Podcast appearances and mentions of Jorge Garcia

Jorge Garcia joins us to discuss the process of selecting abstracts for oral presentation and select highlights from this session.

CLL #2517 (feat. Jorge Garcia) 05/23/2005 – Monday Night Show Source – Tucker Stream Recording (2025)  This episode is 100% complete with a medium audio upgrade. Adam brings up Jorge’s Jack in the Box commercial much to his delight. Later in the show Drew describes Ian Somerhalder’s character on “lost’ as “a quasi evil guy who is into Maggie’s character” Adam steps in and corrects him and tells him that he was mistaking reality for the show and Ian was a quasi evil guy who was into Maggie in real life, to which Jorge lets out a very telling laugh. The Love Between The Two Hosts – CLL on Youtube, with Video for select episodes. https://adamanddrdrewshow.com/1743-loveline-nostalgia-with-superfan-giovanni/ https://account.venmo.com/u/GiovanniGiorgio Paid Read More →

Although it's a lighter weekend of action, there are a couple of solid contender main events and we've aslo got some interesting fight news and more on the "Big Fight Weekend Preview Podcast!"Host T.J. Rives returns with insider Dan Rafael to go over it all.They begin with the preview of the Matchroom/DAZN main event Saturday in LondonJohnny Fisher vs. Dave Allen, rematch in a 10 round heavyweight battle. Will Fisher step up this time and decisively win over the veteran Allen? Also, they preview the 360 Promotions/UFC Fight Pass main event in Commerce, Calif.Contender Serhii Bohachuk meets. Mykel Fox, who's stepping up to junior middleweight in the main event. Bohachuk wants to get in the 154 lb. title picture with a big win. Can the crafty, southpaw Fox create problems? News Wait, the Canelo Alvarez-Terence Crawford mega-fight, announced for September 12th for  Las Vegas isn't going to be on that date and maybe, not in Vegas?? Dan isn't so sure. The guys go over it. Also, the presser on Thursday in NYC for Turki Alashikh's July 12 Ring mag / DAZN PPV that will take place at Louis Armstrong Stadium tennis stadium in Queens, NY. Plenty of talk between Shakur Stevenson and top contender William Zepeda along with Edgar Berlanga and Hamzah Sheeraz at the presser.  And, Turki tells Dan he is unsure, if he will proceed with Garcia-Haney 2 right away and may look to get Garcia another fight first. Next, the California commission says Charli Suarez has appealed the technical decision loss to Emanuel Navarrete last Saturday night and the hearing is on agenda for June 2 commission meeting. Meanwhile, Bob Arum tells me he would like to do the immediate rematch in October in Manila to celebrate the 50th anniversary of the Thrilla in Manila, Ali-Fraizer 3, which he also promoted  Top Rank/Golden Boy/Zanfer made deal, avoid purse bid for vacant WBO junior middleweight title bout between Xander Zayas and Jorge Garcia. Dan's reporting is it is likely going to be July 26 at TBA. And, this would be on final Top Rank/ESPN card as their contract expires July 31. Hall of Famer Holly Holm has signed with MVP and is coming back to boxing for first time since 2013 (she went UFC and became a champion) to fight Yolanda Vega, who also signed with MVP, on Jake Paul-Chavez PPV on June 28.  NostalgiaMay 14, 2005 — 20 years ago on Wednesday – Winky Wright W12 Felix Trinidad domination. Big Dan was ringside andMay 15, 2044 -- 21 years ago Thursday – in the light heavyweight title rematch Antonio "Magic Man" Tarver KO2 Roy Jones in gargantuan shocker. WATCH these famous fight recaps on our BFW Youtube page here: https://www.youtube.com/@bigfightweekend9132And, make sure to be following/subscribed to our pod content on Apple/Spreaker/Spotify, etc.! 

Although it's a lighter weekend of action, there are a couple of solid contender main events and we've aslo got some interesting fight news and more on the "Big Fight Weekend Preview Podcast!"Host T.J. Rives returns with insider Dan Rafael to go over it all.They begin with the preview of the Matchroom/DAZN main event Saturday in LondonJohnny Fisher vs. Dave Allen, rematch in a 10 round heavyweight battle. Will Fisher step up this time and decisively win over the veteran Allen? Also, they preview the 360 Promotions/UFC Fight Pass main event in Commerce, Calif.Contender Serhii Bohachuk meets. Mykel Fox, who's stepping up to junior middleweight in the main event. Bohachuk wants to get in the 154 lb. title picture with a big win. Can the crafty, southpaw Fox create problems? News Wait, the Canelo Alvarez-Terence Crawford mega-fight, announced for September 12th for  Las Vegas isn't going to be on that date and maybe, not in Vegas?? Dan isn't so sure. The guys go over it. Also, the presser on Thursday in NYC for Turki Alashikh's July 12 Ring mag / DAZN PPV that will take place at Louis Armstrong Stadium tennis stadium in Queens, NY. Plenty of talk between Shakur Stevenson and top contender William Zepeda along with Edgar Berlanga and Hamzah Sheeraz at the presser.  And, Turki tells Dan he is unsure, if he will proceed with Garcia-Haney 2 right away and may look to get Garcia another fight first. Next, the California commission says Charli Suarez has appealed the technical decision loss to Emanuel Navarrete last Saturday night and the hearing is on agenda for June 2 commission meeting. Meanwhile, Bob Arum tells me he would like to do the immediate rematch in October in Manila to celebrate the 50th anniversary of the Thrilla in Manila, Ali-Fraizer 3, which he also promoted  Top Rank/Golden Boy/Zanfer made deal, avoid purse bid for vacant WBO junior middleweight title bout between Xander Zayas and Jorge Garcia. Dan's reporting is it is likely going to be July 26 at TBA. And, this would be on final Top Rank/ESPN card as their contract expires July 31. Hall of Famer Holly Holm has signed with MVP and is coming back to boxing for first time since 2013 (she went UFC and became a champion) to fight Yolanda Vega, who also signed with MVP, on Jake Paul-Chavez PPV on June 28.  NostalgiaMay 14, 2005 — 20 years ago on Wednesday – Winky Wright W12 Felix Trinidad domination. Big Dan was ringside andMay 15, 2044 -- 21 years ago Thursday – in the light heavyweight title rematch Antonio "Magic Man" Tarver KO2 Roy Jones in gargantuan shocker. WATCH these famous fight recaps on our BFW Youtube page here: https://www.youtube.com/@bigfightweekend9132And, make sure to be following/subscribed to our pod content on Apple/Spreaker/Spotify, etc.! 

National Superhero day.  Entertainment from 1996. Maryland became 7th state, Mutiny on the Bounty happened, 1st free fall parachute jump.  Todays birthdays - James Monroe, Oskar Schindler, Ann-Margret, Marcia Strassman, Jay Leno, Mary McDonnell, Bridget Moynahan, Jorge Garcia, Penelope Cruz, Jessica Alba.  Jim Valvano died.Intro - God did good - Dianna Corcoran   https://www.diannacorcoran.com/I am superman - REMLast night - Morgan WallenRock & a hard place - Bailey ZimmermanBirthday - The BeatlesBirthdays - In da club - 50 Cent     http://50cent.com/I just don't undeerstand - Ann-MargretGroovy world of Jack & Jill - Marcia StrassmanExit - Aint nothin else to do - Pat Waters      https://www.patwaters.com/countryundergroundradio.comHistory and Factoids website

The ⁨@PittsburghRiverhoundsSC⁩ Goal of the Week contender, Jorge Garcia, stops by to talk all about his transition to the pro game, walk us through that goal, and discuss the upcoming match against ⁨@DetroitCityFC⁩ #Riverhounds #USL #DETvPIT Hosted on Acast. See acast.com/privacy for more information.

Nueva entrevista, y esta vez con motivo de las próximas Xuntanzas del Xoan de Lugo nos hemos juntado unos gallegos para charlar un poco de nuestras cosas (todos hemos pasado por las Xuntanzas) y salió un programilla genial En esta ocasión nos reunimos un arquitecto, un profesor y un empresario forestal para sacar a relucir por un lado la experiencia tan gratificante que son las xuntanzas para el cuerpo y el alma, y para también echar un vistazo a nuestra España actual, tan podrida estatalmente... Xoan de Lugo: https://xoandelugo.org/ NUESTRAS REDES Y DEMÁS: Damos las gracias a: - Mariño Digital: www.Mariñodigital.es Contacto - EMAIL: escueladeserpientes@gmail.com - Telegram: https://t.me/joinchat/cPvFyjUHH2EzMWQ0 - Facebook: https://www.facebook.com/escueladeserpientes - Twitter: https://twitter.com/de_serpientes - Twitch: https://www.twitch.tv/escuela_de_serpientes - Instagram: https://www.instagram.com/escueladeserpientes/?hl=es - TikTok: https://www.tiktok.com/@de_serpientes - Linkedin: https://www.linkedin.com/in/podcast-escuela-de-serpientes-a04023201/ - Youtube: https://www.youtube.com/channel/UCyWmd7SjTQJlgvKLCKY6dMA Apóyanos: - Patreon: https://www.patreon.com/escueladeserpientes?fan_landing=true - Ko-Fi: https://ko-fi.com/escueladeserpientes Tienda: - https://www.latostadora.com/escueladeserpientes/ - https://www.spreadshirt.es/shop/user/escuela+de+serpientes/

A plan to sell the shuttered Harding High School to Bridgeport Hospital fell through and now there are plans to potentially create a pre-K through eight grade school at the location. But with three existing schools in the East End and talks about eliminating schools in the district, how does this proposal make sense? We got some clarity from Jorge Garcia, Director of Facilities for the Bridgeport school district. Image Credit: Getty Images

In This Episode There's something happening beneath the surface of every pizza order, every childcare payment, and every invoice sent by businesses across America. A quiet revolution that most people— sometimes even business owners themselves— have barely noticed. Traditional banks are being methodically extracted from the daily financial lives of businesses, replaced by something more streamlined, more embedded, as banking becomes just another node in a business operating system. We dug into those threats last episode on “The Invisible Heist”. This week, Jorge Garcia, Founder and CEO of Linker Finance, and Samer Saab, SVP of Product for Alloy Labs, join host JP Nicols and co-host Barb MacLean as we look at some viable options for banks to foil the heist and create a competitive response. We'll look at the surprising opportunities sitting right in front of us, and how banks are rewriting the playbook to land and expand commercial customers through digital banking.

The future of Bridgeport Public School buildings is being worked out as we speak. We got an update of the district's master plan from Jorge Garcia, Director of Facilities for Bridgeport Public Schools. He broke down some of the key findings from the study conducted for this plan, specifically addressing the potential to close down schools. For the full master plan: https://resources.finalsite.net/images/v1740689364/bridgeportedunet/pi6uc68jvfu1q2alfegz/BPS_Findings_Meeting_2025-2-27.pdf Image Credit: Getty Images

Jorge Garcia's journey is the kind of immigrant success story that deserves a toast over a glass of red wine. Arriving in Miami during the 1960s Cuban exodus, his family settled in Liberty City, where he quickly learned the art of resilience. That grit took him to the University of Miami's School of Architecture, and eventually, to the bold decision to launch his own firm with partner Peter Stromberg.From designing public bathrooms for free to transforming The Boca Raton Resort & Club for Wayne Huizenga and Michael Dell, Jorge's career has been a masterclass in reinvention. In this episode, he shares the twists, turns, and untold stories behind his architectural legacy—and the evolution of South Florida itself.Pour yourself a glass and tune in.Connect with usLooking to dive deeper into the Miami commercial real estate scene? Well, you've stumbled upon our favorite topic of conversation. So, whether you're a curious beachcomber or a seasoned investor, drop us a line at info@gridlineproperties.com or dial us up at 305.507.7098. Or if you're feeling social, you can stalk us on LinkedIn and connect with us there. Let's make some waves in the 305 real estate world together! Ben Hoffman's bio & LinkedIn ( linkedin.com/in/ben-hoffman-818a0949/ ) Felipe Azenha's bio & LinkedIn ( linkedin.com/in/felipeazenha/ ) We extend our sincere gratitude to Büro coworking space for generously granting us the opportunity to record all our podcasts at any of their 8 convenient locations across South Florida.

Stehen die Schauspieler Matthew Fox, Evangeline Lilly, Terry O'Quinn und Jorge Garcia, die die Titelgesichter von «Lost» waren, für schlechtes Fernsehen? Sechs Jahre haben die Fernsehzuschauer damals beim US-Sender ABC mitgefiebert, in Deutschland wurde die Serie aufgrund von schlechten Quoten zwischenzeitlich von ProSieben zu Kabel Eins abgeschoben. Das Ende war für viele Menschen nicht wirklich zufriedenstellend. Ähnlich unzufrieden waren die Zuschauer mit der dritten «Star Wars»-Trilogie. Dieses Mammut-Projekt hat Lucasfilm-Chefin Kathryn Kennedy immer noch nicht ihren Job gekostet, obwohl ihrerseits gravierende Fehlentscheidungen gefällt wurden. Die Sequel-Filme hatten keine übergreifende Handlung, nachdem J. J. Abrams „Das Erwachen der Macht“ hergestellt hatte, versuchte Rian Johnson einen anderen Film zu produzieren. Für den letzten Teil übernahm wieder Abrams, doch die Handlung ist für viele Menschen verpfuscht. Ein positives Beispiel für ein gelungenes Serienende ist «Emergency Room». Die Notaufnahme schloss sich nach 15 Staffeln und 331 Episoden. In den letzten Episoden schauten frühere Darsteller wie Anthony Edwards, George Clooney, Noah Wyle, Sherry Stringfield und Eriq La Sale vorbei. Zu guter Letzt bekamen fast alle Figuren einen würdigen Abschluss. Denis K. Lennepe und Fabian Riedner diskutieren noch mehr Fälle aus.

Estrategia completa de entrenamiento, nutrición y mentalidad. (Serie especial 2025 Epico) Time Stamps: Introducción 00:00 Establecer Metas (SMART) 6:00 Eliminación de malos hábitos 17:09 Metas vs Sistemas 55:44 Cooper test, MET & VO2 1:08:22 Patrones de movimiento 1:51:15

L'équipe de We Have To Go Back se retrouve pour un nouveau rewatch d'épisode. Cette fois, il s'agit de l'épisode 1×09 centré sur Sayid : Solitary. SolitaryAprès s'être isolé du groupe, Sayid découvre un câble sur la plage, en le suivant, il tombe dans un piège. C'est ainsi qu'il rencontre Danielle Rousseau, la femme qui a enregistré le fameux message. Il fait plusieurs découvertes terrifiantes qui pourrait bien changer la donne. Pendant ce temps, le reste du groupe se détend avec une bonne partie de Golf. La recherche d'intimitéCet épisode traite beaucoup d'intimité entre les personnages. Rousseau cherche à se connecter à Sayid, le groupe cherche à rester soudé. Une nouvelle fois, la série démontre l'importance des relations avec les autres. Ils sont à la fois ce qui nous complique la vie, mais ils sont aussi nécessaires à notre évolution et bien être. En ajoutant Rousseau, la série permet d'opposer deux philosophies, celle de John Locke et de Jean-Jacques Rousseau. La mythologieSolitary est également un épisode charnière en ce qui concerne la mythologie de la série. Le spectateur trouve ses premières réponses et il est confronté à de nouvelles questions. Quelle est la maladie dont parle Rousseau ? Qui murmure dans la forêt ? Boone sera-t-il un jour utile ? tant de mystère à suivre Les podcasts de Jorge Garcia sur Lost : https://podcasts.apple.com/gb/podcast/the-storm-a-lost-rewatch-podcast/id952917333 https://archive.org/details/geronimo-jacks-beard Soutenez Sophie dont le texte a été sélectionné dans l'anthologie terreur nordiques : https://fr.ulule.com/terreur-nordique---tremblez-en-terres-viking--/ L'épisode de OASLR sur Beetlejuice 1 et 2: https://jamesetfaye.fr/onaslr-beetlejuice-beetlejuice/ Un grand Merci à Xp pour avoir réalisé le montage de l'épisode. Écouter et suivre Geek en série sur : https://linktr.ee/geekenserie Retrouver Sophie : https://linktr.ee/sophiahautrice? Retrouver Riley: Pourquoi Buffy c'est génial : https://pourquoibuffycestgenial.wordpress.com/ JDR Academy: https://jdracademy.fr/ Découvrir nos autres productions : https://linktr.ee/jamesetfaye Nous soutenir grâce à :Tipeee : https://fr.tipeee.com/james-et-faye Et retrouver toute notre actu sur :Le site internet : http://jamesetfaye.fr/

“Christmas is a sexual kink for both of them!” - Chris, on DeVito and Chenoweth's characters On this special holiday episode of WHM, we're chatting about the absolutely unhinged, abhorrent, mid-aughts Christmas comedy, Deck the Halls! Are Danny DeVito and his hot family actually aliens? Why is Broderick's character free-balling outside in his bathrobe? Why doesn't the film conclude with the big winter festival they keep yammering about? Who would've thought we would be missing Tim Allen and Jamie Lee Curtis and their KRANKS characters? And wouldn't comedy legend Charles Grodin have absolutely crushed the straight man role in this movie? PLUS: Is this Broderick's worst movie? DeVito's?  Deck the Halls stars Matthew Broderick, Danny DeVito, Kristen Davis, Kristen Chenoweth, Alia Shawkat, Dylan Blue, Kelly Aldridge, Sabrina Aldridge, Jorge Garcia, Gillian Vigman, and Fred Armisen as Gustave; directed by John Whitesell. This episode is brought to you in part by Diet Smoke! Just for our listeners, Diet Smoke is offering a $50 welcome gift, PLUS 20% off your entire order this holiday season. All you gotta do is head over to www.dietsmoke.com and use the code WHM at checkout.  This holiday season, make the Official WHM Merch Store your one-stop shop for all your holiday needs! T-shirts? Prints? Phone cases? Stickers? We got it all! Head over to our Tee Public shop and check it out today! From December 1, through the entirety of 2025, we'll be donating 100% of our earnings from our merch shop to the Center for Reproductive Rights. So head over and check out all these masterful designs and see what tickles your fancy! Original cover art by Felipe Sobreiro.

Confident. Certain. Poised. Prepared. Jorge Garcia, a first-time city manager in Pismo Beach, California, embodies all of these adjectives. He has spent many years readying himself for this moment -- his first assignment as a chief executive officer for a municipal corporation. He is only one year into his tenure, but as you listen to this interview, you will come away with the impression that he's sat in "the chair" for a decade plus! Jorge is the next generation of public sector leadership and he models a wonderful example for those aspiring to become city managers. There are several really good nuggets in this conversation and in particular, his communications strategy with his elected officials designed to build trust and create confidence. SHOW NOTES: Jorge Garcia's LinkedIn profile Pismo Beach public works director vacancy with an 11/15/2024 application deadline can be found here: https://www.governmentjobs.com/careers/pismobeach EPISODE SPONSOR: This episode is sponsored by KUDO. Make your council meetings accessible with translated audio and live captions into 45+ languages. EXCLUSIVE OFFER: Only listeners of the City Manager Unfiltered podcast can sign up for a FREE, no risk, no obligation one-month trial offer. Use this link: https://kudo.ai/cmu/ SUBMIT JOB POSTING: Do you have an executive or senior level vacancy in your organization? Use this form/link to submit your job listing in my weekly newsletter for just $100: https://forms.gle/ceMzWqeLwiRFRAGj9 SUPPORT THE PODCAST: Subscribe to my FREE weekly report of city and county manager resignations, terminations, and retirements (RTRs) at this link: https://www.linkedin.com/newsletters/city-manager-rtrs-job-board-7164683251112992768/ If you would like to support the podcast by making a donation, please use the "Buy Me A Coffee" link. Please rate and review the podcast on Apple or your preferred platform if you enjoy the show. It helps tremendously. But more importantly, refer your friends and peers to podcast through personal conversations and posts on your social media platforms. Joe Turner's LinkedIn Page City Manager Unfiltered YouTube Page - Subscribe Today! Note: Page may contain affiliate links. As an Amazon Associate I earn from qualifying purchases.

Para mantener las buenas costumbres hoy Jorge visita Tertulia Dura para conversar sobre obesidad, las guías de la FDA , dietas populares, vacunas, Big Pharma y Estáticas, bajo un punto de vista de evidencia y análisis de data.

Join us as we recap and chat about Once Upon a Time Episode 2x13 "Tiny" Did you know the magic mushroom that Anton eats is actually made out of Marzipan? Wiki page for the episode: https://onceuponatime.fandom.com/wiki/Tiny Links, articles, and videos mentioned in this episode: Jorge Garcia's IMDB Join our Book Club on Patreon Follow us on Instagram Follow us on Tiktok --- Support this podcast: https://podcasters.spotify.com/pod/show/obdykpod/support

Anita finds out what is happening in Pismo Beach from City Manager Jorge Garcia.

National Superhero day.  Entertainment from 2023. Maryland became 7th state, Mutiny on the Bounty happened, 1st free fall parachute jump.  Todays birthdays - James Monroe, Oskar Schindler, Ann-Margret, Marcia Strassman, Jay Leno, Mary McDonnell, Bridget Moynahan, Jorge Garcia, Penelope Cruz, Jessica Alba.  Jim Valvano died.Intro - Pour some sugar on me - Def Leppard   http://defleppard.com/I am superman - REMLast night - Morgan WallenRock & a hard place - Bailey ZimmermanBirthday - The BeatlesBirthdays - In da club - 50 Cent     http://50cent.com/I just don't undeerstand - Ann-MargretGrooby world of Jack & Jill - Marcia StrassmanExit - Its not love - Dokken    http://dokken.net/Follow Jeff Stampka on Facebook

Hometown Radio 04/11/24 3p: Guest host Jeanette Trompeter speaks with Jorge Garcia-Newly Appointed City Manager of Pismo Beach Talking Pismo

"Every [banking] app is different, but they're all different in a similar way. So for us, it's actually to have that meta understanding of what an app is, and what needs to be modified and how, and that's what I think we've cracked in a pretty good way." In this episode of the Founders in LA podcast, Jorge Garcia, CEO and Co-Founder of Linker Finance, shares his remarkable journey from Honduras to the US and his mission to revolutionize community banking. Jorge discusses the importance of community banks in the American economy and how Linker's digital banking platform is empowering them to compete with larger institutions. He highlights their white-label solutions, low-code approach, and open ecosystem, enabling banks to provide efficient, modern services. Join us for an insightful conversation about the future of banking and supporting small businesses with Jorge Garcia.

In this episode, Jorge Garcia, BSN RN joins the show to discuss the differences between ICU and ER nursing. We discuss which ones have the best patient interactions, who has the best stories, patient populations, and much more!-------------------------------------------------------------------EPISODE SPONSOR – AMERICAN MOBILEBecome a Travel Nurse at: https://www.americanmobile.com/AMN PassportDownload the app at: https://www.amnpassport.com/-------------------------------------------------------------------TIMESTAMPS:(0:00) Introduction(3:20) Patient Populations(15:44) Does ICU or ER Nursing Have Better Team Work?(24:34) Who Runs the Better Codes(31:40) Better Patient Interactions(38:22) Which Nurse Would Win a Bar Fight(43:23) Should You Start in the ICU or ER(52:50) Does ICU or ER Have Better Stories?-------------------------------------------------------------------ABOUT THE GUESTJorge graduated in August 2018 with his BSN and ICU and ER throughout his career. He started travel nursing in October of 2020 and has completed ICU contracts in Atlanta, Houston, The Woodlands, Tampa, and Las Cruces. Jorge just recently accepted a position as a flight nurse and will be starting later this month. Jorge has a love for critical care nursing, going to the gym, and investing in real estate.Instagram-------------------------------------------------------------------FIND US ONYouTube – https://www.youtube.com/nursingunchartedInstagram – https://www.instagram.com/amnnurseApple Podcasts – https://podcasts.apple.com/us/podcast/nursing-uncharted/id1570694185Spotify – https://open.spotify.com/show/1btLYaMHoabT3icqGUgesBWebsite – https://www.americanmobile.com/podcast/nursing-unchartedPowered by AMN Healthcare

Jorge Garcia is known as an actor (LOST, Alcatraz, Hawaii 5-0, the Munsters, and the Ridiculous 6), but most importantly, Jorge is a husband and a father to a 22 month old little girl. David Greenspan is known as an editor and director (Grey's Anatomy, Station 19, How to Get Away with Murder, Bean Cake), but most importantly, David is a husband and the father of a 13 year old son who has starred for 6 years on a network sitcom as well as 10 year old and 7 year old boys not involved in the entertainment business at all. Jorge and David join us for a very frank and vulnerable conversation about our hopes, fears, successes and failures as fathers.  We share, compare, and contrast our parenting styles, where we all are in our parenting journeys, and make fun of David for not being able to effectively tell a story.  Also, you can't get much more adorable than Jorge's impression of his daughter!      This is Those Who Do: Fatherhood w/ Jorge Garcia & David Greenspan!

Flesh Wound Horror Presents Another TROMA Special, counting down to the 50th Anniversary. On this episode we tackle the wild 2004 gross out horror comedy- TALES FROM THE CRAPPER, featuring James Gunn, Julie Strain, Eli Roth, Ted Raimi, Jorge Garcia, Debbie Rochon, Masuimi Max, Ron Jeremy, Trey Parker, and Lloyd Kaufman himself as The CrapKeeper. In addition we tackle the 1998 Slasher Comedy, DECAMPITATED. https://youtu.be/xrc6Ar_FTAs

On this episode of Fractured Frequency we explore the idea of anxiety. Jorge Garcia and Albert Felipe offer their thoughts on anxiety as DJs, and offer some suggestions on what not to do your DJ which may or may not include requesting songs by Drake.

In this episode of ASCO Educational podcasts, we'll explore how we interpret and integrate recently reported clinical research into practice. Part One involved a 72-year old man with high-risk, localized prostate cancer progressing to hormone-sensitive metastatic disease. Today's scenario focuses on de novo metastatic prostate cancer. Our guests are Dr. Kriti Mittal (UMass Chan Medical School) and Dr. Jorge Garcia (Case Western Reserve University School of Medicine). Together they present the patient scenario (1:13), going beyond the one-size-fits-all approach (4:54), and thinking about the patient as a whole (13:39). Speaker Disclosures Dr. Kriti Mittal:  Honoraria – IntrinsiQ; Targeted Oncology; Medpage; Aptitude Health; Cardinal Health  Consulting or Advisory Role – Bayer; Aveo; Dendreon; Myovant; Fletcher; Curio Science; AVEO; Janssen; Dedham Group  Research Funding - Pfizer Dr. Jorge Garcia:  Honoraria - MJH Associates: Aptitude Health; Janssen Consulting or Advisor – Eisai; Targeted Oncology Research Funding – Merck; Pfizer; Orion Pharma GmbH; Janssen Oncology;  Genentech/Roche; Lilly  Other Relationship - FDA Resources  ASCO Article: Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019 ASCO Course: How Do I Integrate Metastasis-directed Therapy in Patients with Oligometastatic Prostate Cancer? (Free to Full and Allied ASCO Members) If you liked this episode, please follow the show. To explore other educational content, including courses, visit education.asco.org. Contact us at education@asco.org. TRANSCRIPT Disclosures for this podcast are listed on the podcast page.  Dr. Kriti Mittal: Hello and welcome to this episode of the ASCO Education Podcast. Today, we'll explore how we interpret and integrate recently reported clinical research into practice. In a previous episode, we explored the clinical scenario of localized prostate cancer progressing to metastatic hormone-sensitive disease. Today, our focus will be on de novo metastatic prostate cancer. My name is Kriti Mittal and I am the Medical Director of GU Oncology at the University of Massachusetts. I am delighted to co-host today's discussion with my colleague, Dr. Jorge Garcia.  Dr. Garcia is a Professor of Medicine and Urology at Case Western Reserve University School of Medicine. He is also the George and Edith Richmond Distinguished Scientist Chair and the current Chair of the Solid Tumor Oncology Division at University Hospitals Seidman Cancer Center.  Here are the details of the patient case we will be exploring: The patient also notes intermittent difficulty in emptying his bladder with poor stream for the last six months. A CT scan of the abdomen and pelvis demonstrates enlarged prostate gland with bladder distension, pathologically enlarged internal and external iliac lymph nodes, and multiple osteolytic lesions in the lumbar sacral, spine, and pelvic bones. A CT chest also reveals supraclavicular lymphadenopathy and sclerotic foci in three ribs. So this patient meets the criteria for high-volume disease and also has axial and appendicular lesions.  The patient was admitted for further evaluation. A bone scan confirmed uptake in multiple areas identified on the CT, and a PSA was found to be greater than 1500. Biopsy of a pelvic lymph node confirmed the diagnosis of prostate cancer. This patient is somewhat different from the first case we presented in terms of timing of presentation; this patient presents with de novo metastatic high-volume disease, in contrast to the first patient who then became metastatic after undergoing treatment for high-risk localized disease.  Would you consider these two cases different for the purposes of dosing docetaxel therapy when you offer upfront triplet therapy combinations?  Dr. Jorge Garcia: That's a great question. I actually do not. The natural history of someone with localized disease receiving local definitive therapy progressing over time is different than someone walking in with de novo metastatic disease. But now, with the challenges that we have seen with prostate cancer screening, maybe even COVID, to be honest with you, in North America, with the late care and access to testing, we do see quite a bit of patients actually walking in the office with de novo metastatic disease. So, to me, what defines the need for this patient to get chemotherapy is the volume of his disease, the symptoms of his disease – to be honest with you – and the fact that, number one, he is clinically impaired. He has symptomatic disease, and he does have a fair amount of disease, even though he may not have visceral metastasis. Then his diseases give him significant pain.  Oral agents are very good for pain control. I'm not disputing the fact that that is something that actually these agents can do. But I also believe I'm senior enough and old enough to remember that chemotherapy, when it works, can actually really alleviate pain quite drastically. So for me, I think that the way that I would probably counsel this patient is to say, "Listen, we can give you ADT plus an oral agent, but I really believe your symptomatic progression really talks about the importance of rapid control of your disease.” And based upon the charted data from the United States, and equally important, PEACE-1, which is the French version of ADT, followed by abiraterone, if you will, and certainly ARASENS is the standard of care for me for a patient like this will be triple therapy with ADT and docetaxel.  What I think is important for us to remember is that, in ARASENS, it was triple therapy together. I am worried sometimes about the fatigue that patients can have during the first six cycles of docetaxel. So oftentimes, I tell them if they're super fit, I may just do triple therapy up front, but if they I think they're going to struggle, what I tell them is, "Hey, we're going to put you on ADT chemotherapy. Right after you're about to complete chemo, we'll actually add on the darolutamide." So I do it in a sequence, and I think that's part of the data; we just still don't know if it should be given three at front or ADT chemo, followed by immediately, followed by an ARI. So I love to hear if that's how you practice or you perhaps have a different thought process. Dr. Kriti Mittal: So I usually start the process of prior authorization for darolutamide the day I meet them for the first time. I think getting access to giving docetaxel at the infusion center is usually much faster than the few weeks it takes for the prior authorization team to get copay assistance for darolutamide. So, in general, most of my patients start that darolutamide either with cycle two or, depending on their frailty, I do tend to start a few cycles in like you suggested. I've had a few patients that I've used the layered-in approach, completing six cycles of chemotherapy first and then layering in with darolutamide.  I think conceptually the role of intensifying treatment with an androgen receptor inhibitor is not just to get a response. We know ADT will get us a PSA response. I think the role of an androgen receptor inhibitor is to prevent the development of resistance. So, delaying the development of resistance will be pertinent to whether we started with cycle one, cycle six, or after. So, we really have to make decisions looking at the patient in front of us, looking at their ECOG performance status, their comorbidities, and frailty, and we cannot use a one-size-fits-all approach.  Dr. Jorge Garcia: Yeah, I like that and I concur with that. Thank you for that discussion. I think that you may recall some of our discussions in different venues. When I counsel patients, I tell the patients that really the goal of their care is on the concept of the three Ps, P as in Peter. The first P is we want to prolong your life. That's the hallmark of this regimen, the hallmark of the data that we have. That's the goal, the primary goal of these three indications is survival improvement. So we want to prolong your life so you don't die anytime soon from prostate cancer.  The second P, as in Peter, is to prevent, and the question is preventing what? We want to prevent your cancer from growing, from growing clinically, from growing radiographically, and from growing serologically, which is PSA and blood work. Now, you and I know and the audience probably realize that the natural history of prostate cancer is such that traditionally your PSA will rise first. There is a lead time bias between the rise and the scan changes and another gap in time between scans and symptoms. So it's often not the case when we see symptomatic disease preceding scans or PSAs, but sometimes in this case, it's at the same time. So that is the number one. And as you indicated, it's prevention of resistance as well, which obviously we can delay rPFS, which is a composite endpoint of radiographic progression, symptomatic progression, and death of any cause.  But the third P is I called it the P and M, which is protecting and maintaining, and that is we want to protect your quality of life while we treat you. And we want to maintain your quality of life while we treat you. So to me, it's critically important that in addition of aiming for an efficacy endpoint, we don't lose sight of the importance of quality of life and the protection of that patient in front of us. Because, undoubtedly, where you get chemo or where you get an oral agent, anything that we offer our patients has the potential of causing harm. And I think it is a balance between that benefit and side effect profile that is so critically important for us to elucidate and review with the patient.  And as you know, with the charted data, Dr. Alicia Morgans now at Dana-Farber, published a very elegant paper in JCO looking at the impact of docetaxel-based chemotherapy as part of the charted data in the North American trial and into quality of life. And we clearly define that your quality of life may go down a bit in the first few months of therapy, predictably because you're getting chemotherapy. But at the end of the six months, nine months, and certainly at the end of a year mark, the quality of life data for those who receive ADT and chemotherapy was far better than those who actually got ADT alone.  Now, if you look at the quality of data for RSNs, a similar pattern will appear that although chemotherapy is tied to misconceptions of significant toxicity, in our hands, in good hands, and I think our community of oncology in North America are pretty familiar with the side effects and how to manage and minimize side effects on chemotherapy, I think it still requires a balance and a thoughtful discussion to make sure that we're not moving forward chasing a PSA reduction at the expense of the quality of life of the patient. So I think orchestrating that together with the patient as a team is critically important as well.  Dr. Kriti Mittal: Thank you, Dr. Garcia. Moving on to the next concept we'd like to discuss in today's podcast the role of PARP inhibitors. Case Two was treated with androgen deprivation docetaxel and darolutamide. Consistent with current guidelines, the patient was also referred to germline testing and was found to be BRCA 2-positive. The patient's disease remained stable for 24 months, at which time he demonstrated disease progression, radiographically and clinically, and his disease was termed castration-resistant. There has been a lot published in the last few years regarding the role of PARP inhibitors in metastatic castration-resistant prostate cancer, or mCRPC.  The PROfound trial led to the approval of olaparib in patients with deleterious mutations in HRR genes for those who had been treated previously with AR-directed therapy. The TRITON2 trial led to the approval of rucaparib in the same month for mCRPC patients with BRCA mutation for those patients who had previously been treated with AR inhibitors and taxine-based chemotherapy. More recently, we saw data from the TRITON3 trial exploring the role of rucaparib versus physicians' choice of docetaxel versus AR-inhibitor therapy in the mCRPC space for patients harboring BRCA 1, BRCA 2, or ATM mutation. Based on these data, it would be very tempting to offer a PARP inhibitor to the patient in case two. While regulatory authorities are still reviewing those data for approval, how would you consider treating this newly castrate-resistant patient in the frontline setting? Would you consider a PARP inhibitor in the frontline treatment of mCRPC in this patient with a BRCA 2 mutation? Dr. Jorge Garcia: So that's a loaded question, to be honest with you. We have compelling data, but controversial data, as you know as well. So I think that since we have a genomic profile on this patient and we know he had high volume disease, then the first thought to me is not a genetic or a genomic question or a sequence. It's actually a clinical question, to be honest with you. And that is: How are you progressing? Because I think that if you're progressing serologically, you and I may think of that patient differently. If you're progressing radiographically with alone plus minus PSA production but no symptoms, you may also tilt your scale into this life-prolonging agents in a different way. Whereas if you have true symptomatic disease, knowing what you know, prior therapy, CrPC with a BRCA 2 alteration, then you may actually go for something different.   So if it's a rising PSA, if it is radiographic, but the patient is stable clinically, is not basically compromised by symptomatic disease, I do feel that a PARP inhibitor as a single agent would be a very reasonable choice. In this case, you can use, obviously, rucaparib. You can use olaparib. I don't have a vested interest in either/or. I think either/or is fine. The subtleties and side effects, as you know, the olaparib data was probably the data that you and I probably are more accustomed to, used to the most just by virtue of how the agents got registered in the United States. But either/or, I think a PARP inhibitor would be a reasonable approach.   I think the question perhaps, and I pitch that back to you, is what are you looking for with a PARP inhibitor? Because, as you know, all DNA repair deficiencies are not biologically the same. They do not respond the same way to PARP inhibitors. And even BRCA 2, where we think it's monoallelic or biallelic, may have subtleties in how those patients respond to PARP therapy. But the answer is yes, obviously, you have a biomarker, the patient has it, you can use it. I think the question is, how are you going to follow the patient? And what is going to be the endpoint that you're going to pay attention to in this case to find that the patient has a benefit or not granted, that could be PSA driven, but I think that perhaps I'm pushing you to think beyond PSA.  Dr. Kriti Mittal: I agree, Dr. Garcia. I think we need to think about the patient as a whole. PSA-based changes in treatment are not generally part of our practice. I think evaluating the patient for symptoms and also thinking about the sites of progression, sites of disease they've had in the past, preventing development of cord compression, because some of these patients progress very rapidly and present with cord compression at the time of progression. Those are the things we are trying to predict and prevent. I think in a patient with BRCA 2 mutation, in this situation, I would feel compelled to offer rucaparib, given that even in the intention-to-treat analysis, the hazard ratio was 0.6 in terms of median progression-free survival. I think what was quite impressive was the subset analysis comparing rucaparib versus docetaxel. And that was something surprising. And I think we'll have to wait for long-term outcomes. But certainly, for a BRACA 2-mutated patient, this could be a reasonable consideration provided the drug is available and approved.  Dr. Jorge Garcia: As you know, the three most common DNA repair deficiencies that we see are BRCA1, BRCA2, and ATM. BRCA2 is probably the one that we see the most. But we also recognize that with the limited data we have for ATMs, that patients with an ATM abnormality do not tend to benefit the most. And then yet we have also another series of DNA repair deficiencies, deficiencies, PALB2, CHEK2, CDK12 and so forth. And yet we have some exquisite responses to some of those patients.   So I can tell you that I have a patient of mine who had an ATM mutation, a germline ATM mutation, and I predicted that initially that the likelihood of benefit to a PARP inhibitor would be low. He was placed on a PARP inhibitor and surprise, surprise, he was on a PARP inhibitor for almost a couple of years. What I want to convey to the audience is that if you have the appropriate biomarker, you certainly should consider a PARP inhibitor in this scenario.   I think the bigger question is also understanding that not every DNA repair would benefit the same way. So being very thoughtful and very structured as to how you're going to manage the patient, it cannot be PSA only, the patient has to be followed radiographically and clinically because I would argue that if this patient had just a serologic progression, I would put the patient on a PARP inhibitor and the PSA kinetics change north, but slowly, what is the urgency of you switching the patient to something else?   And also the misconception that if you look at PROfound, that olaparib for that matter has to always be given after docetaxel. That's not the case. The makeup of PROfound is different than this patient, obviously, because this patient got triple therapy upfront, whereas most patients on the PROfound were CRPC who receive chemotherapy in the CRPC space. But yet undoubtedly, I think that your case illustrates the importance of next-generation sequencing and the importance of understanding the access to two oral PARP inhibitors that are super solid.  I think that perhaps the bigger question is going to be should you do a PARP inhibitor alone or should we use a combination of a PARP inhibitor plus an oral agent, such as in this case, maybe abiraterone acetate plus olaparib. Or maybe even thinking of TALAPRO, maybe enza plus a PARP inhibitor. So I don't know where you sit on those thoughts, Doctor-. Dr. Kriti Mittal: I change toxicity considerations, temper my enthusiasm for offering PARP inhibitors in combination with AR inhibitors or abiraterone at this time. I think I would certainly consider monotherapy with rucaparib for a patient in this situation. I am not entirely convinced that putting a patient through dual treatment in the mCRPC setting in the frontline, I don't think we are there yet. Dr. Jorge Garcia: There are two very important trials that are looking at the combination of an adrenal biosynthesis inhibitor plus olaparib in this context, and one is PROpel and the other one is MAGNITUDE. And both trials have very different results in many ways because they look at patients with a biomarker, meaning DNA repair, and patients without the biomarker. And I think the bigger question is, should this patient who was an abiraterone– Let's say this patient hypothetically was on a PEACE-1-like style. So the patient got ADT or triple therapy but was an abiraterone or an adrenal biosynthesis inhibitor instead of chemotherapy. And the patient was progressing slowly on abiraterone, you knew that the patient had a DNA repair deficiency. How comfortable with the PROpel and MAGNITUDE data would you and I feel to add on or layer, if you allow me to express it like that, a PARP inhibitor into this regime? Dr. Kriti Mittal: My personal interpretation of the currently available data is that at this point, combination therapy is not something I would use in my clinical practice. I think there are two camps in the GU oncology community of how people interpret the PROpel, MAGNITUDE, TRITON, and TALAPRO data in full. I think each of these trials had very different patient populations. I think in a biomarker unselected population, I would certainly not advocate for combination therapy. But even in the biomarker-selected population, I think how the biomarkers were tested and how the populations were defined may not always match what we are doing in clinical practice. And so I would, at this time, advocate for monotherapy over combination therapy. Dr. Jorge Garcia: I'm sure the audience will have probably read or heard about PROpel and MAGNITUDE and the data in patients without a biomarker positivity disease. So I'd love to hear your thoughts as to if you had no biomarker. By that I mean if you had a patient with CRPC, with metastatic CRPC without a DNA repair deficiency, would you consider using an adrenal biosynthesis inhibitor and a PARP inhibitor together based upon the potential synergistic of additive benefits and some of the data to suggest that you can delay rPFS when you combine therapy, but in the absence of biomarker positivity. Dr. Kriti Mittal: In the absence of biomarker positivity, I think the preclinical data are stronger than the clinical results we are seeing in trials. So while I think we should continue researching further into this because there certainly is preclinical rationale, looking at the clinical outcomes from these several trials, I would not offer PARP inhibitor to an unselected patient. Dr. Jorge Garcia: Great. Dr. Kriti Mittal: Moving on to second-line treatment for castration-resistant prostate cancer. I think talking of access issues and talking about the current treatment paradigms in the United States, there is still not widespread availability of lutetium. The listeners would love to hear your thoughts, Dr. Garcia, on practical management tips, safety issues, and the multidisciplinary nature of the management of lutetium therapy.  Dr. Kriti Mittal: So I think the challenges with lutetium are multiple. Number one is the correct identification of the patient, the ideal patient for lutetium. Secondly is who manages the patient and as you indicated, the importance of a team approach in that. Thirdly is how do we follow that patient during therapy? So it's beyond the technical aspects of who infuses the patient. Fourthly is what are the true goals of lutetium for that patient population and the side effects that those patients may embark on that some people may not be fully aware of and creates complexity. And lastly, perhaps, is how the movement, how we develop lutetium in CRPC and how we're going to move lutetium or have started to move lutetium and alike, meaning radiopharmaceuticals, radioligand-based therapies outside lutetium opinion and others as you know, earlier into the natural history of prostate cancer, maybe even in the locally advanced disease in combination with radiation or for patients with N1 positive disease. So it's a lot of movement in that space. I think that this is just the beginning of radiopharmaceutical entering diagnostics. But let me just address this succinctly, if I may. Number one, you do need a PET PSMA in order for you to select the patient because we're talking about a potential biomarker. But this is what I call an imaging biomarker. If you see it, you treat it.  So the standard of care right now for lutetium is very simple: you need to have men with metastatic castration-resistant prostate cancer. Two, you need to have failed a prior oral agent, in this case, a novel hormonal agent, independent of which agent you have seen, independent of the timing when you have seen an oral agent at the front, the middle, the end. And lastly, you have to have progress through chemotherapy. Yet again, it depends on when you see chemo.  So if you have someone who has high volume metastatic disease from the beginning, de novo disease, and you got ADT, daro, and docetaxel, and the patient progresses, that patient can go on. If that patient has a positive PSMA PET, that patient can go on to get lutetium. Similarly, if you have someone who got ADT alone in the adjuvant space for radiation therapy, progress, got an oral agent, progress, got a PARP or not, or got docetaxel, that patient could also be a candidate for lutetium. It's dependent on how you run the patient through therapy.  Secondly is who gives lutetium? So I do believe, and I may be biased, I certainly believe in the importance of a team approach with radiation oncology and nuclear medicine. But the reality of it is, I believe these patients are so advanced in their stage of their disease, then the idea of quarterback, in my personal opinion, resides in medical oncology. And I think the bigger question is going to be if nuclear medicine at your given institution is going to be delivering lutetium, or is it going to be radiation oncology? And I think, as you know, in places in America, it's RadOnC, in other places is NucMed, in our institution right now it is NucMed. Having said that, I do predict that for those places where nuclear medicine is heavily involved in delivering lutetium or partnering with MedOnc to deliver lutetium, radiation oncology in the future will have a bigger role as well because we are moving lutetium earlier in settings where radiation oncology is commonly used, such as high-risk prostate cancer patients, or even in the salvage setting, or even in patients with metastatic disease, where we want to combine radiation and lutetium, which are part of clinical trials as we think through for the future. But either/or, I think the quarterback should be really MedOnc in this case.  Thirdly is how do we do it? So clearly, at least in my practice, and I think it's probably standard across the United States, MedOnc will see the patient, determine viability and feasibility of therapy, determine who's the ideal candidate, discusses the pros and the cons, and then works along with RadOnc or NucMed to start the process. As you know, it is once every six weeks. So here in my practice, we will see the patient every time before treatment. Sometimes we see them the day off, sometimes we see them a few days before. Patients will get blood work. Specifically, we're interested in seeing everything CMPs, but certainly blood counts, red cell counts, platelets, and white cell counts, just to make sure that patients do not start with impaired bone marrow that can increase the risk for myelosuppression and therefore significant challenges with side effects, hematologic side effects, specifically. And we do that.   Sometimes we see them, sometimes our nurse practitioners would do so. And then the patient will basically follow through and complete up to six cycles of treatments. Six times six, that's actually 36 weeks or so. That's a long time on therapy for those who can get six cycles. I think the question becomes how do you follow those patients? And if we pay attention to the VISION data, as you know, those patients were actually followed serially quite closely on trial every eight weeks for the first 24 weeks, and then they stretch the scans out. But the scans that we're using in the trial are conventional imaging.  And I think the bigger question that you and I will have is if we get a PET PSMA to use to make that decision to get on lutetium PSMA, should I go back and use a CT or so to stage the patient? I think we're moving more toward PET follow-up, but we also don't know fully the impact of lutetium PSMA on PSMA metabolically during treatment. I think that we all recognize anecdotally and at least with some of the emerging data and we have the SUV may change, that PSA reductions also appear to be important as to define who is likely to benefit or not. But those are questions that remain to be seen, to be honest with you. We follow the patients serologically, clinically, and radiographically. And at least in my group, we tend to do PSMA PETs in between therapy to ascertain the impact of therapy in radiographic and also metabolic changes. And lastly is how we manage side effects. So I think that I'm pretty OCD about these patients because I have seen in my practice patients having outstanding responses to therapy but unfortunately become transfusion dependent, either transiently or permanently, just by virtue of side effects. And I think the importance of understanding the most common side effects of lutetium, in this case fatigue, myelosuppression, xerostomia, are really, really important. And that is the importance of having a multi-team effort approach so everybody is fully aware of the baseline characteristics of that patient or how the patient is enduring therapy and how the therapy is impacting the quality of life and impacting bone marrow production for those patients.  I think I remind the audience that the vast majority of our patients do have bone metastases. In fact, in the VISION trial it was around what, over 85, 90% of patients are so with bone metastases. So their marrow has already been impacted not only by disease but equally importantly by the prior chemotherapy that they may have seen. And some of the patients that we have in the first bubble effect is they have seen probably docetaxel, some may even have seen dual therapy with cabazitaxel as a second-line chemotherapy. So I think the understanding as to how you manage the side effects is critically important for our patients as well.  Dr. Kriti Mittal: Those are very relevant, practical life issues. Thank you Dr. Garcia for a terrific discussion on the application of recent advances in prostate cancer to clinical practice. [28:54] The ASCO Education podcast is where we explore topics ranging from implementing new cancer treatments and improving patient care to oncologists' well-being and professional development. If you have an idea for a topic or a guest you'd like to see on the ASCO Education Podcast, please email us at education@asco.org. To stay up to date with the latest episodes and explore other educational content, please visit education.asco.org. Dr. Jorge Garcia: Thank you, Kriti. It's great to see you and thanks again to ASCO for the amazing opportunity to be here with you guys today. I hope the audience can see the benefit of understanding how the many changes we have seen have impacted our patients in a positive way. So thank you again for the opportunity. Dr. Kriti Mittal: Thank you, Dr. Garcia, and thank you so much to the ASCO team for inviting me. This was a great experience.  Thank you Dr. Garcia for sharing your perspective on incorporating recent research advances into the management of patients with de novo metastatic prostate cancer. The ASCO Education Podcast is where we explore topics ranging from implementing new cancer treatments and improving patient care to oncologists' well-being and professional development. If you have an idea for a topic or a guest you'd like to see on the ASCO Education Podcast, please email us at education@asco.org. To stay up to date with the latest episodes and explore other educational content, please visit education.asco.org. 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, experiences, 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.    

Hoy me acompaña el siempre esperado Dr. Jorge Garcia para una colaboracion con Dra. Romina Zerga para conversar sobre un tema del que nadie quiere escuchar, pero del cual conocer los puntos discutidos es un enorme diferenciador.

On this episode of Fractured Frequency we are joined by Jorge Garcia and Albert Felipe to have a part two talk on relationships, specifically work relationships and work besties.

En esta ocasión me acompaña mi amigo y casi co-host, el Dr. Jorge Garcia y el Dr. Eliomar Garcia, especialista en Cardiología. Una conversación sumamente interesante, llana y sobretodo practica alrededor del modelo de medicina preventiva y el concepto de “Life's Essential 8”.

In this captivating discussion with Jorge Garcia, we delve into the universal formula for achieving your dreams. Whether you're working a 40-hour week or seeking ways to maximize your potential, adopting an abundance mentality can transform your journey. 

Interim Pismo Beach City Manager Jorge Garcia is Anita's guest Produced by Jim Richards

En esta ocasión salimos del estudio nuevamente y grabamos en el Cigar Club de Arturo Fuente. Una continuación de lo que fue el EP#100 con mis amigos John Paul Garrido y Jorge Garcia.

Jorge Garcia is the Co-Founder and CTO of Hello Iconic, a company that offers end-to-end product development services for fintech innovators.In this episode of the Fintech Confidential podcast, he shares the story behind the company's inception and how Hello Iconic transitioned from the media and entertainment industry to Fintech. Jorge discusses Hello Iconic's mission to help startups and established companies create and grow their fintech products.Here are the three things we dive into in this episode:1️⃣ The company's background and how they got into fintech2️⃣ Hello Iconic's approach to product development and customer experience3️⃣ Opportunities for fintech in the next five years, including niche-focused servicesAlso, watch the entire episode on youtube. [link here]Links:Events and websites mentioned:MX Summit: https://www.mx.com/summit (00:18:12)Alloy: https://alloy.co/ (00:18:28)Hello IconicWebsite: https://helloiconic.com/ Linkedin: https://www.linkedin.com/company/helloiconic/Facebook: https://www.facebook.com/helloiconiccareersInstagram: https://www.instagram.com/hello.iconic/Twitter: https://twitter.com/hello_iconicYoutube: https://www.youtube.com/@helloiconic6794Jorge Garcia - Linkedin Profile: https://www.linkedin.com/in/jagbolanosJorge Garcia Twitter: https://twitter.com/jagbolanosFintech Confidential FOLLOW, LIKE & SUBSCRIBEYouTube: https://youtube.com/@fintechconfidentialPodcast: http://podcast.fintechconfidential.comNewsletter: http://access.fintechconfidential.comLinkedIn: https://www.linkedin.com/company/fintechconfidentialTwitter: https://twitter.com/FTconfidentialInstagram: https://www.instagram.com/fintechconfidentialFacebook: https://www.facebook.com/fintechconfidentialSupport is provided by Solvpath, an A.I.-driven customer support system that uses a visual format and self-serve technology to quickly and effectively resolve issues, resulting in satisfying support experiences for customers. Get the best customer support system for your business. Get Solvpath. Get started by visiting www dot Get Solvpath dot com www.getsolvpath.com...

In this episode of ASCO Educational podcasts, we'll explore how we interpret and integrate recently reported clinical research into practice. The first scenario involves a 72-year old man with high-risk, localized prostate cancer progressing to hormone-sensitive metastatic disease.  Our guests are Dr. Kriti Mittal (UMass Chan Medical School) and Dr. Jorge Garcia (Case Western Reserve University School of Medicine). Together they present the patient scenario (1:12), review research evidence regarding systemic and radiation therapy for high-risk localized disease (5:45), and reflect on the importance of genetic testing and (10:57) and considerations for treatment approaches at progression to metastatic disease (16:13).  Speaker Disclosures Dr. Kriti Mittal:  Honoraria – IntrinsiQ; Targeted Oncology; Medpage; Aptitude Health; Cardinal Health  Consulting or Advisory Role – Bayer; Aveo; Dendreon; Myovant; Fletcher; Curio Science; AVEO; Janssen; Dedham Group  Research Funding - Pfizer Dr. Jorge Garcia:  Honoraria - MJH Associates: Aptitude Health; Janssen Consulting or Advisor – Eisai; Targeted Oncology Research Funding – Merck; Pfizer; Orion Pharma GmbH; Janssen Oncology;  Genentech/Roche; Lilly  Other Relationship - FDA Resources  ASCO Article: Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019 ASCO Course: How Do I Integrate Metastasis-directed Therapy in Patients with Oligometastatic Prostate Cancer? (Free to Full and Allied ASCO Members) If you liked this episode, please follow the show. To explore other educational content, including courses, visit education.asco.org. Contact us at education@asco.org. TRANSCRIPT Dr. Kriti Mittal: Hello and welcome to this episode of the ASCO Education Podcast. Today we'll explore how we interpret and integrate recently reported clinical research into practice, focusing on two clinical scenarios: localized prostate cancer progressing to hormone-sensitive metastatic disease; and a case of de novo metastatic hormone-sensitive prostate cancer progressing to castration-resistant disease.   My name is Kriti Mittal and I am the Medical Director of GU Oncology at the University of Massachusetts. I am delighted to co-host today's discussion with my colleague, Dr. Jorge Garcia. Dr. Garcia is a Professor of Medicine and Urology at Case Western Reserve University School of Medicine. He is also the George and Edith Richmond Distinguished Scientist chair and the current chair of the Solid Tumor Oncology Division at University Hospital's Seidman Cancer Center. Let me begin by presenting the first patient scenario.  Case 1: A 72-year-old male was referred to urology for evaluation of hematuria. A rectal exam revealed an enlarged prostate without any nodules. A CT urogram was performed that revealed an enlarged prostate with bladder trabeculations. A cystoscopy revealed no stones or tumors in the bladder, but the prostatic urethra appeared to be abnormal looking. Transurethral resection of the prostate was performed. The pathology revealed Gleason score 4+5=9 prostate cancer, involving 90% of the submitted tissue. PSA was performed one week later and was elevated at 50. Patient declined the option of radical prostatectomy and was referred to radiation and medical oncology.   So I guess the question at this point is, Dr. Garcia, in 2023, how do you stage patients with high-risk localized prostate cancer and how would you approach this case? Dr. Jorge Garcia: That's a great question and a great case, by the way, sort of what you and I in our practice will call ‘bread and butter'. Patients like this type of case that you just presented come from different places to our practice.  So either they come through urology or oftentimes they may come through radiation oncology. And certainly, it depends where you practice in the United States, at ‘X', US, they may come through medical oncology.   So I think that the first question that I have is in whatever role I'm playing in this case, where the patient has seen a urologist or a rad onc or me first, I think it's important for us in medical oncology, at least in the prostate cancer space, to talk about how do we think of their case and put those comments into context for the patient. It's very simple for you to tell a patient you can probably have surgery, radiation therapy, but at the end of the day, how do you counsel that patient as to the implications of the features of his disease is going to be really important. I use very simple examples that I relate to my patients, but really this patient is a patient that has very high-risk prostate cancer based upon the NCCN guidelines and how we actually stratify patients into what we call low-risk, intermediate-, and high-risk, and between those very low and very high risk.  So his PSA is high, very high, I would argue. His Gleason score, now, what we call group grading is high. He has high-volume disease. So the first question that I would have is, what are the choices for treatment for a patient like this? But even before you and I may talk about treatment options, we really want to understand the volume of their disease and whether or not they have localized prostate cancer with high-risk features or whether or not they have locally advanced or hopefully not metastatic disease. So back in the days prior to the FDA approval for PSMA PET imaging, we probably will have a Technetium-99 whole-body bone scan, and/or we probably will actually use CT scanning. Most people in the past, we used to do just a CT of the abdomen and pelvic region. As you know, with the movement of oral agents in the advanced setting, I think most of us will do a chest CT, abdomen and pelvic region, and certainly we also probably will have a Technetium-99 bone scan.  Now, with the utility and the use of PET imaging, I think most people like him will probably undergo PET PSMA, where you use F-18 PSMA or Gallium-68 PSMA. I think the importance depends on how you look at the approval of these two technologies. I think that PET PSMA imaging is here to stay. It's probably what most of us will use. And based upon that, we will define yet the truest stage of this patient. So right now, what we know is he has high-risk features. Hopefully, their disease is localized. We'll probably put the patient through an imaging technology. If you don't have access to a PET, then obviously CT and a bone scan will do. But if you do, the PET will actually help us define if the patient has disease outside of the prostate region, in the pelvic area, or even if they have distant metastases. Dr. Kriti Mittal: I would agree with that approach, Dr. Garcia. I think in the United States, we've been late adopters of PSMA scans. I think this patient with high-risk localized disease, if insurance allows at our institution, would get a PSMA for staging. There are still some patients where insurance companies, despite peer-to-peer evaluations, are not approving PSMAs. And in those situations, the patient would benefit from conventional CTs and a bone scan. So let's say this patient had a PSMA and was found not to have any regional or distant metastases. He decided against surgery, and he is seeing you as his medical oncologist together with radiation. What would your recommendations be?  Dr. Jorge Garcia: I think the bigger question is, do we have any data to suggest or to demonstrate that if in the absence of metastatic disease with conventional imaging or with emerging technologies such as PSMA PET, there is no evidence of distant disease, which I think you probably agree with me, that would be sort of unlikely with a patient with these features not to have some form of PSMA uptake somewhere in their body. But let's assume that indeed then the PSMA PET was negative, so we're really talking about high-risk localized prostate cancer. So I don't think we can tell a patient that radical prostatectomy would not be a standard of care. We never had a randomized trial comparing surgery against radiation therapy. This patient has already made that decision and surgery is not an option for him. If he, indeed, had elected radiotherapy, the three bigger questions that I ask myself are where are you going to aim the beam of that radiation therapy? What technology, dose, and fractionation are you going to use? And lastly, what sort of systemic therapy do you need, if any, for that matter? Where we do have some data maybe less controversial today in 2023 compared to the past? But I think the question is, do we do radiation to the prostate only or do we expand the field of that radiation to include the pelvic nodes?  Secondly, do we use IMRT? Do you use proton beam or not? Again, that's a big question that I think that opens up significant discussions. But more important, in my opinion, is the term of hypofractionation. I think the field of radiation oncology has shifted away from the old standard, five, seven weeks of radiation therapy to more hypofractionation, which in simple terms means a higher dose over a short period of time. And there was a concern in the past that when you give more radiation on a short period of time, toxicities or side effects would increase. And I think that there is plenty of data right now, very elegant data, demonstrated that hypofractionation is not worse with regards to side effects. I think most of us will be doing or supporting hypofractionation. And perhaps even to stretch that, the question now is of SBRT. Can we offer SBRT to a selected group of patients with high-risk prostate cancer? And again, those are discussions that we will naturally, I assume, in your practice, in your group, you probably also have along with radiation oncology.  Now, the bigger question, which in my mind is really not debatable today in the United States, is the need for systemic therapy. And I think we all will go back to the old data from the European EORTC data looking at the duration of androgen deprivation therapy. And I think most of us would suggest that at the very least, 24 months of androgen deprivation therapy is the standard of care for men with high-risk prostate cancer who elect to have local definitive radiation therapy as their modality of treatment. I think that whether or not it's 24 or 36, I think that the Canadian data looking at 18 months didn't hit the mark. But I think the radiation oncology community in the prostate cancer space probably has agreed that 24 months clinically is the right sort of the sweetest spot.  What I think is a bit different right now is whether or not these patients need treatment intensification. And we have now very elegant data from the British group and also from the French group, suggesting, in fact, that patients with very high-risk prostate cancer who don't have evidence of objective metastasis may, in fact, benefit from ADT plus one of the novel hormonal agents, in this case, the use of an adrenal biosynthesis inhibitor such as abiraterone acetate. So I think in my practice, what I would counsel this patient is to probably embark on radiotherapy as local definitive therapy and also to consider 24 months of androgen deprivation therapy. But I would, based upon his Gleason score of group grading, his high-volume disease in the prostate gland, and his PSA, to probably consider the use of the addition of abiraterone in that context. Dr. Kriti Mittal: That is in fact how this patient was offered treatment. The patient decided to proceed with radiation therapy with two years of androgen deprivation. And based on data from the multi-arm STAMPEDE platform, the patient met two of the following three high-risk features Gleason score >8, PSA >40, and clinical >T3 disease. He was offered two years of abiraterone therapy. Unfortunately, the patient chose to decline upfront intensification of therapy. In addition, given the diagnosis of high-risk localized prostate cancer, the patient was also referred to genetic counseling based on the current Philadelphia Consensus Conference guidelines. Germline testing should be considered in patients with high-risk localized node-positive or metastatic prostate cancer, regardless of their family history. In addition, patients with intermediate-risk prostate cancer who have cribriform histology should also consider germline genetic testing.  Access to genetic counseling remains a challenge at several sites across the US, including ours. There is a growing need to educate urologists and medical oncologists to make them feel comfortable administering pretest counseling themselves and potentially ordering the test while waiting for the results and then referring patients who are found to have abnormalities for a formal genetics evaluation. In fact, the Philadelphia Consensus Conference Guideline offers a very elegant framework to help implement this workflow paradigm in clinical practice. And at our site, one of our fellows is actually using this as a research project so that patients don't have to wait months to be seen by genetics. This will have implications, as we will see later in this podcast, not only for this individual patient as we talk about the role of PARP inhibitors but also has implications for cascade testing and preventative cancer screening in the next of kin. Dr. Jorge Garcia: Dr. Mittal, I think that we cannot stress enough the importance of genetic testing for these patients. Oftentimes I think one of the challenges that our patients are facing is how they come into the system. If you come through urology, especially in the community side, what I have heard is that there are challenges trying to get to that genetic counsel. Not so much because you cannot do the test, but rather the interpretation of the testing and the downstream effect as you're describing the consequences of having a positive test and how you're going to counsel that patient. If you disregard the potential of you having an active agent based upon your genomic alteration, is the downstream of how your family may be impacted by a finding such as the DNA repair deficiency or something of that nature. So for us at major academic institutions because the flow how those patients come through us, and certainly the bigger utilization of multi-disciplinary clinics where we actually have more proximity with radiation oncology urology, and we actually maybe finesse those cases through the three teams more often than not, at least discuss them, then I think that's less likely to occur. But I think the bigger question is the timing of when we do testing and how we do it.  So there are two ways -- and I'd love to hear how you do it at your institution -- because there are two ways that I can think one can do that. The low-hanging fruit is you have tissue material from the biopsy specimen. So what you do, you actually use any of the commercial platforms to do genomic or next-generation sequencing or you can do in-house sequencing if your facility has an in-house lab that can do testing. And that only gets you to what we call ‘somatic testing', which is really epigenetic changes over time that are only found in abnormal cells. It may not tell you the entire story of that patient because you may be missing the potential of identifying a germline finding. So when you do that, did you do germline testing at the same time that you do somatic testing or did you start with one and then you send to genetic counseling and then they define who gets germline testing? Dr. Kriti Mittal: So at our site, we start with germline genetic testing. We use either blood testing or a cheek swab assay and we send the full 84-gene multigene panel. Dr. Jorge Garcia: Yeah, and I think for our audience, Dr. Mittal, that's great. I don't think you and I will be too draconian deciding which platform one uses. It's just that we want to make sure that at least you test those patients. And I think the importance of this is if you look at the New England Journal paper from many years ago, from the Pritchard data looking at the incidence of DNA repair deficiency in men with prostate cancer in North America, that was about what,  around 10% or so, take it or leave it. So if you were to look only for germline testing, you only will, in theory, capture around 10% of patients. But if you add somatic changes that are also impacting the DNA pathway, then you may add around 23%, 25% of patients. So we really are talking that if we only do one type of testing, we may be missing a significant proportion of patients who still may be candidates, maybe not for family counseling if you had a somatic change, rather than germline testing, the positivity, but if you do have somatic, then you can add into that equation the potential for that patient to embark on PARP inhibitors down the road as you stated earlier. It may not change how we think of the patient today, or the treatment for that matter. But you may allow to counsel that patient differently and may allow to sequence your treatments in a different way based upon the findings that you have. So I could not stress the importance of the NCCN guidelines and the importance of doing genetic testing for pretty much the vast majority of our patients with prostate cancer. Dr. Kriti Mittal: Going back to our patient, three years after completion of his therapy, the patient was noted to have a rising PSA. On surveillance testing, his PSA rose from 0.05 a few months prior to 12.2 at the time of his medical oncology appointment. He was also noted to have worsening low back pain. A PSMA scan was performed that was noteworthy for innumerable intensely PSMA avid osseous lesions throughout his axial and appendicular skeleton. The largest lesion involved the right acetabulum and the right ischium. Multiple additional sizable lesions were seen throughout the pelvis and spine without any evidence of pathologic fractures. So the question is, what do we do next? Dr. Jorge Garcia: The first question that I would have is, the patient completed ADT, right? So the patient did not have treatment intensification, but at the very least he got at least systemic therapy based upon the EORTC data. And therefore, one would predict that his outcome will have been improved compared to those patients who receive either no ADT or less time on ADT. But what I'm interested in understanding is his nadir PSA matters to me while he was on radiation and ADT. I would like to know if his nadir PSA was undetectable, that's one thing. If he was unable to achieve an undetectable PSA nadir, that would be a different thought process for me.   And secondly, before I can comment, I would like to know if you have access to his testosterone level. Because notably, what happens to patients like this maybe is that you will drive down testosterone while you get ADT, PSAs become undetectable. Any of us could assume that the undetectability is the result of the radiation therapy. But the true benefit of the combination of radiation and ADT in that context really comes to be seen when the patient has got off the ADT, has recovered testosterone, and only when your testosterone has normalized or is not castrated, then we'll know what happens with your serologic changes. If you rise your PSA while you recover testosterone, that is one makeup of patient. But if you rise your PSA while you have a testosterone at the castrated level, that would be a different makeup of a patient. So do we have a sense as to when the patient recovered testosterone and whether or not if his PSA rose after recovery?  Dr. Kriti Mittal: At the time his PSA rose to 12, his testosterone was 275. Dr. Jorge Garcia: Okay, perfect. You and I would call this patient castration-naive or castration-sensitive. I know that it's semantics. A lot of people struggle with the castration-naive and castration-sensitive state. What that means really to me, castration-naive is not necessarily that you have not seen ADT before. It's just that your cancer progression is dependent on the primary fuel that is feeding prostate cancer, in this case, testosterone or dihydrotestosterone, which is the active metabolite of testosterone. So in this case, recognizing the patient had a testosterone recovery and his biochemical recurrence, which is the rising of his PSA occur when you have recovery of testosterone, makes this patient castration-sensitive. Now the PET scan demonstrates now progression of his disease. So clearly he has a serologic progression, he has radiographic progression. I assume that the patient may have no symptoms, right, from his disease?  Dr. Kriti Mittal: This patient had some low back pain at the time of this visit. So I think we can conclude he has clinical progression as well. Dr. Jorge Garcia: Okay, so he had the triple progression, serologic, clinical, and radiographic progression. The first order of business for me would be to understand the volume of his disease and whether we use the US CHAARTED definition of high volume or low volume, or whether we use the French definition for high volume from Latitude, or whether we use STAMPEDE variation for definition, it does appear to me that this patient does have high-volume disease. Why? If you follow the French, it's a Gleason score of >8, more than three bone metastases, and the presence of visceral disease, and you need to have two out of the three. If you follow CHAARTED definition, we did not use Gleason scoring, the US definition. We only use either the presence of visceral metastases or the presence of more than four bone lesions, two of which had to be outside the appendicular skeleton. So if we were to follow either/or, this patient would be high-volume in nature.  So the standard of care for someone with metastatic disease, regardless of volume, is treatment intensification, is you suppress testosterone with androgen deprivation therapy. And in this case, I'd love to hear how you do it in Massachusetts, but here, for the most part, I would actually use a GnRH agonist-based approach, any of the agents that we have. Having said that, I think there is a role to do GnRH antagonist-based therapy. In this case, degarelix, or the oral GnRH antagonist, relugolix, is easier to get patients on a three-month injection or six-month injection with GnRH agonist than what it is on a monthly basis. But I think it's also fair for our audience to realize that there is data suggesting that perhaps degarelix can render testosterone at a lower level, meaning that you can castrate even further or have very low levels of testosterone contrary to GnRH agonist-based approaches.  And also for patients maybe like this patient that you're describing, you can minimize the flare that possibly you could get with a GnRH agonist by transiently raising the DHT before the hypothalamic-pituitary axis would shut it down. So either/or would be fine with me. Relugolix, as you know, the attraction of relugolix for us right now, based upon the HERO data, is that you may have possibly less cardiovascular side effects. My rationale not to use a lot of relugolix when I need treatment intensification is quite simple. I'm not aware, I don't know if you can mitigate or minimize that potential cardiovascular benefit by adding abiraterone or adding one of the ARIs, because ARIs and abiraterone by themselves also have cardiovascular side effects. But either/or would be fine with me. The goal of the game is to suppress your male hormone.  But very important is that regardless of volume, high or low, every patient with metastatic disease requires treatment intensification. You can do an adrenal biosynthesis inhibitor such as abiraterone acetate. You can pick an androgen receptor inhibitor such as apalutamide or enzalutamide if that's the case. The subtleties in how people feel comfortable using these agents, I think, none of us – as you know, Dr. Mittal - can comment that one oral agent is better than the other one. Independently, each of these three oral agents have randomized level 1, phase III data demonstrating survival improvement when you do treatment intensification with each respective agent. But we don't have, obviously, head-to-head data looking at this.  What I think is different right now, as you know, is the data with the ARASENS data, which was a randomized phase III trial, an international effort looking at triple therapy, and that is male hormone suppression plus docetaxel-based chemotherapy against testosterone suppression plus docetaxel-based chemotherapy plus the novel androgen receptor inhibitor known as darolutamide. This trial demonstrated an outcome survival improvement when you do triple therapy for those high-volume patients. And therefore, what I can tell you in my personal opinion and when I define a patient of mine who is in need of chemotherapy, then the standard of care in my practice will be triple therapy. So if I know you are a candidate for chemotherapy, however, I make that decision that I want you to get on docetaxel upfront. If you have high-volume features, then the standard of care would not be ADT and chemo alone, it would be ADT, chemo, and darolutamide.  What I don't know, and what we don't know, as you know, is whether or not triple therapy for a high-volume patient is better, the same, equivalent, or less than giving someone ADT plus a novel hormonal agent. That is the data that we don't have. There are some meta-analyses looking at the data, but I can tell you that at the very least, if you prefer chemo, it should be triple therapy. If you prefer an oral agent, it certainly should be either apalutamide, abiraterone acetate, and/or enzalutamide. But either/or, patients do need treatment intensification, and what is perplexing to me, and I know for you as well, is that a significant proportion of our patients in North America are still not getting treatment intensification, which is really sub-optimal and sub-standard for our practice.  Dr. Kriti Mittal: Thank you, Dr. Garcia, for a terrific discussion on the application of recent advances in prostate cancer to clinical practice. In an upcoming podcast, we will continue that discussion exploring management of de novo metastatic prostate cancer.   The ASCO Education Podcast is where we explore topics ranging from implementing new cancer treatments and improving patient care to oncologists' well-being and professional development. If you have an idea for a topic or a guest you'd like to see on the ASCO Education Podcast, please email us at education@asco.org. To stay up to date with the latest episodes and explore other educational content, please visit education.asco.org. 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.    

Jorge Garcia discusses the recent ODAC meeting for the FDA.

The Ridiculous 2 (Eric & Jeremy) discuss "The Ridiculous 6" starring Adam Sandler, Terry Crews, Jorge Garcia, Taylor Lautner, Rob Schneider, and Luke Wilson. Go to patreon.com/ericandjeremy for bonus stuff!

A raíz del episodio “El hombre de poco valor” (# 118) recibimos solicitudes de que hiciéramos algo similar bajo el ángulo de la mujer. Para hacer una conversación objetiva y bajo un lente profesional y clínico invitamos a la Lic. Monica Mejia. Una conversación sin desperdicios que da a lugar a próximas colaboraciones y continuar desarrollando capas de profundidad.

En esta colaboración con el Dr. Jorge Garcia estuvimos conversando muy a fondo sobre la obesidad, el uso de fármacos populares como el Semaglutide y cambios muy necesarios que deberían ser empleados en el sistema de salud preventiva.

This is an amazing episode because Jorge Garcia boards the mothership! You know him as Hurley on Lost. He now appears in Condor's Nest - a new film releasing soon starring Arnold Vosloo and Jeremy Ironside. Enjoy!   #Lost #Jorgegarcia #Hurley #Actor #Condorsnest

Your favorite bad movie podcast is back! Howard Jones, Charlie Bellmore, and Brian MacKay join me to watch the new reboot of The Munsters! The Munsters is a 2022 American horror comedy film produced, written, and directed by Rob Zombie and starring Sheri Moon Zombie, Jeff Daniel Phillips, Daniel Roebuck, Richard Brake, Jorge Garcia, Sylvester McCoy, Catherine Schell, and Cassandra Peterson. Based on the 1960s family sitcom of the same title, the story takes place prior to the events of the series, serving as an origin story for the characters.Support Our SponsorsThe Ridge - https://ridge.com/ use promo code jastaIndie Merch Store - https://www.indiemerchstore.com use promo code JASTA10 at check outManscaped - Get 20% Off + Free Shipping, with the code JASTA at https://Manscaped.com. Your balls will thank you™!Martyrstore - https://martyrstore.net Mad RussianApothecary - https://www.madrussianapothecary.com Use Promo Code JASTA21Subscribe On GaS Digitalhttps://gasdigitalnetwork.com/gdn-show-channels/the-jasta-show/USE PROMO Code JASTA for a 1 week free trial.Follow Jamey On Patreonhttps://www.patreon.com/jastaFollow The Show On Social Mediahttps://twitter.com/lttorchbandhttps://www.instagram.com/charliebellmorehttps://twitter.com/CharlieBellmorehttps://twitter.com/jameyjastahttps://www.instagram.com/jameyjasta/https://twitter.com/bmackayisrighthttps://www.instagram.com/bmackayisright/Musician, former television host, and podcaster Jamey Jasta (Hatebreed, Kingdom of Sorrow, Jasta and the former host of MTV's Headbanger's Ball) interviews your heroes every Monday and Thursday. The newest 20 episodes are always free, but if you want access to all the archives, watch live, chat live, access to the forums, and get the show a week before it comes out everywhere else - you can subscribe now at gasdigitalnetwork.com and use the code JASTA“To advertise your product on GaS Digital podcasts please email jimmy@gasdigitalmarketing.com with a brief description about your product and any shows you may be interested in advertising on”See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

¿Qué es un hombre de poco valor social? ¿Cuales son los rasgos más comunes en él? Este es el centro de mi conversación con Jorge en este episodio y a la vez una pincelada de un proyecto que daremos a conocer muy pronto.

The competitive mind tells us, “there's so much stuff I NEED to be doing right now” and it leaves you feeling guilty when resting. Jorge Garcia is familiar with this voice. It's led him to a lot of success. Also, a lot of guilt. In this episode, we talk about healthy ways to handle that guilt, and the different definitions of excellence. This episode is awesome – especially as a fellow Hispanic – to hear about Jorge's move from Honduras to LA to grow and scale a global company. Give it a listen! ----- Show Notes: (13:30) - Diversity goals of a 99% Latino organization (36:50) - Defining excellence (30:20) - Jay-Z defining excellence (40:00) - Staying innovative while learning to be a methodical planner ----- Links: * helloiconic.com * Twitter and Insta: @jagbolanos * From Good to Great by Jim Collins * https://hbr.org/2001/01/the-making-of-a-corporate-athlete * https://www.gsb.stanford.edu/faculty-research/labs-initiatives/slei ----- Episode Quotes I Enjoyed “A business… is successful when it generates value for others, and at the same time is able to capture a little bit of that value for the company.” “If it doesn't hurt in the stomach, you're not setting [the right] goals.” ---- Episodes Like This Luis Gustavo Flores: https://anchor.fm/playhardpodcast/episodes/27--How-to-Grow-a-Startup-Scene-in-Latin-America-with-Luis-Gustavo-Flores-Founder-of-Movitext-e1ok5t9/a-a8k532c ---- If you liked the episode, subscribe for more! Let's chat: reach me at armand@playhardpodcast.com --- Support this podcast: https://anchor.fm/playhardpodcast/support

Retos que no conducen a nada, fármacos sobre utilizados en la perdida de peso, fertilidad , hombres en contacto con su lado femenino, deportes y hermandad.

Crossover time! The Fried Squirms and General Nerdery team up to examine the Munsters. Both some old, and some of what Rob Zombie just brought us. Support our Patreon! www.patreon.com/FriedSquirms Listen to more Fried Squirms at www.friedsquirms.com Check out all earVVyrm podcasts at www.earvvyrm.com Email us at squirmcast@gmail.com

On this very special, bonus episode of Not A Bomb, Brad and Troy gather some ghoulish guests to deliver an auditory treat for your Halloween season. Justin and Jose from the Watch/Skip+ podcast and Sammy from the GGTMC stop by to talk about the newest film from Rob Zombie, The Munsters. With everyone assembled, the gang jumps into the filmography of Zombie, their history with The Munsters television show, and their opinions on Zombie's 2022 film. If you ever wanted to hear a man die on the inside, do yourself a favor and take a listen - somebody had a pretty dramatic reaction to a few opinions shared during the discussion!The Munsters is directed by Rob Zombie and stars Sheri Moon Zombie, Jeff Daniel Phillips, Daniel Roebuck, Richard Brake, Jorge Garcia, Sylvester McCoy, Catherine Schell, and Cassandra Peterson.If you want to leave feedback or suggest a movie bomb, please drop us a line at NotABombPod@gmail.com. Also, if you like what you hear, leave a review on Apple Podcast.Cast: Brad, Troy, Jose, Justin, Sammy

Frocky is a typical 50-year-old ex-radio DJ who's looking to rekindle his former glory until he joins his favorite podcast and brings them a divisive film to discuss. Things go down a dark and dirty path that might damage more than their friendship. On Episode 531 of Trick or Treat Radio we are joined by Rocky of the band Knowman and one of the co-hosts of The Force Insensitive Podcast to discuss The Munsters from writer/director Rob Zombie! We also discuss everyone's favorite game Connect the Four by Pocket Brothers, we expand the depths of our hip-hop knowledge, and introduce Rule 34 of the internet to some hosts. So grab your Herman Munster album, don't forget to feed your pet scapegoat, and strap on for the world's most dangerous podcast!Stuff we talk about: Rob Zombie, Ares von Wolfenshadow, skiing, vacation, K-12 Hot Dog eating contest, Seaside Shanty Chateau, taking your pets on vacation, Cobra Kai, tasting a winery, Connect the Four by Pocket Brothers, “snort these nuts”, getting a good head rub, Whampyr, Jim Steranko, an elaborate rib, American Chop Suey, unfrozen caveman logger, RIP Coolio, Amish Paradise, Busta Rhymes, Q-Tip, A Tribe Called Quest, De La Soul, French Canadian Maid, Genius/GZA, Deltron 3030, Dr. Octagon, Chuck D, Fat Boys, Disorderlies, Flavor Flavorless, The Munsters, Rule 34, maneuver 34, the rules of the internet, The Addams Family, Sheri Moon Zombie, Jeff Daniel Phillips, Richard Brake, Daniel Roebuck, Cassandra Peterson, Raul Julia, Anjelica Huston, Fred Gwynn, From Dusk Till Dawn, Young Frankenstein, Jorge Garcia, Three's Company, a sitcom at half speed, aggressive forehead veins, Da Ali G Show, Tommy Lee or Tommy Lee Jones?, Dildo Baggins, Luke and Leia style, wolfman penis, Powerman 5000, grundlefly, Dragula, Pearl, Barbarian, Don't Worry Darling, Netflix, Batman ‘66, MZ's cry for help, surprises at the gloryhole, my pet Scapegoat, Ol' Dirty Jibbers, Rodriguez wouldn't let me down, and what a beautiful sediment.Support us on Patreon: https://www.patreon.com/trickortreatradioJoin our Discord Community: discord.trickortreatradio.comSend Email/Voicemail: mailto:podcast@trickortreatradio.comVisit our website: http://trickortreatradio.comStart your own podcast: https://www.buzzsprout.com/?referrer_id=386Use our Amazon link: http://amzn.to/2CTdZzKFB Group: http://www.facebook.com/groups/trickortreatradioTwitter: http://twitter.com/TrickTreatRadioFacebook: http://facebook.com/TrickOrTreatRadioYouTube: http://youtube.com/TrickOrTreatRadioInstagram: http://instagram.com/TrickorTreatRadioSupport the show

Lo que empezó a modo de prueba y sin muchas expectativas va cogiendo forma! Tertulia Dura llega a su episodio numero 100 y aprovechamos la ocasión para darle un giro especial a este episodio en las instalaciones de Arturo Fuente Cigar Club.

Siempre disfruto sentarme con Jorge y ponernos al día con los temas que nos interesan.

Jorge Garcia steps Behind The Rope. Fresh off his “The Masked Singer” elimination the night before, Jorge is here to chat about the experience. Jorge chats about why he chose The Cyclops, how much you can really see in those costumes, the judges Nicole Scherzinger, Jenny McCarthy Wahlberg, Robin Thicke, and Ken Jeong, his early elimination and, of course, his choice of the epic classic song “Flashdance…What a Feeling” by the Iconic Irene Cara. Of course, the convo quickly turns to a little show he starred in called “Lost”. We chat about what it was like being part of an ensemble cast of one of the most groundbreaking shows of all time, co-stars, highs and lows and playing fan favorite Hugo “Hurley” Reyes. Finally, we chat about his role in Rob Zombie's upcoming “The Munsters”. @pronouncedhorhay @behindvelvetrope @davidyontef BONUS & AD FREE EPISODES Available at - www.patreon.com/behindthevelvetrope Brought To You By: RESET - www.reset.com/velvet (Reset's science-based plan only requires two strict Reset Days each week - the other five days, you have the freedom to eat without rules or restrictions!) ELYSIUM HEALTH - www.trybasis.com/VELVET (10% Off At Checkout. Use Code Velvet) FRAMEBRIDGE - www.framebridge.com (15% Off Your First Order. Use Code “VELVET”) L'OCCITANE - www.loccitane.com (Review All Products and DM Us With Your Favorites!) SKILLSHARE - www.skillshare.com/velvet (One Month Free) MERCH Available at - https://www.teepublic.com/stores/behind-the-velvet-rope?ref_id=13198 Learn more about your ad choices. Visit megaphone.fm/adchoices