our neighbors, our family. Saw Chachi PT for the first time in March of 2023. They saw the deep fakes, they saw the poetry, they saw the music. They came to us as tech people and said, did we just light up Skynet? [00:02:58] Jay McBain: And that consumer trend has triggered this next 20 years. I could walk through the richest people in the world through those trends. I could walk through the most valuable companies. It all aligns. ’cause by the way, Apple’s no longer at the top. Nvidia is at the top, Microsoft. Second, things change really quickly. [00:03:17] Jay McBain: So in that course of time, you start to look at our industry and as people are talking about a six and a half or $7 trillion build out of ai, that’s open AI and Microsoft numbers, that is bigger than our industry that’s taken over 50 years to build. This year, we’re gonna finish the year at $5.3 trillion. [00:03:36] Jay McBain: That’s from the smallest flower shop to the biggest bank. Biggest governments that Caresoft would, uh, serve biggest customer in the world is actually the federal government of the us. But you look at this pie chart and you look at the changes that we’re gonna go through over the next 20 years, there’s about a trillion dollars in hardware. [00:03:54] Jay McBain: There’s about a trillion dollars in software. If you look forward through all of the merging trends, quantum computing, humanoid robots, all the things that are coming that dollar to dollar software to hardware will continue to exist all the way through. We see services making up almost two thirds of this pie. [00:04:13] Jay McBain: Yesterday I was in a telco conference with at and t and Verizon and T-Mobile and some of the biggest wireless players and IT services, which happen to be growing faster than products. At the moment, there is more work to be done wrapping around the deal than the actual products that the customer is buying. [00:04:32] Jay McBain: So in an industry that’s growing at 7%. On top of the world economy that’s grown at 2.2. This is the fastest growing industry, and it will be at least for the next 10 years, if not 2070 0.1% of this entire $5 trillion gets transacted through partners. While what we’re talking to today about the ultimate partner, 96% of this industry is surrounded by partners in one way or another. [00:05:01] Jay McBain: They’re there before the deal. They’re there at the deal. They’re there after the deal. Two thirds of our industry is now subscription consumption based. So every 30 days forever, and a customer for life becomes everything. So if every deal in medium, mid-market, and higher has seven partners, according to McKinsey, who are those seven people trying to get into the deal? [00:05:25] Jay McBain: While there’s millions of companies that have come into tech over the last 10 to 20 years. Digital agencies, accountants, legal firms, everybody’s come in. The 250,000 SaaS companies, a million emerging tech companies, there’s a big fight to be one of those seven trusted people at the table. So millions of companies and tens of millions of people our competing for these slots. [00:05:49] Jay McBain: So one of the pieces of research I’m most proud of, uh, in my analyst career is this. And this took over two years to build. It’s a lot of logos. Not this PowerPoint slide, but the actual data. Thousands of people hours. Because guess what? When you look at partners from the top down, the top 1000 partners, by capability and capacity, not by resale. [00:06:15] Jay McBain: It’s not a ranking of CDW and insight and resale numbers. It is the surrounding. Consulting, design, architecture, implementations, integrations, managed services, all the pieces that’s gonna make the next 20 years run. So when you start to look at this, 98% of these companies are private, so very difficult to get to those numbers and, uh, a ton of research and help from AI and other things to get this. [00:06:41] Jay McBain: But this is it. And if you look at this list, there’s a thousand logos out of the million companies. There’s a thousand logos that drive two thirds of all tech services in the world. $1.07 trillion gets delivered by a thousand companies, but here’s where it gets fun. Those companies in the middle, in blue, the 30 of them deliver more tech services than the next 970. [00:07:08] Jay McBain: Combined the 970 combined in white deliver more tech services. Then the next million combined. So if you think we live in an 80 20 rule or maybe a 99, a 95 5 rule, or a 99 1 rule, we actually live in a 99.9 0.1 parallel principle. These companies spread around the world evenly split across the uh, different regions. [00:07:35] Jay McBain: South Africa, Latin America, they’re all over. They split. They split among types. All of the Venn diagram I just showed from GSIs to VARs to MSPs, to agencies and other types of companies. But this is a really rich list and it’s public. So every company in the world now, if you’re looking at Transactable data, if you’re looking at quantifiable data that you can go put your revenue numbers against, it represents 70 to 80% of every company in this room’s Tam. [00:08:08] Jay McBain: In one piece of research. So what do you do below that? How do you cover a million companies that you can’t afford to put a channel account manager? You can’t afford to write programs directly for well after the top down analysis and all the wallet share and you know exactly where the lowest hanging fruit is for most of your tam. [00:08:28] Jay McBain: The available markets. The obtainable markets. You gotta start from the community level grassroots up. So you need to ask the question for the million companies and the maybe a hundred thousand companies out there, partner companies that are surrounding your customer. These are the seven partners that surround your customer. [00:08:48] Jay McBain: What do they read, where do they go, and who do they follow? Interestingly enough, our industry globally equates to only a thousand watering holes, a thousand companies at the top, a thousand places at the bottom. 35% of this audience we’re talking. Millions of people here love events and there’s 352 of them like this one that they love to go to. [00:09:13] Jay McBain: They love the hallway chats, they love the hotel lobby bar, you know, in a time reminded by the pandemic. They love to be in person. It’s the number one way they’re influenced. So if you don’t have a solid event strategy and you don’t have a community team out giving out socks every week, your competitors might beat you. [00:09:31] Jay McBain: 12% of this audience loves podcasts. It’s the Joe Rogan effect of our industry. And while you know, you may not think the 121 podcasts out there are important, well, you’re missing 12% of your audience. It’s over a million people. If you’re not on a weekly podcast in one of these podcasts in the world, there’s still people that read one of the 106 magazines in the world. [00:09:55] Jay McBain: There are people that love peer groups, associations, they wanna be part of this. There’s 15 different ways people are influenced. And a solid grassroots strategy is how you make this happen. In the last 10 years, we’ve created a number of billionaires. Bottom up. They never had to go talk to la large enterprise. [00:10:15] Jay McBain: They never had to go build out a mid-market strategy. They just went and give away socks and new community marketing. And this has created, I could rip through a bunch of names that became unicorns just in the last couple of years, bottoms up. You go back to your board walking into next year, top down, bottom up. [00:10:34] Jay McBain: You’ve covered a hundred percent of your tam, and now you’ve covered it with names, faces, and places. You haven’t covered it with a flywheel or a theory. And for 44 years, we have gone to our board every fourth quarter with flywheels and theory. Trust me, partners are important. The channel is key to us. [00:10:57] Jay McBain: Well, let’s talk at the point of this granularity, and now we’re getting supported by technology 261 entrepreneurs. Many of them in the room actually here that are driving this ability to succeed with seven partners in every deal to exchange data to be able to exchange telemetry of these prospects to be able to see twice or three times in terms of pipeline of your target addressable market. [00:11:26] Jay McBain: All these ai, um, technologies, agentic technologies are coming into this. It’s all about data. It’s all about quantifiable names, faces, and places. Now none of us should be walking around with flywheels, so let’s flip the flywheels. No. Uh, so we also look at, and I sold PCs for 17 years and that was in the high times of 40% margins for partners. [00:11:55] Jay McBain: But one interesting thing when you study the p and l for broad base of partners around the world, it’s changed pretty significantly in this last 20 year era. What the cloud era did is dropped hardware from what used to be 84% plus the break fix and things that wrap around it of the p and l to now 16% of every partner in the world. [00:12:16] Jay McBain: 84% of their p and l is now software and services. And if you look at profitability, it’s worse. It’s actually 87% is profitability wise. They’ve completely shifted in terms of where they go. Now we look at other parts of our market. I could go through every part of the pie of the slide, but we’re watching each of the companies, and if you can see here, this is what we want to talk about in terms of ultimate partner. [00:12:43] Jay McBain: Microsoft has outgrown AWS for 26 straight quarters. They don’t have a better product. They don’t have a better price, they don’t have better promotion. It’s all place. And I’ll explain why you guess here in the light green line. Exactly. The day that Google went a hundred percent all in partner, every deal, even if a deal didn’t have a partner, one of the 4% of deals that didn’t have a partner, they injected a partner. [00:13:09] Jay McBain: You can see on the left side exactly where they did it. They got to the point of a hundred percent partner driven. Rebuilt their programs, rebuilt their marketplace. Their marketplace is actually larger than Microsoft’s, and they grew faster than Microsoft. A couple of those quarters. It is a partner driven future, and now I have Oracle, which I just walked by as I walked from the hotel. [00:13:31] Jay McBain: Oracle with their RPOs will start to join. Maybe the list of three hyperscalers becomes the list of four in future slides, but that’s a growth slide. Market share is different. AWS early and commanding lead. And it plays out, uh, plays out this way. But we’re at an interesting moment and I stood up six years ago talking about the decade of the ecosystem after we went through a decade of sales starting in 1999 when we all thought we were born to be salespeople. [00:14:02] Jay McBain: We managed territories with our gut. The sales tech stack would have it different, that sales was a science, and we ended the decade 2009, looking at sales very differently in 2009. I remember being at cocktail parties where CMOs would be joking around that 50% of their marketing dollars were wasted. They just didn’t know which 50%. [00:14:23] Jay McBain: And I’ll tell you, that was really funny. In 2009 till every 58-year-old CMO got replaced by a 38-year-old growth hacker who walked in with 15,348 SaaS companies in their MarTech and ad tech stack to solve the problem, every nickel of marketing by 2019 was tracked. Marketo, Eloqua, Pardot, HubSpot, driving this industry. [00:14:50] Jay McBain: Now, we stood up and said the 28 moments that come before a sale are pretty much all partner driven. In the best case scenario, a vendor might see four of the moments. They might come to your website, maybe they read an ebook, maybe they have a salesperson or a demo that comes in. That’s four outta 28 moments. [00:15:10] Jay McBain: The other 24 are done by partners. Yeah, in the worst case scenario and the majority scenario, you don’t see any of the moments. All 28 happen and you lose a deal without knowing there ever was a deal. So this is it. We need to partner in these moments and we need to inject partners into sales and marketing, like no time before, and this was the time to do it. [00:15:33] Jay McBain: And we got some feedback in the Salesforce state of sales report, which doesn’t involve any partnerships or, or. Channel Chiefs or anything else. This is 5,500 of the biggest CROs in the world that obviously use Salesforce. 89% of salespeople today use partners every day. For the 11% who don’t, 58% plan two within a year. [00:15:57] Jay McBain: If you add those two numbers together, that’s magically the 96% number. They recognize that every deal has partners in it. In 2024, last year, half of the salespeople in the world, every industry, every country. Miss their numbers. For the minority who made their numbers, 84 point percent pointed to partners as the reason why they made their numbers. [00:16:21] Jay McBain: It was the cheat code for sales, so that modern salesperson that knows how to orchestrate a deal, orchestrate the 28 moments with the seven partners and get to that final spot is the winning formula. HubSpot’s number in separate research was 84% in marketing. So we’re starting to see partners in here. We don’t have to shout from the mountaintops. [00:16:44] Jay McBain: These communities like ultimate Partner are working and we’re getting this to the highest levels in the board. And I’ll say that, you know, when 20 years from now half of the companies we know and love fail after we’re done writing the book and blaming the CEO for inventing the thing that ended up killing them, blaming the board for fiduciary responsibility and letting it happen. [00:17:06] Jay McBain: What are the other chapters of the book? And I think it’s all in one slide. We are in this platform economy and the. [00:17:31] Jay McBain: So your battery’s fine. Check, check, check, check. Alright, I’ll, I’ll just hold this in case, but the companies that execute on all five of these areas, well. Not only today become the trillion dollar valued companies, but they become the companies of tomorrow. These will be the fastest growing companies at every level. [00:17:50] Jay McBain: Not only running a platform business, but participating in other platforms. So this is how it breaks out, and there are people at very senior levels, at very big companies that have this now posted in the office of the CEO winning on integrations is everything. We just went through a demographic shift this year where 51% of our buyers are born after 1982. [00:18:15] Jay McBain: Millennials are the number one buyer of the $5 trillion. Their number one buying criteria is not service. Support your price, your brand reputation, it’s integrations. The buy a product, 80% is good as the next one if it works better in their environment. 79% of us won’t buy a car unless it has CarPlay or Android Auto. [00:18:34] Jay McBain: This is an integration world. The company with the most integrations win. Second, there are seven partners that surround the customer. Highly trusted partners. We’re talking, coaching the customer’s, kids soccer team, having a cottage together up at the lake. You know, best men, bate of honors at weddings type of relationships. [00:18:57] Jay McBain: You can’t maybe have all seven, but how does Microsoft beat AWS? They might have had two, three, or four of them saying nice things about them instead of the competition. Winning in service partnerships and channel partnerships changes by category. If you’re selling MarTech, only 10% of it today is resold, so you build more on service partnerships. [00:19:18] Jay McBain: If you’re in cybersecurity today, 91.6% of it is resold. Transacted through partners. So you build a lot of channel partnerships, plus the service partnerships, whatever the mix is in your category, you have to have two or three of those seven people. Saying nice things about you at every stage of the customer journey. [00:19:38] Jay McBain: Now move over to alliances. We have already built the platforms at the hyperscale level. We’ve built the platforms within SaaS, Salesforce, ServiceNow, Workday, Marketo, NetSuite, HubSpot. Every buyer has a set of platforms that they buy. We’ve now built them in cybersecurity this year out of 6,500 as high as cyber companies, the top five are starting to separate. [00:20:02] Jay McBain: We built it in distribution, which I’ll show in a minute. We’re building it in Telco. This is a platform economy and alliances win and you have alliances with your competitors ’cause you compete in the morning, but you’re best friends by the afternoon. Winning in other platforms is just as important as driving your own. [00:20:20] Jay McBain: And probably the most important part of this is go to market. That sales, that marketing, the 28 moments, the every 30 days forever become all a partner strategy. So there’s still CEOs out there that believe platform is a UI or UX on a bunch of disparate products and things you’ve acquired. There’s still CFOs out there that Think platform is a pricing model, a bundle model of just getting everything under one, you know, subscription price or consumption price. [00:20:51] Jay McBain: And it’s not, platforms are synonymous with partnerships. This is the way forward and there’s no conversation around ai. That doesn’t involve Nvidia over there, an open AI over here and a hyperscaler over there and a SaaS company over here. The seven layer stack wins every single time, and the companies that get this will be the ones that survive this cycle. [00:21:16] Jay McBain: Now, flipping over to marketplaces. So we had written research that, um, about five years ago that marketplaces were going to grow at 82% compounded. Yeah, probably one of the most accurate predictions we ever made, because it happened, we, we predicted that, uh, we were gonna get up to about $85 billion. Well, now we’ve extended that to 2030, so we’re gonna get up to $163 billion, and the thing that we’re watching is in green. [00:21:46] Jay McBain: If 96% of these deals are partner assisted in some way, how is the economics of partnering going to work? We predicted that 50% of deals by 2027. Would be partner funded in some way. Private offers multi-partner offers distributor sellers of record, and now that extends to 59% by 2030, the most senior leader of the biggest marketplace AWS, just said to us they’re gonna probably make these numbers on their own. [00:22:14] Jay McBain: And he asked what their two competitors are doing. So he’s telling us that we under called this. Now when you look at each of the press releases, and this is the AWS Billion Dollar Club. Every one of the companies on the left have issued a press release that they’re in the billion dollar club. Some of them are in the multi-billions, but I want you to double click on this press release. [00:22:35] Jay McBain: I’m quoted in here somewhere, but as CrowdStrike is building the marketplace at 91% compounded, they’re almost doubling their revenue every single year. They’re growing the partner funding, in this case, distributor funding by 3548%. Almost triple digit growth in marketplace is translating into almost quadruple digit growth in funding. [00:23:01] Jay McBain: And you see that over and over again as, as Splunk hit three, uh, billion dollars. The same. Salesforce hit $2 billion on AWS in Ulti, 18 months. They joined in October 20, 23, and 18 months later, they’re already at $2 billion. But now you’re seeing at Salesforce, which by the way. Grew up to $40 billion in revenue direct, almost not a nickel in resell. [00:23:28] Jay McBain: Made it really difficult for VARs and managed service providers to work with Salesforce because they couldn’t understand how to add services to something they didn’t book the revenue for. While $40 billion companies now seeing 70% of their deals come through partners. So this is just the world that we’re in. [00:23:44] Jay McBain: It doesn’t matter who you are and what industry you’re in, this takes place. But now we’re starting to see for the first time. Partners join the billion dollar club. So you wonder about partnering and all this funding and everything that’s working through Now you’re seeing press releases and companies that are redoing their LinkedIn branding about joining this illustrious club without a product to sell and all the services that wrap around it. [00:24:10] Jay McBain: So the opening session on Microsoft was interesting because there’s been a number of changes that Microsoft has done just in the last 30 days. One is they cut distribution by two thirds going from 180 distributors to 62. They cut out any small partner lower than a thousand dollars, and that doesn’t sound like a lot, but that’s over a hundred thousand partners that get deed tightening the long tail. [00:24:38] Jay McBain: They we’re the first to really put a global point system in place three years ago. They went to the new commerce experience. If you remember, all kinds of changes being led by. The biggest company for the channel. And so when we’re studying marketplaces, we’re not just studying the three hyperscalers, we’re studying what TD Cynic is doing with Stream One Ingram’s doing with Advant Advantage Aerosphere. [00:25:01] Jay McBain: Also, we’re watching what PAX eight, who by the way, is the 365 bestseller for Microsoft in the world. They are the cybersecurity leader for Microsoft in the world and the copilot. Leader in the world for Microsoft and Partner of the Year for Microsoft. So we’re watching what the cloud platforms are doing, watching what the Telco are doing, which is 25 cents out of every dollar, if you remember that pie chart, watching what the biggest resellers are converting themselves into. [00:25:30] Jay McBain: Vince just mentioned, you know, SHI in the changes there watching the managed services market and the leaders there, what they’re doing in terms of how this industry’s moving forward. By the way, managed services at $608 billion this year. Is one and a half times larger than the SaaS industry overall. [00:25:48] Jay McBain: It’s also one and a half times larger than all the hyperscalers combined. Oracle, Alibaba, IBM, all the way down. This is a massive market and it makes up 15 to 20 cents of every dollar the customer spend. We’re watching that industry hit a trillion dollars by the end of the decade, and we’re watching 150 different marketplace development platforms, the distribution of our industry, which today is 70.1% indirect. [00:26:13] Jay McBain: We’re starting to see that number, uh, solidify in terms of marketplaces as well. Watching distributors go from that linear warehouse in a bank to this orchestration model, watching some of the biggest players as the world comes around, platforms, it tightens around the place. So Caresoft, uh, from from here is the sixth biggest distributor in the world. [00:26:40] Jay McBain: Just shows you how big the. You know, biggest client in the world is that they serve. But understand that we’re publishing the distributor 500 list, but it’ll be the same thing. That little group in blue in the middle today, you know, drives almost two thirds of the market. So what happens in all this next stage in terms of where the dollars change hands. [00:27:07] Jay McBain: And the economics of partnering themselves are going through the most radical shift that we’ve seen ever. So back to the nineties, and, and for those of you that have been channel chiefs and running programs, we went to work every day. You know, everything’s on fire. We’re trying to check hundred boxes, trying to make our program 10% better than our competitors. [00:27:30] Jay McBain: Hey, we gotta fix our deal registration program today, and our incentives are outta whack or training programs or. You know, not where they need to be. Our certification, you know, this was the life of, uh, of a channel chief. Everybody thought we were just out drinking in the Caribbean with our best partners, but we were under the weight of this. [00:27:49] Jay McBain: But something interesting has happened is that we turned around and put the customer at the middle of our programs to say that those 28 moments in green before the sale are really, really important. And the seven partners who participate are really important. Understanding. The customer’s gonna buy a seven layer stack. [00:28:09] Jay McBain: They’re gonna buy it With these seven partners, the procurement stage is much different. The growth of marketplaces, the growth of direct in some of these areas, and then long term every 30 days forever in a managed service, implementations, integrations, how you upsell, cross-sell, enrich a deal changes. So how would you build a program that’s wrapped around the customer instead of the vendor? [00:28:35] Jay McBain: And we’re starting to hear our partners shout back to us. These are global surveys, big numbers, but over half of our partners, regardless of type, are selling consulting to their customer. Over half are designing architecting deals. A third of them are trying to be system integrators showing up at those implementation integration moments. [00:28:55] Jay McBain: Two thirds of them are doing managed services, but the shocking one here is 44% of our partners, regardless of type, are coding. They’re building agents and they’re out helping their customer at that level. So this is the modern partner that says, don’t typecast me. You may have thought of me in your program. [00:29:14] Jay McBain: You might have me slotted as a var. Well, I do 3.2 things, and if I don’t get access to those resources, if you don’t walk me to that room, I’m not gonna do them with you. You may have me as a managed service provider that’s only in the morning. By the afternoon I’m coding, and by the next morning I’m implementing and consulting. [00:29:33] Jay McBain: So again, a partner’s not a partner. That Venn diagram is a very loose one now, as every partner on there is doing 3.2 different business models. And again, they’re telling us for 43 years, they said, I want more leads this year it changed. For the first time, I want to be recognized and incentivized as more than just a cash register for you. [00:29:57] Jay McBain: I want you to recognize when I’m consulting, when I’m designing, when you’re winning deals, because of my wonderful services, by the way, we asked the follow up question, well, where should we spend our money with you? And they overwhelmingly say, in the consulting stage, you win and lose deals. Not at moment 28. [00:30:18] Jay McBain: We’re not buying a pack of gum at the gas station. This is a considered purchase. You win deals from moment 12 through 16 and I’m gonna show you a picture of that later, and they say, you better be spending your money there, or you’re not gonna win your fair share or more than your fair share of deals. [00:30:36] Jay McBain: The shocking thing about this is that Microsoft, when they went to the point system, lifted two thirds of all the money, tens of billions of dollars, and put it post-sale, and we were all scratching our heads going. Well, if the partners are asking for it there, and it seems like to beat your biggest competitors, you want to win there. [00:30:54] Jay McBain: Why would you spend the money on renewal? Well, they went to Wall Street and Goldman Sachs and the people who lift trillions of dollars of pension funds and said, if we renew deals at 108%, we become a cash machine for you. And we think that’s more valuable than a company coming out with a new cell phone in September and selling a lot of them by Christmas every year. [00:31:18] Jay McBain: The industry. And by the way, wall Street responded, Microsoft has been more valuable than Apple since. So we talk in this now multiplier language, and these are reports that we write, uh, at AMIA at canals. But talking about the partner opportunity in that customer cycle, the $6 and 40 cents you can make for every dollar of consumption, or the $7 and 5 cents you can make the $8 and 45 cents you can make. [00:31:46] Jay McBain: There’s over 24 companies speaking at this level now, and guess what? It’s not just cloud or software companies. Hardware companies are starting to speak in this language, and on January 25th, Cisco, you know, probably second to Microsoft in terms of trust built with the channel globally is moving to a full point system. [00:32:09] Jay McBain: So these are the changes that happen fast. But your QBR with your partners now less about drinking beers at the hotel lobby bar and talking dollar by dollar where these opportunities are. So if you’re doing 3.2 of these things, let’s build out a, uh, a play where you can make $3 for every dollar that we make. [00:32:28] Jay McBain: And you make that profitably. You make it in sticky, highly retained business, and that’s the model. ’cause if you make $3 for every dollar. We make, you’re gonna win Partner of the year, and if you win partner of the year, that piece of glass that you win on stage, by the time you get back to your table, you’re gonna have three offers to buy your business. [00:32:51] Jay McBain: CDW just bought a w. S’s Partner of the Year. Insight bought Google’s eight time partner of the year. Presidio bought ServiceNow’s, partner of the year over and over and over again. So I’m at Octane, I’m at CrowdStrike, I’m at all these events in Vegas every week. I’m watching these partners of the year. [00:33:05] Jay McBain: And I’m watching as the big resellers. I’m watching as the GSIs and the m and a folks are surrounding their table after, and they’re selling their businesses for SaaS level valuations. Not the one-to-one service valuation. They’re getting multiples because this is the new future of our industry. This is platform economics. [00:33:25] Jay McBain: This is winning and platforms for partners. Now, like Vince, I spent 20 minutes without talking about ai, but we have to talk about ai. So the next 20 years as it plays out is gonna play out in phases. And the first thing you know to get it out of the way. The first two years since that March of 23, has been underwhelming, to say the least. [00:33:47] Jay McBain: It’s been disappointing. All the companies that should have won the biggest in AI have been the most disappointing. It’s underperformed the s and p by a considerable amount in terms of where we are. And it goes back to this. We always overestimate the first two years, but we underestimate the first 10. [00:34:07] Jay McBain: If you wanna be the point in time person and go look at that 1983 PC or the 1995 internet or that 2007 iPhone or that whatever point in time you wanna look at, or if you want to talk about hallucinations or where chat chip ET version five is version, as opposed to where it’s going to be as it improves every six months here on in. [00:34:30] Jay McBain: But the fact of the matter is, it’s been a consumer trend. Nvidia got to be the most valuable company in the world. OpenAI was the first company to 2 billion users, uh, in that amount of speed. It’s the fastest growing product ever in history, and it’s been a consumer win this trillions of dollars to get it thrown around in the press releases. [00:34:49] Jay McBain: They’re going out every day, you know, open ai, signing up somebody new or Nvidia, investing in somebody new almost every single day in hundreds of billions of dollars. It is all happening really on the consumer side. So we got a little bit worried and said, is that 96% of surround gonna work in ag agentic ai? [00:35:10] Jay McBain: So we went and asked, and the good news is 88% of end customers are using partners to work through their ag agentic strategy. Even though they’re moving slow, they’re actually using partners. But what’s interesting from a partner perspective, and this is new research that out till 2030. This is the number one services opportunity in the entire tech or telco industry. [00:35:34] Jay McBain: 35.3% compounded growth ending at $267 billion in services. Companies are rebuilding themselves, building out practices, and getting on this train and figuring out which vendors they should hook their caboose to as those trains leave the station. But it kind of plays out like this. So in the next three to five years, we’re in this generative, moving into agentic phase. [00:36:01] Jay McBain: Every partner thinks internally first, the sales and marketing. They’re thinking about their invoicing and billing. They’re thinking about their service tickets. They’re thinking about creating a business that’s 10% better than their competitors, taking that knowledge into their customers and drive in business. [00:36:17] Jay McBain: But we understand that ag agentic AI, as it’s going to play out is not a product. A couple of years ago, we thought maybe a copilot or an agent force or something was going to be the product that everybody needed to buy, and it’s not a product, it’s gonna show up as a feature. So you go back in the history of feature ads and it’s gonna show up in software. [00:36:38] Jay McBain: So if you’re calling in SMB, maybe you’re calling on a restaurant. The restaurant isn’t gonna call OpenAI or call Microsoft or call Nvidia directly. They’re running their restaurant. And they may have chosen a platform like Toast Square, Clover, whatever iPads people are running around with, runs on a platform that does everything in their business, does staffing, does food ordering, works with Uber Eats, does everything end to end? [00:37:08] Jay McBain: They’re gonna wait to one of those platforms, dries out agent AI for them, and can run the restaurant more effectively, less human capital and more consistently, but they wait for the SaaS platform as you get larger. A hundred, 150 people. You have vice presidents. Each of those vice presidents already have a SaaS stack. [00:37:28] Jay McBain: I talked about Salesforce, ServiceNow, Workday, et cetera. They’ve already built that seven layer model and in some cases it’s 70 layers. But the fact is, is they’re gonna wait for those SaaS layers to deliver ag agentic to them. So this is how it’s gonna play out for the next three and a half, three to five years. [00:37:45] Jay McBain: And partners are realizing that many of them were slow to pick up SaaS ’cause they didn’t resell it. Well now to win in this next three to half, three to five years, you’re gonna have to play in this environment. When you start looking out from here, the next generation, you know, kind of five through 15 years gets interesting in more of a physical sense. [00:38:06] Jay McBain: Where I was yesterday talking about every IOT device that now is internet access, starts to get access to large language models. Every little sensor, every camera, everything that’s out there starts to get smart. But there’s a point. The first trillionaire, I believe, will be created here. Elon’s already halfway there. [00:38:24] Jay McBain: Um, but when Bill Gates thought there was gonna be a PC in every home, and IBM thought they were gonna sell 10,000 to hobbyists, that created the richest person in the world for 20 years, there will be a humanoid in every home. There’s gonna be a point in time that you’re out having drinks with your friends, and somebody’s gonna say, the early adopter of your friends is gonna say. [00:38:46] Jay McBain: I haven’t done the dishes in six weeks. I haven’t done the laundry. I haven’t made my bed. I haven’t mowed the lawn. When they say that, you’re gonna say, well, how? And they’re gonna say, well, this year I didn’t buy a new car, but I went to the car dealership and I bought this. So we’re very close to the dexterity needed. [00:39:05] Jay McBain: We’ve got the large language models. Now. The chat, GPT version 10 by then is going to make an insane, and every house is gonna have one of the. [00:39:17] Jay McBain: This is the promise of ai. It’s not humanoid robots, it’s not agents. It’s this. 99% of the world’s business data has not been trained or tuned into models yet. Again, this is the slow moving business. If you want to think about the 99% of business data, every flight we’ve all taken in this room sits on a saber system that was put in place in 1964. [00:39:43] Jay McBain: Every banking transaction, we’ve all made, every withdrawal, every deposit sits on an IBM mainframe put in place in the sixties or seventies. 83% of this data sits in cold storage at the edge. It’s not ready to be moved. It’s not cleansed, it’s not, um, indexed. It’s not in any format or sitting on any infrastructure that a large language model will be able to gobble up the data. [00:40:10] Jay McBain: None of the workflows, none of the programming on top of that data is yet ready. So this is your 10 to 20 year arc of this era that chat bot today when they cancel your flight is cute. It’s empathetic, it feels bad for you, or at least it seems to, but it can’t do anything. It can’t book you the Marriott and get you an Uber and then a 5:00 AM flight the next morning. [00:40:34] Jay McBain: It can’t do any of that. But more importantly, it doesn’t know who you are. I’ve got 53 years of flights under my belt and they, I’m the person that get me within six hours of my kids and get me a one-way Hertz rental. You know, if there’s bad weather in Miami, get me to Tampa, get me a Hertz, I’m driving home, I’m gonna make it home. [00:40:56] Jay McBain: I’m not the 5:00 AM get me a hotel person. They would know that if they picked up the flights that I’ve taken in the past. Each of us are different. When you get access to the business data and you become ag agentic, everything changes. Every industry changes because of this around the customers. When you ask about this 35% growth, working on that data, working in traditional consulting and design and implementation, working in the $7 trillion of infrastructure, storage, compute, networking, that’s gonna be around, this is a massive opportunity. [00:41:30] Jay McBain: Services are gonna continue to outgrow products. Probably for the next five to 10 years because of this, and I’m gonna finish here. So we talked a lot about quantifying names, faces, places, and I think where we failed the most as ultimate partners is underneath the tam, which every one of our CEOs knows to the decimal point underneath the TAM that our board thinks they’re chasing. [00:41:59] Jay McBain: We’ve done a very poor job. Of talking about the available markets and obtainable markets underneath it, we, we’ve shown them theory. We’ve shown them a bunch of, you know, really smart stuff, and PowerPoint slides up the wazoo, but we’ve never quantified it for them. If they wanna win, if they want to get access, if they want to double their pipeline, triple their pipeline, if they wanna start winning more deals, if they wanna win deals that are three times larger, they close two times faster. [00:42:31] Jay McBain: And they renew 15% larger. They have to get into the available and obtainable markets. So just in the last couple weeks I spoke at Cribble, I spoke at Octane, I spoke at CrowdStrike Falcon. All three of those companies at the CEO level, main stage use those exact three numbers, three x, two x, 15%. That’s the language of platforms, and they’re investing millions and millions and millions of dollars on teams. [00:42:59] Jay McBain: To go build out the Sam Andal in name spaces and places. So you’ve heard me talk about these 28 moments a lot. They’re the ones that you spend when you buy a car. Some people spend one moment and they drive to the Cadillac dealership. ’cause Larry’s been, you know, taking care of the family for 50 years. [00:43:18] Jay McBain: Some people spend 50 moments like I do, watching every YouTube video and every, you know, thing on the internet. I clear the internet cover to cover. But the fact is, is every deal averages around these 28 moments. Your customer, there’s 13 members of the buying committee today. There’s seven partners and they’re buying seven things. [00:43:37] Jay McBain: There’s 27 things orchestrating inside these 28 moments. And where and how they all take place is a story of partnering. So a couple of years ago, canals. Latin for channel was acquired by amia, which is a part of Informa Tech Target, which is majority owned by Informa. All that being said, there’s hundreds of magazines that we have. [00:44:00] Jay McBain: There’s hundreds of events that we run. If somebody’s buying cybersecurity, they probably went to Black Hat or they probably went to GI Tech. One of these events we run, or one of the magazines. So we pick up these signals, these buyer intent signals as a company. Why did they wanna, um, buy a, uh, a Canals, which was a, you know, a small analyst firm around channels? [00:44:22] Jay McBain: They understood this as well. The 28 moments look a lot like this when marketers and salespeople are busy filling in the spots of every deal. And by the way, this is a real deal. AstraZeneca came in to spend millions of dollars on ASAP transformation, and you can start to see as the customer got smart. [00:44:45] Jay McBain: The eBooks, they read the podcasts, they listened to the events they went to. You start to see how this played out over the long term. But the thing we’ve never had in our industry is the light blue boxes. This deal was won and lost in December. In this particular case, NTT software won and Yash came in and sold the customer five projects. [00:45:07] Jay McBain: The millions of dollars that were going to be spent were solved here. The design and architecture work was all done here. A couple of ISVs You see in light blue came in right at the end, deal was closed in April. You see the six month cycle. But what if you could fill in every one of the 28 boxes in every single customer prospect that your sales and marketing team have? [00:45:30] Jay McBain: But here’s the brilliance of this. Those light blue boxes didn’t win the deals there. They won the deals months before that. So when NTT and Software one walked into this deal. They probably won the deal back in October and they had to go through the redlining. They had to go through the contracting, they had to go through all the stuff and the Gantt chart to get started. [00:45:54] Jay McBain: But while your CMO is getting all excited about somebody reading an ebook and triggering an MQL that the sales team doesn’t want, ’cause it’s not qualified, it’s not sales qualified, you walk in and say, no, no. This is a multimillion deal, dollar deal. It’s AstraZeneca. I know the five partners that are coming in in December to solidify the seven layers, and you’re walking in at the same time as the CMOs bragging about an ebook. [00:46:21] Jay McBain: This changes everything. If we could get to this level of data about every dollar of our tam, we not only outgrow our competitors, we become the platforms of the next generation. Partnering and ultimate partnering is all here. And this is what we’re doing in this room. This is what we’re doing over these couple of days, and this is what, uh, the mission that Vince is leading. [00:46:43] Jay McBain: Thank you so much. [00:46:47] Vince Menzione: Woo. Day in the house. Good to see you my friend. Good to see you. Oh, we’re gonna spend a couple minutes. Um, I’m put you in the second seat. We’re gonna put, we’re gonna make it sit fireside for a minute. Uh, that was intense. It was pretty incredible actually, Jay. And so I’m, I think I wanna open it up ’cause we only have a few minutes just to, any questions? [00:47:06] Vince Menzione: I’m sure people are just digesting. We already have one up here. See, [00:47:09] Question: Jay knows I’m [00:47:10] Vince Menzione: a question. I love it. We, I don’t think we have any I can grab a mic, a roving mic. I could be a roving mic person. Hold on. We can do this. This is not on. [00:47:25] Vince Menzione: Test, test. Yes it is. Yeah. [00:47:26] Question: Theresa Carriol dared me to ask a question and I say, you don’t have to dare me. You know, I’m going to Anyway. Um, so Jay, of the point of view that with all of the new AI players that strategic alliances is again having a moment, and I was curious your point of view on what you’re seeing around this emergence and trend of strategic alliances and strategic alliance management. [00:47:52] Question: As compared to channel management. And what are you seeing in terms of large vendors like AWS investing in that strategic alliance role versus that channel role training, enablement, measurement, all that good stuff? [00:48:06] Jay McBain: Yeah, it’s, it’s a great question. So when I told the story about toast at the restaurant or Square or Clover, they’re not call, they’re not gonna call open AI or Nvidia themselves either. [00:48:17] Jay McBain: When you look out at the 250,000 ISVs. That make up this AI stack, there is the layers that happen there. So the Alliance with AWS, the alliance they have with Microsoft or Google is going to be how they generate agent AI in their platforms. So when I talk about a seven layer stack, the average deal being seven layers, AI is gonna drive this to nine, and then 11, then probably 13. [00:48:44] Jay McBain: So in terms of how alliances work, I had it up there as one of the five core strategies, and I think it’s pretty even. You can have the best alliances in the world, but if the seven partners trusted by the customer don’t know what that alliance is and the benefits to the customer and never mention it, it’s all for Naugh. [00:49:00] Jay McBain: If you’re go-to market, you’re co-selling, your co-marketing strategies are not built around that alliance. It’s all for naught. If the integration and the co-innovation, the co-development, the all the co-creation work that’s done inside these alliances isn’t translated to customer outcomes, it’s all for naugh. [00:49:17] Jay McBain: These are all five parallel swim lanes. All five are absolutely critically needed. And I think they’re all five pretty equally weighted in terms of needing each other. Yes. To be successful in the era of platforms. Yeah. [00:49:32] Vince Menzione: And the problem is they’re all stove pipe today. If, if at all. Yeah. Maintained, right. [00:49:36] Vince Menzione: Alliances is an example. Channels and other example. They don’t talk to one another. Judge any, we’ve got a mic up here if anybody else has. Yep. We have some questions here, Jacqueline. [00:49:51] Question: So when we’re developing our channel programs, any advice on, you know, what’s the shift that we should make six months from now, a year from now? The historical has been bronze, silver, gold, right? And you’ve got your deal registration, but what’s the future look like? [00:50:05] Jay McBain: Yeah, so I mean, the programs are, are changing to, to the point where the customer should be in the middle and realizing the seven partners you need to win the deal. [00:50:15] Jay McBain: And depending on what category of product you’re in, security, how much you rely on resell, 91.6%. You know, the channel partners are gonna be critical where the customer spends the money. And if you’re adding friction to that process, you’re adding friction in terms of your growth. So you know, if you’re in cybersecurity, you have to have a pretty wide open reseller model. [00:50:39] Jay McBain: You have to have a wide open distribution model, and you have to make sure you’re there at that point of sale. While at the same time, considering the other six partners at moment 12 who are in either saying nice things about you or not, the customer might even be starting with you. ’cause there is actually one thing that I didn’t mention when I showed the 28 moments filled in. [00:51:00] Jay McBain: You’ll notice that the customer went to AWS twice direct. AWS lost the deal. Microsoft won the deal software. One is Microsoft’s biggest reseller in the world. They just acquired crayon. NTT who, who loves both had their Microsoft team go in. [00:51:18] Question: Mm. [00:51:19] Jay McBain: So I think that they went to AWS thinking it was A-W-S-S-A-P, you know, kind of starting this seven layer stack. [00:51:25] Jay McBain: I think they finished those, you know, critical moments in the middle looking at it. And then they went back to AWS kind of going probably WWTF. Yeah. What we thought was happening isn’t actually the outcome that was painted by our most trusted people. So, you know, to answer your question, listen to your partners. [00:51:43] Jay McBain: They want to be recognized for the other things they’re doing. You can’t be spending a hundred percent of the dollars at the point of sale. You gotta have a point of system that recognizes the point of sale, maybe even gold, silver, bronze, but recognizing that you’re paying for these other moments as well. [00:51:57] Jay McBain: Paying for alliances, paying for integrations and everything else, uh, in the cyber stack. And, um, you know, recognizing also the top 1000. So if I took your tam. And I overlaid those thousand logos. I would be walking into 2026 the best I could of showing my company logo by logo, where 80% of our TAM sits as wallet share, not by revenue. [00:52:25] Jay McBain: Remember, a million dollar partner is not a million dollar partner. One of them sells 1.2 million in our category. We should buy them a baseball cap and have ’em sit in the front row of our event. One of them sells $10 million and only sells our stuff if the customer asks. So my company should be looking at that $9 million opportunity and making sure my programs are writing the checks and my coverage. [00:52:48] Jay McBain: My capacity and capability planning is getting obsessed over that $9 million. My farmers can go over there, my hunters can go over here, and I should be submitting a list of a thousand sorted in descending order of opportunity. Of where my company can write program dollars into. [00:53:07] Vince Menzione: Great answer. All right. I, I do wanna be cognizant of time and the, all the other sessions we have. [00:53:14] Vince Menzione: So we’ll just take one other question if there are any here and if not, we’ll let I know. Jay, you’re gonna be mingling around for a little while before your flight. I’m [00:53:21] Jay McBain: here the whole day. [00:53:22] Vince Menzione: You, you’re the whole day. I see that Jay’s here the whole day. So if you have any other questions and, and, uh, sharing the deck is that. [00:53:29] Vince Menzione: Yep. Alright. We have permission to share the deck with the each of you as well. [00:53:34] Jay McBain: Alright, well thank you very much everyone. Jay. Great to have you.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into the significant events of 2025, a year marked by pivotal scientific breakthroughs, regulatory changes, and industry trends that have reshaped drug development and patient care.One of the standout advancements was Novo Nordisk gaining FDA approval for an oral version of Wegovy, a glucagon-like peptide-1 (GLP-1) receptor agonist for obesity management. This marks a notable shift in treatment accessibility, as it provides an easier alternative to injectables for those managing weight and cardiovascular risks. This development could significantly enhance patient adherence and broaden access to this critical therapy.However, not all news was positive. Pfizer faced a challenging situation when a patient death occurred in the extension of their Hympavzi hemophilia study. Such incidents highlight the intrinsic risks of clinical trials, especially within gene therapy realms where safety monitoring is paramount. These events remind us of the delicate balance between innovation and patient safety in advanced biologic therapies.In legal news, Johnson & Johnson was ordered by a Baltimore jury to pay $1.56 billion in a talc-related cancer case. This ruling underscores heightened scrutiny on product safety and consumer protection within the pharmaceutical industry, potentially influencing future litigation and regulatory measures.Clinical trial outcomes also presented mixed results. Neurocrine Biosciences' Ingrezza did not meet efficacy endpoints in its phase 3 trial for cerebral palsy-related dyskinesia. Although it is approved for other movement disorders, this setback reflects the complexities involved in expanding drug indications. Such challenges highlight ongoing hurdles in translating preclinical successes into clinical realities.Despite geopolitical tensions, particularly between China and the U.S., Chinese biotech firms thrived, maintaining robust deal activity. China's continued growth as an innovation hub is driven by strategic investments and collaborations that bolster global drug development efforts, underscoring its increasing influence in life sciences.Regulatory landscapes also shifted with proposals from the Center for Medicare & Medicaid Innovation to align U.S. drug prices with international rates under Medicare Parts B and D. These proposed models could significantly impact pricing strategies and market dynamics within the U.S., requiring pharmaceutical companies to adapt while ensuring equitable access to medications.Ethical challenges surfaced as six individuals were charged with insider trading involving biotech stocks. Such incidents highlight the necessity for stringent ethical standards and regulatory oversight to maintain investor confidence and market integrity.Meanwhile, AstraZeneca's extended partnership with Niowave for actinium-225 supply reflects an interest in radiopharmaceuticals as targeted cancer therapies. This collaboration highlights the potential of radiopharmaceuticals in oncology, opening promising avenues for precision medicine approaches.As 2025 closes, it's clear that this year has been one of both triumphs and trials for the pharmaceutical and biotech industries. Scientific innovations like Novo Nordisk's oral GLP-1 receptor agonist offer new hope for patients, yet challenges such as clinical trial setbacks and legal battles indicate ongoing hurdles in drug development and commercialization. These developments will likely influence industry strategies and regulatory policies as we advance into 2026.The sustained momentum of China's biotech industry amid global trade tensions remains notable. This trend reflects China's strategic investments in biotech capabilities and its growing role in global markets despite geopolitical frictions.In clinical research, Hope BioscienceSupport the show

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world.In a dynamic landscape marked by both advancements and challenges, the pharmaceutical and biotech sectors continue to evolve with notable scientific, regulatory, and strategic updates. Ipsen's recent $1 billion acquisition of Simcere's preclinical LRRC15-targeting asset underscores a growing focus on antibody-drug conjugates (ADCs). These conjugates leverage the targeted action of antibodies combined with the cytotoxic effects of drugs, representing a promising approach to cancer treatment by potentially minimizing systemic toxicity. Ipsen's strategic move reflects its commitment to expanding its oncology portfolio and staying competitive within the rapidly advancing ADC landscape.AstraZeneca has been active in its pursuit of innovative cancer treatments. The company has invested $100 million in Jacobio's clinical-stage pan-KRAS inhibitor, a promising development targeting KRAS mutations prevalent in various cancers. This investment aligns with AstraZeneca's strategy to tackle challenging oncogenic targets. However, their efforts faced a setback as their Phase 3 trial for ceralasertib, an ATR inhibitor for lung cancer, failed to meet its primary endpoint. Despite this setback, AstraZeneca maintains confidence by investing significantly in promising areas like KRAS inhibitors, highlighting the inherent risks involved in pioneering novel therapeutic strategies, particularly those aiming to overcome resistance mechanisms in immuno-oncology.BioMarin has quietly discontinued its liver disease candidate amid a $4.8 billion deal with Amicus. This decision points to the complex nature of pipeline prioritization and resource allocation within high-stakes financial environments. The company's strategic shifts reflect ongoing evaluations of their development priorities in light of evolving market demands.Boehringer Ingelheim has demonstrated a commitment to renal therapeutics with a $448 million investment in Rectify Pharmaceuticals for a preclinical chronic kidney disease program. This partnership seeks to address significant unmet medical needs within kidney disease treatment. Meanwhile, Gilead Sciences has entered into a $35 million licensing agreement with Assembly Biosciences for herpes simplex virus (HSV) assets, diversifying its infectious disease portfolio and expanding its reach within antiviral therapies.Novo Holdings-backed Windward Bio's acquisition of rights to Qyun's clinical-stage immunology bispecifics for $700 million highlights robust activity in the immunology space. Bispecific antibodies are gaining traction due to their ability to target two antigens simultaneously, offering enhanced therapeutic efficacy. This acquisition illustrates ongoing interest in this area as companies seek innovative solutions to complex immunological challenges.The broader industry is also witnessing strategic partnerships such as Aditum Bio's launch of a new biotech venture with Fosun Pharma. This collaboration aims to foster novel therapies through a synergistic blend of biotechnology innovation and pharmaceutical expertise. These alliances reflect an industry trend towards collaborative efforts that leverage diverse strengths to advance therapeutic development.In regulatory news, nine major pharmaceutical companies have reached agreements with the U.S. government to lower certain drug prices in exchange for tariff relief. This development signals ongoing negotiations aimed at balancing drug affordability with industry sustainability amid growing scrutiny over pricing practices.In December 2025, significant developments emerged, impacting scientific innovation, regulatory approvals, mergers, and strategic partnerships across the industry. Notably, the U.S. Food and Drug Administration (FDA) granted early approval to Cytokinetics' MyqorzSupport the show

For episode 659 of the BlockHash Podcast, host Brandon Zemp is joined by Vijit Katta, CEO & Co-founder of Tria. Vijit Katta is the CEO and Co-founder of Tria, with over a decade of experience across entrepreneurship, commercial strategy, and early-stage investing. He built Polygon's in-house accelerator, funding early-stage projects; founded a healthtech startup in Austria, and led commercial strategy for multiple 9-figure portfolios at GSK and AstraZeneca; he holds a CS degree from BITS Pilani and an MBA from INSEAD. Tria is a self-custodial neobank that unifies spending, trading, and earning across all chains — without bridges, gas, or custodians. Built for both humans and AI, Tria makes money programmable, enabling anyone or any agent to transact natively on-chain. Powered by its interoperability layer, BestPath AVS, Tria abstracts away the complexity of crypto to deliver instant, global, and autonomous finance. 

Returning guest Dean McAlister, EVP, Inizio Biotech, has spent over 35 years in Fortune 500 pharma leadership, including nearly 3 decades at AstraZeneca. Hear how to prepare to lead in an uncertain environment, how to develop conscious competence as a leadership skill, how to become more adaptable as a leader, how to stop your ego from getting in the way as a leader, and how to build the courage to say what needs to be said in meetings. Connect with Shirley at ShirleyKavanagh.com and on LinkedIn, and Dean on LinkedIn

Pablo García, director general de Divacons-Alphavalue, repasa lo más destacado en Europa: Rheinmetall, Astrazeneca, Telecom Italia y la industria automovilística.

This podcast brings you highlights from Scrip Awards 2025, including wins for AstraZeneca, Syndax, Akeso and Summit Therapeutics and the Lifetime Achievement Award for Flagship Pioneering's Noubar Afeyan.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of groundbreaking advancements, revealing a landscape rich with scientific innovation and strategic maneuvers poised to impact patient care and the drug development pipeline.Let's start with Johnson & Johnson's recent FDA approval for a subcutaneous version of Rybrevant, their lung cancer medication. This new formulation offers a more convenient administration method compared to AstraZeneca's Tagrisso, intensifying competition in the non-small cell lung cancer market. The shift towards more patient-friendly delivery systems underscores the industry's commitment to enhancing treatment adherence and convenience. In contrast, Insmed faced a setback with its phase 2 trial for Brinsupri in treating chronic rhinosinusitis without nasal polyps. The discontinuation of this program highlights the unpredictable nature of clinical trials and emphasizes the need for rigorous scientific validation before advancing therapeutic candidates.Meanwhile, Lilly has shown promising results with its oral obesity pill, marking significant progress in weight management therapies. Patients transitioning from injectable GLP-1 therapies to Lilly's oral drug candidate maintained substantial weight loss, positioning Lilly favorably against Novo Nordisk's Wegovy. The potential for oral formulations to revolutionize treatment paradigms in chronic conditions cannot be understated. Lilly's progress in obesity treatment with its oral medication orforglipron further cements its competitive edge. Participants in their Phase III clinical trial maintained weight loss after switching from Wegovy or Zepbound to orforglipron, suggesting an efficacious oral alternative to injectable treatments and potentially enhancing patient adherence.On the regulatory front, the Biosecure Act's progression within a major defense spending bill could impose new challenges for life sciences companies with Chinese affiliations. This legislative shift reflects geopolitical tensions impacting global pharmaceutical collaborations and underscores the importance of regulatory compliance in international partnerships. Similarly, Intercept Pharmaceuticals' restructuring following the withdrawal of Ocaliva from the U.S. market is indicative of strategic pivots in response to regulatory hurdles and evolving market dynamics.In dermatology, Takeda's successful phase 3 trials for Zasocitinib highlight the competitive nature of drug development as multiple players vie for market share within therapeutic areas. Their anticipated 2026 FDA filing underscores the prolonged timelines involved in bringing novel therapies to market despite successful clinical outcomes.Public-private collaborations continue to play a crucial role in vaccine development, as evidenced by Moderna's pandemic influenza vaccine advancement into phase 3 trials with support from the Coalition for Epidemic Preparedness Innovations (CEPI). This $54 million investment illustrates ongoing efforts to bolster pandemic preparedness through innovative mRNA technologies. Meanwhile, Moderna's $54 million funding from CEPI to advance its bird flu vaccine highlights resilience amidst fluctuating governmental support. This endeavor leverages Moderna's mRNA technology platform, emphasizing mRNA's versatility across various infectious diseases.Shifting our focus slightly, medical groups have expressed opposition to changes in hepatitis B vaccination recommendations by the CDC for newborns. Such policy debates have significant implications for public health strategies and highlight ongoing discussions within medical communities regarding optimal vaccination protocols.GSK's strategic collaboration with Camp4 Therapeutics marks another key industry development. With an investment exceeding $400 million, GSK aims to Support the show

In this podcast episode, Jeremy S. Abramson, MD, MMSc, reviews data from select presentations in lymphomas at the ASH 2025 Annual Meeting and provides perspectives on the clinical implications of these data for patients with chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), and diffuse large B-cell lymphoma (DLBCL), including:CLL17: randomized phase III trial of continuous ibrutinib vs fixed-duration venetoclax plus obinutuzumab or venetoclax plus ibrutinib for untreatedCLL BRUIN CLL-313: randomized phase III trial of pirtobrutinib vs BR for previously untreated patients with CLLBRUIN CLL-314: pirtobrutinib vs ibrutinib in treatment-naive and BTKi-naive R/R CLL/SLL EPCORE-FL-1: randomized phase III trial of epcoritamab with rituximab and lenalidomide vs rituximab and lenalidomide for R/R FLSTARGLO: 3-year follow-up data from the randomized phase III trial of glofitamab plus GemOx vs rituximab plus GemOx for patients with R/R DLBCLPresenter: Jeremy S. Abramson, MD, MMScProfessor of MedicineHarvard Medical SchoolDirector, Center for LymphomaMass General Brigham Cancer InsBoston, MassachusettsContent based on an online CME program supported by educational grants from AstraZeneca, BeOne Medicines, Genentech, Geron Corporation, Incyte, Johnson & Johnson, Lilly, and Novartis Pharmaceuticals Corporation.Link to full program:https://bit.ly/4aqMobZ Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Today's guest is Robert Wenier, Global Head of Cloud and Infrastructure at AstraZeneca. Robert leads enterprise cloud, infrastructure, and platform strategy across a highly regulated, data-intensive global organization. Robert joins Emerj CEO and Head of Research Daniel Faggella to discuss how enterprise data and AI architectures are shifting from service-oriented and microservice models toward emerging agentic architectures that prioritize end-to-end business outcomes over stepwise technical execution. The conversation explores why AI is moving from a supporting role to a direct driver of competitive advantage, and how this changes expectations for infrastructure, data strategy, and leadership ownership. Want to share your AI adoption story with executive peers? Click emerj.com/expert2 for more information and to be a potential future guest on the 'AI in Business' podcast! If you've enjoyed or benefited from some of the insights of this episode, consider leaving us a five-star review on Apple Podcasts, and let us know what you learned, found helpful, or liked most about this show! Watch Daniel and Robert's conversation on our new YouTube Channel: youtube.com/@EmerjAIResearch.

“People are not looking for a perfect, polished answer. They're looking for a human to speak to them like a human,” says Jessica Malaty Rivera, an infectious disease epidemiologist and one of the most trusted science communicators in the U.S. to emerge from the COVID-19 pandemic. That philosophy explains her relatable, judgement-free approach to communications which aims to make science more human, more accessible and less institutional. In this wide-ranging Raise the Line discussion, host Lindsey Smith taps Rivera's expertise on how to elevate science understanding, build public trust, and equip people to recognize disinformation. She is also keen to help people understand the nuances of misinformation -- which she is careful to define – and the emotional drivers behind it in order to contain the “infodemics” that complicate battling epidemics and other public health threats. It's a thoughtful call to educate the general public about the science of information as well as the science behind medicine. Tune in for Rivera's take on the promise and peril of AI-generated content, why clinicians should see communication as part of their professional responsibility, and how to prepare children to navigate an increasingly complex information ecosystem.Mentioned in this episode:de Beaumont Foundation If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

In this episode, Hanny Al-Samkari, MD, gives his thoughts on 5 key presentations from ASH 2025, and provides perspectives on the clinical implications of these data for patients with nonmalignant hematologic disorders such as ITP and vWD, including: LBA-2: Primary results from VAYHIT2, a randomized, double-blind, phase III trial of ianalumab plus eltrombopag vs placebo plus eltrombopag in patients with primary immune thrombocytopenia (ITP) who failed first-line corticosteroid treatmentAbstract 844: Secondary analysis results from VAYHIT3, a phase II study of ianalumab in patients with primary immune thrombocytopenia previously treated with at least 2 lines of therapyAbstract 5: Deciphering the dilemma: intravenous (IV) iron use in iron deficiency anemia during acute infectionsAbstract 308: Subcutaneous, every-4-week maintenance dosing of a novel protein S antibody is well tolerated and substantially reduces bleeding rates: results from a phase I/II multidose study of VGA039 in patients with von Willebrand diseaseAbstract 841: Immune thrombocytopenia in patients treated with immune checkpoint inhibitorsPresenter:Hanny Al-Samkari, MDThe Peggy S. Blitz Endowed Chair in Hematology/OncologyCo-Director, Hereditary Hemorrhagic Telangiectasia Center of ExcellenceMassachusetts General HospitalAssociate Professor of MedicineHarvard Medical SchoolBoston, MassachusettsContent based on an online CME program supported by educational grants from AstraZeneca, BeOne Medicines, Genentech, Geron Corporation, Incyte, Johnson & Johnson, Lilly, and Novartis Pharmaceuticals Corporation.Link to full program:https://bit.ly/48Ye45N Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This week on Careers in Discovery, we're joined by Peter Hamley, Founder and CEO of Scripta Therapeutics.  Peter didn't follow the typical founder path. After a long and successful career in big pharma R&D and business development, he made the leap into Biotech with a mission: to unlock the potential of transcription factors in treating neurodegenerative diseases. What followed was a complete mindset shift - from structure and scale to agility and risk.  In this episode, Peter shares the thinking behind Scripta's unique approach to drug discovery, how his experience at Sanofi and AstraZeneca shaped his leadership style, and why failure, iteration, and clarity of purpose are more important now than ever. 

JCO PO author Dr. Shilpa Gupta at Cleveland Clinic Children's Hospital shares insights into her article, "Fibroblast Growth Factor Receptor 3 (FGFR3) Alteration Status and Outcomes on Immune Checkpoint Inhibitors (ICPI) in Patients with Metastatic Urothelial Carcinoma". Host Dr. Rafeh Naqash and Dr. Gupta discuss how FGFR3 combined with TMB emerged as a biomarker that may be predictive for response to ICPI in mUC. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and Associate Professor at the OU Health Stephenson Cancer Center. Today I am excited to be joined by Dr. Shilpa Gupta, Director of Genitourinary Medical Oncology at the Cancer Institute and co-leader of the GU Oncology Program at the Cleveland Clinic, and also lead author of the JCO PO article titled "Fibroblast Growth Factor Receptor 3 Alteration Status and Outcomes on Immune Checkpoint Inhibitors in Patients With Metastatic Urothelial Carcinoma." At the time of this recording, our guest's disclosures will be linked in the transcript. Shilpa, welcome again to the podcast. Thank you for joining us today. Dr. Shilpa Gupta: Thank you, Rafeh. Honor to be here with you again. Dr. Rafeh Naqash: It is nice to connect with you again after two years, approximately. I think we were in our infancy of our JCO PO podcast when we had you first time, and it has been an interesting journey since then. Dr. Shilpa Gupta: Absolutely. Dr. Rafeh Naqash: Well, excited to talk to you about this article that you published. Wanted to first understand what is the genomic landscape of urothelial cancer in general, and why should we be interested in FGFR3 alterations specifically? Dr. Shilpa Gupta: Bladder cancer or urothelial cancer is a very heterogeneous cancer. And while we find there is a lot of mutations can be there, you know, like BRCA1, 2, in HER2, in FGFR, we never really understood what is driving the cancer. Like a lot of old studies with targeted therapies did not really work. For example, we think VEGF can be upregulated, but VEGF inhibitors have not really shown definite promise so far. Now, FGFR3 receptor is the only therapeutic target so far that has an FDA approved therapy for treating metastatic urothelial cancer patients, and erdafitinib was approved in 2019 for patients whose tumors overexpressed FGFR3 mutations, alterations, or fusions. And in the landscape of bladder cancer, it is important because in patients with non-muscle invasive bladder cancer, about 70 to 80% patients can have this FGFR3. But as patients become metastatic, the alterations are seen in, you know, only about 10% of patients. So the clinical trials that got the erdafitinib approved actually used archival tumor from local cancer. So when in the real world, we don't see a lot of patients if we are trying to do metastatic lesion biopsies. And why it is important to know this is because that is the only targeted therapy available for our patients right now. Dr. Rafeh Naqash: Thank you for giving us that overview. Now, on the clinical side, there is obviously some interesting data for FGFR3 on the mutation side and the fusion side. In your clinical practice, do you tend to approach these patients differently when you have a mutation versus when you have a fusion? Dr. Shilpa Gupta: We can use the treatment regardless of that. Dr. Rafeh Naqash: I recently remember I had a patient with lung cancer, squamous lung cancer, who also had a synchronous bladder mass. And the first thought from multiple colleagues was that this is metastatic lung. And interestingly, the liquid biopsy ended up showing an FGFR3-TACC fusion, which we generally don't see in squamous lung cancers. And then eventually, I was able to convince our GU colleagues, urologists, to get a biopsy. They did a transurethral resection of this tumor, ended up being primary urothelial and synchronous lung, which again, going back to the FGFR3 story, I saw in your paper there is a mention of FGFR3-TACC fusions. Anything interesting that you find with these fusions as far as biology or tumor behavior is concerned? Dr. Shilpa Gupta: We found in our paper of all the patients that were sequenced that 20% had the pathognomonic FGFR3 alteration, and the most common were the S249C, and the FGFR3-TACC3 fusion was in 45 patients. And basically I will say that we didn't want to generate too much as to fusion or the differences in that. The key aspect of this paper was that historically there were these anecdotal reports saying that patients who have FGFR alterations or mutations, they may not respond well to checkpoint inhibitors because they have the luminal subtype. And these were backed by some preclinical data and small anecdotal reports. But since then, we have seen that, and that's why a lot of people would say that if somebody's tumor has FGFR3, don't give them immunotherapy, give them erdafitinib first, right? So then we had this Phase 3 trial called the THOR trial, which actually showed that giving erdafitinib before pembrolizumab was not better. That debunked that myth, and we are actually reiterating that because in our work we found that patients who had FGFR3 alterations or fusions, and if they also have TMB-high, they actually respond very well to single agent immunotherapy. And that is, I think, very important because it tells us that we are not really seeing that so-called potential of resistance to immunotherapy in these patients. So to answer your question, yeah, we did see those differences, but I wouldn't say that any one marker is more prominent. Dr. Rafeh Naqash: The analogy is kind of similar to what we see in lung cancer with these mutations called STK11/KEAP1, which are also present in some other tumors. And one of the questions that I don't think has been answered is when you have in lung cancer, if you extrapolate this, where doublet or single agent immunotherapy doesn't do as well in tumors that are STK11 mutated. But then if you have a high TMB, question is does that TMB supersede or trump the actual mutation? Could that be one reason why you see the TMB-high but FGFR3 altered tumors in your dataset responding or having better outcomes to immunotherapy where potentially there is just more neoantigens and that results in a more durable or perhaps better response to checkpoint therapy? Dr. Shilpa Gupta: It could be. But you know, the patients who have FGFR alterations are not that many, right? So we have already seen that just patients with TMB-high respond very well to immunotherapy. Our last podcast was actually on that, regardless of PD-L1 that was a better predictor of response to immunotherapy. So I think it's not clear if this is adding more chances of response or not, because either way they would respond. But what we didn't see, which was good, that if they had FGFR3, it's not really downplaying the fact that they have TMB-high and that patients are not responding to immunotherapy. So we saw that regardless, and that was very reassuring. Dr. Rafeh Naqash: So if tomorrow in your clinic you had an individual with an FGFR3 alteration but TMB-high, I guess one could be comfortable just going ahead with immunotherapy, which is what the THOR trial as you mentioned. Dr. Shilpa Gupta: Yes, absolutely. And you know, when you look at the toxicity profiles of pembrolizumab and erdafitinib, really patients really struggle with using the FGFR3 inhibitors. And of course, if they have to use it, we have to, and we reserve it for patients. But it's not an easy drug to tolerate. Currently the landscape is such that, you know, frontline therapy has now evolved with an ADC and immunotherapy combinations. So really if patients progress and have FGFR3 alterations, we are using erdafitinib. But let's say if there were a situation where a patient has had chemotherapy, no immunotherapy, and they have FGFR3 upregulation and TMB-high, yes, I would be comfortable with using only pembrolizumab. And that really ties well together what we saw in the THOR trial as well. Dr. Rafeh Naqash: Going to the clinical applications, you mentioned a little bit of this in the manuscript, is combination therapies. You alluded to it a second back. Everything tends to get combined with checkpoint therapy these days, as you've seen with the frontline urothelial, pembrolizumab with an ADC. What is the landscape like as far as some of these FGFR alterations are concerned? Is it reasonable to combine some of those drugs with immune checkpoint therapy? And what are some of the toxicity patterns that you've potentially seen in your experience? Dr. Shilpa Gupta: So there was indeed a trial called the NORSE trial. It was a randomized trial but not a comparative cohort, where they looked at FGFR altered patients. And when they combined erdafitinib plus cetrelimab, that did numerically the response rates were much higher than those who got just erdafitinib. So yeah, the combination is definitely doable. There is no overlapping toxicities. But unfortunately that combination has not really moved forward to a Phase 3 trial because it's so challenging to enroll patients with such kind of rare mutations on large trials, especially to do registration trials. And since then the frontline therapy has evolved to enfortumab vedotin and pembrolizumab. I know there is an early phase trial looking at a next generation FGFR inhibitor. There is a triplet combination looking in Phase 1 setting with a next generation FGFR inhibitor with EV-pembro. However, it's not a randomized trial. So you know, I worry about such kinds of combinations where we don't have a path for registration. And in the four patients that have been treated, four or five patients in the early phase as a part of basket trial, the toxicities were a lot, you know, when you combine the EV-pembro and an FGFR3 inhibitor, we see more and more toxicity. So the big question is do we really need the "kitchen sink" approach when we have a very good doublet, or unless the bar is so high with the doublet, like what are we trying to add at the expense of patient toxicity and quality of life is the big question in my mind. Dr. Rafeh Naqash: Going back to your manuscript specifically, there could be a composite biomarker. You point out like FGFR in addition to FGFR TMB ends up being predictive prognostic there. So that could potentially be used as an approach to stratify patients as far as treatment, whether it's a single agent versus combination. Maybe the TMB-low/FGFR3 mutated require a combination, but the TMB-high/FGFR mutated don't require a combination, right? Dr. Shilpa Gupta: No, that's a great point, yeah. Dr. Rafeh Naqash: But again, very interesting, intriguing concepts that you've alluded to and described in this manuscript. Now, a quick take on how things have changed in the bladder cancer space in the last two years. We did a podcast with you regarding some biomarkers as you mentioned two years back. So I really would like to spend the next minute to two to understand how have things changed in the bladder cancer space? What are some of the exciting things that were not there two years back that are in practice now? And how do you anticipate the next two years to be like? Maybe we'll have another podcast with you in another two years when the space will have changed even more. Dr. Shilpa Gupta: Certainly a lot has happened in the two years, you know. EV-pembro became the universal frontline standard, right? We have really moved away from cisplatin eligibility in metastatic setting because anybody would benefit from EV-pembro regardless of whether they are candidates for cisplatin or not, which historically was relevant. And just two days ago, we saw that EV-pembro has now been approved for localized bladder cancer for patients who are cisplatin ineligible or refusing. So, you know, this very effective regimen moving into earlier setting, we now have to really think of good treatment options in the metastatic setting, right? So I think that's where a lot of these novel combinations may come up. And what else we've seen is in a tumor agnostic trial called the DESTINY-PanTumor trial, patients who had HER2 3+ on immunohistochemistry, we saw the drug approval for T-DXd, and I think that has kind of reinvigorated the interest in HER2 in bladder cancer, because in the past targeting HER2 really didn't work. And we still don't know if HER2 is a driver or not. And at ESMO this year, we saw an excellent study coming out of China with DV which is targeting HER2, and toripalimab, which is a Chinese checkpoint inhibitor, showing pretty much similar results to what we saw with EV-pembro. Now, you know, not to do cross-trial comparisons, but that was really an amazing, amazing study. It was in the presidential session. And I think the big question is: does that really tell us that HER2-low patients will not benefit? Because that included 1+, 2+, 3+. So that part we really don't know, and I think we want to study from the EV-302 how the HER2 positive patients did with EV and pembro. So that's an additional option, at least in China, and hopefully if it gets approved here, there is a trial going on with DV and pembro. And lastly, we've seen a very promising biomarker, like ctDNA, for the first time in bladder cancer in the adjuvant setting guiding treatment with adjuvant atezolizumab. So patients who were ctDNA positive derived overall survival and recurrence-free survival benefit. So that could help us select moving forward with more studies. We can spare unnecessary checkpoint inhibitors in patients who are not going to benefit. So I think there is a lot happening in our field, and this will help do more studies because we already have the next generation FGFR inhibitors which don't have the toxicities that erdafitinib comes with. And combining those with these novel ADCs and checkpoint inhibitors, you know, using maybe TMB as a biomarker, because we really need to move away from PD-L1 in bladder cancer. It's shown no utility whatsoever, but TMB has. Dr. Rafeh Naqash: Well, thank you so much, Shilpa, for that tour de force of how things have changed in bladder cancer. There used to be a time when lung and melanoma used to lead this space in terms of the number of approvals, the biomarker development. It looks like bladder cancer is shifting the trend at this stage. So definitely exciting to see all the new changes that are coming up. I'd like to spend another minute and a half on your career. You've obviously been a leader and example for many people in the GU space and beyond. Could you, for the sake of our early career especially, the trainees and other listeners, describe how you focused on things that you're currently leading as a leader, and how you shaped your career trajectory over the last 10 years? Dr. Shilpa Gupta: That's a really important question, Rafeh, and you and I have had these discussions before, you know, being an IMG on visas like you, and being in different places. I think I try to make the most of it, you know, instead of focusing on the setbacks or the negative things. Like tried to grab the opportunities that came along. When I was at Moffitt, got to get involved with the Phase 1 trial of pembrolizumab in different tumor types. And just keeping my options open, you know, getting into the bladder cancer at that time when I wanted to really do only prostate, but it was a good idea for me to keep my options open and got all these opportunities that I made use of. I think an important thing is to, like you said, you know, have a focus. So I am trying to focus more on biomarkers that, you know, we know that 70% patients will respond to EV-pembro, right? But what about the remaining 30%? Like, so I'm really trying to understand what determines hyperprogressors with such effective regimens who we really struggle with in the clinic. They really don't do well with anything we give them after that. So we are doing some work with that and also trying to focus on PROs and kind of patient-reported outcomes. And a special interest that I've now developed and working on it is young-onset bladder cancer. You know, the colorectal cancer world has made a lot of progress and we are really far behind. And bladder cancer has historically been a disease of the elderly, which is not the case anymore. We are seeing patients in their 30s and 40s. So we launched this young-onset bladder cancer initiative at a Bladder Cancer Advocacy Network meeting and now looking at more deep dive and creating a working group around that. But yeah, you know, I would say that my philosophy has been to just take the best out of the situation I'm in, no matter where I am. And it has just helped shape my career where I am, despite everything. Dr. Rafeh Naqash: Well, thank you again. It is always a pleasure to learn from your experiences and things that you have helped lead. Appreciate all your insights, and thank you for publishing with JCO PO. Hopefully we will see more of your biomarker work being published and perhaps bring you for another podcast in a couple of years. Dr. Shilpa Gupta: Yeah, thank you, Rafeh, for the opportunity. And thanks to JCO PO for making these podcasts for our readers. So thanks a lot. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. DISCLOSURES Dr. Shilpa Gupta Stock and Other Ownership Interests: Company: BioNTech SE,  Nektar Consulting or Advisory Role: Company: Gilead Sciences, Pfizer, Merck, Foundation Medicine, Bristol-Myers Squibb/Medarex, Natera, Astellas Pharma, AstraZeneca, Novartis, Johnson & Johnson/Janssen Research Funding: Recipient: Your Institution Company: Bristol Myers Squibb Foundation, Merck, Roche/Genentech, EMD Serono, Exelixis, Novartis, Tyra Biosciences, Pfizer, Convergent Therapeutics, Acrivon Therapeutics, Flare Therapeutics, Amgen Travel, Accommodations, Expenses: Company: Pfizer, Astellas Pharma, Merck    

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into a series of significant updates that are shaping the future of healthcare, patient care, and drug development.The U.S. Food and Drug Administration has been particularly active recently, granting Johnson & Johnson a National Priority Review Voucher for its multiple myeloma drug combination. This move highlights the importance of J&J's treatment in addressing unmet needs within oncology, a field continuously striving for innovative solutions. These vouchers expedite the review process, reflecting a broader commitment to accelerating the availability of critical therapies for patients who need them most.Continuing with regulatory advancements, AstraZeneca and Daiichi Sankyo's Enhertu, in combination with Roche's Perjeta, has gained FDA approval as a first-line treatment for unresectable or metastatic HER2-positive breast cancer. This breakthrough is supported by late-stage study results demonstrating a 44% reduction in disease progression or death compared to standard care. The approval signifies not only progress in breast cancer therapeutics but also underscores the potential benefits of strategic collaborations in drug development. Such partnerships are increasingly vital as they aim to optimize therapeutic efficacy through shared expertise and resources.In contrast to these advancements, Pfizer is facing financial recalibrations with projected revenues for 2026 estimated to decline due to diminishing COVID-19 vaccine sales and patent expirations. This situation reflects broader industry challenges as companies navigate post-pandemic market dynamics and patent cliffs, forcing reevaluations of long-term strategies.On another front, Gilead Sciences continues to push boundaries in HIV treatment with a promising single-tablet regimen combining bictegravir and lenacapavir. This innovation targets underserved segments within the HIV market, offering streamlined treatment options that could enhance patient adherence and outcomes significantly.Shifting focus to obesity management, Novo Nordisk's oral semaglutide is emerging as a highly anticipated medication among primary care providers. This trend highlights a growing preference for oral GLP-1 therapies as convenient alternatives to injectable formulations, marking a shift in how obesity—a major public health concern—is managed.The importance of regulatory compliance remains evident as Novo Nordisk received an FDA warning letter concerning manufacturing issues at an Indiana site previously owned by Catalent. This incident underscores the necessity for rigorous quality control in pharmaceutical manufacturing, which can have far-reaching implications on operational dynamics and supply chains.The FDA is also pioneering efforts to incorporate real-world evidence into medical device submissions by opening pathways for extensive deidentified datasets from sources like national cancer registries and electronic health records. This policy shift aims to integrate diverse data sources into the evidentiary foundation for medical device evaluations, potentially fostering innovation within this sector.In line with collaborative efforts, Genentech has partnered with Caris Life Sciences in a multi-year agreement valued at up to $1.1 billion, emphasizing the strategic importance of integrating diagnostic advancements with therapeutic developments to achieve precision medicine goals.Meanwhile, Yarrow Bioscience has acquired an autoimmune thyroid disease drug from China's Gensci, exemplifying a growing trend of cross-border collaborations aimed at leveraging global innovation ecosystems to address diverse therapeutic areas. This acquisition is part of a $1.37 billion deal, reinforcing the globalization of biotech partnerships as companies seek access to novel therapeutics andSupport the show

In this podcast episode, Amir T. Fathi, MD, reviews data from select presentations in leukemias at the ASH 2025 Annual Meeting, and provides perspectives on the clinical implications of these data for patients with acute myeloid leukemia (AML) or chronic myeloid leukemia (CML), including:Abstract 6: Phase II PARADIGM trial of azacitidine and venetoclax vs conventional intensive chemotherapy for fit patients with newly diagnosed AMLAbstract 47: Phase I/II SAVE trial of revumenib plus decitabine/cedazuridine and venetoclax in the cohort of patients with newly diagnosed AMLAbstract 766: Phase Ib KOMET-007 trial of ziftomenib in combination with venetoclax and azacitidine in newly diagnosed NPM1-mutant AMLAbstract 654: Phase I/II VICEROY trial of venetoclax and azacitidine + gilteritinib in patients with newly diagnosed FLT3-mutated AML ineligible for intensive induction chemotherapyAbstract 903: 3-Yr Update of the phase II FASCINATION trial of asciminib and conventional BCR::ABL1 inhibitors in newly diagnosed CMLAbstract 906: Phase II ASC2ESCALATE trial of asciminib in patients with chronic-phase CML after 1 prior TKIPresenter:Amir T. Fathi, MDDirector, Leukemia ProgramMassachusetts General HospitalAssociate Professor of MedicineHarvard Medical SchoolBoston, MassachusettsContent based on an online CME program supported by educational grants from AstraZeneca, BeOne Medicines, Genentech, Geron Corporation, Incyte, Johnson & Johnson, Lilly, and Novartis Pharmaceuticals Corporation.Link to full program:https://bit.ly/48Ye45N Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

“Delivering a baby one day and holding a patient's hand at the end of life literally the next day...that continuity is very powerful,” says Dr. Jen Brull, board chair of the American Academy of Family Physicians (AAFP). And as she points out, that continuity also builds trust with patients, an increasingly valuable commodity when faith in medicine and science is declining. As you might expect given her role, Dr. Brull believes strengthening family medicine is the key to improving health and healthcare. Exactly how to do that is at the heart of her conversation with host Lindsey Smith on this episode of Raise the Line, which covers ideas for payment reform, reducing administrative burdens, and stronger support for physician well-being. And with a projected shortage of nearly forty thousand primary care physicians, Dr. Brull also shares details on AAFP's “Be There First” initiative which is designed to attract service-minded medical students – whom she describes as family physicians at heart -- early in their educational journey. “I have great hope that increasing the number of these service-first medical students will fill part of this gap.”Tune-in for an informative look at a cornerstone of the healthcare system and what it means to communities of all sizes throughout the nation.  Mentioned in this episode:AAFP If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Dr. Pedro Barata and Dr. Ravin Garg discuss strategies to increase trial representation, including leveraging trial navigators and prioritizing pragmatic trial models, as featured in the ASCO Educational Book article, "Practical Guide to Clinical Trial Accessibility: Making Trial Participation a Standard of Care." TRANSCRIPT Dr. Pedro Barata: Hello, and welcome to By the Book, a podcast from ASCO featuring compelling perspectives from authors and editors of the ASCO Educational Book. I'm Dr. Pedro Barata. I am a medical oncologist at University Hospital Seidman Cancer Center and an associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I am also the associate editor of the ASCO Educational Book. We know that in recent years, the oncology community has increasingly prioritized the need to modernize clinical trial eligibility, reduce patient burden, and enhance diversity in trial participation. On that note, today we will be speaking about ways to enhance access to clinical trials with Dr. Ravin Garg. He is a hematologist oncologist at Maryland Oncology Hematology and also an assistant professor of oncology at Johns Hopkins Hospital in Baltimore. Dr. Garg is also the co-author of a fantastic paper in the ASCO Educational Book titled, "Practical Guide to Clinical Trial Accessibility: Making Trial Participation a Standard of Care."  Dr. Garg, welcome. Thanks for being here, and congrats on your paper. Dr. Ravin Garg: Thank you for having me, Pedro. I am excited to be here. Dr. Pedro Barata: [KI1]  Your paper is a wonderful, multidisciplinary piece that actually features perspectives from the different stakeholders, right? The patient advocacy, industry, community practice, and academia about these challenges in making trials more available. This podcast is a wonderful platform. It reaches out to a lot of folks within our community. So, I will start by asking you the obvious. Why do you think it is a must read for our community, for our listeners? Dr. Ravin Garg: So Pedro, thanks again for inviting me. You do a great job with these podcasts.  So, I think first and foremost, oncologists right now are under a lot of stress, just in terms of clinical volume. There is concern for research money, and how we get the best care for our patients. So I think this article is very important because it helps bring together, as you had mentioned, the stakeholders throughout academic to community practice and everywhere in between, and try to find how, as a team with different oncologists who partake in different aspects of oncology, can come together to streamline the process to try to get our patients on trials, or certainly have them have availability of trials, just if they are interested in going on them. Being in practice, we have had several challenges that we can talk about throughout this podcast, but I think it is a very important paper because it recognizes that at the end of the day, it takes a team effort for all of us in academics, community, industry, and pharmaceuticals to really come together as a team to really help put forth the trials for our patients. Dr. Pedro Barata: So, from the perspective of a community oncologist, how do you put together, or maybe you can describe some of the challenges that you see to increase trial participation in the community? Dr. Ravin Garg: Yes, Pedro, that is a great question, and it is something that I keep on thinking about and trying to find ways to be better at it myself. But I will say some of the challenges as a community doctor that I have seen for myself and talking to other colleagues. Number one, I do think there is a lot of stress on doctors in the community in general, Pedro. Oftentimes we are tasked to see a wide smorgasbord of patients, so we may not have the luxury of being a specialist in any particular tumor subtype. Like oftentimes, we will have to see lung cancer, the next one will be breast cancer, the next one could be CML, the next one could be thrombocytopenia. And as you know better than I do, Pedro, the field in each one of these disciplines is changing so rapidly: molecular genomics, radioligand treatments, different imaging tests, MRD testing for some of our hematologic malignancies. And I think one challenge we have in community is just keeping up with the basics of Oncology 101. In the process of doing that, it can be very difficult to sometimes remember that we have very exciting trials available for our patients. So, I think a lot of it is the day in and day out of being an oncologist is so taxing at times that oftentimes a research trial is not the first thing in our head space when we see a patient. I think number two, Pedro, at least in the community, and perhaps this is with academics too, is that we are bombarded, I would say, by a lot of messaging these days. We have in-baskets to go through, labs to go through, things of that nature. And in the process of a patient visit, seeing them, doing an exam, taking a history, trying to go over the NCCN guidelines on best practice for how to manage their care, at least for me at times, it is very hard to remember, "Hey, there might be a great trial available, whether within our network or maybe partnering with an academic center." So getting through a day can be fraught with a lot of peril and just difficulties, I would say. And I would say number three, Pedro, at least as, you know, I am in a private practice where I do see a wide range of benign and malignant hematology and solid tumors, so I would not call myself a specialist. And I think the challenge with that, at least for trials, Pedro, is that when you are a specialist or perhaps you are focusing on a couple of disease subtypes, you become more of an authoritative voice in those types of tumors, and you might be more aware of the trials within your network or perhaps in proxy with an academic center that you can offer your patient. So I think when sometimes we spread ourselves too thin, it can be very hard to be a thought leader, if you will, in a particular subtype of a malignancy, let's say, and maybe not be aware of a trial that could be really well-suited for your patient. In terms of ideas that myself and colleagues have had in terms of helping mitigate against some of these, I would say, setbacks or issues in the practice for trial enrollment, some of the things we have talked about, Pedro, is, number one, is we do partner with academic centers. So we live here in Maryland. We have several really fantastic academic centers. So, you know, oftentimes, not just within our practice of Maryland Oncology Hematology, we have a lot of great trials available here too, for certain, but in addition to that, we will often times work with doctors at Georgetown, Johns Hopkins, and Maryland if they have a compelling trial that we do not have within our network. It is really of the patient's interest, Pedro, to reach out to them in a collaborative manner to see if they have a trial that might be really compelling for your patient. So I do find myself collaborating a lot with colleagues in, like talented like yourself in academics. You know, I think you do a lot of GU malignancies. So as an example, like partnering with colleagues who are GU experts and say, "Hey, we have a patient with stage IV renal cell. These are the standard options I know, but are there any trials that you might have available?" I think the other thing that has been very helpful for us is having navigators within research, Pedro. Like as an example, what has really helped the uptake of trial enrollment for our center in Annapolis is having a research navigator because often times what they can do is, a priori, Pedro, before you see the patient and you are kind of formulating a standard of care treatment plan perhaps, they might tug you on the shirt and say, "Hey, we have a great trial here through Sarah Cannon, or there might be something else out there." And being aware of that when you go into a patient's room really provides a nice arena, if you will, to go and say, "The standard of care is here, but hey, we have a trial option that might be well suited for you, maybe perhaps even better, that we can talk about, too." So having research support in the community is really a huge boon, I think, Pedro, for us to really increase our enrollment for patients onto trials. Dr. Pedro Barata: Yes, I really love that, Ravin. So, let me switch gears a bit. I would love for you to talk a little bit about patient advocacy because they do play a huge role in cancer, and they address many barriers. How do you think we should leverage the patient advocacy groups to reduce patient burden and maybe have them really leverage patient advocacies to improve representation in clinical trials? What do we think we can do more? Dr. Ravin Garg: Oh, Pedro, I think they are very critically important. As a clinical oncologist now, and I would say this is for anyone in the field of medicine, you are exactly right. I think patients are bombarded by information. There are a lot of things online, whether it be TikTok, Facebook, Google, Yahoo, and people really just have a lot of information given to them. And some of it is fact driven, and some of it is not, Pedro. And oftentimes, I do think there can be at times a mistrust with some medical personnel. I think we are in an era where we are seeing that to some degree with some attributes of medicine. And I think of it as an opportunity for education for the patient and for myself as a physician. And I think patient advocates, to your point, which was well taken, serve as a bridge to both. And what I mean is that, you know, patient advocates are wonderful. They are, I think, outstanding communicators. They almost are a neutral party, Pedro, where many patients feel that they are an independent source of information that is free of bias, if you will. They are there to provide support, emotional support, scientific support for patients so they can make an informed decision. So, in terms of our practice right now, patient advocates is something that we are evolving in that capacity, I would say, Pedro. I think now more than ever, having more people as bridges of communication with care providers along with patients is of critical importance. And I would venture a guess, and I think this has been published, where patient advocates really can help tremendously in familiarizing patients with trials and what they are all about and maybe clear up some misconceptions of what trials, what the mission of trials are. Because I do think some patients, at least I have had a few over the years, where when they hear the term trial, they almost think they are being experimented upon, when, in point of fact, they could really help advance their care. That messaging along the way for some can may be mixed up a little bit. And so I think patient advocates is a really great way to offer more information for patients with a source they find very independent and trustworthy, if you will. And it can really help expedite, and I think make a more fruitful conversation for care providers, whether academic or community, and they might be more open-minded in terms of enrolling onto a trial. Dr. Pedro Barata: Wonderful. Yes, I agree. I agree with you completely.  So let's focus a little bit now on the folks designing the studies. We usually call them the sponsors. It might be an academic sponsorship, if you will, but we can also have pharma being the sponsor of a study. The angle from an academic design, it is not necessarily the same as what happens when we have pharma. And from that angle, how do you think a more inclusive research can be promoted? Dr. Ravin Garg: Oftentimes with trials, I think keeping them simple, as simple as we can. And what I mean by that is, often times for trials, Pedro, even for care providers who are enrolling, it can be daunting when there are a lot of different things involved, particularly, let's say, for investigator sponsored, which are incredibly brilliant science, incredible, but it can be a little bit daunting for patients and even the referring physician to talk about getting translational specimens, imaging, traveling to certain centers to get scans and biopsies and even different diagnostic testing like PSMA testing for, you know, prostate cancer. And it can, I think, be very intimidating for patients in terms of what might be required of him or her to enter onto a trial. Like, "This is not what I signed up for. This is laborious. This is a full time job for me. Do I have to pay for parking to go to a city? Do I have to pay for these imaging tests? And do I have to stay in a place for my family to enroll onto a trial?" So I think keeping trials as simple as possible, but yet cull the data we need as investigators where we can really advance the care, hopefully get approval for a drug, but also learn more about the medication and how it works for our patients. So I think simplifying language for trial is very important. I know when I have gone over studies for patients, Pedro, if it is a voluminous amount of information, they can right away get very intimidated. "Like, oh my goodness, this is like a term paper for college again," you know? I am joking, but you know, keeping language simplified is very important, I think, number one. And I feel that sometimes when they are asked to do a lot of different diagnostic testing, which is very important for translational work, I 100% understand, but I do think sometimes patients can get a little bit off put, if you will, and frustrated with the whole process of doing it. The second thing for our patients, Pedro, that they have mentioned to us when we put them on trials, not just within our own site but elsewhere, is that it takes a lot of time in terms of collecting information, perhaps a washout period from their last standard of treatment prior to enrollment onto a study. Many patients, Pedro, as you know better than I do, are in maybe crisis in terms of their health and their cancer might be growing, promulgating out of control, and they worry about not being able to expeditiously start onto a treatment, onto a trial. So that can lead to a lot of frustration. And one thing that you brought up, which was outstanding for me, is the enrollment criterion for some of our patients is felt to be somewhat strict. We have had some patients who may have had a remote history of a stage I malignancy that was by all accounts in remission, you know, let's say 4 or 5 years in the past, and the risk of recurrence at this point would be incredibly low, but they may not be able to enter onto a study because of some stringent criterion put forth. And that can be a little bit frustrating. In fact, I have had one or two patients who, as an example, with kidney issues, but the GFR was about 60, like right near a cutoff that oftentimes, as you know, we use where you can get into trial or not. And you know, if they are at 58, as an example, and otherwise they are a picture of health, a great candidate for a trial that will likely advance their care, and if the entry criterion is too stringent, that might be a lost opportunity for all parties involved, all stakeholders, if you will. I do appreciate the criterion for entry onto studies cannot be too liberalized. You have to have a certain baseline, but there is a little bit of a gray area and tension, of sorts, if you will, where the patient has a comorbid illness that is a disqualifying offense, but in practicality, perhaps it shouldn't be, especially if they are motivated and there is an opportunity to really advance their care. We have run into, not often, but sometimes in the past, I should say, where patients have been very off put because we try to get them onto a study and there may have been a particular feature or attribute in their underlying care that they couldn't get onto it. So I think having a little bit more thoughtfulness, perhaps, in terms of entry criterion and practicality, if you will, I think would really help enrollment onto studies. Dr. Pedro Barata: Really well said. Is there anything else that you would like to tell our listeners before we wrap up the podcast today? Dr. Ravin Garg: I would say just macroscopically speaking, it is really an honor to be an oncologist. I think I speak for both of us. Anyone listening who is thinking about the field, it is tremendous. Just the research, the bravery of our patients, and the thoughtfulness of our scientists like Pedro and translationalists and clinical trialists is really awe inspiring. So I have really loved this field. I will say from a trial perspective, we really need to enter as many patients as we can onto trials because the science is so brilliant now, the genomic underpinnings of the tumor, we are making great strides as a team of clinicians and scientists, translationalists. So the more that we can get people onto trials and get approved drugs, it is going to help them out in the end. So I think it is such an important time for all of us to come together as a community, find the best way to help our patients out. And clinical trials have to be at the forefront of how we can continue to advance care for our patients. Dr. Pedro Barata: Yeah, no Ravin, I really agree with you. We really need to increase access to clinical studies, and actually your paper is a great step in that direction by raising awareness, bringing up solutions, and again, collaboration, collaboration, collaboration is really a multidisciplinary effort to accomplish that.  Thank you so much for sharing your fantastic thoughts and insights with us. Dr. Ravin Garg: Thank you, Pedro. I am- you do a wonderful job with these podcasts. I am really honored to meet you and to be part of this. Dr. Pedro Barata: And thank you to our listeners for your time today. I encourage you to check out Dr. Garg's article in the 2025 ASCO Educational Book. We will post a link to the paper in our show notes. And please join us again next month on By the Book for more insights on key advances and innovations that are shaping modern oncology. Thank you for your attention. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:          Dr. Pedro Barata   @PBarataMD    Dr. Ravin Garg Follow ASCO on social media:          @ASCO on X      ASCO on Bluesky     ASCO on Facebook       ASCO on LinkedIn       Disclosures:       Dr. Pedro Barata:   Stock and Other Ownership Interests: Luminate Medical   Honoraria: UroToday   Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon   Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas   Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck    Dr. Ravin Garg: Patents, Royalties, Other Intellectual Property: Creator, editor, and writer of hemeoncquestions.com  

“This is a time to reimagine public health and public health/healthcare system integration,” says Dr. Deb Houry, the former chief medical officer for the US Centers for Disease Control and Prevention. In this thoughtful Raise the Line conversation, Dr. Houry reflects on unprecedented federal action in vaccine guidance and other issues since her noteworthy resignation from the CDC in August, and sees a more decentralized landscape emerging where states and localities play a larger role in providing public health recommendations. And while she acknowledges upsides to this shift, she's also concerned what the absence of a national consensus on health standards could mean. “Diseases don't recognize borders, and it's also important that people have equitable access to preventative services, vaccines, and other things,” she tells host Lindsey Smith. Tune in for Dr. Houry's seasoned perspective on this consequential moment in public health, and her encouraging message for learners and early career providers considering a career in the sector.Mentioned in this episode:DH Leadership & Strategy Solutions If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

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