Podcasts about Outstanding

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, provides the latest on Operation Epic Fury, how this may impact domestic terror concerns, and previews the Texas

Guest Bios Dr. Suhas Kshirsagar, BAMS, MD (Ayurveda) One of the most academically accomplished Ayurvedic physicians in the Western world. Former personal physician to Maharishi Mahesh Yogi. Bestselling author of Change Your Schedule, Change Your Life and co-author of Awakened Sleep. Faculty at numerous integrative medicine programs. Trained in both classical Ayurvedic medicine and modern clinical research. His work bridges 5,000 years of Vedic wisdom with cutting-edge neuroscience and AI-driven health research. Renowned globally for his clinical expertise and his ability to make the ancient tradition accessible, scientific, and immediately practical. Dr. Sheila Patel, MD Board-certified family medicine physician and a leading voice in integrative health. Former Chief Medical Officer of the Chopra Center. Co-author of Awakened Sleep. Dr. Patel's clinical practice synthesizes conventional medicine with Ayurvedic principles, meditation, and mind-body approaches. She has spent decades helping patients understand the connection between emotional regulation, sensory awareness, and physical health — with sleep as the connective thread. Brought to you by MTE — More Than Energy, the performance formula designed for those who live life at full resonance. Trusted by top performers worldwide, MTE blends adaptogens, nootropics, and essential minerals to fuel focus, vitality, and flow — without the crash.  Code Michael Elevate your day, sharpen your mind, and feel More Than Energy. 15% OFF YOUR ORDER:: https://getmte.com/products/mte-daily-energy-wellness?ref=MICHAEL Key Themes & Timestamps  [00:00] Introduction — launching Resonance, the long tail of a book [02:28] What is Awakened Sleep? The Vedic perspective on sleep as a journey into consciousness [06:13] Modern science validates ancient wisdom — the convergence [08:13] The doshas explained — Vata, Pitta, Kapha and your sleep constitution [14:24] Universal sleep principles — temperature, light, timing, and the Stanford AI study [17:19] Personalized sleep — why one size doesn't fit all [20:00] The nervous system connection — parasympathetic tone and sensory overload [23:47] Your evening meal is your sleep prescription [25:50] The world has changed more since 1992 than in the previous thousand years [28:14] Orthosomnia — the new tech-induced sleep disease [29:09] Email apnea and text apnea — we literally stop breathing [30:15] Somniphobia — the fear of being alone in the dark (and why loneliness is the real insomnia) [37:47] Breath as medicine — the yogic prescription for sleep [40:11] Mantra, sound, and the neuro-associative conditioning of sleep [42:27] Creating your evening routine — the practice Michael is starting tonight [45:05] The dress rehearsal for dying — sleep as a journey into consciousness [51:17] Awakened Sleep as meditation's companion — the fourth state of consciousness [56:04] Geography, doshas, and the places that heal us [59:56] Vedic astrology, the eclipse, and the chapter we're entering [1:02:49] Closing — guiding us home in a noisy world Key Quotes Dr. Suhas: "We are doing a dress rehearsal of dying every night. We go to the same place where we were before we were born and long after we will be gone." "Sleep outweighs diet and exercise. If you rank lifestyle things, sleep is even higher ranked than diet and exercise and loneliness." "Orthosomnia — about 40% of Gen Z adults are experiencing sleep anxiety because of the gadgets they are wearing." "Where your attention goes, that's where the energy is flowing." "These techniques are not free. They are very expensive — because the most expensive commodity right now is me time." "An introspective sage is awake when the rest of the world is sleeping." — Bhagavad Gita Dr. Sheila: "Sleep is an active process. It's not just rest — it's an active rest." "So much of depression, anxiety is that disconnect from nature, disconnect from community. Everyone's all in their own individual bubbles." "Pick the weeds, plant some seeds, water them with gratitude." "We have so many tools within us — and with our breath, it's free." Michael: "I think a lot of us as humans have lost our way with all of the conflicting signals. And it's hard in a noisy world to find true signal that reminds us of who we are and how we can find our way home." Resources Mentioned Awakened Sleep by Dr. Suhas Kshirsagar & Dr. Sheila Patel Change Your Schedule, Change Your Life by Dr. Suhas Stanford Medicine AI Sleep Study (January 2025) — 65,000 participants, 600,000 hours of sleep data, predicting 130+ health conditions Oura Ring — wearable sleep tracking Vedic Meditation / Mantra practice Temescal (traditional sweat lodge) ceremony Bhagavad Gita — "Yānishā sarva-bhūtānāṁ tasyāṁ jāgarti saṅyamī" Rathri Sukta — Vedic hymn to the twin sisters Usha (dawn) and Nisha (dusk) Cognitive Behavioral Therapy for Insomnia (CBT-I) Connect Dr. Suhas Kshirsagar: [website] | [Instagram]  Dr. Sheila Patel: [website] | [Instagram]  Michael Trainer: michaeltrainer.net | @michaeltrainer | Resonance Podcast Pre-Order Resonance Resonance: The Art and Science of Human Connection arrives May 5, 2026 from BenBella Books. Foreword by Steven Pressfield, author of The War of Art. "Outstanding. I wouldn't change a word." — Steven Pressfield  Companion Substack Read Michael's full essay on this conversation: "The Dress Rehearsal for Dying: What Vedic Sleep Science Reveals About Why We Can't Connect" — exploring how orthosomnia, somniphobia, and the loneliness epidemic collide with the Resonance framework and the Seven Pillars of authentic connection. https://substack.com/@michaeltrainer Michael Trainer has spent 30 years learning from Nobel laureates, neuroscientists, and wisdom keepers worldwide. He's the author of RESONANCE: The Art and Science of Human Connection (March 31, 2026), co-creator of Global Citizen and the Global Citizen Festival, and host of the RESONANCE podcast.Featured in Forbes, Inc, Good Morning America. Follow on YouTube

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on former Secretary of State Hillary Clinton's deposition on the Epstein files, and the Health, Education, Labor

Dr. Lakshmi Rajdev and Dr. Manish Shah join the podcast to discuss the updated guideline on immunotherapy and targeted therapy in unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. They share first-line and subsequent-line recommendations for both gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma based on actionable biomarkers including PD-L1 expression, MMR and/or MSI, CLDN18.2 expression, and HER2 status. They note the importance of the algorithms and tables in the guidelines that provide visual illustrations and quick reference guides of the evidence-based recommendations. They also comment on ongoing and recently presented trials that may impact future guidelines in this space. Read the full guideline, "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update" at www.asco.org/gastrointestinal-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/gastrointestinal-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02958      Timestamps ·       00:00 – 02:15 Introduction and Overview ·       02:16 - 08:20 First-line treatment for patients with pMMR/MSS, HER2-negative gastroesophageal adenocarcinoma ·       08:21 –10:29 First-line treatment for patients with pMMR/MSS, HER2-positive gastroesophageal adenocarcinoma ·       10:30 – 14:39 First-line treatment for patients with dMMR/MSI-H, gastroesophageal adenocarcinoma ·       14:40 – 18:03 First-line treatment for ESCC ·       18:04 – 22:04 Second- and third-line therapy for gastroesophageal adenocarcinoma and ESCC ·       22:05 – 24:38 Importance of guideline ·       24:39 – 27:45 Outstanding questions and future research   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.   My name is Brittany Harvey, and today I am interviewing Dr. Lakshmi Rajdev from the Icahn School of Medicine at Mount Sinai and Dr. Manish Shah from Weill Cornell Medicine, co-chairs on "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update." Thank you for being here today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you for having us. It is wonderful. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Rajdev and Dr. Shah, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into what we are here today to talk about, Dr. Shah, I would like to start first with what prompted the update to this guideline, which was previously published in 2023, and what is the scope of this updated guideline? Dr. Manish Shah: Yes, terrific. So even in the last few years, the pace of drug development in gastroesophageal cancers has just been astounding. So, what prompted this guideline is actually the practice-changing results for a new biomarker, CLDN18.2 hat was based on the GLOW and SPOTLIGHT studies, as well as a practice-changing study in HER2-positive disease where we added pembrolizumab to trastuzumab and chemotherapy for tumors that are HER2-positive and PD-L1 CPS 1 or greater. And then there were also new studies and new approvals in esophageal squamous cell cancer that you will hear about as well. So there were several studies, overall more than 5,000 patients were reported on, and that led to several new therapies, new indications, and it really necessitated this guideline. Brittany Harvey: Excellent. It is great to hear about all of these exciting updates in this space. So then to next review the key recommendations of this guideline by clinical question that the expert panel addressed. So, Dr. Rajdev, what is the recommended first-line treatment for patients with proficient mismatch repair, microsatellite stable, HER2-negative gastroesophageal adenocarcinoma? Dr. Lakshmi Rajdev: Thank you for that question. So historically, we have sort of used fluoropyrimidine and platinum doublets, which yielded a survival of about one year. More recently, immunotherapy and targeted therapy options have improved outcomes in patients with advanced esophageal and gastric adenocarcinoma, as well as squamous cell carcinoma. Patients with gastric and GE junction adenocarcinoma have a high rate of actionable alterations, so it is imperative that physicians test the following biomarkers upfront so that it can help guide therapy. The markers recommended by the ASCO panel are HER2, MMR or MSI, CLDN18.2, and PD-L1. And also, it was recommended to use NGS if feasible in this patient population. HER2, as we know, is expressed in about 15% to 25% of patients; PD-L1 expression occurs in about 80% of patients; MSI-high, deficient MMR is present in about 5% to 8% of patients; and CLDN18.2 expression is present in about 40% of patients. There is, of course, biomarker overlap. About 13% to 22% of CLDN18.2 patients are also PD-L1 positive. For patients with pMMR or microsatellite stable HER2-negative disease with PD-L1 expression greater than 1 and absence of CLDN18.2, the panel recommended a first-line therapy with fluoropyrimidine and platinum-based therapy in combination with immunotherapy. These recommendations stem from large phase 3 trials, and the agents approved in the United States are pembrolizumab, nivolumab, and tislelizumab. It has been shown that immunotherapy benefit is greater in patients with higher PD-L1 expression, and it is not possible to comment on the individual PD-L1 cutoff scores and sort of identify the optimal PD-L1 cutoff score that sort of balances benefits and harms. But what is recommended is that immunotherapy-based treatments can be offered in patients with a CPS score of greater than 1. With regard to the choice of immunotherapy agents, that is pembrolizumab, nivolumab, or tislelizumab, these agents are considered to have similar efficacy, and the selection of an agent could be based on dosing schedule, cost considerations, toxicity, and the method of administration. Typically, clinicians should avoid withholding the start of chemotherapy while awaiting biomarker testing, depending on the clinical scenario. Now, for patients with pMMR microsatellite stable disease that is HER2-negative with PD-L1 expression less than 1 and positive CLDN18.2 expression, zolbetuximab-based treatments or in combination with chemotherapy is recommended, and this is based on two global phase III randomized controlled trials, the GLOW and the SPOTLIGHT. And across both studies, the hazard ratio for the overall survival was 0.78, and similarly, there was also an improvement in progression-free survival favoring the zolbetuximab group compared to the chemotherapy group alone. An important note is that nausea, vomiting is commonly associated with zolbetuximab-based treatments, and the panel recommended prophylactic antiemetics, adjusting zolbetuximab infusion rates, pausing infusion temporarily, using non-prophylactic antiemetics, and hydration intravenously prior to discontinuation of zolbetuximab-based chemotherapy. So effective handling of the GI-related symptoms with zolbetuximab is recommended prior to discontinuation of therapy. Now, for patients with pMMR microsatellite stable HER2-negative gastric, GE junction adenocarcinoma with PD-L1 expression greater than 1 and CLDN18.2 positivity, the ones with the dual expression with CLDN18.2 as well as PD-L1 chemotherapy, the choice of therapy can be based on the degree of PD-L1 expression, the toxicity profile, the burden of symptoms, and the anticipated improvement in symptoms associated with response to treatment, the patient comorbidities, the prior medical and treatment history. So this decision needs to be made on a case-by-case basis, and these are some of the factors that we suggested that could potentially influence the choice of therapy. For patients with pMMR microsatellite stable disease that is HER2-negative and a PD-L1 expression less than 1 and an absence of CLDN18.2 expression, first-line therapy with fluoropyrimidine and platinum-based chemotherapy is recommended. So you can see we have segmented out patients based on PD-L1 expression, pMMR and microsatellite stable disease expression, and also based on CLDN expression. Brittany Harvey: Absolutely. And that first point you noted, I think is really important, that biomarker testing is really critical for treatment decision-making in this space. So then the next subgroup of patients that the panel looked at, Dr. Shah, what first-line therapy is recommended for patients with proficient mismatch repair, microsatellite stable, HER2-positive gastroesophageal adenocarcinoma? Dr. Manish Shah: So this was an update from a few years ago. So we have known for 15 years now that if you are HER2-positive, you should get trastuzumab plus chemotherapy. That was based on the ToGA trial. And the update now is based on a trial called KEYNOTE-811, where it examined the addition of pembrolizumab to trastuzumab and chemotherapy versus trastuzumab and chemotherapy, and there was a progression-free and overall survival benefit. And again, here, the biomarkers are important. If your CPS PD-L1 is less than 1, we would not recommend Pembrolizumab in that setting, so you would still get trastuzumab and chemotherapy. But if it is 1 or greater, the PD-L1 CPS score, then we do recommend pembrolizumab unless there is a contraindication to immunotherapy. The take-home message really is from the onset of diagnosis, please check your biomarkers. And I will just, it is worth repeating, it is important to check your PD-L1 status, HER2 status, mismatch repair status, and CLDN18.2 status. And then the optimal therapy, and it is outlined in the publication, is really biomarker-driven. We know that if we are able to hit the target that is overexpressed, we are going to have a better outcome. And Dr. Rajdev did mention where there is overlap, there can be a lack of data, and that is where we are with both PD-L1 positive and CLDN positive. Here we do have data in HER2-positive cases where if you are both HER2-positive and PD-L1 positive, you would combine trastuzumab and pembrolizumab for the best outcomes. Brittany Harvey: Understood. I really appreciate you detailing what is most important for each individual biomarker combination that patients may have. So then following that, Dr. Rajdev, what does the expert panel recommend for first-line treatment for patients with esophageal squamous cell carcinoma that is not amenable to definitive chemoradiation? Dr. Lakshmi Rajdev: There are three phase III randomized clinical trials that have influenced practice in patients with esophageal squamous cell carcinoma examining the benefit of immunotherapy in this patient population. The RATIONALE-306 was a randomized trial of tislelizumab plus chemotherapy with platinum and fluoropyrimidine or paclitaxel versus placebo with chemotherapy. And then you have the KEYNOTE-590, which compared pembrolizumab plus chemotherapy versus chemotherapy alone. And then you have CheckMate-648, which included comparisons of nivolumab plus chemotherapy versus nivolumab plus ipilimumab or chemotherapy. And the primary endpoints for these studies were overall survival, and they did look at subgroups with PD-L1 expression. They used TPS score greater than 1% in CheckMate-648 and PD-L1 CPS greater than 10 in KEYNOTE-590. The bottom line is that the overall hazard ratio for overall survival across this patient population was 0.72. So clearly, there is benefit in patients that express PD-L1 CPS greater than 1 for benefit for the addition of immunotherapy. Now, the benefit again in patients with a PD-L1 expression less than 1 remains limited, and so the panel has made a recommendation for using immunotherapy in combination with platinum-based chemotherapy in patients with a PD-L1 greater than 1. Again, we know that it is hard to make recommendations on what PD-L1 cutoffs are recommended in this patient population, meaning that should it be limited to patients with a PD-L1 of 1 to 4 or greater than 10? I think that the general consensus that has been gleaned from the data is that the higher the PD-L1 expression, the greater the benefit. I do want to comment on another option that is available in patients with squamous cell carcinoma compared to adenocarcinoma, and that is the combination of nivolumab and ipilimumab. Now, in CheckMate-648, nivolumab with ipilimumab was also recommended as a treatment option in patients that have a PD-L1 score of greater than 1. There was a survival benefit demonstrated with this combination compared to chemotherapy alone. And an important observation in this study is that, although there was a slightly increased rate in early death, but there was really no significant difference in PFS and OS compared to chemotherapy alone. Importantly, the treatment appeared to be pretty well tolerated by the study population. There was a notable difference in the objective response rate, which was 35% in the nivolumab plus ipilimumab group compared to patients receiving nivolumab and chemotherapy, where it was 53%. So superiority is, so the importance of chemotherapy in patients with esophageal squamous cell carcinoma is to be noted. However, there is no difference in overall survival and progression-free survival when using the combination of nivolumab and ipilimumab, and thus it affords a chemotherapy-free option for this patient population with esophageal squamous cell carcinoma and a CPS with a score of greater than 1. Brittany Harvey: Understood. I appreciate you reviewing the evidence underpinning those recommendations as well. So then the next patient population that the guideline panel addressed, what first-line therapy is recommended for patients with deficient mismatch repair, microsatellite instability-high, gastroesophageal adenocarcinoma or esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: The rate of MSI-high expression is about 3% to 7% across different studies. Now, the KEYNOTE-158 was a tumor-agnostic study in patients with non-colorectal cancers, and again, the problem with the MSI-high population, given that it is so rare, the numbers in the individual studies are fairly small. But consistent outcomes do emerge, indicating high response to immunotherapy. So in KEYNOTE-158, a response rate of about 46% was noted. The number of patients was small, it was about 24. In CheckMate-649, which is a study of chemotherapy plus or minus nivolumab in patients with advanced gastric adenocarcinoma, there was again a very small number of patients, and patients that were MSI-high or deficient MMR did experience substantial benefits with the addition of immunotherapy, with hazard ratios in the order of about 0.38. In KEYNOTE-062, again, it was a very small number of patients, again about 6% or so, and similar to CheckMate-649, a substantial benefit was noted in combination with chemotherapy, but also there were benefits noted with pembrolizumab alone. The RATIONALE-305 again was a study of tislelizumab in combination with chemotherapy and similarly showed benefits to the combination of chemotherapy plus immunotherapy in this patient population. I think that we are all aware of the dramatic benefits of immunotherapy in this particular subset of patients, deficient MMR MSI-high, and also we have seen in CheckMate-649 they did have a subset of patients that received nivolumab and ipilimumab. And in this patient population, they noted unstratified hazard ratio of 0.28. So I think that the overall consensus is that immunotherapy is a very important treatment modality in patients with deficient MMR MSI-high disease, given that a lot of the trials in gastroesophageal adenocarcinoma have utilized chemotherapy-based options, that is certainly a recommendation of the panel to use chemotherapy in combination with immunotherapy. However, on a case-by-case basis, the panel recommended immunotherapy alone as well, and given the high response rates noted in trials across different diseases as well as noted in this disease as well. Brittany Harvey: Certainly. And I appreciate you both for reviewing these first-line recommendations. So moving to later lines of therapy, Dr. Rajdev, what recommendations did the expert panel make for second or third-line therapy for gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: So, I think that the RAINBOW trial that investigated the utility of the addition of ramucirumab as second-line therapy has been around since 2014, and those results have led to the addition of ramucirumab to taxane-based therapy in the second-line setting. Based on the utilization of oxaliplatin and platinum-based therapy in the front-line setting, there may be patients that have an underlying neuropathy, and so we wanted to really include treatment options for this patient population so that an agent that is less neurotoxic could also be recommended in combination with ramucirumab. The RAMIRIS trial is one such trial where ramucirumab was combined with FOLFIRI, and it demonstrated benefit in combination with ramucirumab. So we have listed that as a potential treatment option for patients in the second-line setting who may have an underlying neuropathy or even for whatever reason that based on the toxicity profile, that needs to be the preferred option by a physician, that recommendation is new from the older guidelines that we have. With regard to the utility of PD-1 inhibitors, there really has been no benefit noted in the second-line setting with regard to overall survival or progression-free survival, so no recommendation is made for that option. I think an important study that has been recently presented is the DESTINY-Gastric04 trial, which really has been practice-changing and has led to the recommendation for trastuzumab deruxtecan in patients that have HER2-positive metastatic gastric or GE junction adenocarcinoma. Now, this is a phase III trial in patients who retained HER2-positive disease after progressing on front-line trastuzumab-based treatments, and the comparator for this trial was trastuzumab deruxtecan versus ramucirumab plus paclitaxel. There was significant improvement and progression-free survival in patients that received trastuzumab deruxtecan. The patients that were excluded from the trial are patients that have pulmonary problems, interstitial lung disease; that is one of the toxicities of this particular agent, and close monitoring and prompt initiation of therapy such as glucocorticoid treatment in patients who develop this toxicity was also highlighted by the panel. So to summarize, the new guidelines highlight the possibility of FOLFIRI plus ramucirumab as a second-line option and then trastuzumab deruxtecan as a later-line option in patients that still retain HER2 expression. And that is very important because the trial did retest patients whether they expressed HER2. As we know, in a substantial number of patients, there is downregulation of HER2, and there is emerging data that the benefit for subsequent HER2-directed therapies is best noted in patients that still retain HER2 expression. Brittany Harvey: Great. So as our listeners have heard, there are many recommendations and new treatment options for advanced gastroesophageal cancer. Dr. Shah, earlier you highlighted the importance of biomarker testing, but I would like to hear in your view, what is the importance of this guideline and how will it impact both clinicians and patients with gastroesophageal carcinoma? Dr. Manish Shah: So as we have discussed throughout this podcast, the treatment for gastroesophageal cancer, both adenocarcinoma and squamous cell cancer, is increasingly complex, increasingly biomarker-driven. And I think the value of the guideline is to place all of that into context. So it provides the data for why certain biomarkers are important, what therapies should be indicated. Not only that, but if you are able to review the guideline, it provides the details of each of these studies and summarizes them in a meta-analysis fashion to sort of give you the context, because sometimes the individual studies can be maybe a little bit discordant or confusing and the guideline attempts to harmonize all that. And then also, I think the tables are very, very interesting because they give you actual numbers in terms of how many patients over a thousand would this benefit or how many patients over a thousand would this cause harm in terms of nausea, vomiting, or other things like that. So it gives you context for helping clinicians and patients weigh the potential benefits of the novel treatment strategies against the potential adverse events. And then finally, the guideline does also provide an algorithm that you are able to follow based on the biomarkers, and those are in figures 4 and 5. So I think overall, it is a very comprehensive guideline. It intends to make more manageable a very complex subject, and you know, I really encourage our listeners to review it after listening to the podcast. Dr. Lakshmi Rajdev: If I can add to that, I think that what is also really good about the guidelines is there are quick summaries. So if someone is busy in the clinic, of course, there is the opportunity to review the data supporting the guidelines in great depth in the manuscript, but what is also really good is that there are good summaries. In the event that you are very busy, you can easily identify what the recommendations should be for that particular patient based on these summaries. Brittany Harvey: Absolutely. Listeners are encouraged to review the full guideline, including those tables and figures that may be more helpful when they are looking for something quick to look at in the clinic as well. So, as you both mentioned, there have been a number of recent practice-changing trials in this area. So I imagine there is still a lot of ongoing research as well. So Dr. Shah, what are the outstanding questions regarding treatment options for patients with locally advanced unresectable, advanced, or metastatic gastroesophageal carcinoma? Dr. Manish Shah: I think we touched upon it a little bit. The guidelines are based on the data available, and they are primarily examining one novel therapy with chemotherapy in a specific biomarker population. But as you know, the biomarkers are not either/or; you are not either CLDN18.2 positive or PD-L1 positive. A portion of patients could have dual biomarkers, and you know, I think that we are generating data on how to manage those patients. At the recent GI Symposium in January this year, the ILUSTRO trial was presented by Dr. Shitara, which looked at combining zolbetuximab and chemotherapy with immunotherapy for dual-positive biomarkers, and that is leading to a phase III study that has begun to enroll. So unanswered questions are: how do we manage dual-positive biomarkers? The other thing that was mentioned is that the current data for mismatch repair deficiency involve chemotherapy plus immunotherapy. Only squamous cell cancer is there a study with a positive non-chemotherapy kind of backbone, that is CheckMate-648 that Dr. Rajdev mentioned. As we move forward, it will be good to get data on non-chemotherapy options in certain biomarker-positive populations. And then finally, another update, which is likely to be practice-changing, is the HERIZON-GEA-01 study that looked at zanidatamab, which is another biparatopic antibody that targets HER2, and that is likely to change practice. And as that data gets published, we may look to even do a rapid update for the current immunotherapy and targeted therapy guideline that is just being published. Dr. Lakshmi Rajdev: So, if I can add to that, there are numerous ADCs that look very interesting. There are bispecific antibodies; in fact, the zanidatamab is a bispecific antibody showing improved activity in patients with HER2-positive disease. So I think there are studies from Asia looking at CLDN CAR T-based therapies. So, I think that there are a lot of novel agents and a lot of excitement in the field. We know that the bemarituzumab study, unfortunately, the FGFR2 inhibitor failed to demonstrate any benefit, but I think that there are other agents that are being explored, so there are newer targets, newer agents, ADCs, bispecifics that could potentially change the field in the future. Brittany Harvey: Yes, we will look forward to the data to address these unanswered questions and new agents and inform future guideline updates. So, I would like to thank you both for all of your work to review the evidence here and update this important guideline, and for your time today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Host Casey Harper is joined by Dr. David Prentice, who is one of the founders for Science Alliance For Life and Technology (SALT) and The Washington Stand’s Jared Bridges to discuss the current ethical concerns surrounding lab-created embryos. David shares why he started SALT, the development and dangers of gene screening and modification, and the role AI is currently playing in embryo selection.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports the highlights from the State of the Union, and sheds light on the U.S. military buildup in the Middle East. Brad

Host Casey Harper is joined by Dr. David Prentice, who is one of the founders for Science Alliance For Life and Technology (SALT) and The Washington Stand’s Jared Bridges to discuss the current ethical concerns surrounding lab-created embryos. David shares why he started SALT, the development and dangers of gene screening and modification, and the role AI is currently playing in embryo selection.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, previews the State of the Union, reports on the consequences of the recent violence in Mexico, and reflects on the fourth

“Send Coach John a message”I found this post from Greg Berge (@GregBerge) where he shared this clip from American Freestyle skier, Eileen Gu. Greg's intro was this:  “This is a Mindset MUST-watch. Bookmark and share.  We can become exactly who we want to become. We can control our thoughts.”  It was such a breath of fresh air starting out with a sincere question from the reporter, whose name was Charlotte, and you can tell there is a bit more of humor coming from other reporters as to the down to earth way of asking it. The answer that Eileen gave - total brilliance!  These were my thoughts as I shared this post:  “Love this!! I've been thinking a lot lately of how my 8 year old little self would be proud of me today! (Also remembering he's still a part of me) I'm also thinking about how my future self would be grateful for the things I'm doing & thinking today!” You can tell by how fast she talks, that she has a lot going on in her head and / or she's simply full of passion for what she does in life. I think that's really cool that she explained a little bit of what is going on inside her head and what we can learn about it. Outstanding clip here and I'm glad I found it as I think the value from this is simply tremendous.  Thanks for listening.  Please take a few moments to subscribe & share this with someone, also leave a 5 Star rating on Apple Podcasts and ITunes or other services where you find this show.  Find me on Facebook:  https://www.facebook.com/coachtoexpectsuccess/   on Twitter / “X”:  @coachtosuccess   and on Instagram at:  @coachjohndaly  - My YouTube Channel is at: Coach John Daly.   Email me at: CoachJohnDalyPodcast@gmail.com     You can also head on over to https://www.coachtoexpectsuccess.com/ and get in touch with me there on my homepage along with checking out my Top Book list too.  Other things there on my site are being worked on too.  Please let me know that you are reaching out to me from my podcast.  ** I would appreciate anyone to try clicking on the top of the show notes where it says "Send us a text" to leave a few thoughts / comments / questions.  It's a new feature that I'd like to see how it works. **

Finding Your Voice in Life's Hardest Seasons - A Conversation with Sonja Crosby In this episode of the OUTSTANDING Life Podcast, Johnny D the Motivational Cowboy sits down with Sonja Crosby for a powerful conversation about purpose, resilience, and using your voice in every season of life. They talk about the art of the side hustle, Sonja's personal caregiver journey, and the self-care resources she created to support other caregivers. From her professional voice-over work to her husband bringing Sinatra into nursing homes, this episode highlights how creativity can spark connection, dignity, and hope. They also dive into menopause, midlife transitions, and why laughter may be one of the most important tools for navigating change. If you're a caregiver, entrepreneur, woman in transition, or someone searching for motivation and encouragement, this episode will remind you that living an OUTSTANDING life starts right where you are. Have An OUTSTANDING Day. PODCAST ‘Outstanding Life' HOST The Motivational Cowboy - Johnny D. (John Dmytryszyn) WEBSITE https://www.MotivationalCowboy.com/podcast/ SOUNDCLOUD PODCAST https://soundcloud.com/outstandinglifepodcast iTUNES APPLE PODCAST https://itunes.apple.com/us/podcast/outstanding-life-with-the-motivational-cowboy/id1410576520?mt=2 SPOTIFY PODCAST https://open.spotify.com/show/4OFNmM9Rv9jNA0gQMPv8XU STITCHER https://www.stitcher.com/s?fid=389557&refid=stpr YOUTUBE https://www.youtube.com/watch?v=tttQkLT7SfE&list=PL1Jmeb31MqLiNLxcnufzmCCca3HGH20Rj&index=2&t=0s SUPPORT with PAYPAL https://www.paypal.me/motivationalcowboy LISTEN for FREE to ‘Outstanding Life' PODCAST with Johnny D. the Motivational Cowboy on iTunes, Spotify, SoundCloud, Stitcher, YouTube & other major platforms and stations. Now with Over 1 Million Listeners! Motivational Speaker, John Dmytryszyn (Johnny D) has developed a strong brand as “The Motivational Cowboy”. He impacts audiences across the country with his message of “Living the Outstanding Life”, helping to change lives by reshaping thoughts about Image, Attitude, Focus and Consistency. His podcast is the latest in a long list of platforms that allows him to reach people. Among his most notable accomplishments is a 2nd Grammy consideration for his recently released spoken word CD “Time to Stand Out!”. https://www.MotivationalCowboy.com

The Santa Barbara International Film Festival honored Micheal B Jordan for The Outstanding Performer of the Year Award. KCSB's Inesha Ranasinghe-Denish talked to Jordan on the red carpet.

A quick note from Farwell to start this episode: "I don't think I'm alone in saying that the 'Eastern Swing' through Kingston, Ottawa, and Peterborough for a Western Conference team is one of the most enjoyable trips we take every year, so allow me to reminisce for a moment as we start this week's show. It involves cheesecake. 'Nuff said." With that out of the way, the guys also talk about the OHL talent that was on display at this year's Olympics and they speculate about the possibility of this year's Red Tilson Trophy winner (Most Outstanding Player) and Max Kaminsky Trophy winner (Most Outstanding Defenceman) coming from the same team. That's only happened three times in league history. Could this season be the fourth? Plus, you'll get your weekly Wraparound through every market in the league, a look at OHL Onside, a deep dive into The OHL Podcast mailbag (email us, we'll answer! ohlpodcast@rogers.com), and our Prospects of the Week. The OHL Podcast is supported by Draft Kings Sportsbook. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on revelations of a U.S. military-led group aiding Mexico's hunt for the El Mencho cartel boss, renewed student

The award ceremony started with the red carpet and then led to a 2-hour long sit down interview between the executive director of SBIFF and Micheal B Jordan. KCSB's Inesha Ranasinghe-Denish covers the story.

•⁠ ⁠Outstanding and long awaited win at Parkhead

Spurs Chat: Discussing all Things Tottenham Hotspur: Hosted by Chris Cowlin: The Daily Tottenham/Spurs Podcast Hosted on Acast. See acast.com/privacy for more information.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on Day 7 of the partial government shutdown, the U.S. Supreme Court's decision striking down President Trump's

Kouri Richins Trial Judge Rules On Key Motions Before Trial Begins MondayBecome a supporter of this podcast: https://www.spreaker.com/podcast/pretty-lies-and-alibis--4447192/support.ALL MERCH 10% off with code Sherlock10 at checkout  - NEW STYLES Donate: (Thank you for your support! Couldn't do what I love without all y'all) PayPal - paypal.com/paypalme/prettyliesandalibisVenmo - @prettyliesalibisBuy Me A Coffee - https://www.buymeacoffee.com/prettyliesrCash App- PrettyliesandalibisAll links: https://linktr.ee/prettyliesandalibisMerch: prettyliesandalibis.myshopify.comPatreon: https://www.patreon.com/PrettyLiesAndAlibis(Weekly lives and private message board)

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the first meeting of the Gaza Board of Peace, former Prince Andrew's arrest for misconduct alleged in the

Host Casey Harper is joined by journalist Yoe Suarez and The Washington Stand’s Jared Bridges to discuss the economic and political state of Cuba. Growing up in Havana, Yoe knows firsthand what the socialist regime is capable of. The three unpack Venezuela’s impact on Cuba, what life is like on the island, and where the country is headed. Only time will tell what will happen to Cuba.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on Day 5 of the partial government shutdown, the FDA's decision to reverse course and agree to review its decision

Host Casey Harper is joined by journalist Yoe Suarez and The Washington Stand’s Jared Bridges to discuss the economic and political state of Cuba. Growing up in Havana, Yoe knows firsthand what the socialist regime is capable of. The three unpack Venezuela’s impact on Cuba, what life is like on the island, and where the country is headed. Only time will tell what will happen to Cuba.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the fourth day of the Democrat-led partial government shutdown, a Rhode Island shooting allegedly perpetrated

At this year's SBIFF, 4 Oscar nominated directors were awarded with the Outstanding Directors Awards. KCSB's Kelly Darroch and Inesha Ranasinghe-Denish spoke with Chloe Zhao and Joachim Trier on the red carpet.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports the latest on the partial government shutdown, and Israeli air force's strikes on terrorist targets across Gaza in

David, Jon and Alfie record an emergency pod to ask if this is Gary Caldwell's final match in charge of Exeter City. And if you'd like to support the pod and receive episodes early, a Patreon only pod, Jon's Thursday night preview videos, immediate match reviews on a Saturday and be part of a super little community then sign up to https://www.patreon.com/ydkwydpod Learn more about your ad choices. Visit megaphone.fm/adchoices

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reviews the Senate Oversight Committee hearing on fraud and immigration enforcement in Minnesota and the drawdown of

Lance Reisland of Cleveland.com joins Afternoon Drive on The Fan. He talks about the Browns draft strategy with the sixth overall pick, his top wide receiver prospects in the class, the team's search for a new defensive coordinator, and more.

The medical community is finally realizing that transgender surgeries are harming America’s children. Recently, both the American Society of Plastic Surgeons and the American Medical Association released statements recommending gender-affirming surgeries be delayed until adulthood, but what does this mean for the issue as a whole? Is change happening? Host Casey Harper is joined by American Parents Coalition’s Alleigh Marre, and The Washington Stand’s Joshua Arnold to discuss the new research and mentality shift we are seeing in the medical world.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the meeting between President Trump and Israeli Prime Minister Benjamin Netanyahu, Trump's comments on Judea

Doug Schmell joins us to discuss the opening night of the Grateful Dead's final run in the Fillmore East....Outstanding performances of Hard to Handle and Morning Dew highlight this underrated gem...a consistent and seamless performance featuring several new additions to the band's repertoire...

The medical community is finally realizing that transgender surgeries are harming America’s children. Recently, both the American Society of Plastic Surgeons and the American Medical Association released statements recommending gender-affirming surgeries be delayed until adulthood, but what does this mean for the issue as a whole? Is change happening? Host Casey Harper is joined by American Parents Coalition’s Alleigh Marre, and The Washington Stand’s Joshua Arnold to discuss the new research and mentality shift we are seeing in the medical world.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the meeting between President Trump and Israeli Prime Minister Benjamin Netanyahu, Trump's comments on Judea

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on hearings concerning anti-Semitism, the Epstein probe, and debates over funding for the Department of Homeland

This Week on the Toy Power Podcast; we board the Hype Train - as we take a look at all the latest News! Neca with another Sesame Street Figure - this round Big Bird! Then a tease from Neca regarding the upcoming Muppets Toyline. But will they potentially live up to the Palisades offerings from 20+ years ago? Hasbro tease New Collaborations from both Voltron & Street Fighter. Both these franchise have Movies on the way - what can we expect? The Emperor is cashing in on Ben's Wallet - as a Foreign Micronauts figure is teased from Super7. Superman from Mondo - is just OUTSTANDING. But so is the Mondo Man-At-Arms too! Then we continue the MOTU chat as we breakdown the Movie Toy Announcements thus far! Both the Chronicles offerings plus the basic 5inch line too. Then we switch gears & chat towards the Excitement of what is being announced on the Big Screen. 2026 Hit or Shit of Cinema. A fun discussion & further solidifies how exciting 2026 will be for Pop-Culture fans of all different ages & passions! Enjoy this extended recording!!Support the show: http://patreon.com/toypowerpodcastSee omnystudio.com/listener for privacy information.

WHAT A DEBUT AND WIN OVER BOSTON! Jose Alvarado proved to everyone why he belongs in New York, in his very first game for the team! INSTANT IMPACT is the best way to describe what Alvarado brings but his energy and effort could end up changing this team forever... for the better! But the play of rookie Mohamed Diawara has been OUTSTANDING! He is the future, a future star but right now, he's turning into the exact player we need off the bench. It's time for Diawara to receive consistent minutes, whether NY is banged up or not... Troy Mahabir breaks all of this down! SHOW CHAPTERS: 00:00 - Intro 00:21 - Presented By FanDuel 00:45 - Alvarado SHINES In Debut! 00:46 - Alvarado Debut Will Not Happen Against Pistons! 01:36 - FanDuel Odds For Winner Of Knicks V Celtics Game 53 03:54 - GTA 5 Had An Incredible Debut! 06:50 - The Alvarado Effect IS REAL 08:37 - Diawara IS READY RIGHT NOW! 10:38 - Mohamed Diawara Deserves Consistent Minutes LISTEN NOW TO GET YOUR KNICKS FIX! Catch the latest special interviews, shorts, fan interactions, and more by following the show! Don't forget to turn on notifications so you don't miss another episode! Rather Watch the latest Knicks Recap episode? Catch us on YouTube here: https://www.youtube.com/@TheKnicksRecap Follow The Knicks Recap on all social media platforms! Twitter: https://twitter.com/TheKnicksRecap Instagram: https://www.instagram.com/TheKnicksRecap/ Reddit: https://www.reddit.com/u/TheKnicksRecap?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=share_button Facebook: https://www.facebook.com/TheKnicksRecap/ Rather Listen to The Knicks Recap on a different platform? Catch us on ALL of your favorite streaming platforms: Apple Podcast: https://apple.co/3SKSl8o Spotify: https://spoti.fi/3QrEfr6 iHeart Radio: https://www.iheart.com/podcast/269-the-knicks-recap-a-new-yor-100895112/ Amazon Music: https://amzn.to/3QoZrOd Other Pod Channels: https://anchor.fm/the-knicks-recap Grab our MERCH featuring some of the graphics you've seen us create to take your Knicks fandom to the NEXT LEVEL: MAIN STORE: https://theknicksrecap.myspreadshop.com/ CashApp: $TheKnicksRecap Have a comment about the show, an interview, or a graphic idea? Reach out to The Knicks Recap on ALL SOCIAL MEDIA PLATFORMS! Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the new guidance from the Department of Education for prayer and religious activities in schools, the faith

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, covers the 2026 National Prayer Breakfast and the demands from Democrats to overhaul ICE. Andy Biggs, U.S. Representative

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on the reduction of immigration agents in Minnesota, the American Society of Plastic Surgeons' position against

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, shares the latest on the government shutdown, positive news on an abortion drug case in Texas, and context surrounding

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, gives an update on Department of Homeland Security (DHS) funding amid the partial government shutdown, the Minnesota

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on Capitol Hill

Chad discusses the news of Catherine O'Hara passing away and her career of outstanding, hilarious work in TV and film.

Jay Yu is a prominent DeepTech and NuclearTech entrepreneur with a Wall Street capital markets background. Driven by a vision to make energy more accessible, affordable, and sustainable worldwide, he currently serves as Executive Chairman & CEO of LIS Technologies Inc. (LIST) and Founder & Chairman of NANO Nuclear Energy Inc. (NASDAQ: NNE). LIS Technologies is the only U.S.-origin and patented laser uranium enrichment technology company, delivering a revolutionary, energy- and cost-efficient approach that is set to redefine nuclear fuel industry standards while also producing medical and stable isotopes; including silicon-28 critical for AI and quantum computing. NANO Nuclear Energy Inc. (NNE) is the first publicly listed, vertically integrated advanced nuclear micro modular reactor company in the United States. Under Jay Yu's leadership, NNE acquired one of the highest Technology Readiness Level (TRL) and patented microreactor designs in development, achieved a market capitalization exceeding $3 billion, raised over $600 million in just a year and a half, and earned the title of Wall Street's Cinderella story of 2024 as the #1 Top IPO Performer. Leading a world-class team of nuclear engineers, former national leaders in military and policy, U.S. Department of Energy experts, national laboratory veterans, and regulatory specialists, Jay is developing smaller, simpler, and safer advanced nuclear microreactors. He brings deep expertise in corporate structuring, capital fundraising, and recruiting top-tier talent while passionately building strategic relationships and creating lasting value for partners and stakeholders. In 2021, Jay Yu was honored as one of The Outstanding 50 Asian Americans in Business; the highest recognition in the U.S. AAPI community. Shawn Ryan Show Sponsors: Check out Maui Nui for wild Axis deer venison, harvested and shipped from Maui under USDA inspection—visit https://mauinuivenison.com/srs If you're serious about selling to the Department of War, go to https://SBIRAdvisors.com and mention Shawn Ryan for your first month free. Head to https://Superpower.com and use code SRS at checkout for $20 off your membership. Live up to your 100-Year potential. #superpowerpod Get firearm security redesigned and save 10% off @StopBoxUSA with code SRS at https://www.stopboxusa.com/srs #stopboxpod Jay Yu Links: X - https://x.com/nano_nuclear IG - https://www.instagram.com/nanonuclear YT - https://www.youtube.com/@nanonuclearenergy NANO Nuclear - https://nanonuclearenergy.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

Dr. Oz goes to southern California and uncovers a hospice fraud ring run by Armenians and Russian mobsters. You can't make it up. Illinois is swimming in college fraud as ghost students steal Americans' identities, take out monster federal loans under them and fake enroll in community colleges around the country. Zohran Mamdani says NYC is bracing for a great depression and must punish the rich by raising taxes. Senate republicans grow a set and seem ready to vote on the SAVE Act for election integrity,

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, covers the press conference with White House Border Czar, Tom Homan, and the attack on a synagogue in New Jersey. Andrew

How would you respond if someone came into your office on a mission to kill you? Would it even cross your mind to share the gospel? Host Casey Harper is joined by Virginia Prodan author and international human rights attorney as she shares her story of persecution and saving her assassin. Living in communist Romania, Virginia felt called to share the gospel with her clients, even when it meant putting herself in danger. She tells her story and encourages believers to allow the Lord to use you in ways you may never expect.

today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, reports on President Trump's critique of Minneapolis Mayor Jacob Frey and the decline in migration linked to slower

On today's program: Casey Harper, Managing Editor for Broadcast at The Washington Stand and Host of the "Outstanding" podcast, provides the latest updates on Minnesota's uprising and President Trump's trip to Iowa. Dr. Andy Harris, U.S.

How do we define what is? Host Casey Harper is joined by author and pastor, David Schrock, and The Washington Stand’s Jared Bridges to unpack how Christians can begin to define the world the way God originally created it. Where do we start to understand what we know? The three discuss what has diluted Truth, the impact of post modernism on understanding what is true, and the definition of humanity. Resources The Business of Is-Ness: How to Live in the World God Made by David Schrock