Podcasts about Roche

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce mardi 28 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce mardi 28 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce mardi 28 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce mardi 28 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Hello and welcome to the Focus on Greatness Podcast. In the month of June, we celebrate Father's Day and throughout this month we are celebrating the different men in my life. Tonight I thought it would be right for me to share my story as a father. So tonight I'm going to open up, be vulnerable like all the other's that have come before me and share my story. You don't want to miss this conversation. Sponsored By: The Salt Society www.thesaltsociety.co Last Podcast: A Father's Story by Hiram Roche' Sr. https://bit.ly/3Aatnsa Guest Information: Instagram: @ppfours Facebook: @Perfect Petit-Fours www.perfectpetitfours.com Follow Me Facebook: @hrochemedia Instagram: @hiram.roche.media Twitch: @focusongreatness YouTube: Hiram Roche Media Website: www.hiramroche.com Show support by DONATING to: PayPal: @hrochemedia Cash App: $hrochemedia Venmo: @hrochemedia Mail Us: 108 E. FM 2410 Suite F #116 Harker Heights, TX 76548 --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/focusongreatness/support

Pearl Jam has two legs of their 2022 tour! What are the trends we've seen so far?  Varied openers! No Covers shows! Tighter song rotations!It's been a topsy turvy ride and we are barely halfway through the tour. To help make sense of what we've seen so far and with Billie Jean "on assignment". Roche speaks with Randy Sobel of the Live On 4 Legs podcast about U.S v Euro, Gigaton v Ten, and full show v festival sets. Randy also takes us behind the Jamaroke night in Las Vegas after the band bowed out due to COVID. Roche and Randy also look ahead to the future of Pearl Jam as a touring band. Finally, Randy plays "My PJ Experience..." and explains why the PJ fan community is so important to him. Live On 4 Legs (and Jamily Matters) is available wherever you get your podcasts. 

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce lundi 27 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce lundi 27 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Liquid biopsy has emerged as a novel diagnostic tool, enabling rapid, non-invasive molecular testing of thyroid cancers. This episode offers insight into some of the opportunities and challenges that are presented by liquid biopsy in this field. To answer questions on this topic, we have invited Professor Frederique Penault-Llorca to join us. She is Professor of Pathology at the University of Clermont-Ferrand and CEO of the Comprehensive Regional Cancer Institute Centre Jean Perrin in Clermont-Ferrand, France. Funding Information: This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty. Faculty Disclosures: Professor Frederique Penault-Llorca has disclosures are as follows: Advisory board: Roche, EliLilly, Illumina, Speaker: Roche, EliLilly, Illumina, References 1. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–1214 2. Albarel F, Conte-Devolx B, Oliver C. From nodule to differentiated thyroid carcinoma: Contributions of molecular analysis in 2012. Ann Endocrinol (Paris). 2012;73:155–164 3. Nylen C, Mechera R, Marechal-Ross I, et al. Molecular markers guiding thyroid cancer management. Cancers (Basel). 2020;12:2164 4. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Thyroid Carcinoma. Version 2.2022. May 5, 2022. Available at: https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf (accessed June 2022) 5. Pinchot SN, Al-Wagih H, Schaefer S, et al. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg. 2009;144:649–655 6. Bellevicine C, Sgariglia R, Nacchio M, et al. Molecular testing of thyroid fine-needle aspiration: local issues and solutions. An interventional cytopathologist perspective. J Mol Pathol. 2021;2:233–240 7. Kasraeian S, Allison DC, Ahlmann ER, et al. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res. 2010;468:2992–3002 8. Lindeman NI, Cagle PT, Aisner DL, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors: Guideline from the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. Arch Pathol Lab Med. 2018;142:321–346 9. Pennell NA, Arcila ME, Gandara DR, et al. Biomarker testing for patients with advanced non-small cell lung cancer: Real-world issues and tough choices. Am Soc Clin Oncol Educ Book. 2019;39:531–542 10. Belli C, Penault-Llorca F, Ladanyi M, et al. ESMO recommendations on the standard methods to detect RET fusions and mutations in daily practice and clinical research. Ann Oncol. 2021;32:337–350 11. Li MM, Datto M, Duncavage EJ, et al. Standards and guidelines for the interpretation and reporting of sequence variants in cancer: A joint consensus recommendation of the Association for Molecular Pathology, American Society of Clinical Oncology, and College of American Pathologists. J Mol Diagn. 2017;19:4–23

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce lundi 27 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce lundi 27 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 17h00 de ce dimanche 26 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 09h00 de ce dimanche 26 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 16h00 de ce samedi 25 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Sulatha Dwarakanath is the co-founder and CEO of Kaya17 - a point of care diagnostics company. Sulatha has more than 25 years of experience in the Life Sciences industry. She is committed to helping foster better clinical trials, pathogen detection, rapid testing, and biodefense contracts. Previously Sulatha held leadership positions at Bayer Diagnostics, Thermo Fisher Scientific, and Roche. --- Support this podcast: https://anchor.fm/theindustryshow/support

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce samedi 25 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce vendredi 24 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Peter Stern joined Mr Jeff in 2021 as the new Managing Director of Mr Jeff in the U.S. Anchored with more than 20 years of experience in the laundromat industry. Peter Stern joined the Mr Jeff team bringing 20 years of multi-faceted industry expertise including store operations, finance, business development and innovation. Prior to joining Mr Jeff, Stern was the SVP of Laundry Capital and Managing Director of Clean Ventures and he was owner/operator for many years of Great American Laundromat, one of the highest grossing laundromats in the NY Metro located in the Bronx. Early in his career, Peter worked for PricewaterhouseCoopers on their Financial Advisory Services team, specializing in forensic accounting, fraud investigations and post-acquisition dispute analysis. Additionally, Peter then worked in commodities trading at International Specialty Chemicals, specializing in procuring rare raw materials for large Pharma and Bio-tech (Roche, Bristol-Meyers Squibb, Eisai) clinical trials through overseas contract manufacturing agreements. Later, Peter led product and business development for a video-auditing and AI company called Arrowsight, where he worked with companies like McDonald's utilizing video to analyze key operational performance metrics providing immediate feedback to front-line and executive management. In addition to listening to the episode, you can watch a video of their discussion on our YouTube Channel.  And be sure to subscribe to support the podcast! For general information about the podcast, send an email to info@beinhakerlaw.com To follow Mitch and the podcast, go to linktr.ee/beinhakerlaw. You can subscribe and listen to episodes on Apple Podcasts, Google Podcasts, Amazon Music, Spotify and most other directories. Please review us whenever possible and thanks for your continued support! Sponsorships and paid guest appearances are available. Connect with us by email or on social media. The Accidental Entrepreneur is brought to you by Beinhaker Law, a boutique business & estates legal practice in Clark, NJ. To learn about shared outside general counsel services and how to better protect your business, visit https://beinhakerlaw.com/fractional-gen-counsel/ Please support our affiliate sponsors (https://beinhakerlaw.com/podcast-affiliates/). Also, support the show and get your own podcast merch! (https://beinhakerlaw.com/podcast-store/) One of One Productions - a New Jersey-based studio, just over the George Washington bridge, that caters to the booming business of podcasting. Be sure to check out the guesting kit that they've created exclusively for our listeners! https://one-of-one-productions.myshopify.com/products/mitchell-beinhakers-guesting-kit North Authentic - NorthAuthentic.com is a conscious hair care marketplace offering the cleanest brands from around the world. Their pro stylists curate only the most fabulous non-toxic hair products. Use our affiliate link for all your purchases! https://shrsl.com/38heu The Healthy Place - Findyourhealthyplace.com has thousands of supplements to help you live a better quality of life; as well as natural solutions for chronic pain, stress, anxiety, depression, sleep and much, much more. Need guidance? Use their Live Chat feature and talk to a Wellness Consultant right on their website. The Accidental Entrepreneur is a trademark of Mitchell C. Beinhaker. Copyright 2018-2022. All rights reserved.

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce vendredi 24 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

A Roche Genentech Alzheimer's therapy failed an important clinical trial. At the press conference that followed, the scientists involved parsed over what when wrong and what should happen next. We'll discuss this conference and dive into what scientists are saying about an Alzheimer's moonshot. But that's not all. During a panel discussion at the BIO conference, a Fierce journalist witnessed a controversial take on a diversity—which led to a conversation on diversity in biotech. Lastly, we'll take a close look at the top winners in pharma, health and wellness at the Cannes Lions International Festival of Creativity. To learn more about the topics in this episode:  Will we ever land the Alzheimer's moonshot? Genentech's crenezumab partners reflect on failure Another knock back for amyloid: Roche's approach to presymptomatic Alzheimer's ends in failure BIO: 'Diversity candidates' and knowledge 'shortfalls': Women in biotech say 'I'm here to do my job' despite toxic tropes Bausch Health pulls the plug on Solta Medical IPO and 3-way company split FDA signs off on Pfizer, Moderna COVID-19 vaccines for kids 6 months and older Galapagos finally takes M&A plunge, spending $251M for 2 biotechs in CAR-T push Hot on Alnylam's heels, AstraZeneca racks up phase 3 win for Ionis-partnered rare disease drug Big Pharmas lose out at Cannes Lions as VMLY&R sweeps health categories with campaigns for Dell and Maxx Flash Winning agency behind Cannes Lions says its double health Grand Prix win shows a major shift in thinking Fierce Biotech NextGen Virtual Event The Top Line is produced by senior multimedia producer Teresa Carey with editor-in-chief Tracy Staton, managing editor Querida Anderson and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. See omnystudio.com/listener for privacy information.

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce vendredi 24 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce vendredi 24 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Slam the Gavel welcomes George Roche to the show. George Roche has a Masters in Clinical Psychology with a focus on Family Systems, Child Development and the various forms of abuse related to Parental Alienation. He also brings a BA in Business Administration to the Presidency and CEO of America and Canadian Rights Watch, a human rights defense organizations that provide various logistics consultations, legal referrals and mental health services to citizens. We discussed how questionable statements of known liars works people into compliance through fear and control. We also talked about the book/movie "The Stand," by Steven King as well as, "Bradshaw On: The Family: A New Way of Creating Solid Self-Esteem," by John Bradshaw (on Amazon). "For Your Own Good, The Hidden Cruelty in Child-Rearing and The Roots of Violence," by Alice Miller (on Amazon) which George highly recommends. George Roche also states that society has been divided and alienated from all it's people, they want us to hate each other and fight and want us in chaos as much as possible because those distractions keep us preoccupied and unaware of what's coming on the heels of our ignorance, which is the NWO. Fascinating conversation on all levels of alienation. To Reach George Roche: Canadian Rights Media - Home - Facebook, Twitter: @Canadian_Rights Rumble: canadianrightswatch www.canadianrightswatch.com wellness@canadianrightswatch.com Support the show(https://www.buymeacoffee.com/maryannpetri) http://beentheregotout.com/ https://monicaszymonik.mykajabi.com/Masterclass USE CODE SLAM THE GAVEL PODCAST FOR 10% OFF THE COURSE http://www.dismantlingfamilycourtcorruption.com/ Music by: mictechmusic@yahoo.com

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce jeudi 23 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

     Slam the Gavel welcomes George Roche to the show. George Roche has a Masters in Clinical Psychology with a focus on Family Systems, Child Development and the various forms of abuse related to Parental Alienation.    He also brings a BA in Business Administration to the Presidency and CEO of America and Canadian Rights Watch, a human rights defense organizations that provide various logistics consultations, legal referrals and mental health services to citizens.     We discussed how questionable statements of known liars works people into compliance through fear and control. We also talked about the book/movie "The Stand," by Steven King as well as, "Bradshaw On: The Family: A New Way of Creating Solid Self-Esteem," by John Bradshaw (on Amazon). "For Your Own Good, The Hidden Cruelty in Child-Rearing and The Roots of Violence,”  by Alice Miller (on Amazon) which George highly recommends.    George Roche also states that society has been divided and alienated from all it's people, they want us to hate each other and fight and want us in chaos as much as possible because those distractions keep us preoccupied and unaware of what's coming on the heels of our ignorance, which is the NWO. Fascinating conversation on all levels of alienation.To Reach George Roche: www.facebook.com/CanadianRights WatchTwitter: crw_rightsmediaRumble: canadianrightswatchwww.canadianrightswatch.comwellness@canadianrightswatch.comSupport the show(https://www.buymeacoffee.com/maryannpetri)http://beentheregotout.com/https://monicaszymonik.mykajabi.com/Masterclass  USE CODE SLAM THE GAVEL PODCAST FOR 10% OFF THE COURSEhttp://www.dismantlingfamilycourtcorruption.com/Music by: mictechmusic@yahoo.comSupport the show

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce jeudi 23 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce jeudi 23 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce jeudi 23 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

This week we sit down with a fellow that catches a lot of fish. He does it in his own unique method. Daniel Tarbox joins us from outside of Kamloops BC to tell us about his fly fishing journey. He tells us about his obsession for fishing, tying flies and chasing fins on the still water. Thanks Daniel for sharing your journey with us!

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce mercredi 22 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce mercredi 22 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce mercredi 22 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce mercredi 22 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

In part one, of this two-part ASCO Education podcast episode, host Dr. Jeremy Cetnar (Oregon Health & Science University) interviews two very accomplished physicians and researchers, Dr. Lauren Abrey and Dr. Jason Faris. We'll hear about their motivations for pursuing medicine and how they arrived at the different positions they've held in academia and industry.  If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT   Dr. Jeremy Cetnar: Hello, and welcome to the ASCO Education podcast episode on career paths and oncology. My name is Jeremy Cetnar. I'm a Medical Oncologist and Associate Professor of Medicine at Oregon Health and Science University in Portland. I'm delighted to introduce today's two guests, whose careers in oncology have crisscrossed academia and industry. Dr. Lauren Abrey and Dr. Jason Faris, I'm excited to chat with you about the inspiration and motivations that drive you, people you've leaned on, how you've made your career decisions, challenges you've faced, and more.  So let's start by asking each of you, could you share a little bit about your early life and background, what attracted you to medicine, and who are some of your early mentors and role models? Let's start with you, Dr. Faris.  Dr. Jason Faris: Yeah, I'd be happy to. Thank you. So, I grew up in a small town in South Jersey in Greater Philadelphia. My mom was a registered nurse in pediatrics in the maternal infant unit for many years at Cooper Hospital. I was always interested in science and medicine and my mom's dedication to her patients. Her altruism and compassion served as a real inspiration for me, for my eventual decision to go to medical school. But I took a long time to get there. I had a bit of a circuitous route to arrive to my career in medicine though it started off conventionally enough. I was initially geared towards a premedical track in college, majoring in biology, but an exciting summer research project, working on the biochemical mechanisms underlying osmoregulation in a marine crustacean with mentoring from my first true mentor, Dr. Don Lovett, led me to apply to and attend graduate school in molecular biology at Princeton.  This was followed by a position at Merck as a molecular biologist in the genetic and cellular toxicology group. I went to veterinary school at the University of Pennsylvania where I met my future wife. And then finally, back to the original plan of attending medical school, but I have to say with a much better sense of why I wanted to attend medical school in the first place, now in my late 20s, which was a bit unconventional at the time. I really did my fair share of exploration of Allied Health careers. That's for sure. I attended Johns Hopkins for medical school, where I quickly discovered a passion for internal medicine. And that was far and away my favorite clerkship and sub-internship. That's the background to how I got to medical school.  Dr. Jeremy Cetnar: Dr. Abrey?  Dr. Lauren Abrey: Interesting. I love your story. We share... I grew up in a small town, not so far away, but I was in upstate New York. And I think there were two influences that kind of got me to my ultimate passion for brain tumors. And this sounds a little quirky to start with. But I had a pretty serious head injury as a tween. So I guess I was about 12. I had a skull fracture, epidural hematoma. And while I would never have said I woke up at that moment and thought I have to be a doctor, I think I became fascinated about things to do with the brain.  In parallel, something that I think tinged a lot of my childhood was a number of family members who had cancer. So both of my grandmothers had breast cancer, while I was well aware of the fact that they were sick and battling this. And two of my aunts also had cancer. And I would say it's an interesting split in my family. So about half of them are survivors and about half ultimately died of their disease.  So both of these things really motivated me or focused me on the need to do something important, but also to do something that really motivated me to get out of bed in the morning. I think I was much more to the point. I went straight to college, straight to medical school. I remember calling my parents and telling them I was applying to medical school and having them say, “Wait. You? Really?” So it wasn't necessarily the family expectation that I would do this, but I was very driven and motivated to make some of these choices and then discover my particular interests as I progressed through medical school. So I went to Georgetown for medical school and then have trained at a number of places in the US. I think that's a little bit how I took my first step on this career journey, let's say.  Dr. Jeremy Cetnar: So take us through what the decisions were like in your head at the end of fellowship in terms of first jobs. Dr. Faris?  Dr. Jason Faris: In terms of my choice to pursue a career in medical oncology, this goes back to medical school during an internal medicine clerkship. I had an assistant chief of service, ACS, at the time, Phil Nivatpumin. He'd go on to become a medical oncologist. He really inspired me with his optimism and bedside manner, including with multiple oncology patients on that clerkship. His enthusiasm for science and medicine, his teaching skills, and an absolutely legendary fund of knowledge. For Phil, he was just an incredible ambassador for both internal medicine and for oncology.  After medical school, I went to internship and residency at Mass General Hospital. And in one of my first rotations, I was on the oncology service, which was not so creatively called Team Three. I think they can up the ante there, but oncology services on Team Three. I was caring for many extremely ill patients battling disease progression from their metastatic cancers, or sadly, in many cases complications of their treatments. During that rotation, I was intrigued by clinical trials offering novel treatment options based on cutting edge science, but also struck by the number of patients who just didn't have any clinical trial options. I became aware of the limitations of the conventional treatments that were offered.  I was really inspired by the patience and dedication of the nurses and doctors caring for them. And I vividly recall a roughly 50-year-old woman I helped care for with AML, watching as the 7+3 chemotherapy caused lots of side effects for her and being amazed by her strength and grace, her resilience as she faced her illness, her potential mortality, and the intense chemotherapy she was undergoing. And I knew during those moments with that leukemia patient while caring for other patients on that oncology service that this was the field I would pursue. Oncology was really the perfect blend of humanism, problem solving, longitudinal follow-up and rapidly accelerating scientific progress leading to new avenues for clinical trial treatments.  Like Lauren, I was motivated and inspired by cancer diagnoses in my own family. My maternal grandmother died of pancreatic cancer during my junior year of college. My dad was diagnosed with colon cancer during my first year of fellowship. So those are all really strong motivators, I would say. And after completing my fellowship at the combined Dana-Farber MGH program, my first position out of fellowship was in the gastrointestinal cancer group at MGH. I actually had been training in genitourinary oncology after my main clinically focused year of fellowship, but I did a chief resident year in the middle of fellowship, and that was the tradition at MGH. And as I was about to return to fellowship for my senior year of fellowship, the head of the GI Group and head of the Cancer Center at the time, Dave Ryan, offered to serve as a clinical research mentor for me in GI cancers. As a senior fellow, I wrote an investigator-initiated trial of cabozantinib for patients with neuroendocrine tumors under his mentorship that went on to demonstrate encouraging results, led to a Phase III study in that cancer population, and I ultimately accepted a position at the MGH Cancer Center in the GI cancer group about 11 years ago. And that was the start of my post-training career.  Dr. Jeremy Cetnar: And how about you, Dr. Abrey?  Dr. Lauren Abrey: So for people who don't know, I'm actually a neurologist. I finished my training in neurology and then pursued a fellowship in neuro oncology. I would say it was really patients and observations of things that were happening with patients during my residency. I did my residency at the University of Southern California at Los Angeles. I was at the LA County Hospital, which for people who don't know, is one of the largest hospitals in the country. I had the chance to see several patients who had paraneoplastic syndromes, and got the support from different faculty members to write those cases up, and really resulting in my first independent publications. That was what kind of got me bitten by the bug to understand this link between neurology and oncology.  I very intentionally went to Memorial Sloan Kettering to have the opportunity to work with Jerry Posner. And I think I no sooner got there than I got totally bitten by the brain tumor bug, which seems a little counterintuitive. But the paraneoplastic work was kind of deep laboratory work. And I realized that I really enjoyed seeing the patients having the partnership with neurosurgeons and digging into what is still a pretty intense unmet medical need.  So it was an interesting pivot because I really thought I was going to Sloane to focus on paraneoplasia. I still think I learned so much with that interest that I think we can reflect on when we consider how immunology has finally entered into the treatment landscape today for different tumor types and understanding is there a background in paraneoplastic disorders that could help us. But I have to say it was really the brain tumor work that got me focused and the chance to work with people like Lisa DeAngelis, Phil Gutin, and others that was kind of fundamental to my choices. I stayed there for two years of fellowship and then continued as faculty for about another 15 years at Sloan Kettering. So that's really the start of my academic career and the pivot to industry came much later.  Dr. Jeremy Cetnar: So both of you have impressive career CVs, have been trained at very prestigious institutions. So at some point in time, take me through, what was that transition like between, 'Hmm, what I'm doing is enjoyable, but maybe there's something else out there that I want to explore.' And what I mean by that is mostly industry at this point. So that's an important question that I think a lot of junior faculty face, a lot of mid-career faculty, maybe even later-stage faculty. But I think that's a tension point for a lot of people because I think there's a lot of fear. I think there's a lot of anxiety about moving outside of the academic realm. So, tell us a little bit about what was the pull in terms of going to industry and what were some of the thought processes that were going on. Dr. Faris?    Dr. Jason Faris: I've experienced two transitions, actually, between academia and industry. I like to do things in pairs, I guess. But the first was, after multiple years at the MGH as a resident fellow and as a clinical investigator at the MGH Cancer Center. As a new attending and clinical investigator, I was attempting to balance my work priorities, providing patients with GI cancers, which is a rewarding but complex and I'd say emotionally intense experience, given the phenomenally aggressive and devastating cancers these patients grapple with such as pancreatic cancer, alongside the other responsibilities of my clinical investigator position.  Those other responsibilities included writing grants and papers and protocols, evaluating patients who were interested in open clinical trials, and serving as the principal investigator for multiple studies. I was serving on committees, mentoring and teaching. Patient care was always my top priority as it should and really must be. And I feel incredibly lucky to have had truly amazing colleagues at MGH across several disciplines, from medical oncology, nurse practitioners, practice nurses, radiation oncologists, and surgeons. It was and continues to be a dynamic place full of extremely talented and dedicated clinicians. I think we really all benefited from the coordinated teamwork in both patient care and research in a really tight-knit GI Group.  But nonetheless, for me as someone who delighted in spending large amounts of time with my patients in the clinic rooms, and I think my colleagues would agree frequently agonizing over decisions impacting their care, achieving sufficient balance to really focus on writing and overseeing clinical trials was becoming increasingly challenging for me. And it was in that context, after spending roughly a decade and the combination of residency fellowship training and as an attending in the GI cancer group all at MGH that I made a truly difficult decision to move from my beloved outpatient clinical and clinical investigator role to industry to focus more exclusively on clinical research.  And after interviewing for several industry-based roles, I accepted a position in the early-phase group at the Novartis Institutes for Biomedical Research or NIBR as we kind of pronounced those words in Cambridge. I absolutely loved my time at NIBR. It's an incredible place with a strong history of and commitment to innovation as well as passionate, talented colleagues, many of whom I've worked with in the past. When I first started at Novartis, I was amazed at the array of experts on the teams I was helping to lead as a clinical program leader. Our teams are the definition of multidisciplinary. They're composed of what we call line function experts in multiple disciplines. This includes preclinical safety experts who design and analyze data from studies that precede the filing of an IND, research scientists, chemists, preclinical, and clinical pharmacologists, statisticians, program managers, drug and regulatory affair colleagues, who focus on the interactions with health authorities, including the FDA, operational colleagues called clinical trial leaders, and many others.  In my role as a senior clinical program leader, I also have the opportunity to collaborate frequently with research colleagues on preclinical programs, designing and writing first in human trials, followed by conducting the actual studies and in close collaboration with our academic colleagues, analyzing the clinical and translational results.  Dr. Jeremy Cetnar: Dr. Abrey, how about you? Was there a moment or what were the moments that led to you deciding to make this transition?  Dr. Lauren Abrey: I guess I have the other sort of story. I got pushed, I would say, in the sense that like many of us, I'm married, and my husband was the one who took a job with Novartis and said, “This would be an adventure. Let's go live in Switzerland.” So similar to Jason, he took a position at NIBR, and I think for many of the same reasons, he really wanted to delve deeply into early mechanism of action and allow himself to dedicate really a chunk of his career to developing key drugs. But moving to Switzerland changes your options suddenly. I think I had spent most of my career at Sloan Kettering doing clinical trials. That was really my comfort zone, my sweet spot. And when we moved over here, I explored briefly, could I set up an academic career here?  And very kindly, I was invited by a number of Swiss colleagues to look for opportunities to do that. But I realized what I loved was talking to patients, and that that was going to be difficult with the language barrier. And I equally loved running clinical trials. So I had a great opportunity to join Roche shortly after their merge or full acquisition of Genentech. This allowed me to continue the work I had been doing on Avastin for brain tumors.  But I think the other thing that allowed me to do, that was something I was really looking for was to broaden my scope and to no longer be niched as just a brain tumor expert. And if you're in academia and you're a neurologist, obviously, you're going to be fairly constrained in that space. But moving into a role in industry really allows you to look much more broadly and work across multiple tumor types. And I spent the next seven years at Roche running not just the Avastin teams that were developing drugs for a number of indications, but really overseeing the clinical development group based in the European sites. And they had about 14 different drugs in different stages of development as well as partnerships with their early research group that was European based.  So it was a fascinating time for me, and I feel kind of like I got thrown into the pond. I knew a lot about clinical trials. I had no idea about so many other aspects of what I needed to consider. And I think Jason started to allude to some of this with the different line function expertise and things I think we take for granted or maybe we simply have blind spots around them when we are sitting in our academic organizations. So it's been a really delightful plunge into the pool. I've continued to swim mostly. Occasionally, a little bit of drowning, but a lot of fun.  Dr. Jeremy Cetnar: What would you say are the major differences between an academic career and industry?  Dr. Lauren Abrey: I think, as you said, the things that are similar is that the purpose or the mission for both is in many ways the same. We would like to develop better treatments for patients with cancer. And so there's a huge focus on clinical trials. There needs to be a huge focus on patients, and that can get diluted in industry. I think the things that you don't appreciate sometimes when you're sitting on the academic side is just really the overarching business structure and the complexity of some of the very large organizations. So you suddenly are in this huge space with people focused on regulatory approvals focused on pricing, focused on manufacturing, focused on the clinical trial execution, and why you are doing it in different spots.  And so I think some of the different factors that you have to consider are things that again, we either take for granted or are super focused when you're in one organization. And I think the tradeoffs and how decisions are made, particularly in large pharma, can be frustrating. I think we are all used to applying for grants or getting the funding we need to do whatever our project or trial is. And then you just start very laser focused on getting to the end. If you're in a large organization and they have a portfolio where they're developing 14, 15, 20 different things, you might suddenly find that the project you think is most important gets de-prioritized against something that the company thinks is more critical to move forward. And that could be because there's better data, but it could also be because there's increasing competition in the space or there's a different pull for a large company. I haven't seen the early development side as much. I've seen the development. I've now seen Medical Affairs for how some of those decisions are made, but I'd be curious to hear what Jason has seen in some of his experiences as well.  Dr. Jason Faris: Comparing and contrasting a little bit between the two, because I've run early phase studies on the academic side, I'll talk more about that in a little bit in terms of another academic position that I held. So I've run early-phase studies there. I've run early-phase studies in industry as well. And they share a lot of similarities, certainly following compelling science, the excitement about new therapies that are going to be offered to patients. But I think the execution is a bit different, and I would say, when you're running clinical trials in the academic setting, you're meeting every patient that you're going to put on study or at least one of your colleagues is, if you have sub-eyes on the study, that's a major, major difference, right? You're directly taking care of a patient going on to an experimental therapy, consenting that patient, following them over time, getting the firsthand experience and data from that patient interaction, but not necessarily, unless you're running an investigator-initiated study, not necessarily having access to the data across the whole study.  You're hearing about the data across the whole study at certain time points on investigator calls, PI meetings, dose escalation meetings, those kinds of things. But you're not necessarily having access to the real-time emergence of data across the whole study from other people's patients. So you're a bit dependent on the sponsor to provide those glimpses of the data, synthesize that and present overview. So those are some operational differences, I would say, because you're not taking direct care of the patients and having your time split among different commitments in that way I have felt a greater ability to focus on the clinical research that I'm doing in my industry-based role, which I like, of course, but I also miss taking care of patients. I love taking care of patients.   So I think it's always a double-edged sword with that if we can use a sword analogy here. But I think they both offer really exciting options to pursue new therapies for patients, which for me, was one of the fundamental reasons that I pursued medical oncology in the first place. It was really this idea that the field is rapidly advancing. I wanted to be a part of that. I saw firsthand what cancer could do to my family or family members, and I took care of patients in the hospital as an intern resident and fellow where I think there's just a tremendous unmet medical need. And so having an opportunity to contribute to the development of new therapies was always a real inspiration for me.  Dr. Jeremy Cetnar: With that being said, what led you to go back into academia?  Dr. Jason Faris: This is an ongoing saga, I guess. So after several years of professional growth at Novartis, gaining experience with designing and conducting clinical trials on the industry side, I was actually at ASCO and I learned of an open role for the director of the early phase trials program at Dartmouth's Cancer Center. After extensive consideration, which I think you can see as my trademark at this point, I made another difficult decision to interview for the position, which was focused on helping to grow the early phase trials program at an NCI comprehensive designated cancer center that's unique in a way because it's in a rural area. And it had a new director of the Cancer Center, Steve Leach, who's a renowned laboratory scientist with a focus on pancreatic cancer and a surgeon by training.  I ultimately decided to accept the early phase director position, moving my family away from Greater Boston, where we had lived for about 15 years, to the upper valley of New Hampshire. And while at Dartmouth, I was part of exciting projects, including writing and overseeing an NCI grant called Catch Up, which was geared towards improving access to early phase clinical trials for rural patients. I opened numerous sponsor-initiated immunotherapy and targeted therapy, early phase trials. Just to say a little bit about Dartmouth's Cancer Center - I think they also benefit from tremendous collaboration, this time across Dartmouth College, the Geisel School of Medicine, the School of Public Health. I think they provide really excellent care to their cancer patients. And I was extremely proud to be part of that culture in the GI Group, which was much smaller than the one at MGH, but also an incredibly dedicated group of multidisciplinary colleagues who work tirelessly to care for their patients.  But nonetheless, less than six months into that new position, the COVID pandemic started, and that introduced some significant and new challenges on the clinical trials side in terms of staffing, infrastructure, those kinds of things. In that context, I made a decision to return to NIBR, refocus on clinical research, and hope to harness my background in running clinical trials in both settings, both academic and industry, as well as the resources and pipeline of Novartis to really maximize my impact on drug development. So for me, it was a question of where can I have the maximum impact at this crazy time, difficult time. I saw that my best option was to return to industry to work on studies to try to develop new therapies. Broadly speaking, my role as a senior clinical program leader in the translational and clinical oncology group at NIBR is to design, write, conduct, and analyze innovative clinical trials of early phase therapeutics.  Dr. Jeremy Cetnar: Wow, that's fascinating, very, very interesting. A lot of stress. You should definitely be buying lots of presents for your family for moving them all over the place.  This concludes part one of our interview with Drs. Abrey and Faris. Thank you so much for sharing your inspiring career stories. And thank you to all our listeners for tuning into this episode of the ASCO Education Cancer Topics podcast.  Thank you for listening to the ASCO Education podcast. To stay up to date with the latest episodes, please click subscribe. Let us know what you think by leaving a review. For more information, visit the Comprehensive Education Center at 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. 

It's been an unsatisfying period for D.C. United for both the club and its supporters. But with rumors swirling of multiple additions incoming during the summer transfer window, there is a sense of excitement around the team. Roche spoke with DCU GM Lucy Rushton about potential reinforcements, the type of player the club is looking to add, and when we might see them on the pitch. Rushton also walks Roche through the recruitment process of Taxi Fountas and how the club identifies and tracks potential new signings. Finally, she gives insight on D.C. United's overall vision and how it is evolving post-Hernan Losada. 

Ecoutez les infos de la Loire avec le flash info de 18h00 de ce mardi 21 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 12h00 de ce mardi 21 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 08h00 de ce mardi 21 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

Ecoutez les infos de la Loire avec le flash info de 07h00 de ce mardi 21 juin 2022. L'actualité à Saint-Etienne, Saint-Chamond, Roanne, Firminy, Montbrison, Rive-de-Gier, Saint-Just-Saint-Rambert, Le Chambon-Feugerolles, Riorges, Andrézieux-Bouthéon, Roche-la-Molière, Veauche, Unieux, Feurs, Villars, Sorbiers, La Ricamarie, Mably, Le Coteau, La Talaudière...

The 2021/22 season is over. Arsenal have finished 5th with no silverware. Has this season been a success or a failure? What were the key moments? Individual player awards and looking ahead to the summer transfer window. I'm joined by three gargantuan guests: James Benge of CBS Sports - @JamesBenge Art de Roche of The Athletic - @artderoche Kaya Kaynak of Football.London - @kayakaynak97

Ps. Jenny Roche - What The Bible Is All About by Dr Theo And Beverley Wolmarans Ministries

Año XVI. Núm. 141. Respuestas que da en entrevista el prefecto de la Congregación para el Culto Divino y la Disciplina de los Sacramentos.-Mauricio I. PérezSeminans ad Seminandum

The ADA 2022 was full of interesting symposia, updates on ongoing clinical trials, and a draft of an updated ADA-EASD consensus report. This year's conference also put particular emphasis on weight [EP1] management in the setting of type 2 diabetes as well as its associated cardiovascular and kidney comorbidities. Join us as we speak to Professor Jennifer Green about her conference highlights, including: - Draft ADA-EASD Consensus Report - Results from the SURMOUNT-1 clinical trial of tirzepatide in people with obesity - Further data for dual and triple incretin agonists and their potential future role By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources. References available here Disclosures: Prof. Jennifer Green declares the following financial relationships from the past 24 months: Consultant: AstraZeneca, Bayer, Boehringer Ingelheim/Lilly, Hawthorne Effect/Omada (ended), Pfizer, NovoNordisk, Sanofi/Lexicon, ICON/Vertex, and Anji. Research support: Boehringer Ingelheim/Lilly, Merck, and Roche. Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose. The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity. Funding: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

Jackie Tyrrell and Conor Neville join Mikey Stafford and Rory O'Neill on Wednesday to look ahead to the All-Ireland hurling quarter-finals, while Wexford manager Shane Roche and Pat Spillane preview the Tailteann Cup semi-finals.

"Cancer and Armed Conflict: Crossing Realities," by Tamamyan, et al: the story of a young patient with cancer from Nagorno-Karabakh Republic and his thoughts and sufferings during the war in 2020.   TRANSCRIPT Narrator: Cancer and Armed Conflict: Crossing Realities, by Alisa Kamalyan, MSc, Yeva Margaryan, MD, MPH, Jemma Arakelyan, MD, Liana Safaryan, MD, Gevorg Tamamyan, MD, MSc, DSc, and Stella Arakelyan, MD, MPH, MscIH, PhD (10.1200/JCO.22.00663) In 2007, Armen, a 6-year-old boy from a village in the mountainous Nagorno-Karabakh Republic (NKR), was diagnosed with Hodgkin lymphoma. NKR is a de facto independent state located in the South Caucasus which has historically been inhabited by Armenians and declared its independence after the collapse of Soviet Union in 1991. Armen's hometown had a small clinic offering only routine health care services. To receive treatment for lymphoma, he and his family had to travel 350 kms to the Hematology Center in Yerevan, the capital of Armenia. The journey was long and exhausting, but every visit to the Hematology Center filled him with hope, and, ultimately, he achieved a complete remission. Thirteen years later, Armen, now a young man, returned to the Hematology Center for evaluation of rapid weight loss, persistent pain, and chronic fatigue and was diagnosed with osteosarcoma. First-line chemotherapy and surgery were ineffective, as was second-line therapy with high-dose methotrexate, doxorubicin, and cisplatin. The tumor was growing and spreading rapidly, causing unbearable pain. Throughout the course of his disease, Armen kept a diary. Recently, his family shared his journal with us, hoping to give a voice to Armen and other young patients with cancer struggling with physical and emotional distress along with overwhelming existential angst. “In the hospital I had dreams which I could not understand. In one of the dreams, it was midnight, and I knew that I was going to die in 3 hours, but time was running backward, which meant that I was going to die at 8 pm … In another dream, I was undergoing a course of chemotherapy when my phone rang, the call was from Hell. I picked up the phone, and it was one of my relatives from Nagorno-Karabakh who is no longer alive. But you are dead …, I said to her, surprised. How are you, my dear? She replied. Once I hung up the phone, a man dressed in black sat down next to me, made the sign of the cross, and then disappeared …” At the time, there were no clinical trials available for patients with osteosarcoma in Armenia and his family could not afford to take Armen abroad to receive any experimental therapy, so, after exhausting all available treatment options, Armen returned home to live out his days in the village that helped raise him. We knew that his home environment would provide the support he needed as his cancer journey came to its tragic end. We hoped for his comfort, safety, and peace among those who loved him. On the morning of September 27, 2020, Armen awoke in a panic, distressed by the loud explosions of bombs dropped on his village as the war between the NKR and Azerbaijan erupted. This conflict, coinciding with the rapid spread of COVID-19 in NKR and Armenia, interrupted access to cancer care and essential palliative medications. Armen was bedridden with intolerable pain and a dwindling supply of analgesics. The encroaching sounds of high-intensity blasts further amplified his anguish and suffering. Armen's psychological trauma resulted in nightmares and chronic anxiety as evidenced by his diary entries. “My house keeps shaking with each explosion, resonating like a high-scale earthquake. Soon, the blasts will shatter all the windows in my house” (October 1, 2020). “Our electricity, heating, and water supplies are cut off. My supply of painkillers is running out” (October 9, 2020). “Don't think about death– think about the future…” Within weeks, the Nagorno-Karabakh conflict escalated, destroying homes, healthcare clinics, hospitals, and schools, resulting in massive population displacement and hundreds of civilians, including health care providers, being killed or wounded. Given these dire circumstances and Armen's worsening pain and weakness, Armen's family sought refuge in Armenia, where his battle with cancer ultimately ended. After the war ended on November 9, 2020, Armen's family took him back home to be laid to eternal rest. This had been his last wish. Armen was a fearless soul. He was a fighter who had already survived cancer once and continued his fight with a smile on his face, giving hope to many of our other patients and staff. But the day the Azeris attacked his home, the smile left his face forever. For our health care team and other colleagues, the 44 days of the Nagorno-Karabakh war caused a psychosocial and emotional crisis. We could not concentrate on our work. Hundreds of soldiers were being killed daily, and many colleagues felt compelled to leave the cancer wards to join frontline military health care workers. With increasing numbers of surgeons, anesthesiologists, and nurses traveling to the NKR or bordering regions of Armenia, we experienced acute staff shortages, undermining the provision of quality care to our patients. COVID-19, the main health care concern for the rest of the world, was no longer our priority, even as the incidence increased 8-fold during the war.1 The vicious cycle of war and pandemic was tormented as we tried to balance our own emotions and fears while continuing to care for and support our patients with cancer. Armen's story provides only a glimpse of what people with terminal cancer and the health care workforce experience in resource-limited settings affected by war. Today, around half of the world's population lives in countries affected by war, with predictions that cancer will disproportionately affect these regions in the coming decades. Because of multifactorial resource limitations, patients with cancer from these areas are usually diagnosed in advanced stages of the disease when palliation is the only viable option for care. Worldwide, an estimated 78% of adults and 98% of children in need of palliative care reside in resource-limited regions. A third of adults needing palliative care services are patients with cancer and 80% of them live with moderate or severe chronic pain. Despite these data, only 10% of the world's overall morphine consumption occurs in resource limited regions. The provision of palliative care services is even more strained by armed conflict. Recently, the World Health Organization reported that palliative care was available in less than two thirds of Syrian health care facilities and that all cancer centers surveyed in Syria lacked immediate-release oral morphine and trained palliative cancer care staff. Currently, we are witnessing an escalating war in Ukraine. The images from this and any new conflict around the world bring back our own wartime experiences with haunting clarity. The desperation we felt trying to care for the most vulnerable patients during lethal and chaotic times will never leave us. How many children are now writing tales of death in their journals? How many villages and families are being shattered, unable to provide last days of peace and comfort to their sick and dying loved ones? Despite recent initiatives to include oncologic and palliative care contingencies in humanitarian responses to crisis, they continue to remain a relatively low priority and have been minimally integrated into emergency response plans during armed conflicts. Protocols detailing how to provide basic care to patients with cancer and maintain supplies of essential medications are yet to be fully developed. We urge the international community to take action to address the existing obstacles to cancer care delivery in conflict affected regions to mitigate the adverse impact of cancer and armed conflict on our most vulnerable patients.   Dr. Lidia Schapira: Welcome to JCO's Cancer Stories: The Art of Oncology, brought to you by the ASCO Podcast Network, which offers a range of educational and scientific content and enriching insights into the world of cancer care. You can find all of the shows, including this one at podcast.asco.org. I'm your host, Lidia Schapira, associate editor for Art of Oncology and Professor of Medicine at Stanford. And with me today is Dr. Gevorg Tamamyan, Chairman and Professor of the Department of Pediatric Oncology and Hematology at Yerevan State Medical University, head of the Pediatric Cancer and Blood Disorders Centers of Armenia, and Chairman of the Board of the Institute of Cancer and Crisis. We will be discussing his Art of Oncology article, ‘Cancer and Armed Conflict Crossing Realities.' Our guest has travel, accommodation, and expenses from Roche. Gevorg, welcome to our podcast. Dr. Gevorg Tamamyan: Thank you! Thank you very much, Dr. Schapira, for the invitation and for this opportunity to speak with you. Dr. Lidia Schapira: It is our pleasure. Can you tell our listeners a little bit about the origin of this narrative? How your team come together to tell the story now? Dr. Gevorg Tamamyan: So, living in a region where every day you face not only - and being an oncologist in the meantime - facing death not only from cancer but also from the war, it makes you think about cancer from a different perspective. During my not-so-long life, I experienced three wars. The second one was a little bit shorter, but the first one was quite a long one. I was a young boy at the school age and the second one, the large one, was recently in 2020. Later on, being already an oncologist, when every day you are walking in between life and death and your everyday work is dedicated to saving one more life, sometimes you realize that with one bomb people can kill hundreds and thousands. So, having this on my mind, I started exploring the field a few years ago, even not knowing that a new war is going to begin in 2020. And we wrote an editorial in Nature Cancer Reviews, I think it was 2019, if I'm not mistaken, about how the war affects cancer patients and cancer care in general. And then in 2020, when we had this sad experience, then we thought that we must express our feelings and reveal what happened, what happens with cancer patients during the war situation. And just recently, of course, there is a new war in the world and we see all this struggling every day. So, unfortunately, this topic does not lose its actuality, I would say. Dr. Lidia Schapira: You chose to tell the story of a young boy who first came to your major academic center in Armenia at age 6, and you treated and cured him of Hodgkin's lymphoma. And then he returns as a young adult, 19 years old, with an osteosarcoma that you treated. But unfortunately, treatment was not curative, and he goes back to his village and needs to receive palliative care but is suffering now in 2020 with the war in NKR. Can you tell our readers a little bit about the Nagorno-Karabakh war and how it affected your team and the care you provided to children and young adults with cancer? Dr. Gevorg Tamamyan: So, Nagorno-Karabakh Republic is located in South Caucasus. It's historically inhabited with Armenians and it has been a land for wars for many years. The first war, what I observed, started in the late 1980s. I was just born a few years ago and I cannot clearly say what happened, but I know from the history definitely. There were massacres of Armenians and the war erupted. But for many years, for three decades, the situation was unstable. And during the COVID 19 pandemic, Nagorno-Karabakh Republic was attacked by Azerbaijan, supported by Turkey. And just to kind of illustrate what the situation is, there are like 100- 150,000 people residing there. So, this is a small country. It was attacked and there were thousands of people killed and tens of thousands displaced. So, this was the sad reality, what we have seen, of course. One day I was in Stepanakert, the capital of the Nagorno-Karabakh Republic when bombs were falling on the civilian buildings. I was on the ground floor of the hospital, and I was seeing how these wounded people, civilians, were coming to the hospital. It was really, I mean, my English is very poor to describe all this situation, but back in the hospital, we had a lot of patients from Nagorno-Karabakh and we were seeing their struggles. It was not only from cancer. Some people were losing part of their families, and some of their family members were at the worst stage. And kids, I mean, there was no smile on the kids' faces. It's difficult to describe. I think it happens with every war, anywhere in the world. And we decided to describe this young boy's story and through this story, to deliver the message about the war, about cancer, and about how patients with cancer struggle during this crisis and these difficult times. Dr. Lidia Schapira: You tell in your story very movingly how difficult it was for this young man to run out of his pain medication, to also run out of all of the sources of delivery of palliative care. And also, you tell us a little bit about how this made your team feel, that you were struggling with the war, you were struggling with this idea that you couldn't relieve the symptoms and pain of your patients. Tell us a little bit about how your team struggled through this and what helped you as you went about your work every day? Dr. Gevorg Tamamyan: Our hospital is a major hospital not only for pediatric cancer. We have the only pediatric cancer center located in the hospital, but also our center, the hematology center, where our pediatric cancer center is located, is the major and the main blood bank. So, we were kind of primarily involved in saving patients' lives through the blood bank, of course, because all the people were coming to donate the blood and we were sending this blood to different hospitals. And I must confess that this pain medication and palliative care is an issue not only during the war but also during peacetime in many resource-limited settings. But during the war it becomes dramatic. And for the people living in the war area, in the region affected by conflicts, it's almost impossible for them to receive this treatment. I've seen the stories from Syria, back, let's say ten years ago, photos from the hospitals, and photos of kids who were not able to receive the treatment. Let's say a kid with lymphoma with all the chances to get cured and he or she is not receiving the medications because there is a war, because people fight, and people are dying and kids are dying in pain because they are not able to receive their opioids, their painkillers. So, for doctors, of course, realizing this is very difficult. And the second one, because the supply chains are kind of disrupted, it's difficult to get the medications on time. Then many doctors leave the hospitals and go to the war front and let's say, do surgeries there or just help the wounded people. Sometimes we're out of the staff or out of the specialists, some of our surgeons. We are a small country and there might be four narrow specialists, one or two specialists, and when your specialists are at the military hospitals, how can they operate? How can they do surgeries for the kids? And of course, everyone has a relative, everyone has a friend who is there and you are thinking about them even if you are not there. So, from all sides, you are depressed. And that's the war. That's how the war looks. In the cities which are under the bombs, of course, the situation is even more difficult than what we see in different parts of the world. Dr. Lidia Schapira: The reality of the war is always awful and I really admire your ability to bring this to our attention in such a clear way. Let me ask the question again. How do you and your colleagues get through the day? And I imagine that you're probably sort of reliving the trauma in a way when there is a new war in the world, as there is now in your general area of the world. How are you all doing? Dr. Gevorg Tamamyan: With every new war, including this new war in Ukraine, I mean, people are dying. You see these images from the cities. The worst thing is that you know these people are from both sides and you have friends from both sides, and even these fighting sides, I mean, they were brothers a day ago. And you see how kids are dying, you see how young people are dying, and you see displaced people who are leaving their houses. It's really very difficult. In the meantime, the situation here is also not calm. During the last months, several times we observed a similar situation in Karabakh, again, wherein several villages people were displaced. It's kind of a no war, no peace situation. And can you live with the thought that the war is going to begin again soon and you don't know what's going to happen? That's the reality. Dr. Lidia Schapira: So, you bring our attention, Gevorg, to the enormous disruption in care for children and adults with cancer caused by war, both the interruption of cancer-directed care, but also the interruption of palliative care. There's a general feeling, I think, among many oncologists throughout the world of wanting to help. How can people help? Dr. Gevorg Tamamyan: It's very difficult, to be frank, to single out a solution, but there are different ways. First of all, I think one kind of help would be just to write an email and say, ‘How are you doing?' Because in the world, what we are lacking the most, it's paying a little bit more attention to our friends and neighbors and people we know. And of course, with our routine daily life, we are so busy, but even a small message can help the people with the stress. At that time, maybe someone will say, “Okay, do you have ten ampoules of this or fractions of this drug?” Or something like that. “Or would you give me advice on how I might manage this child?” But of course, my suggestion would be that all the professional societies and humanitarian organizations, and major cancer institutions put their efforts into trying to find systematic solutions for how it is possible to help patients or professionals in the conflict-affected regions, and how to help displaced populations. And not only when the conflict erupts or war erupts because there are conflicts all over the world right now. For example, people in Syria, right? They experience so many struggles. I was reading in the ASCO post, there was an editorial, that tens of thousands of professionals left Syria. So, people are left without basic health care, and similarly in Iraq, Afghanistan, Ukraine, and in many parts of the world. So, I think a systematic effort is needed to help the patients and professionals. I'm sure when we get together, we'll find better solutions. But of course, the best way is to keep the peace. But sometimes it's out of our reach. Dr. Lidia Schapira: That's right. So, some things are out of our reach. But one of the things that we can all do is, as you so beautifully articulated, to show some solidarity and to start by reaching out to a colleague we know or to somebody who is in that area just by checking in, ‘How are you doing?', ‘Is there something I can do to help?' And then, of course, through the power of these stories, I think to sort of help people understand that there are ways of getting involved, as you say, to think about creating perhaps a better infrastructure to deal with both cancer care and pain and symptom management for all the people affected by and displaced by war. Dr. Gevorg Tamamyan: Yeah, I agree, definitely. Dr. Lidia Schapira: Do you have a final message perhaps for our listeners, Gevorg? Let me give you the last word. Dr. Gevorg Tamamyan: We are talking about war and we are talking about cancer. My only wish is for there to be peace in the world and there is a cancer-free world, of course. Dr. Lidia Schapira: Thank you so much for taking the time out of your busy schedule to share your thoughts. Thank you so much to you and your team for sending this beautiful essay to us. Until next time, thank you to our listeners for listening to JCO's Cancer Stories: The Art of Oncology. 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