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4 episodes with cancer moonshot
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4 episodes with cancer moonshot
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3 episodes with cancer moonshot
2 episodes with cancer moonshot
Former President Joe Biden has been diagnosed with an aggressive form of prostate cancer that has spread to his bones. The news came Sunday in a statement from his office detailing a Gleason score of 9 — the most severe grade for this cancer. It means it's fast-moving and deadly serious. Doctors say it's hormone-sensitive, which opens the door for treatment. But make no mistake — cancer that reaches the bones is not curable. The 82-year-old has long championed cancer research, after losing his son Beau to brain cancer in 2015. In office, he revived the Cancer Moonshot and pushed to cut U.S. cancer deaths in half over the next 25 years. Now, he's facing the very disease he once vowed to end. Former Vice President Kamala Harris, President Donald Trump, former President Barack Obama and former Secretary of State Hillary Clinton all offered public well-wishes. Learn more about your ad choices. Visit megaphone.fm/adchoices
Send us a textDr. Catharine Young, Ph.D. recently served as Assistant Director of Cancer Moonshot Policy and International Engagement at the White House Office of Science and Technology Policy ( https://www.whitehouse.gov/ostp/ ) where she served at OSTP to advance the Cancer Moonshot ( https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative ), with a mission to decrease the number of cancer deaths by 50% over the next 25 years. Dr. Young's varied career has spanned a variety of sectors including academia, non-profit, biotech, and foreign government, all with a focus on advancing science. Dr. Young previously served as Executive Director of the SHEPHERD Foundation, where she championed rare cancer research and drove critical policy changes. Her work has also included fostering interdisciplinary collaborations and advancing the use of AI, data sharing, and clinical trial reform to accelerate cancer breakthroughs.Dr. Young's leadership in diplomacy and innovation includes roles such as Senior Director of Science Policy at the Biden Cancer Initiative and Senior Science and Innovation Policy Advisor at the British Embassy, where she facilitated international agreements to enhance research collaborations. A Presidential Leadership Scholar and TED Fellow, Dr. Young holds a Ph.D. in Biomedical Sciences and completed her post-doctorate work in Biomedical Engineering at Cornell University and is recognized for her ability to bridge science, policy, and advocacy to build sustainable, impactful health ecosystems.#CatharineYoung #OSTP #WhiteHouseOfficeOfScienceAndTechnologyPolicy #CancerMoonshot #SHEPHERDFoundation #BidenCancerInitiative #DepartmentOfDefense #BritishEmbassy #Neurogenetics #AntimicrobialResistance #GlobalHealthSecurityAgenda #OneHealth #RareCancers #ChildhoodCancer #RareDisease #ForeignAndCommonwealthOffice #BiologicalThreats #MitigationStrategies #RiskMitigation #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #ViralPodcast #STEM #Innovation #Technology #Science #ResearchSupport the show
In this episode of Lab Rats to Unicorns, we welcome Dede Willis, co-founder and CEO of Orbit Genomics, a trailblazer in the field of diagnostics and life sciences. With a background in aerospace engineering and over 25 years of leadership experience, Dede shares how her engineering mindset and entrepreneurial resilience have driven her to build impactful startups that tackle complex challenges. Dede dives into the mission of Orbit Genomics, exploring how they're harnessing the potential of “junk DNA” to revolutionize cancer detection and save lives. She also opens up about the challenges of securing funding in the diagnostics space, the importance of fostering team diversity, and the pivotal role government programs like ARPA-H and Cancer Moonshot play in advancing healthcare innovation. Through thoughtful storytelling and actionable insights, Dede reveals how diagnostics can complement therapeutics, why collaboration is essential to progress, and how startups can thrive by embracing resilience and adaptability. This episode is an inspiring testament to the power of persistence, innovation, and building bridges in science and beyond.
In this episode of Lab Rats to Unicorns: Rising Stars, we are joined by Dr. Gabe Kwong, a trailblazing biomedical engineer, innovator, and entrepreneur. Gabe is the director of the Laboratory for Synthetic Immunity at Georgia Tech and Emory University, where his groundbreaking research focuses on engineering immune cells as living drugs and developing cutting-edge diagnostics for early disease detection. Gabe shares his journey from academia to entrepreneurship, founding Glimpse Bio and Port Therapeutics to bring life-saving technologies from the lab to the market. He delves into the transformative potential of synthetic immunity and his work on the Cancer Moonshot initiative, which aims to create an activity-based cancer atlas and advance multi-cancer early detection. In this candid conversation, Gabe reflects on the importance of mentorship, the power of community spaces like Science Square in Atlanta, and the challenges of aligning science with market demands. Tune in to hear how Gabe is driving innovation, building bridges in the biotech ecosystem, and training the next generation of entrepreneurial researchers. This episode is an inspiring look at the intersection of science, innovation, and the human drive to make a difference.
Sit back and listen well as Adrian Guess delivers news stories from around the country in an effort to inspire community ane civic engagement and motivate people to care about one another. 1st Segment (0:42) North Carolina hospital company forgives debts of 11,500 people after NBC News report DOJ launches civil rights probe of Mississippi sheriff's office whose deputies tortured 2 Black men in ‘Goon Squad' case Georgia elections board to require hand count of ballots Newly popular Harris builds momentum, challenging Trump for the mantle of change What's Minneapolis' secret to fixing housing? Build more Before the Break: Why an Alaska island is using peanut butter and black lights to find a rat that might not exist 2nd Segment (26:57) Federal Government Awareness Biden rolls out global Cancer Moonshot effort, targeting cervical cancer White House rolls out ‘The Record' to highlight Biden agenda online Senate panel votes to hold Steward Health CEO in contempt of Congress House unanimously votes to boost Trump security as Congress scrambles to ensure candidate safety Supreme Court rejects Green Party's appeal to put Jill Stein on Nevada ballot Alaska man charged with threatening to assassinate 6 Supreme Court justices Scandals with GOP Candidate for Gov in NC Trump rejects second TV debate as 'too late' Brett Favre to appear before US House panel looking at welfare misspending California governor signs law to protect children from social media addiction Before the Break: Cards Against Humanity sues Elon Musk's SpaceX over alleged trespassing in Texas Final Message (50:10) A Scottish woman leaves notes and trinkets of affirmation around her hometown Music*: I Don't Need Your Love by Adi Goldstein Announcements Next News Update epside in 2 weeks Be on the lookout for Michele's interview episode Become a member of Brothers in Law, Inc. Apply for a National Leadership Position *Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/adi-goldstein/i-dont-need-your-love License code: 3UJIT174EGUDG6FQ
The leaders of the Quad nations, Prime Ministers Narendra Modi of India, Anthony Albanese of Australia, and Kishida Fumio of Japan, and US President Joe Biden unveiled the Quad Cancer Moonshot, a collaborative effort in the Indo-Pacific region, in a statement called The Wilmington Declaration, on Sep. 21. This partnership will initially focus on cervical cancer, which the leaders note is a preventable disease that continues to affect many. The leaders also announced greater collaboration in critical technologies.
In today's episode, you'll get to explore the world of early cancer detection with Dr. Azra Raza, a pioneering oncologist and professor of medicine. We discuss the anxiety-inducing issues surrounding current cancer screening methods like mammograms and colonoscopies and examine advanced alternatives such as GRAIL and Cologuard. Dr. Raza also shares her groundbreaking work in detecting "The First Cell" and explores the potential of biomarkers and wearable devices for early detection (check out her fascinating book on this topic for more invaluable information!). In a deeply personal segment, Dr. Raza opens up about her late husband's battle with leukemia and how it shaped her understanding of cancer. We'll also discuss the flaws in the current cancer research model, the financial struggles for innovative scientists, and the urgent need for better funding to accelerate progress. Dr. Azra Raza is the Chan Soon-Shiong Professor of Medicine and Clinical Director of The Edward P. Evans Foundation MDS Center at Columbia University in New York. A practicing oncologist seeing 30–40 cancer patients weekly, she directs a basic cancer research lab with hundreds of original publications in high-profile journals. Her life is dedicated to the prevention of all chronic diseases, including cancer, by early detection. She worked with President Clinton, designing breakthrough developments in science and technology, and with President Joe Biden for the Cancer Moonshot initiative. Her latest book is a national bestseller and has been translated into nine languages. Dr. Raza is now involved in First Cell Therapeutics, developing a specific antibody to target and remove the tumor macrophage hybrid cells that act as The First Cell giving rise to cancer. Full show notes: https://bengreenfieldlife.com/firstcell Episode Sponsors: Aires Tech: Aires Tech is offering you a 30% discount at airestech.com/ben by using code BEN30. Wild Health: Get 20% off with code BEN at wildhealth.com/ben. FUM: Head to tryfum.com/BEN and use code BEN to get a free gift with your Journey Pack! Vivobarefoot: You can purchase yours today with an exclusive 20% discount by going to vivobarefoot.com/bengreenfield and using code BENG20. MOSH: Head to moshlife.com/BEN to save 20% off plus FREE shipping on either the Best Sellers Trial Pack or the new Plant-Based Trial Pack.See omnystudio.com/listener for privacy information.
Join Dr. Martin in today's episode of The Doctor Is In Podcast.
Today's Headlines: The US has approved $20 billion in arms sales to Israel, but don't expect those fighter jets and missiles to arrive anytime soon—these are long-term contracts aimed at strengthening Israel's defenses for years to come. In other news, Project 2025's training videos, published by ProPublica, reveal plans to overhaul the federal government, including tips on dodging FOIA requests and outmaneuvering “left-wing” judges. Despite Trump's attempts to distance himself, most of the speakers involved had ties to his administration. Meanwhile Donald and Elon Musk are now facing federal labor charges after their Twitter Spaces chat led to accusations of anti-union behavior. Arizona and Missouri have secured spots for abortion rights initiatives on their November ballots, with more states possibly joining soon. The Biden-Harris administration is also making moves with their “Time Is Money” initiative to curb corporate practices that waste consumers' time, and Biden announced $150 million in grants for the Cancer Moonshot program. Tropical Storm Ernesto is set to become a Category 3 hurricane, threatening Puerto Rico with potential power outages. And finally, the Olympics Court of Arbitration rejected the US's appeal over Jordan Chiles' bronze medal, while Algerian boxer Imane Khelief filed a lawsuit against Elon Musk and JK Rowling for cyber harassment. Resources/Articles mentioned in this episode: AP News: US approves $20 billion in weapons sales to Israel amid threat of wider Middle East war Pro Publica: Inside Project 2025's Secret Training Videos Axios: UAW files labor charges against Trump and Musk over strike remarks AP News: Arizona will put abortion rights on the November ballot NBC News: Abortion rights initiative will appear on Missouri's November ballot CNBC: White House launches broad new regulatory effort, as Harris prepares to unveil economic plan AP News: Cancer 'moonshot': Biden announcing $150 million in research grants NBS News: Tropical Storm Ernesto expected to strengthen into a hurricane in the Atlantic NY Times: Jordan Chiles case won't be reconsidered, CAS tells USA Gymnastics Variety: J.K. Rowling and Elon Musk Named in Cyberbullying Lawsuit Filed by Algerian Boxer Imane Khelif After Olympic Win (EXCLUSIVE) Morning Announcements is produced by Sami Sage alongside Bridget Schwartz and edited by Grace Hernandez-Johnson Learn more about your ad choices. Visit megaphone.fm/adchoices
Mass Shooting reported on a Wednesday outta VA. Breakdown of todays MLB games, pretty shitty day yesterday so ima make up for it. Biden with the CANCER MOONSHOT when we know CANCER is ruled by the MOON in astrology. PLEASE SUBSCRIBE TO MY YOUTUBE CHANNEL (same name) FOR THE VISUALS!!!!!
President Biden and First Lady Jill Biden announce Cancer Moonshot research grants, Gov. Walz (D-MN) at AFSCME convention, former DNI Richard Grenell on presidential race, Secret Service update on Democratic National Convention security, updates on Iran's threats to retaliate militarily against Israel and Ukraine's military advance into Russian territory. Learn more about your ad choices. Visit megaphone.fm/adchoices
The Business Elevation Show with Chris Cooper - Be More. Achieve More
Join us for a hugely inspiring conversation with Dr. Azra Raza, the Chan Soon-Shiong Professor of Medicine and Clinical Director of The Edward P. Evans Foundation MDS Center at Columbia University in New York. As a practicing oncologist, Dr. Raza sees 30-40 cancer patients weekly and leads a cutting-edge cancer research lab with numerous original publications in high-profile journals. With a career dedicated to the early detection and prevention of chronic diseases, including cancer, Dr. Raza has collaborated with President Clinton on Breakthrough Developments in Science and Technology and President Joe Biden on the Cancer Moonshot initiative. Her latest book, THE FIRST CELL: And the Human Costs of Pursuing Cancer to the Last, is a national bestseller and has been trans-lated into nine languages. This interview will delve into Dr. Raza's groundbreaking work, her passion for transforming cancer treatment, and her vision for early chronic disease detection. Don't miss this opportunity to learn from one of the leading voices in oncology today and be inspired to step up and contribute to a better world through your work.
“Cancer” is a dreaded word in the doctor's office. But about 40% of us will be diagnosed with cancer at some point during our lives, the most common being breast, prostate, and lung cancer, according to the National Institutes of Health.But in the last few decades, major progress has been made in the world of cancer treatment and prevention. Cancer death rates have decreased by about 30% over the last quarter century, with some of the largest decreases seen in lung, melanoma, and myeloma cancers. The Biden administration's Cancer Moonshot program aims to reduce the number of cancer deaths by at least 50% by 2050.Early detection methods like mammograms and colonoscopies have improved outcomes for many types of cancer, and new treatment options, like cancer vaccines, immunotherapy, and targeted genetic therapies, have shown promising early results. And the breakthroughs made from the development of the mRNA covid vaccines are bringing even more promise for hard-to-treat cancers.Dr. Siddhartha Mukherjee, assistant professor of medicine at Columbia University and author of the Pulitzer Prize-winning book The Emperor of all Maladies: The Biography of Cancer, joins guest host John Dankosky to give a broad update on the progress made in cancer treatment and prevention. They also discuss the role AI can play in new breakthroughs, and why some cancers are still particularly difficult to treat.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.
For malignant brain cancers, such as glioblastoma, treatment options have not significantly improved. The current standard of care involves surgery followed by radiation or chemotherapy.Dr. Kesari and his team are exploring a new approach. The PNI (Precision Immunotherapy in the Neoadjuvant setting) method uses targeted treatments based on the patient's tumor genetics before administering chemotherapy and radiation, when the immune system is stronger.The goal is to prime the body to recognize and target the cancer as a foreign entity, enabling the body's own immune system to combat the disease before it is weakened by chemotherapy and radiation.Learn more: 310-829-8265
In this enlightening episode of the Veterinary Cancer Pioneers Podcast, host Dr. Rachel Venable speaks with Dr. Amy LeBlanc, a Senior Scientist and Director at the National Institute of Health's CCR Comparative Oncology Program. Dr. LeBlanc discusses the compelling integration of canine models into cancer research, emphasizing the translational benefits that dogs offer in understanding and treating human cancers. She highlights her team's work with naturally occurring cancers in pets, aiming to improve treatment options for both human and veterinary patients. The episode delves into the challenges and innovations in comparative oncology, showcasing how dogs, sharing our environments and cancers similar to humans, provide a unique bridge in cancer research that could lead to breakthrough therapies.
On this week's Biotech Hangout, hosts Daphne Zohar, Eric Schmidt, Yaron Werber and Luba Greenwood are joined by special guest and STAT reporter, Adam Feuerstein. The episode kicks off with the hosts sharing their thoughts on industry sentiment and some of the revealing trends in the week's Stifel report before diving into Q1 earning reports from Ascendis, Amgen and SpringWorks. The hosts talk about ONO's acquisition of Deciphera for $2.4B, X4's FDA approval of XOLREMDI, and how COVID fatigue could be causing us to minimize the threat of the avian influenza H5N1. The group also discusses Biden's Cancer Moonshot getting killed by Congress, a federal judge throws out two drugmaker IRA lawsuits and the FTC goes after drug company's “junk” patents in obesity and other device combos. Adam sparks a group discussion around his exclusive STAT article on how an emerging safety issue in MorphoSys' Phase 3 cancer study may complicate its acquisition by Novartis. Other topics covered this week include BridgeBio spinning out an oncology company as it focuses on the anticipated launch of its heart drug, US government moving to reclassify marijuana from schedule 1 to schedule 111 drug, and more. *This episode aired on May 3, 2024.
Are there instigators in the Gaza protest groups? Scumbag Republicans block Biden's Cancer Moonshot. Ankle monitors for pregnant women? Sure, why not? The WA GOP put it in writing that they're not into democracy. Happy Beltane, a Gaelic festival that marks the beginning of summer and is traditionally celebrated on May 1st. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
April 3, 2024 ~ Priority Health is a nationally recognized health plan serving more than 1.3 million members. Praveen Thadani, President and CEO of Priority Health, talks with Guy, Lloyd, and Jamie about his meeting with First Lady Jill Biden about how they're expanding care for cancer patients.
While there is undeniable hope for the future of cancer care, systemic barriers still impact access for many patients – particularly those in underserved communities. This session, originally recorded in front of a live audience at SXSW 2024, examines how increasing collaboration and partnerships among organizations that touch all aspects of the cancer journey and reach patients, providers and treatment centers, is critical to expanding access to optimal cancer care and making the goals of the “Cancer Moonshot” a reality. Hear from City of Hope, American Society of Clinical Oncology (ASCO), and American Cancer Society (ACS) about how they are approaching partnerships to create a future where every cancer patient has access to the care they need.
The Participant Engagement and Cancer Genome Sequencing Network (PECGS) part of the Cancer Moonshot Initiative is a collaboration between the National Cancer Institute and research institutions to engage cancer patients directly and ultimately better understand cancer genomics. One of six funded projects is with Washington University, which is focusing on rare and understudied cancer populations with health disparities. Dr. Bettina Drake, professor at the university's School of Medicine, discusses how her team is studying molecular changes in tumors for cancers like cholangiocarcinoma, multiple myeloma in African Americans and colorectal cancer under age 50 in African Americans. NCI Program Director Dr. Leah Mechanic also discusses how the PECGS Network overall is advancing health equity and precision medicine efforts around cancer care and treatment. This is an in-depth peek into one of many programs within a broader collaborative effort to better understand cancer and accelerate the White House's Cancer Moonshot's mission to end cancer as we know it.
JCO PO authors Lauren C. Leiman and Dr. Emma Alme share insights into their JCO PO article, “Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care”. Host Dr. Rafeh Naqash and guests discusses increasing access to liquid biopsy for cancer, reviewing the barriers and examining the proposed solutions. 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, Social Media Editor for JCO Precision Oncology and Assistant Professor of Medicine at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, we are excited to be joined by Lauren Leiman, Executive Director of BloodPAC, and Dr. Emma Alme, Public Policy Director at Guardant Health. They are both authors of the JCO Precision Oncology article titled "Recommendations for the Equitable and Widespread Implementation of Liquid Biopsy for Cancer Care." Our guest disclosures will be linked in the transcript. For the sake of this conversation, we will refer to each other using our first names. So, Lauren and Emma, welcome to the podcast and thank you for joining us today. Lauren Leiman: Thank you for having us. Dr. Emma Alme: Thank you so much. Dr. Rafeh Naqash: So, this article is an opinion piece that addresses something that is emerging and current and tries to connect it to something that is futuristic also and hopefully, will address a lot of different needs relevant to patients with cancer. For starters, since our audience is pretty diverse, could you tell us what the BloodPAC is? Since the article is somewhat a combined piece from different stakeholders, could you explain what this BloodPAC Consortium is as an entity and what is its role for this BloodPAC? Lauren Leiman: Sure, this is Lauren Leiman. The BloodPAC was formed almost seven years ago as an initial commitment to the White House Cancer Moonshot back in 2016. I was the head of external partnerships and had this idea with a colleague of mine, Dr. Jerry Lee: Could you accelerate the development and approval of liquid biopsy assays for cancer patient benefit if you were able to create some standards and frameworks for the field broadly, and also if you could aggregate data to support those standards and frameworks? So, we brought together about 20 different organizations across pharmaceutical companies, diagnostic partners, foundations funding in the space, government agencies, all to think through can we create these frameworks, are we willing to submit data. We were extremely successful in that first round, and by the end of 2016, we were able to have our first data deposit into- we built a BloodPAC Data Commons, which is housed in Chicago and was created by Dr. Bob Grossman up there. In 2017, when it became clear that the last administration was not going to continue the White House Cancer Moonshot, we became an independent non-profit 501(c)(3). And we have grown substantially since that time from those original 20 different organizations to about 66 different organizations today, across all those areas again, including today, payers, which is very exciting. And we have added on to our mission statement one word that we will discuss today, which is very exciting, which is “accessibility”. After our five-year anniversary and even slightly before then, we decided that we really feel that we have been able to contribute, as a community, to accelerating the development and approval of these tests. But, in actuality if we don't get them into patients' hands, what is the point of all of our hard work? So, we added the word "accessibility." Today, we have these 66 different organizations that collaborate, essentially, to compete. They're pulling together projects and deliverables in about ten different working group areas to contribute products to the liquid biopsy community to help accelerate those three things. Dr. Rafeh Naqash: Thank you for explaining that. That seems like a very important initiative. Now, when you say that you're contributing data, does it mean that different companies and entities are contributing patient-level data so that you can pool that and assess what is the utilization, what is the utility, what is the payer-related aspects, coverage aspects. Is that all part of the initiative? Lauren Leiman: It is. We started with the idea, which is kind of scary, I think, for a lot of different companies: Are you willing to submit your protocols essentially, pre-analytical data? I think, much to the FDA's surprise, I was kind of, “Of course, everyone should be willing to do this, they should absolutely do this, it'll be really exciting. Why wouldn't they?” And I think others were a little skeptical that these companies who are highly competitive including Emma's company, Guardant, would be willing to contribute data. And in fact, Guardant is probably one of the first ones, first two at the table to actually submit their data which was just extremely exciting. And the data was around mostly protocols and pre-analytical variables, what tube types are you using? As we moved on, our pharmaceutical partners did submit full clinical trials with deidentified patient data, which was extremely exciting. Today, our Data Commons sits in two different areas or visibilities for our members. One is membership-only data that only our members can see, so have been been contributed by them potentially sometimes for certain projects we're working on. And then we also have an open segment of our Data Commons that's open to the public, that includes published data and studies that anyone can take a look at and see. Our goal is to continue to open up all of our data over time, so that anyone can take a look at it. We are, I think, the leading liquid biopsy repository. As we move into the future though, I think because we are mostly an organization that has pharmaceutical companies and diagnostic partners, we are company driven, aggregating large sums of research data is not necessarily their goal. And so to try to identify an area of mutually beneficial interests for everyone, I do think that over the next year or two, you'll see a potential shift or pivot in the use of Data Commons to where the industry is today which is probably, hopefully a little bit more coverage focused. How do we pivot from being a source of aggregated research to a source of identifying and approving the value of liquid biopsy to the full community? And again, that's for the full spectrum all the way through payers and the coverage of these tests, which I do think would add a tremendous amount of value to everyone on the life cycle of this industry but would also add a tremendous amount of value for access in getting these tests into patients' hands. Dr. Rafeh Naqash: Of course, you importantly covered a bunch of different concepts. One is data democratization, which is extremely important in the current day and age for different people in the public domain if they have access to data, they can do a lot of interesting and important things and add to the overall understanding of what we know or don't know in this space of liquid biopsy utilization. And then, of course, the aspect of disparities and coverage assessments. Now, going to Emma, for the sake of our listeners, some of them are trainees, and many of them are oncologists, perhaps many are patients. What is the current landscape for liquid biopsies? Where do we use them, and what are the general approaches and principles of where things stand? Dr. Emma Alme: That's a great question, and it really spans the cancer care continuum. And I think the space where it's most established is in the advanced cancer stage for therapy selection. So that's where we actually have some even FDA approved assays for liquid biopsy, with Guardant 360 test being one of them. It's comprehensive genomic profiling to identify actionable biomarkers to get patients on targeted therapy. So that's where it's really been integral to precision medicine. And we're seeing an increase in utilization of liquid biopsy as the technology becomes more established. It's not just in cases where tissue is insufficient now. Most recently, we've seen NCCN guidelines and non-small cell lung cancer change for concurrent testing for liquid biopsies. So that's been an exciting trend in adoption. And then as you move across the cancer care continuum, there's residual disease monitoring and response, where we can actually use ctDNA to look at a patient's response to therapy, even after surgery - is there still ctDNA there? Instead of just having imaging as an option, we can actually look sooner to see how the patient is responding and if there is still cancer present. So that's a really exciting place where we're seeing growth in liquid biopsy. And then moving even earlier, before a patient even has cancer, there's a tremendous opportunity for liquid biopsy in early cancer detection. I think that's something that has been previously discussed on this podcast and we see it a lot in popular media. But it's not just for multi-cancer, we have the opportunity for single cancer as well liquid biopsy tests in cancer screening. That's a really exciting space, really thinking about the accessibility of these tests. Because a lot of cancer screening modalities today are hard for a lot of patients to access. And it requires going to a medical facility. So if the first step is a blood test, that really opens that up to communities that traditionally have been left out of screening. So I think there's a huge opportunity there, not just when we're thinking about screening for cancers that don't have screening modalities currently, but also screening for those that do, where maybe a first non-invasive step can really open the door to patients who don't have access. So it's a long answer to say that, really, it's across the entire cancer care continuum. We see a lot of opportunity here for liquid biopsy to be a way to advance the field but also increase access for patients who have been left out of precision medicine. Dr. Rafeh Naqash: I think access is definitely the focus here. And I can give you my example. So I do early phase drug development and I do a lot of research in liquid biopsies and ctDNA monitoring. In the center of care, I treat people with lung cancer also and there have been instances, probably about a year or a year and a half back, where a patient could not come to the clinic. The clinic wasn't done and on my to-do list for that individual patient, I put in ctDNA testing just to remind me when I see the patient, to get it done. But the patient didn't make it to the clinic. Surprisingly enough, mobile phlebotomy was available. And later I came to know that this is something that can be done and provided to the patient at their home and you can still get the same results, which was very surprising in a good way. And it did help in making some treatment decisions for some patients who, sometimes in a state like Oklahoma, which is where I am based, we have a significant rural population and people drive six hours for some of our trials, especially the early phase trials. And then if you tell them, “Well, if you don't make this appointment, XYZ cannot get done,” it doesn't necessarily change things for them. So something of this sort definitely helps. Now, going to Lauren, I noticed this interesting sentence in the article, "fork in the road," where you describe, based on the current practices and policies, in the direction that we're going in, we can either increase or deepen the divide and disparities or decrease it. Could you tell us a little bit more about what currently exists on the disparity side and how do you see us narrowing that gap in the near future and implementing something that is equitable? Lauren Leiman: What's exciting about this paper is I think as we are talking about trying to condense this discussion down to something that's really digestible for everyone in the community, there are six barriers that we've identified. And I also should start by saying the working group that we have within BloodPAC that wrote this paper is intended to look at two different areas. One is that broadly, liquid biopsy still isn't available for the majority of the population domestically here in the US so that's a problem. In addition, it's clearly not available in underserved areas, and that's an even deeper divide. So we're kind of at this fork in the road because it's not broadly accessible to the majority of patients today. And so we have this moment in time where we're able to make a decision to bring everyone along with us, which is very exciting but also will take a lot of work. And these six barriers that the paper identifies, I think are very clearly articulated. They are: lack of uncertainty around test performance, the lack of familiarity with this technology, inconsistent payer coverage is an issue, mistrust of the medical establishment - especially in underserved areas, fear of discrimination in seeking this kind of technology, and the difficulty with terminology. I think that the whole liquid biopsy community has a role to play in addressing these six areas. I think that BloodPAC, in particular, as a consortium and a collaborative process for 66 different organizations that work in the field, we have a role to play, most certainly in helping to address specifically some of these areas. We have working groups that specifically address reimbursement and policy, so that would obviously fall into payer coverage of these tests. We have working groups creating lexicons both in the molecular residual disease area, as well as our multi-cancer early detection areas. So creating terminology and lexicons that are consistent across the entire community and also digestible for patients, which is really important. And so mitigating these barriers is going to be a collaborative process across all stakeholders in the liquid biopsy field. And I think BloodPAC is uniquely positioned to address many of these because of our diverse stakeholders and membership, which is exciting. But I do think that this is the perfect moment in time now to start addressing these challenges, and we shouldn't wait much longer, as we think through how we can bring everyone along with us and make sure we're not leaving anyone behind. Dr. Rafeh Naqash: As this entity or consortium, as you call it BloodPAC, has moved forward, this is a question for both of you, Emma and Lauren. Emma, I guess you can start. How were things five years back? What are some of the things that you have been able to achieve, and where do you potentially see the next five years? Dr. Emma Alme: I think we have made a lot of strides on the coverage side when it comes to advanced cancer testing for liquid biopsy. By no means are we there by any stretch of imagination, but we're starting to see some coverage adoption, which does make a huge difference because at the end of the day, that's so important to ensure equitable access. Especially when we're talking about a technology that has the potential to close some of the barriers in precision medicine because of the fact that you don't need access to some of the medical facilities, as you pointed out earlier, rural patients don't have access to. Because transportation is not necessarily a barrier here the way it is for some for some of these other treatment aspects. But if you don't have consistent pay or coverage, that's a place where you're really going to see drop off in terms of patients not getting equitable care and not getting standard of care as liquid biopsy enters into that realm. The increase we've seen in private payers adopting coverage, the way we see Medicare coverage for advanced cancer liquid biopsy, is encouraging. We've seen states adopt legislation to require coverage of biomarker testing, that's passed in 15 states now, thanks to the work of the American Cancer Society and a broad coalition of stakeholders. I think that's beginning to make a difference, but we have a long road to go. We still, on the MRD side, that's just emerging. And so one space where we have some recommendations on this is continued evidence generation - continue to gather that clinical utility data that will support payer adoption increasing on the advanced cancer side, but then moving across that cancer care continuum to those other types of liquid biopsy tests. I think that's hugely important and there's a role for BloodPAC to play in that as well, especially in making sure that we bring everyone to the table to have these conversations on what is the evidence that, we need to generate, what should that look like, what are the standards to ensure that everyone feels confident in these tests. That's one area that we're really excited to see. And I also think another space is on the diversity in clinical trials. It's so important to make sure that when we are bringing these tests to market, the data that we gather to support that is representative of all patients who can benefit. It is so important to make sure that the tests work, but also to build confidence in all of the people who are going to get these tests and feel like, “Okay. I know that this test works for patients that look like me, too.” And so that is something that at Guardant we are working really hard on. We read out our clinical trial, ECLIPSE, for our blood based test screening for colorectal cancer a little over a year ago, and we were really happy to be able to say that our trial was representative of the US population, particularly for Black Americans, where colorectal cancer incidence is increasing, 30% to 40% higher rates of mortality, in Black patients than White patients for CRC. So it's especially important to make sure that the population is representative in the clinical trial of the patients who will benefit. And I think we are seeing companies increasingly realize their responsibility in that space and it's something that we can all really prioritize moving forward with things like making sure transportation is accessible to patients, making sure that clinical trial materials are accessible, culturally sensitive in a broad set of languages. There are a lot of different activities. You have mentioned mobile phlebotomy earlier, that can be incorporated into trials working with community centers and not just academic medical centers to ensure that the trials are taking place close to where patients live and work. This is a tractable problem and I think we've made a lot of headway in the five years. But looking to the future, there's still a lot more we can do together to ensure that work continues. Dr. Rafeh Naqash: All excellent points. And I completely agree with you. Bringing the trial to the patient is more important and likely to lead to better outcomes than the patient driving six hours to a facility to come on for trial. So, the question for Lauren that I have from a physician or scientist standpoint, is what gets covered or does not get covered is not necessarily that I know about in my daily clinic of 15-20 patients. What is the difference between different states having different coverage policies for something like this? If it's the same payer in state A and the same payer in state B, why is the coverage policy in state B different from that in state A? And what are some of the things we can do locally and at a national level to help bridge some of these disparities and gaps? Lauren Leiman: I'm going to hand that question over to Emma. This is her bread and butter. Dr. Emma Alme: That is such a great question, and I wish I had a more satisfactory answer for you. The reality is that when it comes to diagnostics, coverage is really a patchwork, compared to when we think about drugs whether it's FDA approved, we expect to be covered. With diagnostics, it's really up to the insurer. And I keep going back to the advanced cancer space because that's where we see the broadest coverage because it has been around the longest. But we see broad coverage from Medicare for these types of tests. But, for private payers, it's really a patchwork. We see a lot of payers only just starting to cover these tests, maybe where there's a CDX indication with an FDA-approved drug we see it, but not more broadly for tumor profiling. Especially not for the larger, more expensive comprehensive genomic profiling panels that are more expensive. I think you can extrapolate the obvious reasons why that might be. But, as this is being moving into NCCN guidelines, we see very slow adoption by some private payers. And you touched on the legislation in different states. This coalition on American Cancer Society has been spearheading is trying to pass state-level legislation that will align coverage with a strong, robust set of evidence, and that's an FDA-approved companion diagnostic indication, medicare coverage, whether it's an NCD National Coverage Determination, a Local Coverage Determination, or National Clinical Practice Guidelines like NCCN, so really a robust set of evidence. And so this is resonating with state legislators across the country where we are seeing that take off in 15 states. But the political climate is different in different states so there are differences in terms of which state will adopt this, some of the differences are in language that they put into this. But even now that these are passing, we're seeing differential implementation, some plans are not necessarily reading this legislation and saying, “Okay, I have to cover all the tests that Medicare covers.” They are thinking that maybe they have some agency to put on other medical necessity criteria. So I think there's a lot that will play out on the individual state level to see how this nets out. But it's really kind of how different insurance companies and plans are interpreting these mandates, are interpreting guidelines, etc. But you touched on the differences between the states and one of the things that has actually been shown in data from the precision medicine coalition is that even when you change insurance coverage for one individual plan, it doesn't necessarily translate into adoption in the direct correlation that you would expect. And part of that is because it's such a patchwork and it's so chaotic. Providers don't necessarily know for their patients which plan will cover, which one won't. They're very hesitant to subject their patients to out of pocket costs and so you get providers being reticent to order liquid biopsy just because of this coverage landscape. And so there really is that need not just to go step by step but get broader coverage for these patients across the board. And so I think the long term vision is can we get to a change at the federal level. That's hard compared to the state level. It's a long road ahead. That's why I started this with I don't have a satisfactory answer. There is still a lot of chaos ahead even though we made some progress along the way. Dr. Rafeh Naqash: I completely agree. Lots of things to do together. But, in my daily role as a physician or a scientist, I come across situations where a patient's situation was denied for liquid biopsy, then the company went and appealed or insurance doesn't want to pay for it, and then they ask for peer-to-peer review, which is a lot of time and energy on the provider's side, the physician's side, even for as simple as a CAT scan for cancer, let alone a liquid biopsy. I started thinking at that time, is there a scenario where if I were ordering a Guardant or a foundation or any liquid biopsy for that matter, can they not provide additional support where I don't have to do a peer to peer and I can spend time and energy concentrating on the more important patient issues that are right in front of me, rather than having to wait for an insurance company to call me at a certain time of the day where I may or may not be available and then having to reschedule the call and spend another 30 minutes to them explaining. So I don't know if you guys on the other side of the aisle also think about some of these issues, but could that be a scenario that could potentially be implemented in the near future? Dr. Emma Alme: Yes, absolutely. This is something that we at Guardant think about a lot. One of the challenges is that, as a laboratory offering liquid biopsy, you are an ancillary provider, and so I think you touched on it, a lot of this role falls to you as the physician to secure prior authorization and to be the patient's advocate. And not all plans – this is often true for Medicare Advantage – allow the laboratory to be the one to, for example, initiate prior authorization and provide the medical necessity information to make sure that that test is approved by the insurance company, and then to be the advocate for that patient in appeal process as you mentioned. And I think there is a lot of education that needs to happen among policymakers to make some tweaks to this process to ensure that the patient can have access, that the laboratory can be involved in the process where it makes sense, to smooth out this process. And exactly right, I think you touched on a place where it is a huge burden for providers. There are places where the laboratory is best equipped to move the patient through that process and there's a lot of red tape that we can help overcome. And that's not specific to liquid biopsy. I think that's true across the diagnostics industry. But you're exactly right that it is another hurdle to access is if this is a process that has a lot of red tape. So I'm pleased to hear you think about this the same way. Dr. Rafeh Naqash: I'm glad you guys are having those conversations, having conversations is the first important step to make a change in the near future. If there's a patient listening out there and that patient has gotten a recent bill of $5,000 for liquid biopsy, what are some of the steps that you would like to highlight for them from a patient standpoint so that they can advocate for themselves? And should they talk to the physician in the company? Should they directly approach the company to not have that additional financial toxicity in situations where it may not be covered? Lauren Leiman: I would 100% encourage those patients to please reach out to the company. I can only speak for Guardant but we have a patient access program. Our team calls any patient that's going to have more than $100 out of pocket because our goal at Guardant is to make sure that patients have access to the testing they need to inform their treatment and get the best possible care. I think we're all aligned across these companies across both- like we want to make sure that we are lowering the burden for cancer patients. There's already so much stress on these patients initiating treatment. They don't need to have the added stress of battling insurance. So we're here to help and no patient should be on their own in that space. So please tell your patients to reach out to the company in those instances, but I would hope that they would already have gotten outreach from the company in the first place. Dr. Rafeh Naqash: I often discuss with some of my colleagues about the financial burden of cancer care, unfortunately, that people tend to have. And I remember this scenario a couple of months back where a patient of mine, when I sat down in the clinic room, they had this big, thick folder with them. And after I finished the discussion about what was going on with the cancer, they said, "Could you help figure this out?" And they opened this folder. It had so many bills, and one of the bills was obviously a liquid biopsy bill. And that was my understanding, too, that there is a lot of resources available to these people. And eventually things worked out. The company took the cost of whatever was not being covered by the insurance. But again, you touched upon an aspect in the article about educating the physicians, the providers. I think definitely a lot of work needs to be done there so that the patients can advocate for themselves and the healthcare providers can advocate for the patients, too, like having those checks and balances and those resources present and in the institutions where these people get cared for or knowing what's the right way to channelize these issues and to whom within the companies, so that all of this gets taken care within a timely period, so that the patient doesn't come back with the same issue six months later, “I still have this bill,” that even if it's being sent to the patient or their family by mistake, it does add a lot of psychological pressure. So I think a lot of things potentially need to be done in that space, and hopefully you guys are still doing that and continue to do that, make progress in that space to help mitigate and alleviate some of that patient level burden, which is extremely crucial in their care. Lauren Leiman: I think what's interesting about what we're looking at now is BloodPAC is thinking through these financial challenges, the coverage challenges for someone who's probably made it to an academic center to access these tests to begin with. And so to go back a little bit in the conversation, I think there still are challenges, which I'd love to hear more about from the experience of a clinician. But we have talked about, does mobile phlebotomy access everyone? Is it capable of providing access for everyone? I don't know. There's new technologies that we are looking at, like home blood collection. Most of the companies that we work with right now, they're not getting enough quantity. The quantity isn't there. But is that something that we should be pursuing? Because as you've already said, people drive six hours, and sometimes you can't make that drive. And sometimes a mobile phlebotomy lab is not able to get those six hours away. There's a limit on how far they can go. That's a huge challenge. I'm also fascinated by the idea that if you were to eliminate coverage as an issue, so if we were to say we're offering tests for free, is there still the educational barrier, the understanding barrier that we are not putting enough emphasis on? I don't know the answer to that question. I think there is a large element to that, though. And I think that when you say education, I have asked colleagues, "Okay, guys, who are we educating? Are we educating the clinician on specific tests? Are we educating the community health worker somewhere else outside of an academic center? Are we educating the patients themselves? Do they need to really understand exactly what this kind of futuristic technology is and what it can do for them?" Those are a lot of permutations of what if, what if, what if, what is the barrier? And so to take a step back, the reality is for that big bucket of individuals that I talked about at first, yes, coverage is going to be the primary barrier for them. But if you were to remove that barrier for some individuals, I think you still have a lot of challenges left ahead of you, which is essentially what the paper is saying. But I think that that is the really big question that I still have in my mind. If we can eliminate coverage, what's left and how do we address it? Dr. Rafeh Naqash: To that point, I would like to add also- you pointed out educational barriers and there's definitely educational barriers on the provider side also, physicians, whether it's academic or community, that's a different discussion altogether. And this is not just one example, but this is an example that I'm giving because there's several other examples similar I've seen where somebody gets a liquid biopsy done in the community setting, or maybe even in an academic setting somewhere else. And somebody like me who deals with some of these results, I do a lot of precision medicine, I do a lot of genomics, but that's not everybody's interest or forte. That's not something that everybody's necessarily interested in or I try to read each and every detail in a report and understand implications, and not everybody necessarily thinks that that's the best utilization of their time. And I have identified a lot of patients that have been in the system within our state or outside our state where liquid biopsy two years back showed a certain potential germline mutation with a very high variant allele frequency and never got any germline testing. And then I see the patient and I start connecting the dots and the patient gets germline testing done - patients is positive, children are positive, children get XYZ procedures done as part of surveillance or mitigation strategies to prevent future cancers, which again, prevention is cure. At the end of the day, you catch something earlier, as we all know, higher chances for cure. So I think that part of education, we still need to do a lot more on educating the providers, the physicians, or making it somewhat easy, like is there a way that, well, if you have a potential finding of a germline mutation, let's say on a report, instead of just mentioning the potential of germline mutations, maybe we can go to the next level and offer free germline testing and free genetic counseling and make sure that you communicate with that provider versus the responsibility being on the provider or the physician that, “Hey, did you read this carefully? Did you miss something? Did you not miss something?” This is something I have come across and we're actually doing a project right now looking at some of that and analyzing the data and the percentage is pretty significant, and hopefully, if and when the results of that project are published, you will understand how much of a difference it actually can make in the lives of patients and their families to catch something early. Dr. Emma Alme: I think you raise a really good point and your example of germline testing along with tumor profiling is a good example of the kinds of questions that we'll encounter as liquid biopsy moves across that cancer care continuum. So I think we do have to be thinking about what kind of education will we be giving to providers for how they integrate, for example, MRD liquid biopsy testing with standard of care imaging, what does that patient management process look like? On the early cancer screening side, what happens when you get a positive test for a patient? What does that diagnostic workup look like? Especially when there isn't necessarily a standard of care screening pathway- isn't a diagnostic pathway. Whose responsibility is that? There are so many outstanding questions through how we think about provider education across this board that really will take all stakeholders together to really formulate what this looks like. I think you raise a really good point. Right now, I think we all have more questions than answers, but I think it's an important place for us all to be working really hard on right now, to ensure that this doesn't roll out in a way where there is confusion, especially where the providers offering liquid biopsy, maybe primary care physicians who aren't necessarily, as you said, going to be well versed in the literature on liquid biopsy, thinking about these tests report the way that you are right now. There's a lot of work to be done there. Dr. Rafeh Naqash: Absolutely. It was a pleasure talking to both of you about the science, logistics, and payer aspects. A couple of quick minutes on both of you as individuals. I like to start with you, Lauren, can you tell me briefly, what's your background? How did that background connect to what you're doing today? And what else have you learned in this process? Lauren Leiman: Sure. I am Lauren Leiman. I'm the Executive Director of BlooPAC. My backgrounds are primarily in communications and business and developing collaborations that are mutually beneficial for all participants. I have worked in finance. I've worked in Africa for many years for an economist and really decided during that time that health care and health initiatives were really what interests me and ended up working in a melanoma foundation for many, many years, developing interesting collaborations between academic institutions and funding formats, and took that to the White House for the first White House Cancer Moonshot as the Head of External Partnerships, and work towards identifying collaborations between different government agencies and different companies, as well as straight corporate commitments to the Cancer Moonshot, which was “a decade of progress in half the time”, the mission statement. And having worked in melanoma for a while and working at the Moonshot, I'd heard about this liquid biopsy technology. It's out there and I thought it was pretty cool. I have melanoma in my family, and was like, wouldn't it be really interesting if you could get your blood drawn and just tell me if I have melanoma as opposed to kind of scanning my body every six months? And my colleague Jerry Lee, at the time kind of dropped a ream of paper on my desk and said, “Read this.” So I'm neither MD nor PhD, I'm a lowly MBA, who went home and read through everything and came back and said, “You don't have a science problem. You have the collaboration problem, you need to work together, you need to share your data and share your information, which was kind of the birthplace I guess for BloodPAC - could we again, aggregate our data, bringing together these experts in the field to help accelerate the development and approval and accessibility of these technologies. That is my background. Again, an interest in things, going back to Africa and the time I spent there, I'm heavily interested in underserved populations, not just domestically but globally. My hope is that eventually BloodPAC starts really engaging in how do we increase access for all to these really exciting new tests? I do receive, BloodPAC and I as the executive director, receive calls probably once a month from different startups around the world saying, “Good luck with all your $500 test. I want a $5 test, how are we going to get there?” Which you know, I think is the absolute goal for everyone. But slowly but surely, I think we are going to work towards increasing access for all not just domestically here and not just underserved populations here in the US, but hopefully locally as well. Dr. Rafeh Naqash: Thank you, Lauren. Same question to you, Emma. Could you tell us about your background and how it led to your current work and some of the things you learned? Dr. Emma Alme: Absolutely, my background began on the science side. I did a PhD in biochemistry at UCSF University of California, San Francisco. About halfway through my PhD, which I think is a realization many have, I discovered that I loved talking about science and thinking about science and reading about science, but it would be okay if I didn't have to pick up a pipette again. At the time, I was so invigorated by all of the research going on around me but realized that, similar to what Lauren said, it wasn't the science that was the barrier in a lot of cases of this research really reaching patients and changing their care. There were so many policy barriers that were standing in the way of that that I felt like I really wanted to help tackle and so I was fortunate in the fact that there are a lot of fellowships out there for PhDs in science to move into policy roles and serve as science advisors, so I did a smattering of those all around DC. I worked at the National Academy of Science. I worked at NIH and then I went to Congress, where I was a Health Policy Fellow for Anna Eshoo and got to interact with so many different companies in the biotech space and learn about all of their amazing technology, including liquid biopsy that folks were working on where there again, were so many barriers to adoption, where there were policy solutions, and I got really excited to work on that. It was the perfect nexus of my background and biochemistry and genetics and health policy. And so the opportunity came up to work on policy for Guardant who was really thinking about those issues. And so I jumped at the chance to spend all of my time thinking about how do we increase access for patients? How do we make sure that this innovation actually gets into their hands through changes in coverage and reimbursement? And also thinking about most of the things that we've been talking about today - diversity in clinical trials, how we brought in education for patients and providers. So it's been a really exciting space to work in. It's been super fun to get to help the Guardant work with BloodPAC and I think it's an amazing group of collaborators that brings me a little bit back to my academic roots in terms of enjoying the kind of conversations that all these folks have together as we think about standards. That's been a really exciting place for me to sit in the health policy world combining all of that experience together. Dr. Rafeh Naqash: Thank you so much. It looks like all of you within the BloodPAC and perhaps outside the BloodPAC are people driven by a common vision and mission and hopefully will succeed in all of those things that you're trying to achieve. Thank you for giving us the opportunity to talk to you guys and thank you for publishing in JCO Precision Oncology. Hopefully we'll see more of your work with regards to implementation and some of the next steps that you're taking and perhaps even the data for some of these studies that you're combining together, within JCO Precision Oncology in the near future. Dr. Emma Alme: Thank you so much for having us. Lauren Leiman: Thank you. 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. Guests' 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. Leiman COIs: Stock and Other Ownership Interests:Company: Illumina Company: Eli lillyAlme COIs:Employment: Company: Guardant Health Stock and Other Ownership Interests: Company: Guardant Health
Live this week from the ACCC 50th Annual Meeting and Cancer Center Business Summit (AMCCBS), CANCER BUZZ features an update from the White House on the Biden Cancer Moonshot program. Speaker: Dr. Catharine Young Assistant Director of Cancer Moonshot Engagement Policy and International Engagement White House Office of Science and Technology Policy Resources: Cancer Moonshot ACCC Post: Moonshot Highlights from the President's Cancer Panel: Building on a Strong Legacy
Few adults on the planet have not been touched, either directly or indirectly, by cancer. It's one of the things many people see as an inevitable part of life that they hope and pray does not visit directly onto their own life. But what about the oncologists who work with cancer patients every day? Dr. Azra Raza is a cancer specialist who has dedicated her life to pioneering the understanding of cancer and, most importantly, its earliest detection. Despite the weight of her work, Dr. Raza has never lost sight of her clear intention: to cure cancer. She immigrated to the U.S. from Karachi, Pakistan, and has since been featured in high-profile outlets like The New York Times, The Guardian, The Times, The Smithsonian, and more. She was even invited to the dining room of President Joe Biden's home at the Naval Observatory in Washington, D.C., with a handful of other cancer specialists to offer their perspectives on the current cancer landscape, which contributed to shaping what is now known as the "Cancer Moonshot." Dr. Raza's latest bestselling book, "THE FIRST CELL," is a searing account of how medicine and our society (mis)treat cancer, how we can do better, and why we must. Her life is devoted to early detection and prevention of cancer. Imagine the grief of being an oncologist, working with people 70% of whom you will walk to their death. Dr. Raza has not only watched people die but has also discovered that the love of her life, another oncologist, was diagnosed with untreatable cancer, and she had to walk them through to the end. This would make most of us want to crawl into a hole and never return, but not Dr. Raza. She is a true inspiration to us all and a reminder that one person can make a difference in the fight against cancer. Website https://azraraza.com Azra.rasa@columbia.edu Social Media https://twitter.com/AzraRazaMD https://www.linkedin.com/in/azra-raza-2a34a922 Part 2: The Hope and Drive to Cure Cancer The Chronic Inflammation and Cancer Connection Patients, Not Test Rats and Mice Continually Tracking One Patience at a Time The Largest Tissue Repository in The World 60,000 stories Lying Next to a Man Dying of His Specialty Meeting Grief and Walking with It Every Day Pearls or Tears, which are Worth More? The Inspiring, Nobel Courage of a 22-Year-Old Life's Yearning to Know Itself Why Some Doctors Become A-holes The Importance of Skeptical Science A Lesson in Compassion from an Eight-Year-Old When Cancer Comes Back Bankrupt by The Second Year of Diagnosis Treating Problems Rather Than Symptoms Consciousness, Cancer, and Quantum Fields. Dov Baron's brand new course has just been released on coursifyx.com/belonging ------------- Titled: "CREATING A CULTURE OF BELONGING." The course is separated into eight sections that will take you by the hand and walk you through exactly how to create a culture of belonging. Because: CREATING A CULTURE OF BELONGING MAXIMIZES PERSONAL AND CORPORATE SUCCESS. Get Ready to strap on the tanks and Dive Deep into, What it Takes to Create a Culture of Belonging in your organization! Curious to know more? coursifyx.com/belonging "Those Who Control Meaning for The Tribe, Also Control The Movement of That Tribe" #videopodcast #leadership #leadershipdevelopment #emotionsourcecode #neuroscience #emotional #meaning #emotional #logic #culture #curiosity #humanbehavior #purpose
The U.S. vows to retaliate following a drone strike in Jordan that killed three Americans. Plus, jurors have now seen surveillance video of Jennifer Crumbley confronting her son hours after the rampage at Oxford High School. Also, NBC's Kristen Dahlgren introduces us to a new campaign to develop a breast cancer vaccine. And, Jenna Bush Hager's exclusive conversation with best-selling author Sarah J Maas.
Dr. W. Kimryn Rathmell is one month into her post as National Cancer Institute's new director and is already rolling up her sleeves on initiatives impacting health outcomes of cancer patients. Dr. Rathmell discusses her priorities for the year ahead, including a renewed focus on deepening connections across agencies, communities and the nation. She highlights how the agency fits into broader White House priorities around Cancer Moontshot. She also discusses upcoming plans for artificial intelligence and how it might boost cancer prevention as well as improve cancer screenings. Plus, she shares her story about an organization she co-founded that is near and dear to her heart.
The science of oncology is rapidly evolving, as cancer programs and practices around the US continue to make cutting-edge discoveries in the diagnosis and treatment of cancer. In addition, there is an increased spotlight on the effects social drivers of health have on cancer care delivery, as health equity initiatives continue to permeate the oncology landscape. Building on these successes, NCI released the National Cancer Plan on April 3, 2023. The plan outlines goals designed to support the objectives of Cancer Moonshot. In support of this effort, the President's Cancer Panel held its first National Cancer Plan Stakeholder meeting September 7, 2023. ACCC was invited to share the association's key priorities for impacting cancer care in the US. ACCC president Olalekan Ajayi, PharmD, MBA, and chief operating officer at Highlands Oncology Group, PA, discusses the meeting and these initiatives. Guest: Olalekan Ajayi, PharmD, MBA President, ACCC Chief Operating Officer, Highlands Oncology Group, PA Fayetteville, AR Resources: President's Cancer Panel National Cancer Plan
The science of oncology is rapidly evolving, as cancer programs and practices around the US continue to make cutting-edge discoveries in the diagnosis and treatment of cancer. In addition, there is an increased spotlight on the effects social drivers of health have on cancer care delivery, as health equity initiatives continue to permeate the oncology landscape. Building on these successes, NCI released the National Cancer Plan on April 3, 2023. The plan outlines goals designed to support the objectives of Cancer Moonshot. In support of this effort, the President's Cancer Panel held its first National Cancer Plan Stakeholder meeting September 7, 2023. ACCC was invited to share the association's key priorities for impacting cancer care in the US. ACCC president Olalekan Ajayi, PharmD, MBA, and chief operating officer at Highlands Oncology Group, PA, discusses the meeting and these initiatives. Guest: Olalekan Ajayi, PharmD, MBA President, ACCC Chief Operating Officer, Highlands Oncology Group, PA Fayetteville, AR Resources: ● President's Cancer Panel ● National Cancer Plan
Dr. Renee Wegrzyn is the first director of the Advanced Research Projects Agency for Health, (ARPA-H), a new federal agency with a $2.5 billion budget. Modeled after DARPA, the agency is tasked with taking big risks in biomedical research that seem beyond the reach of the private sector. Dr. Wegrzyn joins Preet to discuss how ARPA-H is promoting innovation, and their goal to “end cancer as we know it.” Stay Tuned is nominated for a Signal Award…and you're in the jury box! Head to cafe.com/signal to vote. Stay Tuned in Brief is presented by CAFE and the Vox Media Podcast Network. Please write to us with your thoughts and questions at letters@cafe.com, or leave a voicemail at 669-247-7338. For analysis of recent legal news, join the CAFE Insider community. Head to cafe.com/insider to join for just $1 for the first month. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Welcome to GRUFFtalk where each week we take a deep dive into all the ways we can feel better, look better, live better, and age better. This week host Barbara Hannah Grufferman talks with an incredible woman who had a busy life as a wife and mother, and a full career as a lawyer -- and then in 2012 was diagnosed with leukemia. She had every right and reason to put that proverbial blanket over her head and stay there. Instead, what she did with this diagnosis was . . . well . . . pretty incredible. I think her story will resonate and motivate all of you to seize every single day to help make life here on earth . . . and especially in our oceans . . . much, much better. Lynne Fletcher O'Brien's career over the past thirty years has been primarily in health care in the private, public and non-profit sector. As a lawyer, health care and patient advocate and cancer survivor, her work most recently was with then-Vice President Biden's Cancer Moonshot program. Four years ago, Lynne formed ‘Line in the Sand' combining all of her passions – her love of the ocean and water sports and her commitment to help cure cancer and to preserve the oceans. Lynne found many women were not participating in the activities they love because they could not find swimwear that looked good and that they could wear comfortably and confidently around others while simultaneously protecting themselves from the sun. ‘Line in the Sand' is a line of high end active/waterwear and edited accessories that take a stand for empowering women and the planet. UV swim leggings and sun tops are made from recycled materials and 100% of the profits go to cancer and ocean organizations. KEY LINKS: Learn More About Lynne and ‘Line in the Sand': www.lineinthesand.com Article About ‘Line in the Sand' in Oprah magazine: https://www.oprahdaily.com/style/a43431957/adams-style-sheet-swimsuits/ Article in Katie Couric's Daily Newsletter: https://katiecouric.com/shopping/style/best-vacation-outfits-resortwear/?utm_source=Sailthru&utm_medium=email&utm_campaign=WUC_Tuesday&utm_term=all_users A Few of the Not-for-Profit Organizations that are Supported By ‘Line in the Sand': Sea Legacy: https://www.sealegacy.org/ Leukemia & Lymphoma Society (LLS): www.lls.org Connect with Barbara: Website: https://www.barbarahannahgrufferman.com Facebook: https://www.facebook.com/BarbaraHannahGruffermanAuthor Instagram: https://www.instagram.com/barbarahannahgrufferman/ Learn more about your ad choices. Visit megaphone.fm/adchoices
I was privileged to welcome Dr. Danielle Carnival, White House Cancer Moonshot Coordinator, to the studio. We talked about the President's priorities, principal directives, and legislative strategies, as well as what Americans can look forward to in the coming months and years through this ambitious and transformational National initiative. Carnival, who has a Ph.D. in neuroscience, served as chief of staff and senior policy director for the 2016-2017 White House Cancer Moonshot Task Force. Subsequently, she served as vice president of the Biden Cancer Initiative. She's also a friend of Wegman's. So there's that, too. To learn more about the Whitehouse Cancer Moonshot initiative, visit https://www.whitehouse.gov/cancermoonshot. Enjoy the show.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Follow Mike L on Truth Social: https://truthsocial.com/@mikeLaL Email Mike: AskMikeL2@ProtonMail.com We The People must stand strong, stay united, resolute, calm and focus on the mission - God Wins! We at www.themelkshow.com want to thank all our amazing patriots pals for joining us on this journey, for your support of our work and for your faith in this biblical transition to greatness. We love what we do and are working hard to keep on top of everything to help this transition along peacefully and with love. Please help us amplify our message: Like, Comment & Share! The Show's Partners Page: https://themelkshow.com/partners/ Consider Making A Donation: https://themelkshow.com/donate/ Another way to get involved and find ways to become active in the community is to come meet Mel and many amazing truth warriors at our upcoming live in person speaking events. Together we are unstoppable. We look forward to seeing you. GodWins! https://themelkshow.com/events/ The Villages, Florida June 21 Reawaken America Tour Las Vegas, NV - Aug 25 & 26 Remember to mention Mel K for great discounts on all these fun and informative events. See you there! Our Website www.TheMelKShow.com Locals.com - Exclusive Mel K Content https://melk.locals.com/ CloutHub (Video/Social Media) https://app.clouthub.com/#/users/u/TheMelKShow Mel K Show Video Platform - (Subscription) https://www.themelkshow.tv Rumble (Video) - The Mel K Show https://rumble.com/c/TheMelKShow Bitchute (Video) - Melk.News/Bitchute https://www.bitchute.com/channel/Iw2kiviwZpwx/ Podbean (Podcast) https://themelkshow.podbean.com/ TRUTH Social https://truthsocial.com/@themelkshow Gab (Social Media) https://gab.com/MelKShow GETTR (Social Media) https://www.gettr.com/user/themelkshow Telegram (Social App) The Mel K Show Group - https://t.me/themelkshowgroup The Mel K Show Channel - https://t.me/themelkshowchannel If you are interested to explore investing in precious metals please contact below and mention MelK for special offers: Beverly Hills Precious Metals Exchange Buy Gold & Silver https://themelkshow.com/gold/ Speak with Gold Expert Andrew Sorchini…Tell Him Mel K Sent You! Gray & Sons Jewelers Have you considered alternative methods to hedging against inflation? With all the ongoing geopolitical uncertainty, now is a great time to protect your wealth with hard liquid assets. https://themelkshow.com/grayandsons/ Support Patriots With MyPillow Go to https://www.mypillow.com/melk Use offer code “MelK” to support both MyPillow and The Mel K Show Mel K Superfoods Supercharge your wellness with Mel K Superfoods Use Code: MELKWELLNESS and Save Over $100 off retail today! www.MelKSuperfoods.com HempWorx The #1 selling CBD brand. Offering cutting edge products that run the gamut from CBD oils and other hemp products to essential oils in our Mantra Brand, MDC Daily Sprays which are Vitamin and Herb combination sprays/ https://themelkshow.com/my-daily-choice/ Dr. Zelenko Immunity Protocols https://zstacklife.com/MelK Dr. Stella Immanuel, MD. Consult with a renowned healthcare provider! Offering Telehealth Services & Supplements. Use offer code ‘MelK' for 10% Off https://bit.ly/MelKDrStellaMD Dr. Mark Sherwood. Take care of your health with Dr. Mark Sherwood and his team at Functional Medical Institute. Download the free e-book to develop physical and emotional resiliency www.Sherwood.tv/melk
JCO PO authors Dr. Michael J. Kelley and Dr. Katherine I. Zhou share insights into their JCO PO article, “Real-world Experience With Neurotrophic Tyrosine Receptor Kinase Fusion–positive Tumors and Tropomyosin Receptor Kinase Inhibitors in Veterans.” Host Dr. Rafeh Naqash, Dr. Kelley, and Dr. Zhou discuss the robust Veterans Affairs (VA) National Precision Oncology Program (NPOP), accurate identification of gene fusions, and toxicities landscape of TRK inhibitors. Click here to read the article! 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, Social Media Editor for JCO Precision Oncology, and assistant professor at the OU Stephenson Cancer Center in the Division of Medical Oncology. Today, I'm thrilled to be joined by Dr. Michael J. Kelley. Dr. Kelley is the executive director of Oncology for the Department of Veterans Affairs. He's also the chief of Hematology-Oncology at the Durham VA Medical Center, and also a Professor of Medicine at the Duke University School of Medicine. And he's also a member of the Duke Cancer Institute. We are also joined by Dr. Katherine I. Zhou who is a Hematology-Oncology fellow at the Duke University. Dr. Zhou also spent time at the Duke Medical Center as part of her fellowship training, which I believe is how this project that was led by her came to fruition. So thank you both for joining today. This is going to be, hopefully, of very high interest to our listeners and I look forward to chatting with you both. Dr. Michael Kelley: Great, thanks for having us. Dr. Katherine Zhou: Thank you for having us. Dr. Rafeh Naqash: Thank you so much for joining. So I was very intrigued with this paper, and this paper follows a recent podcast that we had with Dr. Alexander Drilon, who's led some of the NTRK tropomyosin receptor kinase inhibitor studies that have been published in the last several years. And we had a very interesting discussion a couple of weeks back and I felt this was going to be a very interesting subsequent discussion into what was also an interesting discussion with Dr. Drilon. So what caught my attention is obviously the fact that you guys in this report, which is a real-world report, did not exactly see what we generally expect from clinical trials as far as response to target therapies in NTRK fusions. So before I ask you questions related to this project, one of the very interesting things at least I found was the fact is that the Veterans Health Administration is the largest integrated health system. Studies, whether conducted in the UK, for that matter European countries, or in Canada, they have integrated health systems which we do not. But we do have this advantage of the VA trying to do things in a very unique, centralized manner. So I wanted to ask Dr. Kelley first, how is it that you have implemented this National Precision Oncology Program, the NPOP as you call it, into the VA precision medicine workflow and how does it help in conducting research studies like the one that you published in the JCO Precision Oncology? Dr. Michael Kelley: Yeah, thanks for that question, Dr. Naqash. The NPOP started in 2016 as a national program and right from the beginning it grew out of an effort that was a joint collaboration between both clinical operations in the VA and the Research Office or the Office of Research and Development. It was designed from the very beginning to support discovery, new knowledge generation, and identifying patients for clinical trials in addition to bringing them best-in-class molecular testing and a consultation service. So it was initially funded out of the Cancer Moonshot 1 in 2016 when President Biden was then Vice President. The VA endorsed the model going forward in 2019 and now it's continued on and grown even bigger, it's expanded both in terms of scope and the complexity of the testing that's been done. So it was offered as services to facilities. They didn't have to do this, but I think they all saw the value of using NPOP to provide this group of services and that's what led to the generation of the robust underlying dataset that Dr. Zhou has used for this paper. Dr. Rafeh Naqash: Definitely. Thank you so much for that explanation. I did not know, and was not well aware, of how robust this program is. So I think it's a great learning opportunity for our listeners to know that a program like this exists. As we all know, there are different platforms, sequencing platforms, that each institution uses, whether it's commercial or whether it's in-house based. But the fact is, until and unless we have big pool datasets like the ones that you have generated or have access to, it's not easy to answer real-world questions. So first of all, I'd like to congratulate you and the rest of the VA administration to set up a program like this that hopefully is helping in matching the right patients to the right therapies and in clinical trial approvals. Now, before we take a deeper dive into the study that Dr. Zhou led, I did want to ask you, you have access to this amazing centralized platform, what are the kind of sequencing strategies or platforms that you use as part of this program? And is there an incorporation of molecular tumor boards to help understand some of these sequencing results that sometimes can be a little complicated to understand even for oncologists who look at these reports on a daily basis? So could you tell us a little bit more about that, Dr. Kelley? Dr. Michael Kelley: Yeah, certainly. So the VA contracts for the sequencing service, currently we're contracting with Foundation Medicine and Tempus for the comprehensive genomic profiling. There are some other services, and before we started using Foundation, there were two other companies that we used. There is a molecular tumor board. Our molecular oncology tumor board is designed primarily for case-based education. But there's also an asynchronous on-demand consultation service that occurs electronically because we have a unified electronic health record system. So any oncology provider in the country can enter a request through what's called an interfacility consult. It comes to a team, that team vets that, discusses it with the appropriate experts; that includes molecular oncologists, molecular pathologists. A lot of oncology pharmacists have been trained at a course that's at the University of Kentucky. And we have a lot of experience in doing this since that service was set up in 2016 as well, right from the beginning, because we understood the complexity of the data and the need for every oncologist across our enterprise to have access to the very best interpretation of that. We also have educational sessions that are integrated into the molecular tumor board time slot we call primers in terms of the underlying science of why you do the interpretations the way you do. And then there's also some additional education that we'll be endeavoring to offer to our staff and our oncologists coming up this year. Dr. Rafeh Naqash: Excellent. It sounds like you definitely have taken this into a very multidisciplinary approach where you're incorporating oncologists, pharmacists, and perhaps even genetic counselors and then, obviously, keeping the patient at the center and trying to find the best possible therapies that are most relevant for that individual. Now, going to Dr. Zhou's study here. Dr. Zhou, first of all, it's great to see a fellow lead a study and then especially, I think you're our first fellow on the podcast. We've had a lot of different individuals, but we have not had a fellow before. So thanks for coming. Could you tell us, for our listeners, what drove your interest into NTRK fusions? As we know, they are rare, something that is not commonly seen, and we do have clinical trial data in this space. So what was the idea behind looking at a real-world data set? Did you start out with a hypothesis or were you just interested to see how targeting these fusions in the real-world setting, actually, what kind of results does it lead to? Dr. Katherine Zhou: Yeah, well, first of all, thanks for the question. And I do just want to mention that although I did sort of bring this project to the finish line, it was started by another fellow, Vishal Vashistha. So just wanted to mention that. And I think the interest was really just that NTRK is such a rare fusion and just a difficult one to be able to study, like you said, in the real-world setting. And we have the advantage of having so much data through the VA and through NPOP, specifically. And so having seen such great results with the TRK inhibitors and clinical trials, I think there's this big question of how that translates into the real-world setting. We have the ability to do that with our large patient population. Dr. Rafeh Naqash: Excellent. And again, it's nice to acknowledge the support that you had from the other individual who co-led this study. Now, since you would have, I'm guessing, done most of the analysis here and looked into the whole idea of the kind of results that you saw—and from my understanding, you looked at the entire VA data set and tried to understand first the incidence or frequency of NTRK fusions and also responses to treatment, which I think is the main message—but could you tell us a little bit more about the data set? How did you acquire the data set, and what it took to analyze? Because obviously every project has a very unique story, and I'm guessing there's one very unique story here, since as a fellow you have limited time to do all this interesting work. So how did you navigate that and analyze and work with some of the things that you had to look at to get to the results? Dr. Katherine Zhou: Yeah, so again, this was work that was done with multiple people involved, of course. And we used what we had, the resources we had available, some tools we had available through the VA. So first, looking at NPOP and looking at patients who are sequenced through NPOP, we could just find all the ones who had an NTRK rearrangement of some kind. The second way we went about finding patients was through the CDW or the Corporate Data Warehouse where we could see which patients were prescribed larotrectinib or entrectinib and kind of go backwards from there and see which of those patients had NTRK alterations or specifically NTRK rearrangements. And so we combined the patients from both of those different methods to come up with our cohort at the end of 33 patients with NTRK rearrangements and 12 patients who are treated with TRK inhibitors. Dr. Rafeh Naqash: Excellent. Could you walk us through what was the subsequent analysis as far as how many NTRK fusions? I know you mentioned in the paper about DNA versus RNA-based testing. So how many were DNA-based, how many were RNA-based? I think there's some element of ctDNA-based testing also, or what tumor types those people had so that we get an understanding of what's the landscape of the findings that you had. Dr. Katherine Zhou: Sure. Since this is a real-world setting, as you may expect, the vast majority of the sequencing was done through tissue DNA sequencing, and that was the case. So for the 25 patients who were sequenced through NPOP that we found who had NTRK rearrangements, 23 of them had tissue DNA sequencing. And then one was tissue DNA RNA, and one was cell-free DNA sequencing. And so using that and being able to go back and look at how many patients have been sequenced in NPOP in total, we could kind of come up with a yield, although the numbers are very small. But we do see that there does seem to be probably a lower yield, for example, with cell-free DNA sequencing, as one might expect. And then looking at our total group of 33 patients, if we look at what types of cancers they had, we did have quite a few patients just based on prevalent tumors at the VA, I think, and in the population, prostate cancer was common, lung cancer, and then we had smaller numbers of colon and bladder, and I think there's a pancreatic cancer patient. We did have some of these rarer tumor types that more commonly have NTRK fusions as well, so like papillary thyroid carcinoma, and salivary gland cancers as well as soft tissue sarcomas. Dr. Rafeh Naqash: Question for you, Dr. Kelley, related to this data set: do you think that given that the denominator that you have is a unique population, the VA population, that's often males, they're usually above the age of 18, could the frequency have been influenced by that denominator where you may not have been able to capture, let's say, some of the rarer tumors that happen in the younger patient population, for that matter? Could that be a little bit of a bias here? Dr. Michael Kelley: Definitely. The population of veterans that have cancer that is treated in the Veterans Health Administration do represent generally adult males in the United States, but there is some skewing in certain regards. One of them is towards a higher frequency of smoking status. So not current smoking, which is actually about the same as the national average of about 11%, but the former smoking rate is about twice as high as it is in the rest of the United States. So we may have a lower frequency of some actionable variants in cancers in general because there's a higher etiological role for tobacco smoke in our population. But overall, looking at adult men if we look at like EGFR mutations, our incidence of EGFR mutations in adenocarcinoma is similar to what is reported in other real-world evidence bases from the United States, which is significantly lower than that which is found in academic medical centers. Dr. Rafeh Naqash: Thank you. I'm a big fan personally of real-world data sets. I do a lot of this with some other collaborators and generally, I do phase I trials, which is why I'm interested in precision medicine. And two weeks back, actually, I had a patient with prostate cancer, who ended up having NTRK fusion on a liquid biopsy. Now, you do talk about some of this related to in-frame or out-of-frame fusions and how that can have interesting aspects related to the kinase domain functionality and RNA expression. Dr. Zhou, for the sake of our listeners, could you briefly describe why understanding some of that is important and what implications it has? Dr. Katherine Zhou: Yeah, so I think the oncogenic NTRK fusion that we think of and that's being targeted by the TRK inhibitors is a fusion 5-prime of a protein that forms a dimer and on the 3-prime end is the kinase domain of the tropomyosin receptor kinase. And so you have to have some kind of a gene fusion that results in not only the transcription of that RNA fusion, RNA transcript, but then the translation of that fusion protein. So that needs to be, like you mentioned, that has to be in frame so that the entire protein is translated and expressed and it needs to include the kinase domain. It can't be the other end of the NTRK gene. And both of the genes need to be in the same orientation, of course. And then also the partner gene probably matters in that the ones that we know that actually cause activation of this oncogene are the ones that sort of spontaneously dimerize. And so that's a lot of requirements that we don't necessarily see when we just get, for example, a DNA sequencing result that says there's an NTRK rearrangement. Dr. Rafeh Naqash: Excellent way to describe the importance of understanding the functionality of the activated oncogenic fusion. Now, I know here in most of the patients that you have is DNA sequencing and I'm sure you'll talk about some of the results. And when you connect the results to the kind of data that you have, do you think not having the RNA assessment played a role in not knowing perhaps whether those fusions were functionally active? Dr. Katherine Zhou: Yes, I think we can't know for sure without having the RNA sequencing data. But certainly, that is a pattern in our small number of patients that we saw and something that makes sense just in terms of the mechanism of this oncogenic fusion protein. So I think that is a question of when should we be doing RNA sequencing to confirm that a fusion that we see on DNA sequencing is actually transcribed into RNA and how do we use RNA sequencing in a cost-effective and useful way to be able to detect more of these NTRK fusions that are actually clinically relevant. Dr. Rafeh Naqash: I absolutely agree with you and this is an ongoing debate. I know some platforms, commercial platforms that is, have incorporated RNA sequencing both bulk or whole transcriptome as part of their platform assessments, but it's still not made inroads into some other sequencing platforms that are commercially used. So it's an ongoing debate, but at the same time helping people understand that certain fusions need some level of RNA assessments to understand whether they're functionally active or not. Which again has implications, as you pointed out in terms of therapies are extremely relevant. Now, going to the results, which again was very interesting, could you tell us about the findings from the therapeutic standpoint that you observed and what your thoughts are about why you saw those results which were very different from what one would have expected? Dr. Katherine Zhou: Right. So in the clinical trials of larotrectinib and entrectinib, there were quite high objective response rates on the order of 60%, 70%, even almost 80%. In our very small real-world group of 12 patients who were treated with TRK inhibitors, nobody had an objective response and five patients had stable disease and everybody else, the other seven patients, progressed. And so the question is why did we see such a big difference compared to the trials? I sort of think of this as two big buckets. One is the population that we were looking at. So this is a real-world population. For example, in the clinical trials, there were almost no Black or African American patients, whereas here we had about 30%-40% Black or African American patients. Because it's a VA population, it was very heavily male, of course, the age groups are also different in that we didn't have children in the VA population whereas children were included in the trials. And the tumor types also differed because I think in the trials, which makes sense, there's a bias towards tumor types that have more NTRK fusions, and some of the tumor types we were looking at are just common tumor types like prostate and lung cancer where NTRK fusions are not common. But just because there are so many patients with these cancers, we did see them. And so certain of these groups, particularly certain racial and ethnic groups as well as certain tumor types, were not really represented in the trial to the extent that we can make conclusions about whether TRK inhibitors are effective in this population. So that's one. The second part, I think we've already talked about some, is just the method of detecting these NTRK fusions and how many of these NTRK fusions were actually truly producing oncogenic fusion proteins. And I tried to sort of categorize some of these fusions as being canonical in that they've been more studied. We know the partner gene, they are known to produce an oncogenic protein and to respond to TRK inhibitors. But actually of the four patients who had what we called canonical fusions, all four of them had stable disease at least, whereas the ones that were noncanonical mostly did not have a response or have even stable disease and mostly just progressed. And so then you wonder whether they even had the actual target protein we thought we were targeting. So this is where the real-world setting we're not doing the RNA sequencing or this additional testing to confirm that it's an oncogenic fusion protein. Dr. Rafeh Naqash: And I do see in your results there's a patient especially—you pointed out canonical and noncanonical fusions—you have a patient with a papillary thyroid cancer that I believe had a stable disease for close to two years plus. Is there anything interesting apart from an NTRK fusion in that specific patient where certain co-mutation could have played a role or certain other factors that do you think played into the fact that this patient had stable disease but didn't respond on the TRK inhibitor? Dr. Katherine Zhou: I don't have a great answer for that. I think this is one of the cancers that was well represented in the trials and that commonly has NTRK, or more likely has NTRK fusions. And this was a well-studied canonical NTRK fusion. So I think those are all reasons. The question of co-mutations I think is really interesting. We didn't have the data for every single patient, but for the ones we looked at a lot of the time, NTRK fusions are mutually exclusive with other driver mutations. So we didn't see a whole lot of commutations that we could sort of differentiate between responders or stable disease and progression. Dr. Rafeh Naqash: Thank you. Going to the toxicities, as a phase I trialist myself toxicity is the bane of my existence where we have to label toxicities, attribute toxicities, understand toxicities. The trial, obviously, as you very well know, that in the trials, they didn't have a lot of toxicities that caused patients to come off or required significant dose reductions, which is not the case compared to what you saw. Could you tell us a little bit about the landscape of toxicities for TRK inhibitors and what you saw in your cohort? That, again, I feel was interesting. Dr. Katherine Zhou: Of the 12 patients, I think two-thirds of them had either dose reduction or interruption or discontinuation, or some combination of the above. The toxicities we saw were more common than, or at least led to discontinuation and interruption and dose reduction more commonly than in the trials. But the toxicities we saw were also seen in the clinical trials. So LFT elevations, creatinine elevations, neurotoxicity, some cytopenias. We didn't actually see a whole lot of that, but those were present as well, and then some sort of nonspecific things like fatigue. And so, as much as we could tell from retrospective trial review, at least these were severe enough to lead to holding the drug. Dr. Rafeh Naqash: Thank you so much, Dr. Zhou. Question for you, Dr. Kelley. Putting this into perspective, the analysis that you did, how would you connect it to other real-world questions that one could answer using these kinds of data sets? So basically, what are the lessons learned from this amazing program that you guys have run successfully and are, I'm guessing, expanding in different directions? And how can you use a program like this to look at some of these unique questions using real-world data sets? Dr. Michael Kelley: There are a couple of, I guess, next steps for us that are based off this study and other information that we've gotten in other analyses from our NPOP data set. So, first of all, access to an RNA-Seq test. So that has been resolved to some extent, in that we now have two options for comprehensive genomic profiling, one of which does have RNA-Seq. And then the other approach that we're doing is to do more robust data generation. So we're going to be launching a study to collect prospective data on patients who are treated with off-label drugs. And as part of that, we will also have an on-label cohort for rare populations or any investigator in the VA who's interested in a particular drug or a particular genetic variant. They'll be able to tie into this protocol, and we will then collect data from across the system prospectively, which we think will improve the quality to some degree. And then thirdly, I think there's an opportunity to merge the initial generation of data in rare genetic types or other populations, which are highly selected by doing a distributed type of clinical trial where patients can be enrolled in prospective treatment trials. So we're not just generating data based on their real-world exposure to FDA-approved drugs, but we're generating data as we're developing the new drugs, we can have a much more heterogeneous and representative population of patients enrolled in clinical trials. So this is called the decentralized clinical trial model. We're starting to launch some trials with industry partners in this area to test out the model. If it works, I think we'll be able to help contribute to the knowledge that we all can use in terms of the patient types, the patient characteristics, but also some of the different tumor characteristics, and also to bring clinical trial opportunities to a more representative group. A lot of the initial clinical trials are done in urban areas, rural populations in VA are about a third of our patients live in rural areas, compared to only 14% of the country. So we think this is a very important diversity issue that should be addressed. Those are some of the ways that we're taking a lesson from this trial and other data that we have to sort of bring it forward. Dr. Rafeh Naqash: Those are excellent next steps and I think the kind of work that the VA is doing and this specific program, Precision Oncology Program, the NPOP program is doing, it's definitely setting up a unique standard in the United States where we have been limited by not having a centralized database. So setting something up of this sort hopefully will help answer a lot of these unique, interesting questions as you have access to data. And then the fact that you mentioned decentralized clinical trials and trying to cater to this access issue for patients in the VA system, I think that would be huge. And again, I congratulate you and your team on these efforts, and once again, thank you for joining us today and making JCO Precision Oncology a destination for your interesting work. We hope to see more of this work subsequently and hopefully, I get a chance to talk to you more about all the exciting stuff that you guys are leading within the VA health system. 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 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. Bios: Michael J. Kelley, MD, is Executive Director of Oncology for the Department of Veterans Affairs, Chief of Hematology-Oncology, Durham VA Medical Center, Professor of Medicine at Duke University School of Medicine and Member of the Duke Cancer Institute. Katherine I. Zhou, MD, PhD is a hematology-oncology fellow at Duke University. She also spends time at the Durham VA Medical Center as part of her fellowship training. COIs: Michael J. Kelley, MD Research Funding: Novartis (Inst), Bristol-Myers Squibb (Inst), Regeneron (Inst), Genentech (Inst), EQRx (Inst) Katherine I. Zhou, MD, PhD: No disclosures
Drs. Nathan Pennell and Nancy Lin discuss emerging data on the growing problem of prior authorization and insurance denials in cancer care, their potentially harmful impact on patient outcomes, and what can be done to fix the problem. TRANSCRIPT Dr. Nathan Pennell: Hello, I'm Dr. Nathan Pennell, your guest host for the ASCO Daily News Podcast today. I'm the co-director of the Cleveland Clinic Lung Cancer Program and vice chair of clinical research for the Taussig Cancer Institute. More importantly, today, for this podcast, I'm also the editor-in-chief for the ASCO Educational Book. On today's episode, we'll be discussing the growing problem of prior authorization and insurance denials, and how that impacts both providers and patients in their ability to access cancer care. Joining me is Dr. Nancy Lin, a breast cancer medical oncologist at the Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School. She's addressed this problem in a recently published article in the 2023 ASCO Educational Book, and she's joining me today to highlight some emerging data on the possible harms from prior authorization and insurance denials, and what we can do to fix this problem. Nancy, thanks so much for coming on the podcast today. Dr. Nancy Lin: Thank you for inviting me. Dr. Nathan Pennell: Some of our listeners may have noticed that we also did a podcast a number of years ago on a similar topic when we were with the Journal of Oncology Practice, and I was kind of hoping that prior authorizations would not be as big a problem, now, probably 8 or 9 years later, and unfortunately, it seems like it has gotten even worse. Before we begin, I should mention that our disclosures are available in the transcript of this episode, and disclosures relating to all episodes of the podcast are available on our transcripts at asco.orgDNpod. So prior authorizations were, of course, originally intended as a cost control on the overuse of expensive medical care. However, in recent years, it seems like prior authorization has been extended to, more or less, all medical care, including supportive care medications and essential cancer care interventions that we need to use in almost every patient. We're also hearing more and more reports on patients who are denied coverage, and I think the doctors can sympathize with this, with their increasing peer-to-peer requests. And this is leading to patients being forced to wait to receive second-best options, impacting their out-of-pocket costs. And potentially, we all fear this is impacting patient outcomes, although we really would like to learn more about how this is really impacting their care. So, Nancy, can you talk to us a little bit about how prior auth is impacting patient access to cancer care today? Dr. Nancy Lin: Of course, we all have to acknowledge that part of the impetus for prior authorization is just the increasing cost of cancer care. There are some recent statistics that the U.S. spends over $200 billion annually on cancer care and that oncology drugs are a huge part of the overall drug cost in the nation and a large part of the oncology drug budget. So, I think we can't deny that the increasing costs of cancer care are in part driving this drive for more prior authorization. But this has costs, and there are costs in terms of direct patient costs as far as their quality of care, and also costs in terms of the health care providers and health care system. And so we, as part of our article, actually solicited patients to provide their stories. And in fact, in our article, we have selected, with their permission, 3 patients who share their experiences. And these are experiences that, as a practicing oncologist, you'll be very familiar with. A patient wrote that she had been on capecitabine for a year, her disease is responding, and all of a sudden, on a Friday late in the day, she's told, “No, you need a prior authorization now, and you can't get your drug refilled.” And that led obviously to stress and delay and whatnot. And then another example is of a patient whose oncologist requested what sounds like next-generation sequencing, some sort of tumor panel and was denied. And the peer-to-peer here had apparently indicated that they are not aware of the data for the use of genomic testing and cancer treatment, which clearly there is a role for the use of genomic testing in cancer treatment. And in fact, we now have many articles that show that there's unequal access and, if we look at underrepresented minorities or other marginalized groups, that there is a dramatic difference in the utilization of advanced molecular testing. And then just the overall experience on patients and their families feeling like, at a time when they're sick, need to take charge of all of this paperwork and back and forth with insurers that is very stressful. And then, from a provider or health care system standpoint, many, many hours are expended on prior authorizations for things like very new drug approvals that are maybe not on a pathway yet, or very commonly, simple things like a CAT scan for restaging of somebody who has advanced breast cancer where every scan requires prior authorization or antiemetics, or somebody receiving highly immunogenic chemotherapy and these kinds of death by a thousand cuts I think is how people in the health care experience the aspect of prior authorization. Dr. Nathan Pennell: It's one of these things where we used to get a peer-to-peer for say, atypical reason for a PET scan, which made perfect sense, and you'd have to talk to an experienced expert to explain what you were doing and try to get a good rationale for that. And now, it's come to the point where a routine 2-month, 3-month CT scan is getting denied and having to be talking to someone who's not as experienced in this. Again, it feels still like a collection of anecdotes though in many ways. Is there any sort of published data on denials of care and prior auths and how this is impacting approvals and patient access? Dr. Nancy Lin: There are survey data, which one has to admit is not necessarily gold-standard data, but there are data from the American Medical Association, as well as a 2022 ASCO member survey. And in that ASCO member survey, over 90% of oncologists reported that they had personally experienced, in their patients, a delay in treatment related to prior authorization. Over 90% had issues getting needed diagnostic evaluations. Over 90% reported that they were, "forced to go to a second choice of therapy." And about a third of oncologists reported that they believed that the prior authorization, either delays or denial of care, led to changes or worsening of patient survival, which I think is the most concerning statistic of all. Now, I think that one can argue that these are essentially physician self-report and what's the gold standard as far as whether there has been an impact? But I think that the fact that these reports are so prevalent means that, even if the reality is half of what has been reported, it's still a lot. And I think that the power of these kinds of surveys is just enormous, that a high prevalence of the problems have been reported, I think, points to something even if we don't have gold standard quote data now. Within our institution, Dana-Farber, we have done an analysis of oral medication prescribing. So, we do have gold standard and very granular data on patients that we've seen. And we've seen denials and requirements of prior authorization not only for expensive cancer medications and growth factors but also for even medicines like generic tamoxifen, which, honestly, how does that need prior authorization in this day and age? Medications like supportive care, antiemetics, and really things that ultimately, we were able to get approved 97% of the time, but [prior authorization now] introduces a delay and introduces stress. And although one may not be able to measure a so-called negative outcome from a patient recurrence standpoint, I think that there are other kinds of negative outcomes that are important, including just the experience of a cancer patient undergoing treatment, the stress of all of the denial letters and the delays that can occur as a result. Dr. Nathan Pennell: And it's not just patients. Obviously, we want to be patient-centered in our care and focus on how this impacts them. But this is also significantly impacting practitioners and cancer centers and physicians and the administrative burden of having to do the prior authorizations, which of course are not standardized in any way and vary from payer to payer and geographic area to geographic area. Is there data on how the changes in prior auth have impacted practices and physicians? Dr. Nancy Lin: Yes. In fact, there have been several surveys as well as in the practice types of studies trying to understand the staffing that is required to manage the prior authorization requests. And some of the estimates are an additional 40 hours per week per oncologist, that's a full-time position. Some of these tasks can be carried out by non-oncology-trained providers but many of them do require either the oncologist or a nurse practitioner equivalent to be on the phone for the peer-to-peer or a full-time clinical provider and you are given a 4-hour window to do a peer-to-peer in the middle of clinic, that's very disruptive. And I think that that's fine if it's every now and then for drugs that we all agree are perhaps outside of their usual indication. But if this is every CAT scan and every brain MRI and every time we prescribe an oral drug, it really does affect both clinic workflow, and just the psychology; I think it really contributes to burnout. There was a very interesting survey actually of oncology trainees who, not even to the point where one is an attending physician, but at the trainee level indicating that this was something that was causing them a lot of distress, and in some cases, questioning the whole idea of going into medicine. And then when you think with the attrition that we're seeing in the health care workforce, we do really have to be careful about these burnout issues because we really can't afford to lose a lot of oncology staffing as the patient population ages and we're seeing higher prevalence of cancer. I think it's imperative that we take care of our oncology workforce. And I think this survey was very interesting because it went beyond the attending physician to other levels of oncology care, all of which are affected. And there have been, as you know, many growing or nascent attempts at various residency programs to think about unionizing and what are the kinds of concerns or complaints that trainees bring up. And one of [the complaints] that comes up a lot is, “We have to do these prior authorizations and there's all this administrative paperwork that doesn't require an entry-level person.” I'm not saying that they should or shouldn't do it - I'm not going to take a position on that - but the fact is that somebody has to do it in the current system, and whoever does it, it causes burnout. And I think that that is important. And the other piece of it has to do with equity and access to care because we're coming from academic institutions. We have a staff of people who help with prior authorization. That's not true in every practice in the United States. And I really worry about not so much denial of care but even a step beyond that, which is if you are in an under-resourced office and it's too hard to get certain things done, you don't do them because you just don't have the ability or you don't have the staffing to be able to find insurance. And I think that is very concerning to me in terms of access to care, access to some of our immune-targeted therapies, and access to the optimal support of care medications. We come from very well-resourced places as far as the administrative staff, relatively speaking, and that's just not true everywhere. Dr. Nathan Pennell: This whole idea kind of falls under the idea of creating friction in the system to try to slow things down. I've seen data suggesting that things like peer-to-peer requests for appeals actually lead to a majority of physicians not having time or taking the time to actually do that. And that may be sometimes because they know it's indefensible and don't want to go through the process. But probably a lot of the time it's just because they don't have time to do it in their busy day and those patients then don't get their care covered. So, it's really a problem. Now, the other thing that is really remarkable to me is, this is 2023 and everything is so technologically advanced. You can make major financial transactions electronically on your phone in just a few seconds, really complicated things. And yet this kind of [prior authorization] process really is still often done over the phone and by fax and with 100 different systems that don't talk to one another. And at the same time, oncology is becoming more and more guideline-driven where what we do actually have is really good evidence behind it. And there are even published guidelines for almost every disease and line of care about everything that we do from scan intervals to what kinds of treatment and how often and what supportive care is necessary. So, this would seem like an optimal situation for a technology solution where we tie in guidelines to what should and shouldn't be covered. What's going on out there in terms of trying to fix this? Dr. Nancy Lin: Some important questions are: Who makes the guidelines? What are the regulations as far as which guidelines insurance might adopt - their own internal guidelines or NCCN or comparable organizations? And what do you do when somebody wants to deviate from the guideline or pathway? And then finally a practical question, which is you don't really want to have a different platform and a different guideline for every insurance plan for every patient. And I think that is a little bit of even if we move to a purely electronic system, that will still be a problem. The state of Florida had done this pilot study that tried to use or incorporate the NCCN guidelines as part of their approval or review process for prior authorization requests and at least based on the report that's published, saved $15 million in costs. And we would hope if the care was more NCCN guideline-concordant, which has been shown to improve outcomes, that would have been done without a detriment to patient outcomes. I don't think we have enough granular information to be 100% sure of that, but I would assume that that's most likely the case. I do think that some amount of guideline use could be useful. And one of the things that we proposed in our article was the idea that one could create a sort of gold card system such that if a provider or a practice, for example, adheres to certain pre-agreed-upon guidelines or pathways more than 80% of the time, which is sort of considered good adherence and taking into account patient preference and comorbidities and whatnot, that that practice or provider could be sort of gold carded, so to speak, and actually have many of the prior authorization requirements go away so long as that is adhered to. And so that's one idea. One of the concepts that Dario Trapani, who was the first author of our paper, put forward is that you don't necessarily need every person to be compliant with every guideline. Generally, you need for there to be compliance and that there could be different categories of treatment so that supportive care medications, pain medications for cancer-related pain, could potentially be exempt from prior authorization requirements completely. And then at the same time for other kinds of prior authorization requests, it's not enough to just change a fax form to an electronic form. That's an improvement from having faxes going back and forth by paper, but really isn't a fundamental change in the prior authorization process or vision. And so, this idea of the pathways and then only when something is deviated in some sort of major way in various categories to be determined that sort of triggers a peer-to-peer review that would both hopefully serve the purpose of reducing overuse of unnecessary or non- indicated treatments and save money. But also, in a way, I think that is less burdensome to the health care system. And I fully acknowledge that I am not a policy expert, I mostly research metastatic breast cancer, but this issue really affects us all very personally every day. Dr. Nathan Pennell: I know you just said you're not a policy expert, but can you talk to us a little bit about what Congress and ASCO are doing to help from a legislation standpoint or a regulatory standpoint to help make this a little bit less painful? Dr. Nancy Lin: Yeah. So ASCO has endorsed the so-called “Improving Seniors Timely Access to Care Act.” And for those out there listening, particularly patients, you might say, “Well, I'm not a senior.” But it's important because how Medicare deals with issues often is then adopted by private insurers. And so starting with “Improving Seniors Timely Access to Care Act,” the intent is that it will also affect people with cancer at all age groups. But some of the provisions or the proposals are to convert to an electronic prior authorization system, to put systems in place for timely and efficient communication between providers and insurers, to ensure a process for real-time decisions that have some timeframe or timeline or deadline associated with it, to facilitate guidelines and pathway-informed decisions, and to also, importantly, be fully transparent about approvals and denials, portions that are denied, these sorts of reasons for denials, to really have transparency in that process which at the moment does not really exist. I think these are all very, very important steps with the overarching goal to promote timely and appropriate access to medications, procedures, and evaluations for oncology patients. Dr. Nathan Pennell: I'm just curious, in your opinion, do you think that there is actual inertia to try to change some of these things from a policy perspective? It can be kind of frustrating sometimes. It seems like the insurance industry has really kind of taken command of this by implementing these and we see the problems and we talk about them. But from a regulatory standpoint, it really seems like things are kind of maybe being a little bit neglected. Dr. Nancy Lin: I think that this is really something where I do think there will be some movement; maybe it's that I'm an optimist and that's what you need to be to be an oncologist. I think that a big part is going to be really a focus on the impact on patients because although we certainly feel the impact on ourselves as providers and our staff, I don't know that that in and of itself is going to be enough to move the needle, like doctors complaining that they are having to spend too much time on the phone. I think the real impact is really related to the impact on patients. And as I said, I think that the AMA survey and the ASCO survey, those are very important because they really put the focus on [assessing] the impact on patients living with cancer. Again, the limitations of a survey-based study are profound. And I do think that the current [White House] administration is very, very engaged in improving care for people with cancer. And in fact, part of this revised Cancer Moonshot [initiative] is not only better science around cancer and better molecular understanding of cancer but at the end of the day, if we can't get the right treatment to the right patient, it doesn't really matter how good the science is. And part of getting the right treatment to the right patient is not just training, guidelines and education. Part of it is just the practical aspect of insurance coverage as one important aspect of that. And so, I do think that there will be some movement on this because I think that it's really gotten to a point where this is not just inconvenient for doctors. I don't think that that's enough to drive anything forward personally, but I think that when you start to see impact on patients, that is really a big deal. I was struck that one of the studies that we had identified was a study looking at over 13,000 chemotherapy requests and understanding how many were denied and why they were denied. And basically, about 11% of the requests ultimately were denied after peer-to-peer and all sorts of other appeals. And this was essentially the gold standard, so to speak. In this study was the oncologist's opinion as assessed by the so-called board certified oncologist, which is what was described in the publication employed by the insurer. We have these competing narratives and that is ultimately the problem: We have the AMA and the ASCO surveys which are survey-based asking the oncologists, and we have these data which are based on the insurer essentially as the gold standard arbiter. So it's hard to reconcile those two pieces of information because they're not really coming from the same place. And then I think you could also argue that, think about 13,000 chemotherapy requests, that means that essentially 90% were fine. When we looked at our pathways employed at Dana-Farber where we check to make sure that our physicians are adhering to the pathways, we basically want to aim at about 80% with the idea that some patients decline a standard regimen, and we go to something else. They don't want alopecia with the idea that some patients have comorbidities, that you don't want to micromanage how oncologists are managing their patients. And honestly, in most pathway programs, we consider 80% to be pretty good. In this study, 80% were approved. And you might argue, is it worth reviewing 13,000 requests to this level of scrutiny for 90% to be approved? And again, I think that that really raises this idea of like rather than just switching a fax system to an electronic system to really rethink where's the low-hanging fruit? Where would prior authorization really serve a positive purpose? I think there are places where it could serve a positive purpose and where is it just adding unnecessary friction. Dr. Nathan Pennell: Yeah, it's a complicated picture and there are valid arguments on both sides. One of the things that is very appealing to me about the proposed legislation is requiring the payers to actually report and disclose their levels of denials and prior authorizations and this allow us to maybe take it beyond the anecdotal evidence to actually being able to document what they're doing. Because once you shine a light on things, sometimes it becomes a little bit harder to abuse the system. Dr. Nancy Lin: Yes, I agree. Dr. Nathan Pennell: Well, Nancy, thanks so much for coming on the podcast today to discuss this challenging problem. I know we could have talked about this for an hour or more. We really appreciate your work to highlight the impact of this problem both on providers and on patients, as well as outlining some efforts to find solutions. Dr. Nancy Lin: Great, thank you for having me. Dr. Nathan Pennell: I also want to thank our listeners for joining us today. If you value the insights you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Have a great day. 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. Nathan Pennell @n8pennell Dr. Nancy Lin @nlinmd Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Nathan Pennell: Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi Dr. Nancy Lin: Stock and Other Ownership Interests: Artera Inc. Consulting or Advisory Role: Seattle Genetics, Puma Biotechnology, Daichi Sankyo, Denali Therapeutics, AstraZeneca, Prelude Therapeutics, Pfizer, Olema Pharmaceuticals, Aleta Biotherapeutics, Artera, Johnson & Johnson/Janssen, Blueprint Medicines, Genentech, Pfizer, Seattle Genetics, Merck, Zion, Olema Pharmaceuticals
What if it was possible to have a roadmap to optimize the health trajectory of your body? Wearables and AI can utilize set parameters based on personal genetic and historical data and help mitigate risk by suggesting preventative practices, decreasing the chance of suffering chronic illness. How much control will we have over our health in the future? To discover new scientific wellness techniques, Positive Psychology Podcast Host Lisa Cypers Kamen speaks with Dr. Nathan Price about putting healthcare in our hands. Dr. Price is the Chief Science Officer of Thorne Health Tech and co-author of The Age of Scientific Wellness: Why the Future of Medicine is Personalized, Predictive, Data-rich, and in Your Hands. He shares information about the scientific research that has led to breakthroughs in preventative wellness for elongated health spans, and the part AI will play in the future of medicine. Nathan Price — Healthcare in Our Hands: Nathan describes how science has changed medicine in the past and how it will change medicine in the future. [1:53] Technology has brought forth opportunities to collect data for a predictive approach to healthcare. [4:46] How to optimize personal health right now. [7:44] Nathan explains why health spans are more important than lifespans. [16:32] Nathan offers preventative tips for maintaining brain health, which is often neglected in our healthcare system. [18:10] Nathan described Thorne Health Tech's involvement in President Biden's Cancer Moonshot 2.0 project. [24:53] This episode of Harvesting Happiness Talk Radio is sponsored by: OUAI — Daily self-care rituals contribute to happiness. And, when our locks need a little extra TLC, OUAI's shampoo, conditioner, and leave-in spray conditioner are teeming with beauty-boosting ingredients to give you fuller-looking, healthier-feeling, and happier hair for everyone. Good hair is more than just good styling, visit theouai.com and use code HH to get 15% off of your entire purchase.
The National Cancer Institute has established a third Cancer Screening Research Network that will leverage emerging technologies and develop clinical trials that could lead to earlier detection of different types of cancer. Multi-cancer detection tests are showing a great deal of promise when it comes to screening for certain cancers that could result in a more timely diagnosis and treatment which in turn reduces the number of cancer deaths. Dr. Lori Minasian, deputy director for the Division of Cancer Prevention at NCI, discusses how these tests fit into President Biden's Cancer Moonshot initiative, what the challenges around the tests are and more details about a new pilot study coming up in 2024.
With recent movement in healthcare including President Biden's Cancer Moonshot and the Inflation Reduction Act, one thing is clear: American healthcare is at a crossroads.As we begin to tackle the conversation of healthcare reform, how can we rebuild the system around patients?In this episode, MacKay Jimeson, Executive Director of The Patient Access & Affordability Project at Patients Rising, joins the show to explain how the system was never designed for patients, the benefits of a patient-centric system, and what the future holds for the industry.Join us as we discuss:Why patient-centricity is notably absent in our healthcare systemMacKay's op-ed in response to President Biden's SOTUThe impact of The Inflation Reduction Act and Centers for Medicare & Medicaid Services on today's healthcare landscapeThe true human impact of medicinesMacKay's Op-Ed: https://www.statnews.com/2023/02/09/state-of-the-union-highlights-americas-awkward-conversation-on-science-medicine-and-financing-the-development-of-new-medicines/MacKay's Bio:https://accessandaffordability.org/person/02-mackay-jimeson/
Shereef Elnahal, MD, MBA, under secretary for health at the Veterans Health Administration, sat for a conversation with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, that covered the cancer footprint of the VHA, from work within the newly reinvigorated Cancer Moonshot program and screening for vulnerable communities to the Million Veterans Program, the largest genomic database of its kind in the country and of Black Americans, including information on more than 150,000 Black veterans.
Ignition Plan for Cancer Moonshot David Johnson and Julie Murchinson shared their thoughts on cancer prevention and early detection in light of HHS' National Cancer Plan on this special episode of the 4sight Health Roundup podcast moderated by David Burda. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/
The Digital Medicine Society (DiMe) and Moffitt Cancer Center have announced they are co-hosting CancerX, a new public-private partnership effort to rapidly accelerate the pace of cancer innovation in the U.S. Alongside the Office of the National Coordinator for Health Information Technology (ONC) and the Office of the Assistant Secretary for Health (OASH), Moffitt Cancer Center and DiMe are urging the healthcare and digital health sectors to boost technology-driven initiatives to combat cancer. The two groups are working together to accelerate cancer research advancements, and they invite other organizations to do the same. The Biden administration's revived Cancer Moonshot includes the new CancerX public-private partnership. According to officials, the goal is to use industry collaboration and disruptive innovation to lessen the burden of cancer on everyone. The CancerX program will focus on using digital innovation to reduce disparities and financial toxicity in cancer care and research, working with government organizations, and will enlist industry parties to help with the mammoth undertaking. CancerX uniquely blends DiMe's expertise in convening cross-disciplinary groups to develop clinical-quality resources on a tech timeline with Moffitt's top research and care experts working side-by-side to revolutionize cancer treatment, extend access to the highest-quality care, and save more lives. The initiative is open to all those working in the field who are committed to working collaboratively and share a vision of unleashing the power of innovation to design and create a future that's free of the burden of cancer. Topics include: What is the Digital Medicine Society? Announcing CancerX, key initiatives and membership structure Improving the global ecosystem Guest & Host Links Connect with Dan Kendall | LinkedIn Connect with Jennifer Goldsack | LinkedIn and listen to her episode from May 2019 CancerX Digital Medicine Society Dime Academy DiMe Society Slack Digital Health Today would not be possible without the support of leading organizations. Thank you to: > Presenting Partner: Amalgam Rx > Contributing Partners and Sponsors: Akili | Lindus Health | Bayer G4A Connect on Digital Health Today: Browse Episodes | Twitter | LinkedIn | Facebook | Instagram Connect on Health Podcast Network: Browse Shows | Linkedin | Twitter | Facebook | Instagram
Secretary McDonough Office U.S. Department of Veterans Affairs Co-Host: Dr ArnoldPanelist: Dr. Fola May - is a Staff Physician at the Veterans Affairs Greater Los Angeles Healthcare System
Congress has appropriated $1.8 billion for the “cancer moonshot” Biden began in 2016, and positive reaction to Biden's recent request for more suggests it's eager to maintain the momentum. But cancer researchers are less unified about the moonshot than Washington policymakers. Erin Schumaker talks with host Katherine Ellen Foley about Biden's cancer moonshot.
I was privileged to welcome Dr. Danielle Carnival, White House Cancer Moonshot Coordinator, to the studio. We talked about the President's priorities, principal directives, and legislative strategies, as well as what Americans can look forward to in the coming months and years through this ambitious and transformational National initiative. Carnival, who has a Ph.D. in neuroscience, served as chief of staff and senior policy director for the 2016-2017 White House Cancer Moonshot Task Force. Subsequently, she served as vice president of the Biden Cancer Initiative. She's also a friend of Wegman's. So there's that, too. To learn more about the Whitehouse Cancer Moonshot initiative, visit https://www.whitehouse.gov/cancermoonshot. Enjoy the show.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Three of our favorite segments from the week, in case you missed them. Lin-Manuel Miranda On Politics, Art and Mentorship (First) | Andy Borowitz on Ignorance (Starts at 7:12) | Inside Biden's 'Cancer Moonshot' Initiative (Starts at 36:38) If you don't subscribe to the Brian Lehrer Show on iTunes, you can do that here.
Is President Biden's new monkeypox czar a satanist? Glenn reviews everything our system is pushing that used to be considered evil. “Nation of Victims” author Vivek Ramaswamy breaks down why the victimhood narrative is poisoning America. Even the Washington Post is questioning Pennsylvania Democratic Senate candidate John Fetterman's health … or is it Fetterwoman? Glenn reviews the latest evidence that Facebook and the government are colluding to censor people. New Hampshire congressional candidate Tim Baxter joins the program to discuss why he wants to abolish the IRS and CDC. Glenn and Pat review the coincidental timing of President Biden's “Cancer Moonshot.” Learn more about your ad choices. Visit megaphone.fm/adchoices
The news to know for Tuesday, September 13th, 2022! What to know about Ukraine making more progress over the last 24 hours, the encouraging new research about child poverty in the U.S., and the races to watch today in the final few primaries before November. Also: President Biden's ambitious plan to cut cancer deaths in half over the next 25 years. Plus: why a Blue Origin rocket crashed back to Earth, how to get an iPhone 14 pretty much for free, and some of the history-making highlights from the Emmys! Those stories and more in around 10 minutes! Head to www.theNewsWorthy.com/shownotes for sources and to read more about any of the stories mentioned today. This episode is brought to you by Rothys.com/newsworthy and ZocDoc.com/newsworthy Thanks to The NewsWorthy INSIDERS for your support! Become one here: www.theNewsWorthy.com/insider
In hour 2, Chris talks about Biden tripping over his words again, this time taking credit for cancer research that's been going for years. Also, more on the Vegas killer and the media who desperately don't want to say he's an elected democrat. For more coverage on the issues that matter to you download the WMAL app, visit WMAL.com or tune in live on WMAL-FM 105.9 from 9:00am-12:00pm Monday-Friday.To join the conversation, check us out on twitter @WMAL and @ChrisPlanteShowSee omnystudio.com/listener for privacy information.
In a speech on Monday, President Biden announced the next steps of his administration's so-called Cancer Moonshot initiative, which aims to prevent deaths from the disease. Sarah Owermohle, Washington correspondent at STAT News, and Barrett Rollins, MD, PhD, chief scientific officer emeritus at the Dana Farber Cancer Institute and author of the forthcoming book In Sickness: A Memoir (Post Hill Press, November 2022), discuss the details of the president's initiative.
Tonight, the Justice Department subpoenaed dozens as part of its criminal investigation into the Capitol insurrection. Crowds in Scotland are paying their respects to the late Queen Elizabeth II. President Joe Biden made a bold pledge to fight cancer. The nation's first railroad strike in 30 years could happen this week. Lastly, we'll explain how a brisk walk could do wonders for your health.To learn more about how CNN protects listener privacy, visit cnn.com/privacy
President Biden delivers a speech about his initiative to reduce cancer deaths in the United States. Then, Ukraine's impressive gains force Russian troops to retreat. But, are these advances temporary as the Kremlin launches retaliatory strikes? Plus, a message from the Queen's oldest son, the new King. Also, questions over the list of best colleges and universities in the U.S. after one prestigious school said its data was cooked.To learn more about how CNN protects listener privacy, visit cnn.com/privacy
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