Podcasts about Sanofi

We love to hear from our listeners. Send us a message. On this week's episode, Atul Deshpande, Ph.D., CEO at Immediate Therapeutics, talks about partnering with American cities to conduct clinical trials during ambulance rides to the hospital, with the goal of preserving heart function and reducing mortality related to acute cardiovascular events, including heart attacks. Deshpande reflects on his previous experience developing and commercializing Dupixent at Sanofi, describes the history and mechanism of Immediate's glucose-insulin-potassium (GIK) candidate, IMT-358, and explains why there is more to intellectual property than just patents. Access this and hundreds of episodes of the Business of Biotech videocast under the Business of Biotech tab at lifescienceleader.com. Subscribe to our monthly Business of Biotech newsletter. Get in touch with guest and topic suggestions: ben.comer@lifescienceleader.comFind Ben Comer on LinkedIn: https://www.linkedin.com/in/bencomer/

In this episode of Let's Combinate, Subhi Saadeh sits down with Jim Collins, a leader in drug delivery with over 30 years of experience at Eli Lilly, Sanofi, and now as an advisor and board member. Jim shares the history of combination products before the term even existed, from insulin pens in the 1990s to modern platforms and on-body injectors. We cover IP battles that reshaped the industry, supply chain risks that pharma still underestimates, and why platform strategy is one of the most important decisions a company can make today.Timestamps:00:00 – Introduction & Guest Welcome02:00 – Building Lilly's device organization and launching insulin pens06:00 – Early “wild west” days of drug delivery vs. today's structure07:00 – Intellectual property as a competitive weapon10:30 – How Lilly, Novo, and Sanofi shaped the IP landscape13:00 – Device differentiation in the generic space17:00 – Portfolio vs. molecule decisions in platform strategy20:00 – Three reasons to develop your own platform23:00 – Supply chain risk and geopolitical considerations26:00 – Black Swan risks and lessons for pharma companies28:00 – Strategic suppliers vs. transactional vendors33:00 – Drug-device integration inside companies37:00 – Building organizational capability and governance38:00 – Future trends: large volume autoinjectors and connected devices43:00 – Impact of tariffs and supply chain positioning45:00 – Where to find Jim CollinsGuest Bio:Jim Collins is a veteran of the drug delivery field with more than 30 years of leadership experience. At Eli Lilly, he built and led the device organization, overseeing the launch of insulin pens, the Forteo Pen, and the Trulicity platform. Later, at Sanofi, he led drug delivery innovation and platform development, including devices for Dupixent. Today, Jim serves as a board member for Enable Injections and advises startups, helping the next generation of innovators navigate IP, supply chain, and platform strategy.Subhi Bio:Subhi Saadeh is a Quality Professional and host of Let's Combinate. With a background in Quality, Manufacturing Operations, and R&D, he has worked in large medical device and pharma organizations to support the development and launch of hardware devices, disposable devices, and combination products for vaccines, generics, and biologics. Subhi serves as International Committee Chair for the Combination Products Coalition (CPC), as a member of ASTM Committee E55, and previously on AAMI's Combination Products Committee. For questions, inquiries, or suggestions, visit letscombinate.com or connect on LinkedIn.

'One FM' by One MSL strives to connect voices within the global Field Medical community.For episode 12 Helen was joined by Jorge Fragoso, Global Field Based Medical Excellence Lead at Sanofi.If you would like to feature on a future episode, please email community@onemsl.comhttps://www.onemsl.com/

In der heutigen Folge sprechen die Finanzjournalisten Anja Ettel und Philipp Vetter über Dr Peppers Übernahme von Jacobs Krönung, neuen KI-Zoff zwischen Musk und Apple und Verkaufs-Fantasie bei Puma. Außerdem geht es um Kering, Keurig Dr Pepper, Interactive Brokers Group, Walgreens Boots Alliance, JDE Peets, Mercedes-Benz, TotalEnergies, Sanofi, RWE, Allianz, Samsung, Siemens, Orsted, Equinor, Vestas, Nordex, Siemens Energy und GE Vernova. Die Tickets zum Finance Summit am 17. September bekommt ihr 40 Euro günstiger – aber nur mit dem exklusiven Code AAA2025, der ihr unter dem folgenden Link eingeben müsst: https://veranstaltung.businessinsider.de/BN5aLV Außerdem könnt ihr unter diesem Link euer Depot hochladen – und mit etwas Glück wird kein Geringerer als Christian W. Röhl euer Depot beim Summit checken und optimieren. https://form.jotform.com/Product_Unit/formular-finance-summit-depot-check Wir freuen uns an Feedback über aaa@welt.de. Noch mehr "Alles auf Aktien" findet Ihr bei WELTplus und Apple Podcasts – inklusive aller Artikel der Hosts und AAA-Newsletter. Hier bei WELT: https://www.welt.de/podcasts/alles-auf-aktien/plus247399208/Boersen-Podcast-AAA-Bonus-Folgen-Jede-Woche-noch-mehr-Antworten-auf-Eure-Boersen-Fragen.html. Der Börsen-Podcast Disclaimer: Die im Podcast besprochenen Aktien und Fonds stellen keine spezifischen Kauf- oder Anlage-Empfehlungen dar. Die Moderatoren und der Verlag haften nicht für etwaige Verluste, die aufgrund der Umsetzung der Gedanken oder Ideen entstehen. Hörtipps: Für alle, die noch mehr wissen wollen: Holger Zschäpitz können Sie jede Woche im Finanz- und Wirtschaftspodcast "Deffner&Zschäpitz" hören. +++ Werbung +++ Du möchtest mehr über unsere Werbepartner erfahren? Hier findest du alle Infos & Rabatte! https://linktr.ee/alles_auf_aktien Impressum: https://www.welt.de/services/article7893735/Impressum.html Datenschutz: https://www.welt.de/services/article157550705/Datenschutzerklaerung-WELT-DIGITAL.html

Alors que GPT-5 vient tout juste de sortir, retour sur une interview essentielle pour comprendre la stratégie d'OpenAI en Europe et sa vision à long terme. (Rediffusion 27 mai 2025)Arnaud Fournier, responsable du bureau parisien d'OpenAI, dévoile les coulisses de l'implantation de l'entreprise en France et revient sur la mission fondatrice de l'organisation : rendre l'intelligence artificielle accessible à tous, des développeurs aux grandes entreprises, en passant par le grand public.Il détaille comment OpenAI accompagne des acteurs français majeurs comme Sanofi, Orange, Pigment ou Miracle, tout en explorant les nouveaux usages permis par les agents IA, notamment Operator et Deep Research, conçus pour automatiser des tâches complexes.Un échange précieux pour mieux comprendre :La vision à long terme d'OpenAI et ses priorités stratégiques ;L'impact de l'IA générative sur des secteurs comme la santé ou la finance ;Le fonctionnement des agents IA et leur intégration dans ChatGPT ;Les réponses aux défis techniques, comme les hallucinations ;La perspective d'une intelligence artificielle générale (AGI).-----------♥️ Vous aimez ce podcast ? Soutenez-le !https://donorbox.org/monde-numerique

The American Academy of Pediatrics released new vaccine recommendations that directly oppose guidance from the HHS – insisting on COVID-19 vaccinations in babies as young as 6 months. Pathologist Dr. Ryan Cole & Dr. Kelly Victory reveal how the AAP has been captured by Big Pharma interests. The organization's top donors, listed on their own website, are Merck, Moderna, Pfizer, and Sanofi: the 4 pharma companies that “make virtually every vaccine on the CDC recommended childhood vaccine schedule.” HHS Secretary Robert F. Kennedy Jr. issued a stern warning in response: “AAP should also be candid with doctors and hospitals that recommendations that diverge from the CDC's official list are not shielded from liability under the 1986 Vaccine Injury Act.” Dr. Ryan Cole is a board-certified pathologist trained at Mayo Clinic with subspecialty in dermatopathology from Columbia University. He holds a PhD in virology and immunology and directed a medical laboratory in Idaho for 20 years. He testifies globally on Covid policy and medical freedom. Follow at https://x.com/drcole12 Dr. Kelly Victory is Chief of Emergency & Disaster Medicine at The Wellness Company. A trauma and emergency specialist with over 30 years of experience, she served as Chief Medical Officer for Fortune 500 companies and is an alumna of Harvard's National Preparedness Leadership Initiative. More at https://x.com/DrKellyVictory 「 SUPPORT OUR SPONSORS 」 Find out more about the brands that make this show possible and get special discounts on Dr. Drew's favorite products at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/sponsors⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠• FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/fatty15⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/paleovalley⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • VSHREDMD – Formulated by Dr. Drew: The Science of Cellular Health + World-Class Training Programs, Premium Content, and 1-1 Training with Certified V Shred Coaches! More at https://drdrew.com/vshredmd • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twc.health/drew⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://kalebnation.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠) and Susan Pinsky (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twitter.com/firstladyoflov⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠e⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Learn more about your ad choices. Visit megaphone.fm/adchoices

At this year's Retina Innovation Summit, industry experts and leaders gathered in a two-part discussion on investment trends, regulatory environment and FDA changes, emerging therapies in ophthalmology, and more. Panelists include: Laura Feinleib, Managing Director at Redmile Group; Derrick Li, Chief Strategy Officer at ODC Life Sciences; Cameron Taylor, Managing Director at BofA Securities | Life Sciences; Wayne Caulder, Vice President & General Manager of Surgical (U.S. & Canada) at Bausch + Lomb; Paul Hallen, Vice President & Distinguished Fellow at Alcon; Nida Sen, MD, VP, Ophthalmology Strategy & Development Head at Sanofi; and Julian Smith, General Manager Portfolio Commercial Strategy - Eye Care at AbbVie.In this panel learn about:

Stephanie Stabulis is a 15-year veteran influencer marketing strategist working exclusively in the industry since the early days of modern influencer marketing. She's developed impactful, award winning programs and campaigns across a wide range of consumer industries for icons such as Southwest Air, ESPN, Budweiser, Nestle, Nickelodeon, McDonalds, TJMaxx, KellaNova, Sanofi, and Smirnoff. She has worked at both large and small marketing and ad agencies, has freelanced, owned a business and been a full-time employee. She is a VP of Strategy & Analytics at OneFluential, servicing the L'Oreal US portfolio of beauty brands. As a speaker, writer, colleague and mentor, her focus remains on innovation and strategic industry leadership, helping to shape the next generation of influencer marketing, while protecting what's beautiful about human-to-human social relationships.With five years of content creation and almost a decade of social media expertise, Alli Kennon is a Social Creative Producer at Microsoft, shaping brand stories across Copilot and the broader Microsoft ecosystem. After three years as an in-house content creator, she's honed the craft of turning strategy into scroll-stopping visuals. A former speech & debate kid, Alli brings narrative flair to every frame—whether she's producing campaigns or curating matcha latte flavors with the precision of a scientist. She currently resides in Boise, Idaho with her husband.

In this episode, we share Wendy's story of living with Eosinophilic Esophagitis (EoE). She takes us through the confusing early symptoms, the long road to getting a diagnosis, and how she manages her condition today. With honesty and hope, Wendy offers a patient's perspective on what it means to live with EoE. Hear Wendy discuss: The first signs that something was wrong with her throat How symptoms disrupted her eating, social life, and mental health The coping strategies she unknowingly developed along the way What it was like to finally receive an accurate diagnosis and treatment plan Resources & Support:Learn more about EoE and find trusted resources at gastrogirl.com. This episode was made possible with support from Sanofi and Regeneron.

What if one of biotech's biggest production breakthroughs was hiding in plain sight? Not in a new gene or a wonder drug, but in the way we process and purify biologics.Perfusion technology, once dismissed as a pipedream in top biopharma boardrooms, is now quietly powering some of the industry's most efficient and productive manufacturing platforms. Yet, transforming perfusion from controversial buzzword to gold standard required timing, vision, and a willingness to break from tradition.In this episode, host David Brühlmann sits down with Jarno Robin, a bioprocessing pioneer whose 20+ year journey spans industry giants like Novo Nordisk, Sanofi, and Leo Pharma. Jarno has championed upstream continuous processes, including ATF and TFF, for decades, and now, as a leader at Sani Membranes, he's unleashing the next evolution: Vibro® Membrane Filtration, an innovation set to upend conventional wisdom about fouling, pressure loss, scalability, energy usage, and more.Here are three reasons you'll want to listen to Jarno's journey:Innovation Versus Industry Inertia: Behind every platform shift are years of resistance. Jarno recounts how timing, advocacy, and matching the right data with the right decision-makers finally made perfusion mainstream, even after company leaders proclaimed, “We will never ever run perfusion.”State-of-the-Art and the Next Frontier: ATF and TFF remain dominant, but their limitations, like membrane fouling, scale-up headaches, and high energy needs, are real. Jarno explains how Vibro® Membrane Filtration addresses these pain points with a radically new design, offering lower pressure loss, less fouling, higher cell densities, and surprisingly low energy consumption.Practical Wisdom for Bioprocess Developers: Should you always run a control in process development? How do you translate lab-scale wins to robust, money-earning production? Jarno shares counterintuitive advice based on decades of hands-on success and mistakes.Curious how you can optimize your process technology and sidestep costly pitfalls? Listen to this episode and discover how “timing is everything” in bioprocessing innovation and whether new filtration methods could help you leap ahead.Connect with Jarno Robin:LinkedIn: www.linkedin.com/in/jarno-robinWebsite: www.sanimembranes.comCurious about continuous processing challenges and breakthroughs? Don't miss these previous episodes.Episodes 39-40: Balancing Perfusion Process Development and Sustainability with Jochen SieckEpisodes 85-86: Bioprocess 4.0: Integrated Continuous Biomanufacturing with Massimo MorbidelliEpisodes 153-154: The Future of Bioprocessing: Industry 4.0, Digital Twins, and Continuous Manufacturing Strategies with Tiago MatosNext step:Book a free consultation to help you get started on any questions you may have about bioprocess development: https://bruehlmann-consulting.com/call

This episode covers: Cardiology This Week: A concise summary of recent studies Oral anticoagulation in atrial fibrillation: answers to frequent questions Smartwatch, heart rate and ECG Milestones: Lyon Diet Heart study Host: Emer Joyce Guests: Carlos Aguiar, Tim Chico, Paulus Kirchhof Want to watch that episode? Go to: https://esc365.escardio.org/event/1811 Want to watch that extended interview on smartwatch, heart rate and ECG? Go to: https://esc365.escardio.org/event/1811?resource=interview   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Tim Chico has declared to have potential conflicts of interest to report: research funding from Google. Paulus Kirchhof has declared to have potential conflicts of interest to report: partially supported by European Union MAESTRIA (grant agreement 965286), British Heart Foundation (AA/18/2/34218), German Center for Cardiovascular Research supported by the German Ministry of Education and Research (DZHK, grant numbers DZHK FKZ 81X2800182, 81Z0710116, and 81Z0710110), German Research Foundation (Ki 509167694), Dutch Heart Foundation (DHF), the Accelerating Clinical Trials funding stream in Canada, and the Else-Kröner-Fresenius Foundation. Research support for basic, translational, and clinical research projects from German Research Foundation (DFG), European Union, British Heart Foundation, Leducq Foundation, Else-Kröner-Fresenius Foundation, Dutch Heart Foundation (DHF), the Accelerating Clinical Trials funding stream in Canada, Medical Research Council (UK), and German Center for Cardiovascular Research, from several drug and device companies active in atrial fibrillation, and has received honoraria from several such companies in the past, but not in the last five years. Listed as inventor on two issued patents held by University of Hamburg (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783). Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Emer Joyce Guest: Tim Chico Want to watch that extended interview on smartwatch, heart rate and ECG? Go to: https://esc365.escardio.org/event/1811?resource=interview Want to watch that episode? Go to: https://esc365.escardio.org/event/1811   Disclaimer  ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Tim Chico has declared to have potential conflicts of interest to report: research funding from Google. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Send us a textMeet Oscar Trimboli, the award-winning author of ‘How to Listen' which has been touted as the ‘most comprehensive book about listening in the workplace' and which has won four awards from the International Book Awards, Australian Business Book Awards, Axiom Business Book Awards, and Living Now Book Awards. On a quest to create 100 million deep listeners in the workplace, Oscar is also host of the Apple award-winning podcast ‘Deep Listening' and a sought-after keynote speaker.A marketing and technology industry veteran, Oscar through his work with chairs, boards of directors, and executive teams, has experienced first-hand the transformational impact leaders can have when they listen beyond words. He believes that when leadership teams focus their attention and listening, they will build organizations that create powerful legacies for the people they serve – today and more importantly, for future generations. He consults with organizations including American Express, AstraZeneca, Cisco, Google, HSBC, IAG, Montblanc, PwC, Salesforce, Sanofi, SAP, and Siemens.Hit play to find out about Oscar's take on how to really listen! [2:20s] Oscar's journey before ‘How to Listen'[08:42s] Are we listening better and more today?   [16:12s] Listening to understand versus listening to respond[25:55s] Top reasons that can deter you from becoming a good listener [41:06s] Genesis of ‘How to Listen'[49:16s] RWL: Read Oscar's books: ‘How to Listen'; Listen to his podcast ‘Deep Listening: Impact Beyond Words'Find out more about Oscar's work: https://www.oscartrimboli.com/information/Connect with Oscar on LinkedInConnect with Vinay on X (formerly Twitter) and LinkedIn What did you think about this episode? What would you like to hear more about? Or simply, write in and say hello! podcast@c2cod.comSubscribe to us on your favorite platforms – Google Podcasts, Apple Podcasts, Spotify, Overcast, Tune In Alexa, and more.  This podcast is sponsored by C2C-OD, your Organizational Development consulting partner ‘Bringing People and Strategy Together'. Follow @c2cod on Twitter, LinkedIn, Instagram, Facebook 

Audio roundup of selected biopharma industry content from Scrip over the business week ended August 8, 2025. In this episode: Trump ups pressure on MFN pricing; Pfizer says pharma working with Trump on direct sales; Sanofi says direct sales worth considering: Aurigene Oncology CEO on biotech valuations and more; and Novartis progresses pipeline-in-a-product assets. https://insights.citeline.com/scrip/podcasts/scrips-five-must-know-things/quick-listen-scrips-five-must-know-things-RCXSH2B5EVCC3IIK35GXUSNZVA/ This episode was produced with the help of AI text-to-voice and voice emulation tools. Playlist: soundcloud.com/citelinesounds/sets/scrips-five-must-know-things

Dr. Hope Rugo and Dr. Kamaria Lee discuss the prevalence of financial toxicity in cancer care in the United States and globally, focusing on breast cancer, and highlight key interventions to mitigate financial hardship. TRANSCRIPT  Dr. Hope Rugo: Hello, and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm your host, Dr. Hope Rugo. I'm the director of the Women's Cancer Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. Rising healthcare costs are causing financial distress for patients and their families across the globe. Patients with cancer report financial toxicity as a major impediment to their quality of life, and its association with worse outcomes is well documented. Today, we'll be discussing how patients with breast cancer are uniquely at risk for financial toxicity. Joining me for this discussion is Dr. Kamaria Lee, a fourth-year radiation oncology resident and health equity researcher at MD Anderson Cancer Center and a co-author of the recently published article titled, "Financial Toxicity in Breast Cancer: Why Does It Matter, Who Is at Risk, and How Do We Intervene?" Our full disclosures are available in the transcript of this episode.  Dr. Lee, it's great to have you on this podcast. Dr. Kamaria Lee: Hey, Dr. Rugo. Thank you so much for having me. I'm excited to be here today. I also would like to recognize my co-authors, Dr. Alexandru Eniu, Dr. Christopher Booth, Molly MacDonald, and Dr. Fumiko Chino, who worked on this book chapter with me and did a fantastic presentation on the topic at ASCO this past year. Dr. Hope Rugo: Thanks very much. We'll now just jump into the questions. We know that rising medical costs contribute to a growing financial burden on patients, which has [GC1]  [JG2]  been documented to contribute to lower quality-of-life, compromised clinical care, and worse health outcomes. How are patients with breast cancer uniquely at risk for financial toxicity? How does the problem vary within the breast cancer population in terms of age, racial and ethnic groups, and those who have metastatic disease? Dr. Kamaria Lee: Breast cancer patients are uniquely at risk of financial toxicity for several reasons. Three key reasons are that breast cancer often requires multimodal treatment. So this means patients are receiving surgery, many receive systemic therapies, including hormonal therapies, as well as radiation. And so this requires care coordination and multiple visits that can increase costs. Secondly, another key reason that patients with breast cancer are uniquely at risk for financial toxicity is that there's often a long survivorship period that includes long-term care for toxicities and continued follow-ups, and patients might also be involved in activities regarding advocacy, but also physical therapy and mental health appointments during their prolonged survivorship, which can also add costs. And a third key reason that patients with breast cancer are uniquely at risk for financial toxicity is that the patient population is primarily women. And we know that women are more likely to have increased caregiver responsibilities while also potentially working and managing their treatments, and so this is another contributor. Within the breast cancer population, those who are younger and those who are from marginalized racial/ethnic groups and those with metastatic disease have been shown to be at an increased risk. Those who are younger may be more likely to need childcare during treatment if they have kids, or they're more likely to be employed and not yet retired, which can be disrupted while receiving treatment. And those who are racial/ethnic minorities may have increased financial toxicity due to reasons that exist even after controlling for socioeconomic factors. And some of these reasons have been shown to be increased risk of job or income loss or transportation barriers during treatment. And lastly, for those with metastatic breast cancer, there can be ongoing financial distress due to the long-term care that is needed for treatment, and this can include parking, transportation, and medications while managing their metastatic disease. Dr. Hope Rugo: I think it is really important to understand these issues as you just outlined. There has been a lot of focus on financial toxicity research in recent years, and that has led to novel approaches in screening for financial hardship. Can you tell us about the new screening tools and interventions and how you can easily apply that to clinical practice, keeping in mind that people aren't at MD Anderson with a bunch of support and information on this but are in clinical practice and seeing many, many patients a day with lots of different cancers? Dr. Kamaria Lee: You're exactly right that there is incredible nuance needed in understanding how to best screen for financial hardship in different types of practices. There are multiple financial toxicity tools. The most commonly used tool is the Comprehensive Score for Financial Toxicity, also known as the COST tool. In its full form, it's an 11-item survey. There's also a summary question as well. And these questions look at objective and subjective financial burden, and it uses a five-point Likert scale. For example, one question on the full form is, "I know that I have enough money in savings, retirement, or assets to cover the cost of my treatment," and then patients are able to respond "not at all" to "very much" with a threshold score for financial toxicity risk. Of course, as you noted, one critique of having an 11-item survey is that there's limited time in patient encounters with their providers. And so recently, Thom et al validated an abbreviated two-question version of the COST tool. This validation was done in an urban comprehensive cancer center, and it was found to have a high predictive value to the full measure. We note which two questions are specifically pulled from the full measure within the book chapter. And this is one way that it can be easier for clinicians who are in a busier setting to still screen for financial toxicity with fewer questions. I also do recommend that clinicians who know their clinic's workflow the best, work with their team of nurses, financial navigators, and others to best integrate the tool into their workflow. For some, this may mean sending the two-item survey as a portal message so that patients can answer it before consults. Other times, it could mean having it on the tablet that can be done in the clinic waiting room. And so there are different ways that screening can be done, even in a busy setting, and acknowledging that different practices have different amounts of resources and time. Dr. Hope Rugo: And where would people access that easily? I recognize that that information is in your chapter, or your article that's on PubMed that will be linked to this podcast, but it is nice to just know where people could easily access that online. Dr. Kamaria Lee: Yes, and so you should be able to Google ‘the COST measure', and then there is a website that also has the forms as well. So it's also beyond the book chapter, Googling ‘the COST measure', and then online they would be able to find access to the form. Dr. Hope Rugo: And how often would you do that screening? Dr. Kamaria Lee: So, I think it's definitely important that we are as proactive as possible. And so initially, I recommend that the screening happens at the time of diagnosis, and so if it's done through the portal, it can be sent before the initial consult, or again, however, is best in the workflow. So at the time of diagnosis and then at regular intervals, so throughout the treatment process, but then also into the follow-up period as well to best understand if there's still a financial burden even after the treatments have been completed. Dr. Hope Rugo: I wonder if in the metastatic setting, you could do it at the change of treatment, you know, a month after somebody's changed treatment, because people may not be as aware of the financial constraints when they first get prescribed a drug. It's more when you hear back from how much it's going to cost. And leading into that, I think it's, what do you do with this? So, you know, this cost conversation is really important. You're going to be talking to the patient about the cost considerations when you, for example, see that there are financial issues, you're prescribing treatments. How do we implement impactful structured cost conversations with our breast cancer patients, help identify financial issues, and intervene? How do we intervene? I mean, as physicians often we aren't really all that aware, or providers, of how to address the cost. Dr. Kamaria Lee: Yes, I agree fully that another key time when to screen for financial toxicity is at that transition between treatments to best understand where they're at based off of what they've received previously for care, and then to anticipate needs when changing regimens, such as like you said in the metastatic setting. As we're collecting this information, you're right, we screen, we get this information, and what do we do? I do agree that there is a lack of knowledge among us clinicians of how do we manage this information. What is insurance? How do we manage insurance and help patients with insurance concerns? How do we help them navigate out-of-pocket costs or even the indirect costs of transportation? Those are a lot of things that are not covered in-depth in traditional medical training. And so it can be overwhelming for a lot of clinicians, not only due to time limitations in clinic, but also just having those conversations within their visit. And so what I would say, a key thing to note, is that this is another area for multidisciplinary care. So just as we're treating patients in a multidisciplinary way within oncology as we work with our medical oncology, surgical colleagues across the board, it's knowing that this is another area for multidisciplinary care. So the team members include all of the different oncologists, but it also includes team members such as financial counselors and navigators and social workers and even understanding nonprofit partners who we have who have money that can be set aside to help reduce costs for certain different aspects of treatment. Another thing I will note is that most patients with breast cancer often say they do want to have these conversations still with their clinicians. So they do still see a clinician as someone that can weigh in on the costs of their treatment or can weigh in on this other aspect of their care, even if it's not the actual medication or the radiation. And so patients do desire to hear from their clinicians about this topic, and so I think another way to make it feel less overwhelming for clinicians like ourselves is to know that even small conversations are helpful and then being knowledgeable about within your institution or, like I said, outside of it with nonprofits, being aware of who can I refer this patient to for continued follow-up and for more detailed information and resources. Dr. Hope Rugo: Are those the successful interventions? It's really referring to financial navigators? How do people identify? You know, in an academic center, we often will sort of punt this to social workers or our nurse navigators. What about in the community? What's a successful intervention example of mitigating financial toxicity? Dr. Kamaria Lee: I agree completely that the context at which people are practicing is important to note. So as you alluded to, in some bigger systems, we do have financial navigators and this has been seen to be successful in providing applications and assisting with applications for things such as pharmaceutical assistance, insurance applications, discount opportunities.  Another successful intervention are financial toxicity tumor boards, which I acknowledge might not be able to exist everywhere. But where this is possible, multidisciplinary tumor boards that include both doctors and nurses and social workers and any other members of the care team have been able to effectively decrease patients' personal spending on care costs and decrease co-pays through having a dedicated time to discuss concerns as they arise or even proactively. Otherwise, I think in the community, there are other interventions in regards to understanding different aspects of government programs that might be available for patients that are not, you know, limited to an institution, but that are more nationally available, and then again, also having the nonprofit, you know, partnerships to see other resources that patients can have access to.  And then I would also say that the indirect costs are a significant burden for many patients. So by that, I mean even parking costs, transportation, childcare. And so even though those aren't interventions necessarily with someone who is a financial navigator, I would recommend that even if it's a community practice, they discuss ways that they can help offset those indirect costs with patients with parking or if there are ways to help offset transportation costs or at least educate patients on other centers that may be closer to them or they can still receive wonderful care, and then also making sure that patients are able to even have appointments scheduled in ways that are easier for them financially.  So even if someone's receiving care out in the community where there's not a financial navigator, as clinicians or our scheduling teams, sometimes there are options to make sure if a patient wants, visits are more so on one day than throughout the week or many hours apart that can really cause loss of income due to missed work. And so there are also kind of more nuanced interventions that can happen even without a financial navigation system in place. Dr. Hope Rugo: I think that those are really good points and it is interesting when you think about financial toxicity. I mean, we worry a lot when patients can't take the drugs because they can't afford them, but there are obviously many other non-treatment, direct treatment-related issues that come up like the parking, childcare, tolls, you know, having a working car, all those kinds of things, and the unexpected things like school is out or something like that that really play a big role where they don't have alternatives. And I think that if we think about just drug costs, I think those are a big issue in the global setting. And your article did address financial toxicity in the global setting. International financial toxicity rates range from 25% of patients with breast cancer in high-income countries to nearly 80% in low- and middle-income countries or LMICs. You had cited a recent meta-analysis of the global burnout from cancer, and that article found that over half of patients faced catastrophic health expenditures. And of course, I travel internationally and have a lot of colleagues who are working in oncology in many countries, and it is really often kind of shocking from our perspective to see what people can get coverage for and how much they have to pay out-of-pocket and how much that changes, that causes a lot of disparity in access to healthcare options, even those that improve survival. Can you comment on the global impact of this problem? Dr. Kamaria Lee: I am glad that you brought this up for discussion as well. Financial toxicity is something that is a significant global issue. As you mentioned, as high as 80% of patients with breast cancer in low- and middle-income countries have had significant financial toxicity. And it's particularly notable that even when looking at breast cancer compared to other malignancies around the world, the burden appears to be worse. This has been seen even in countries with free universal healthcare. One example is Sri Lanka, where they saw high financial toxicity for their patients with breast cancer, even with this free universal healthcare. But there were also those travel costs and just additional out-of-hospital tests that were not covered. Also, literature in low- and middle-income countries shows that patients might also be borrowing money from their social networks, so from their family and their friends, to help cover their treatment costs, and in some cases, people are making daily food compromises to help offset the cost of their care. So there is a really large burden of financial toxicity generally for cancer globally, but also specifically in breast cancer, it warrants specific discussion. In the meta-analysis that you mentioned, they identified key risk factors of financial toxicity globally that included people who had a larger family size, a lower income, a lack of insurance, longer disease duration, so again, the accumulation of visits and costs and co-pay over time, and those who had multiple treatments. And so in the global setting, there is this significant burden, but then I will also note that there is a lack of literature in low-income countries on financial toxicity. So where we suspect that there is a higher burden and where we need to better understand how it's distributed and what interventions can be applied, especially culturally specific interventions for each country and community, there's less research on this topic. So there is definitely an increased need for research in financial toxicity, particularly in the global setting. Dr. Hope Rugo: Yes, and I think that goes on to how we hope that financial toxicity researchers will have approaches to large-scale multi-institutional interventions to improve financial toxicity. I think this is an enormous challenge, but one of the SWOG organizations has done some great work in this area, and a randomized trial addressing cancer-related financial hardship through the delivery of a proactive financial navigation intervention is one area that SWOG has focused on, which I think is really interesting. Of course, that's going to be US-based, which is how we might find our best paths starting. Do you think that's a good path forward, maybe that being able to provide something like that across institutions that are independent of being a cancer only academic center, or more general academic center, or a community practice? You know, is finding ways to help patients with breast cancer and their families understand and better manage financial aspects of cancer care on a national basis the next approach? Dr. Kamaria Lee: Yes, I agree that that is a good approach, and I think the proactive component is also key. We know that patients that are coming to us with any cancer, but including breast cancer, some of them have already experienced a financial burden or have recently had a job loss before even coming to us and having the added distress of our direct costs and our indirect costs. So I think being proactive when they come to us in regards to the additional burden that their cancer treatments may cause is key to try to get ahead of things as much as we can, knowing that even before they've seen us, there might be many financial concerns that they've been navigating.  I think at the national level, that allows us to try to understand things at what might be a higher level of evidence and make sure that we're able to address this for a diverse cohort of patients. I know that sometimes the enrollment can be challenging at the national level when looking at financial toxicity, as then we're involving many different types of financial navigation partners and programs, and so that can maybe make it more complex to understand the best approaches, but I think that it can be done and can really bring our understanding of important financial toxicity interventions to the next level. And then the benefit to families with the proactive component is just allowing them to feel more informed, which can help decrease anticipation, anxiety related to anticipation, and allow them to help plan things moving forward for themselves and for the whole family. Dr. Hope Rugo: Those are really good points and I wonder, I was just thinking as you were talking, that having some kind of a process where you could attach to the electronic health record, you could click on the financial toxicity survey questions that somebody filled out, and then there would be a drop-down menu for interventions or connecting you to people within your clinic or even more broadly that would be potential approaches to manage that toxicity issue so that it doesn't impact care, you know, that people aren't going to decide not to take their medication or not to come in or not to get their labs because of the cost or the transportation or the home care issues that often are a big problem, even parking, as you pointed out, at the cancer center. And actually, we had a philanthropic donor when I was at UCSF who donated a large sum of money for patient assistance, and it was interesting to then have these sequential meetings with all the stakeholders to try and decide how you would use that money. You need a big program, you need to have a way of assessing the things you can intervene with, which is really tough. In that general vein, you know, what are the governmental, institutional, and provider-level actions that are required to help clinicians do our best to do no financial harm, given the fact that we're prescribing really expensive drugs that require a lot of visits when caring for our patients with breast cancer in the curative and in the metastatic setting? Dr. Kamaria Lee: At the governmental level, there are patient assistant programs that do exist, and I think that those can continue and can become more robust. But I also think one element of those is oftentimes the programs that we have at the government level or even institutional levels might have a lot of paperwork or be harder for people with lower literacy levels to complete. And so I think the government can really try to make sure that the paperwork that is given, within reason, with all the information they need, but that the paperwork can be minimized and that there can be clear instructions, as well as increased health insurance options and, you know, medical debt forgiveness as more broad just overall interventions that are needed. I think additionally, institutions that have clinical trials can help ensure that enrollment can be at geographically diverse locations. Some trials do reimburse for travel costs, of course, but sometimes then patients need the reimbursement sooner than it comes. And so I think there's also those considerations of more so upfront funds for patients involved in clinical trials if they're going to have to travel far to be enrolled in that type of care or trying to, again, make clinical trials more available at diverse locations.  I would also say that it's important that those who design clinical trials use what is known as the “Common Sense Oncology” approach of making sure that they're designed in minimizing the use of outcomes that might have a smaller clinical benefit but may have a high financial toxicity. And that also goes to what providers can do, of understanding what's most important to a particular patient in front of them, what outcomes and what benefit, or you know, how many additional months of progression-free survival or things like that might be important to a particular patient and then also educating them and discussing what the associated financial burden is just so that they have the full picture as they make an informed decision. Dr. Hope Rugo: As much as we know. I mean, I think that that's one of the big challenges is that as we prescribe these expensive drugs and often require multiple visits, even, you know, really outside of the clinical trial setting, trying to balance the benefit versus the financial toxicity can be a huge challenge. And that's a big area, I think, that we still need help with, you know. As we have more drugs approved in the early-stage setting and treatments that could be expensive, oral medications, for example, in our Medicare population where the share of cost may be substantial upfront, you know, with an upfront cost, how do we balance the benefits versus the risk? And I think you make an important point that discussing this individually with patients after we found out what the cost is. I think warning patients about the potential for large out-of-pocket cost and asking them to contact us when they know is one way around this. You know, patients feeling like they're sort of out there with a prescription, a recommendation from their doctor, they're scared of their cancer, and they have this huge share of cost that we didn't know about. That's one challenge, and I don't know if there's any suggestions you have about how one should approach that communication with the patient. Dr. Kamaria Lee: Yes, I think part of it is truly looking at each patient as an individual and asking how much they want to know, right? So we all know that patients, some who want more information, some want less, and so I think one way to approach that is asking them about how much information do they want to know, what is most helpful to them. And then also, knowing that if you're in a well-resourced setting that does have the social workers and financial navigators, also making sure it's integrated in the multidisciplinary setting and so that they know who they can go to for what, but also know that as a clinician, you're always happy for them to bring up their concerns and that if it's something that you're not aware of, that you will connect them to the correct multidisciplinary team members who can accurately provide that additional information. Dr. Hope Rugo: Do you have any other additional comments that you'd like to mention that we haven't covered? I think the idea of a financial toxicity screen with two questions that could be implemented at change of therapy or just periodically throughout the course of treatment would be a really great thing, but I think we do need as much information on potential interventions as possible because that's really what challenges people. It's like finding out information that you can't handle. Your article provides a lot of strategies there, which I think are great and can be discussed on a practice and institutional level and applied. Dr. Kamaria Lee: Yeah, I would just like to thank you for the opportunity to discuss such an important topic within oncology and specifically for our patients with breast cancer. I agree that it can feel overwhelming, both for clinicians and patients, to navigate this topic that many of us are not as familiar with, but I would just say that the area of financial toxicity is continuing to evolve as we gather more information on most successful interventions and that our patients can often inform us on, you know, what interventions are most needed as we see them. And so you can have your thinking about it as you see individual patients of, "This person mentioned this could be more useful to them." And so I think also learning from our patients in this space that can seem overwhelming and that maybe we weren't all trained on in medical school to best understand how to approach it and how to give our patients the best care, not just medically, but also financially. Dr. Hope Rugo: Thank you, Dr. Lee, for sharing your insights with us today. Our listeners will find a link, as I mentioned earlier, to the Ed Book article we discussed today in the transcript of this episode. I think it's very useful, a useful resource, and not just for providers, but for clinic staff overall. I think this can be of great value and help open the discussion as well. Dr. Kamaria Lee: Thank you so much, Dr. Rugo. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at Education Sessions from ASCO meetings and our deep dives into new approaches that are shaping modern oncology. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Kamaria Lee @ lee_kamaria Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx    Dr. Kamaria Lee: No relationships to disclose  

Navigating Vaccine Hesitancy in Pediatrics Evaluation and Credit:   Navigating Vaccine Hesitancy in Pediatrics   Evaluation and Credit:  https://www.surveymonkey.com/r/medchat81 Target AudienceThis activity is targeted toward primary care physicians and advanced providers. Statement of Need Despite the availability of safe and effective vaccines, pediatricians and clinicians continue to encounter significant vaccine hesitancy among caregivers, which can lead to suboptimal immunization rates and increased risk of preventable diseases. This podcast will provide key information for providers on the causes of vaccine hesitancy and how to address with parents. In that it is a podcast, it will be a discussion with the guest and moderator. Objectives Define pediatric vaccine hesitancy and describe its impact on public health. Discuss key factors that contribute to vaccine hesitancy. Describe effective communication strategies to address parental concerns to improve vaccine confidence in pediatric care. ModeratorMark McDonald, M.D., MHA, CPE System Vice President Pediatric Medical Affairs Medical Director, Norton Children's Louisville, Kentucky SpeakerKristina Bryant, M.D. Pediatric Infectious Diseases Physician Norton Children's Infectious Diseases Chair, Norton Children's Hospital Infection Control Associate Fellowship Director Professor UofL School of Medicine Louisville, Kentucky Planner and Moderator Disclosures  The planners and moderator of this activity do not have any relevant financial relationships with ineligible companies to disclose. Speaker DisclosureThe speaker, Kristina Bryant, M.D. discloses relevant financial relationship with Sanofi as an investigator. She had relationships with Gilead, Enanta Pharmaceuticals and Pfizer as an investigator. These relationships have ended.  All relevant financial relationships have been successfully mitigated. Commercial Support  There was no commercial support for this activity.  GrantThis episode is supported by a grant from the Kentucky Medical Association's ‘Small STEPS, Big Impact' campaign, a two-year initiative that encourages patients to achieve long-term success through taking simple steps that can add up to make a big impact on their health. The campaign focuses on five key areas (screenings, tobacco use, exercise & nutrition, physician visits and stress) and offers straightforward strategies and support for patients. It is a partnership between the KMA and its charitable arm, the Kentucky Foundation for Medical, made possible by a grant from the Kentucky Department for Public Health. For more information, visit SmallSTEPSKy.org.     Physician Credits Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing CreditsNorton Healthcare Institute for Education and Development is approved as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This continuing professional development activity has been approved for 0.75 ANCC CE contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org. Social Worker CreditsThe National Association of Social Workers, Kentucky Chapter (NASW-KY), is an approved provider for social work credits through the Kentucky Board of Social Work. This activity will provide 1.0 hours of required continuing education units. NASWKY # 0630/25.   Resources for Additional Study/References A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination https://pubmed.ncbi.nlm.nih.gov/38525549/ A Structural Lens Approach to Vaccine Hesitancy and Identity https://pubmed.ncbi.nlm.nih.gov/36841595/ SmallSTEPSKy.org   Date of Original Release | Aug. 2025; Information is current as of the time of recording.  Course Termination Date | Aug. 2027 Contact Information | Center for Continuing Medical EducationNavigating Vaccine Hesitancy in Pediatrics; (502) 446-5955 or cme@nortonhealthcare.org   Also listen to Norton Healthcare's podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope.   Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. More information about Norton Healthcare is available at NortonHealthcare.com.  

This Day in Legal History: Gulf of Tonkin ResolutionOn August 7, 1964, the U.S. Congress passed the Gulf of Tonkin Resolution, dramatically reshaping the legal landscape of American military engagement. Prompted by reports—later disputed—of North Vietnamese attacks on the USS Maddox in the Gulf of Tonkin, the resolution granted President Lyndon B. Johnson broad authority to use military force in Southeast Asia without a formal declaration of war. It passed nearly unanimously, with only two dissenting votes in the Senate, reflecting the tense Cold War atmosphere and congressional trust in the executive branch.Legally, the resolution functioned as an open-ended authorization for the president to escalate military operations in Vietnam. Within months, it led to the deployment of hundreds of thousands of U.S. troops. Critics would later argue that it allowed the executive to bypass Congress's constitutional war-making powers, effectively green-lighting a years-long conflict based on contested facts.As the war dragged on and public opinion turned, the resolution became a focal point for debates over separation of powers, congressional oversight, and executive overreach. In 1971, amid growing backlash, Congress repealed the resolution, but its legacy endured. It served as a legal and historical precedent for future authorizations of force, including those passed after 9/11.A federal appeals court has upheld the SEC's long-standing “gag rule,” which prevents defendants who settle civil enforcement cases from publicly denying the agency's allegations. The 9th Circuit Court of Appeals ruled 3-0 that the rule is not unconstitutional on its face but left room for future challenges depending on how it's applied. The policy, in place since 1972, requires settling parties to at least refrain from admitting or denying wrongdoing. The court emphasized that defendants remain free to reject settlements if they wish to speak out.Twelve petitioners, including former Xerox CFO Barry Romeril and the New Civil Liberties Alliance (NCLA), challenged the SEC's January 2024 decision not to revise the rule. Romeril had previously brought a similar challenge to the Supreme Court with support from Elon Musk, but the Court declined to hear it. Writing for the panel, Judge Daniel Bress noted that removing the gag could reduce the SEC's ability to settle cases efficiently and that speech restrictions are voluntary components of settlement agreements.The NCLA criticized the decision, arguing it effectively sanctions government-imposed silence and announced plans to pursue further appeals. SEC Commissioner Hester Peirce also dissented from the agency's refusal to revisit the rule, arguing that it hinders public accountability by suppressing potential criticism. The SEC declined to comment on the ruling, which came in the case Powell et al v. SEC.US appeals court upholds SEC 'gag rule' over free speech objections | ReutersThe Stanford Daily, Stanford University's student newspaper, has filed a lawsuit against the Trump administration, accusing it of violating the free speech rights of foreign students. The suit, filed in federal court in California, alleges that threats of arrest, detention, or deportation have created a climate of fear among international students, discouraging them from writing about sensitive political issues—particularly the Israeli-Palestinian conflict. Two unnamed students joined the paper in the lawsuit, which names Secretary of State Marco Rubio and Secretary of Homeland Security Kristi Noem as defendants.According to the plaintiffs, the administration has labeled pro-Palestinian viewpoints as antisemitic or extremist and attempted to deport students expressing such views, framing them as threats to U.S. foreign policy. In some instances, students have been detained without charges, though judges have later ordered their release. The lawsuit contends that these actions have led to widespread self-censorship among international students, chilling constitutionally protected speech in areas such as protests, slogans, and commentary on U.S. and Israeli policy.The Stanford Daily is seeking a court ruling affirming that the First Amendment protects non-citizens from government retaliation based on their speech. The university clarified it is not involved in the suit, as the newspaper operates independently. Attorney Conor Fitzpatrick, representing the paper, called the government's actions antithetical to American values of free expression.Stanford student newspaper sues Trump administration for alleged free speech violations | ReutersA U.S. appeals court has reinstated a lawsuit accusing major drugmakers Sanofi, Eli Lilly, Novo Nordisk, and AstraZeneca of conspiring to limit drug discounts provided under the federal 340B program. The 2nd Circuit Court of Appeals reversed a lower court's dismissal, allowing two health clinics—Mosaic Health and Central Virginia Health Services—to proceed with their proposed class action. These clinics claim the companies colluded in 2020 to restrict discounts on diabetes medications, harming safety-net providers and the low-income patients they serve.The court found that because the four companies control much of the diabetes drug market, coordination to limit discounts could be feasible. Judge Myrna Pérez, writing for the panel, noted the allegations were plausible enough to move forward. The drugmakers have denied wrongdoing and argue their policies were developed independently to address alleged fraud in the 340B program. Sanofi and Novo Nordisk said they are reviewing the decision, while Lilly criticized the ruling and defended its practices as legal.The clinics say the drugmakers earned billions in extra profits through these policies, which allegedly undercut essential savings for providers. The case underscores the broader tension between pharmaceutical companies and healthcare providers over the administration of the 340B program, which requires drugmakers to offer discounts in exchange for access to federal healthcare funds.US appeals court reinstates drug-price conspiracy lawsuit against Sanofi, rival pharma companies | ReutersPepsiCo is facing a proposed class action lawsuit alleging it engaged in illegal price discrimination by giving more favorable pricing and discount terms to large retailers like Walmart while denying the same deals to smaller businesses. Filed in federal court in Manhattan by an Italian restaurant operator, the lawsuit claims this practice violates the Robinson-Patman Act, a rarely enforced 1936 antitrust law meant to prevent discriminatory pricing that harms competition.The suit accuses Pepsi of providing payments and allowances to Walmart that were not extended to other retailers, placing smaller businesses at a competitive disadvantage. Although Walmart is named in the allegations, it is not a defendant in the case. The plaintiff argues that Pepsi's pricing tactics unfairly burden other merchants who must pay more for the same products.This legal action echoes a previous Federal Trade Commission (FTC) lawsuit filed against Pepsi in January under the Biden administration. However, the second Trump administration dropped the case in May, with Trump-appointed FTC Chair Andrew Ferguson criticizing it as a politically motivated effort launched too late in the prior administration's term. The FTC has not commented on the new private lawsuit.The class action seeks unspecified damages on behalf of thousands of Pepsi purchasers nationwide. Neither Pepsi nor Walmart has publicly responded to the allegations.Pepsi accused of price discrimination in new merchant class action | Reuters This is a public episode. 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What if you could learn about type 1 diabetes before symptoms even appear? In this powerful episode, Dr. Steve Edelman and Dr. Jeremy Pettus sit down with Senior Football Insider and Sanofi Spokesperson Adam Schefter to talk about why early screening for T1D is a conversation every family should be having.Adam shares his personal connection to type 1 diabetes through his wife's experience and how it changed his outlook on health, preparation, and the role of care partners. Together, they break down the importance of understanding early-stage T1D, how screening works, and why early knowledge is more than just information—it's peace of mind.Whether you're newly diagnosed, a care partner, or simply looking to stay informed, this episode offers insight, support, and a meaningful call to action.Key Topics:Adam's connection to T1D: How his wife's diagnosis impacted their family and sparked his passion for awareness and advocacy.Why early screening matters: The power of knowing about type 1 diabetes before symptoms begin—and how it can change everything.Understanding early-stage T1D: What auto antibodies are, what they indicate, and how type 1 develops in stages.Advice for care partners and families: Why loved ones should consider screening too, and how to start the conversation with a healthcare provider.Awareness is everything: How misinformation and lack of understanding can delay diagnosis—and why it's time to change that.Start the conversation: How to learn more about screening and what families can do today to stay one step ahead. ★ Support this podcast ★

In our final episode focused on the OX40 pathway and its emerging therapies, Dr. Joy Wan moderates a thoughtful discussion with two leaders from the patient advocacy community. Wendy Smith Begolka, MBS, Chief Program and Mission Officer at the National Eczema Association, and Korey Capozza, MPH, Founder and Executive Director of Global Parents for Eczema Research, share their perspectives on incorporating patient priorities into clinical trials and effectively communicating with patients about new and emerging treatments.Disclosures:Joy Wan, MD - Sun Pharmaceuticals – consulting (DMC), Astria Therapeutics – consulting (ad board), Galderma – fellowship funding (paid to Johns Hopkins)Wendy Smith-Begolka, MBS - Amgen/Kyowa, Kirin, Pfizer, Sanofi – advisory board honoraria; Arcutis, Incyte, Galderma – speaker fees; Pfizer, Sanofi – research grants

As the world's largest biotech partnering event took place in Boston in June, MTPConnect was there introducing an Australian delegation to the Boston ecosystem, hosting business events to drive international collaborations and leading the Australian Pavilion to highlight Australia's fast-growing life sciences sector to the international biotech industry.Our CEO Stuart Dignam was on the ground to find out why people are making the trip to BIO and what the buzz is all about. In this episode, Stuart speaks to Brent Owens, co-founder of Ballarat-based Vitrafy Life Sciences – a company pioneering cryopreservation technology and Brent Barnes, CEO and Manager Director of Adelaide-based Clever Culture Systems - inventor of APAS Independence, an intelligent microbiology culture plate reading technology that is revolutionising pharmaceutical lab work. These Australian start-ups have established a foothold in the US and are looking to expand and navigate the new tariff regime. Stuart also catches up with Professor Chris Molloy from the UK's Medicines Discovery Catapult to get his take on BIO and find out more about the BIOBridge initiative and why collaboration is key to solving the world's health challenges. For the support and partnership, MTPConnect would like to thank the state governments of NSW, Victoria, Queensland, Western Australia and South Australia, and the Department of Industry, Science and Resources, Austrade, CSIRO and AusBiotech.And thanks for the industry support from Moderna, Novartis, Australia & New Zealand, Cytiva, Sanofi, Arrotex Pharmaceuticals and Nutromics, and support for MTPConnect's Australian delegation site visit program from CSL and Global Pharma Solutions. 

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: FDA approves the first fast-acting biosimilar insulin in the US, Tandem issues warning, DOJ stands up for remote monitoring in schools, GLP1 use protects against dementia, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX We've got the first and only biosimilar FDA approved and moving to market. Kirsty – insulin aspart, which is a biosimilar to Novolog will be available as a single-patient-use prefilled pen for subcutaneous use and a multiple-dose vial for subcutaneous and intravenous use. KIRSTY has been available in Europe and Canada since 2022. This same company makes Semglee, the first biosimilar for long acting? Sales of Insulin Aspart in the United States were approximately $1.9 billion in 2024, according to IQVIA. https://www.globenewswire.com/news-release/2025/07/15/3115973/0/en/Biocon-Biologics-Expands-Diabetes-Portfolio-with-FDA-Approval-of-Kirsty-the-First-and-Only-Interchangeable-Rapid-Acting-Insulin-Aspart-in-the-United-States.html XX Tandem Diabetes Care (Nasdaq:TNDM) has issued an urgent medical device correction for some t:slim X2 automated insulin pumps. In a July 22 notice, the San Diego-based company warned of pumps that may exhibit a higher rate of speaker failure. During normal use, the insulin pump software monitors current flowing through the speaker during use. Measurements that fall within a pre-determined range indicate a functioning speaker. Meanwhile, measurements falling outside the range indicate a speaker failure.   When the measurements land outside the expected range, the system declares a malfunction, referred to as “Malfunction 16.” If the pump declares this malfunction, insulin delivery will stop and the pump will no longer be operational. Malfunction 16 terminates communication between the pump and continuous glucose monitor (CGM), as well as the t:slim mobile app.   If not addressed, the issue can lead to hyperglycemia, which can result in hospitalization or medical intervention. The company reports 700 adverse events and 59 reported injuries to date, with no reports of death.   Tandem identified that certain speaker versions have a higher rate of Malfunction 16 events due to a wiring issue within the speaker. Users can continue using their pump but with added precautions because Malfunction 16 can occur at any time. They should use the t:slim mobile app with push notifications turned on so the app alerts them if the malfunction occurs, the company said.   Additionally, Tandem intends to release a software update aimed at enhancing the early detection of speaker failure. The update also introduces persistent vibration alarms to help reduce potential safety risk. Tandem plans to notify affected pump users when it makes the update available. https://www.drugdeliverybusiness.com/tandem-warns-insulin-pump-speaker-malfunction/ XX BIG WIN! The DOJ protects T1D rights again! The US Attorney's office for the Western District of Washington State reached a settlement with a public school district that once again confirms remotely monitoring students' CGMs is a reasonable accommodation that schools must provide to comply with the Americans with Disabilities Act. If its true for one state its true for all states under federal law! If your local schools still refuse to remotely monitor CGMs of their students, provide them with this letter to compel them to FOLLOWT1Ds and FOLLOW Federal Laws. If they still refuse contact us! https://followt1ds.org/ XX new study finds people taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin users. Past studies show that people who have type 2 diabetes — a chronic condition where the body does not use its insulin properly — are at a higher risk of developing dementia. The study found that when comparing the neuroprotective abilities of two diabetes medications — metformin and glucagon-like peptide-1 receptor agonists (GLP-1 agonists) — participants taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin.   https://www.medicalnewstoday.com/articles/glp-1s-may-offer-better-dementia-protection-than-metformin XX Front office changes coming to Dexcom.  CEO Kevin Sayer will step down  & give the reins to current Chief Operating Officer Jake Leach. Scheduled for January 1, 2026, Leach will also join Dexcom's board of directors where Sayer will remain  executive chairman. One of our frequent guests here.. Leach has worked at Dexcom for 21 years. He served as chief technology officer from 2018 to 2022 before he was named COO in late 2022. He was given the title of president in May. https://www.medtechdive.com/news/dexcom-ceo-change-kevin-sayer-jake-leach/756382/ XX A major international study has revealed that many children and young adults in Sub-Saharan Africa who are diagnosed with type 1 diabetes (T1D) may actually have a different, non-immune-based form of the condition. Unlike the traditional autoimmune version of T1D, this form appears to develop without the immune system attacking the insulin-producing cells. This finding could significantly reshape how diabetes is diagnosed and treated across the region, potentially leading to more precise care and better health outcomes. The researchers found that many young people in Sub-Saharan Africa diagnosed with T1D often don't have the usual markers in their blood (called islet autoantibodies) typically seen in people with T1D in other parts of the world. Specifically, 65% of participants with T1D in this region did not have islet autoantibodies. When the researchers compared this data to studies in the U.S., they found a smaller but significant proportion (15%) of Black participants diagnosed with T1D had a similar form of diabetes found in Sub-Saharan Africa – characterized by negative autoantibodies and a low T1D genetic risk score.   However, white Americans with T1D showed the typical autoimmune pattern, even if they didn't have detectable autoantibodies, their genetics still pointed to autoimmune diabetes.   “The identification of this T1D diabetes subtype in Sub-Saharan African populations and among individuals of African ancestry in the U.S. suggests a potential ancestral or genetic link,” Dabelea notes. “These findings highlight the need to consider alternative etiologies in this group and a deeper understanding of the underlying mechanisms may provide important insights for future prevention and treatment strategies.”     https://scitechdaily.com/new-diabetes-subtype-discovered-in-africa-challenges-global-assumptions/   XX Formal recognition for the specialty of Diabetology.   Diabetology is the specialty focused on the full continuum of diabetes care — encompassing diagnosis, treatment, prevention, technology integration, education, and cardiometabolic management. While it intersects with endocrinology, primary care, and public health, diabetology is uniquely defined by its depth and focus on diabetes alone.       The American College of Diabetology (ACD) is the national professional organization representing clinicians who specialize in diabetes care. ACD advances clinical excellence and education to improve the lives of those affected by diabetes. https://www.businesswire.com/news/home/20250725766248/en/American-College-of-Diabetology-Announces-Formal-Taxonomy-Classification-for-Diabetology   XX Tidepool announces cloud-to-cloud integration with Abbott's FreeStyle Libre portfolio. From the release: This integration allows people living with diabetes using the FreeStyle Libre portfolio to connect their data to their Tidepool account seamlessly. For healthcare providers, this means more comprehensive insights and streamlined workflows, with FreeStyle Libre systems data flowing continuously into the Tidepool Data Platform. https://www.tidepool.org/blog/abbott-freestyle-libre-integration-launched XX Stelo dexom ai food XX With high drug prices remaining an ongoing concern for U.S. politicians, Roche is considering following in the footsteps of some of its peers with a direct-to-consumer (DTC) model to cut out the middlemen.     About 50% of the money spent on drugs in the U.S. healthcare system goes straight to PBMs instead of the companies that create the medicines, Roche CEO Thomas Schinecker called out in a press conference on Thursday.   Bringing the drugs directly to the consumer could be a solution to positively impact pricing for patients “without destroying innovation,” Schinecker added on a separate Thursday call with investors, noting that the company has discussed the matter with the U.S. government and its Department of Health and Human Services. The pricing talks come after President Donald Trump inked a “Most Favored Nation” executive order in May, aiming to tie U.S. drug prices to lower prices in other developed nations. The plan was quickly called out by industry voices such as the PhRMA trade group, which labeled it a “bad deal” for U.S. patients. https://www.fiercepharma.com/pharma/roche-weighing-direct-consumer-drug-sales-ease-us-drug-pricing-woes-cut-out-pbms-ceo-says XX SAB BIO secures substantial $175M financing to advance T1D therapy with impressive investor lineup and extended cash runway until 2028. Most critically, this financing fully funds the pivotal Phase 2b SAFEGUARD study evaluating SAB-142 for delaying progression of autoimmune Type 1 diabetes in newly diagnosed patients. By extending the cash runway into mid-2028, SAB has effectively eliminated near-term financing risk and provided clear visibility through this crucial clinical trial and potential commercialization preparation. Participation from strategic investor Sanofi, along with new investors RA Capital Management, Commodore Capital, Vivo Capital, Blackstone Multi-Asset Investing, Spruce Street Capital, Forge Life Science Partners and Woodline Partners LP, and existing investors Sessa Capital, the T1D Fund, and ATW Partners         https://www.stocktitan.net/news/SABS/sab-bio-announces-oversubscribed-175-million-private-fwsf2t91ek4z.html   XX In a landmark 14-year study, researchers have found that artificially sweetened drinks raise the risk of developing type 2 diabetes by more than a third, significantly higher than those loaded with sugar. It challenges the long-standing perception of diet drinks being a healthier alternative and suggests they may carry metabolic risks of their own. In the first longitudinal study of its kind, led by Monash University, researchers tracked 36,608 participants over an average period of 13.9 years to assess how both sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) impacted health outcomes. The self-reported health data, from the Melbourne Collaborative Cohort Study, was drawn from participants aged 40 to 69 years at the time of recruitment.   What they found was that drinking just one can of artificially sweetened soda increased the risk of developing type 2 diabetes by 38%, compared to people who didn't consume these drinks at all. For those consuming the same amount of sugary drinks, the risk was 23% higher. This suggests there's more than obesity at play. The researchers believe this result is due to an independent metabolic effect, possibly gut microbiome disruption or a change in glucose metabolism.   While the study didn't identify which artificial sweeteners were at play,   Evidence suggests that artificial sweeteners can alter the composition and function of gut bacteria, leading to glucose intolerance – a precursor to type 2 diabetes. And that some sweeteners may trigger insulin release, desensitize metabolic responses over time, or confuse the body's glucose regulation system – even without actual sugar in the picture.   Another hypothesis is that regular exposure to the kind of intense sweetness that artificial products deliver may condition the body to anticipate sugar calories that never come, affecting appetite regulation, insulin sensitivity and broader metabolic pathways. However, the authors suggest that how sweeteners affect the gut microbiota and glucose regulation are the most likely drivers of increased diabetes risk.   https://newatlas.com/diet-nutrition/one-drink-diabetes-risk/ XX After months of deliberation, information gathering and public testimony, a state board unanimously agreed Monday that two common medications for type-2 diabetes and other conditions appear to pose an affordability challenge to the state and Marylanders.   The state Prescription Drug Affordability Board approved two resolutions saying that prescription drugs Jardiance and Farxiga likely pose an “an affordability challenge for the state health care system” and the state should look for ways to bring down those costs.   Health care advocates call the long-awaited resolution an “important first step” in the process in bringing down prescription costs for those on the state's health plan.       That milestone has been years in the making. Created in 2019 by the General Assembly, the Prescription Drug Affordability Board was slow to launch due in part to a veto from former Gov. Larry Hogan (R) amid pandemic-induced economic uncertainty in 2020 that delayed the board's formation. The board also cited out-of-pocket costs for consumers and state and local spending on those drugs as indicators that there may be an affordability challenge.   The board will now look at options to address the potential affordability challenge, which could include setting an upper payment limit on those drugs. But it's not clear when the state will see cost savings.   That said, some members of the health care system and the pharmaceutical industry say that policies such as upper payment limits could weaken access to life-saving drugs. Others say that the board has not engaged enough viewpoints from the health care industry. https://marylandmatters.org/2025/07/29/state-board-determines-two-type-2-diabetes-drugs-may-be-unaffordable/   XX One year after it was revealed that Chrissy Teigen and John Legend's son, Miles, was diagnosed with type 1 diabetes, Teigen is revealing how she's making her son feel more included. Teigen first opened up about her 7-year-old son's diagnosis after she and her two oldest kids, Miles and 9-year-old daughter Luna were at the 2024 summer Olympics cheering on Simone Biles. Teigen posted a photo of Miles and Luna holding up a sign. Also visible in the picture was the insulin pump on Miles' arm. Now, Teigen is sharing some insight into how she's making Miles more comfortable with having type 1 diabetes, including giving LeBron James' Barbie doll type 1 diabetes as well. In a video shared on Instagram, Teigen is seen taking the T1D Barbie, removing her insulin pump and gluing the pump onto LeBron James' Barbie. “Turning T1D Barbie into T1D Lebron James for my son,” Teigen captioned the video, revealing James is Miles' hero. 41 million followers https://www.yahoo.com/lifestyle/articles/chrissy-teigen-gives-lebron-james-154608782.html  

Living with Eosinophilic Esophagitis (EoE)—a chronic, often misunderstood condition—can make eating and even swallowing a daily challenge. In this inspiring episode, patient advocate Matt shares his personal journey navigating life with EoE. From the struggle of getting an accurate diagnosis, to identifying and managing daily food triggers, to finding a treatment plan that works, Matt offers an honest look at the physical, emotional, and social realities of living with this condition. His story sheds light on the resilience, trial-and-error, and determination it takes to keep moving forward. In this episode, we discuss how to: Overcome the challenges of getting a proper EoE diagnosis Tackle daily triggers and make smart dietary changes Fine-tune a treatment plan to get real results Navigate the emotional and social toll of a chronic swallowing condition Whether you're living with EoE, supporting someone who is, or just want to understand this condition better, you'll gain valuable insights, practical tips, and a sense of hope from Matt's journey. Resources & Support: Learn more about EoE and find trusted resources: gastrogirl.com This episode was made possible with support from Sanofi and Regeneron.  

In this episode of the Global Hemophilia Report, host Patrick James Lynch and a panel of experts discuss the importance of real world data and patient engagement in hemophilia care. The conversation explores how data collected outside of clinical trials provides deeper insights into treatment outcomes, challenges, and lived experiences. Guests share strategies for improving data reliability, motivating patient participation, and balancing privacy with research needs. Tune in for key takeaways on how both numbers and personal stories shape better care for the hemophilia community.   Guests: Mike Recht, MD, PhD, MBA Samantha Gouw, MD, PhD Maria Santaella, RN-BC, MSN, PhD(c)   Senior Advisor: Donna DiMichele, MD   Hosted by: Patrick James Lynch   Written by: Kay Vermeil   Featured Advertiser: Sanofi   Subscribe to the Global Hemophilia Report   Show Notes:   Presenting Sponsor: Presented by Sanofi   Sanofi's Global Hemophilia Survey uncovers significant care gaps and emotional challenges faced by patients and caregivers. Learn how improving health literacy and fostering better patient-provider communication are essential to addressing these inequities. Explore the findings and see how Sanofi is driving health equity for the hemophilia community. Explore the survey findings here: Global Hemophilia Survey Page. For too long, women and girls who bleed have been dismissed. Left out of the narrative. Ignored by the system. But not anymore. In our new film, “Dismissed,” meet Isabelle—a 15-year-old with hemophilia who's using her voice to uplift the unheard. Alongside her are four powerful stories of women challenging what's "normal" and demanding recognition, care, and justice. This is more than a film. It's a movement.

Fed kept rates on hold with dissent from Waller and Bowman. Powell said will not let tariffs become inflationary.BoJ maintained rates as expected, raised growth and inflation outlook. Continued to note uncertainty over trade.US equity futures rebounded after-hours with strength in tech/AI-related names after Microsoft (+8.3%) and Meta (+11.5%) smashed Q2 earnings.US President Trump announced that South Korea will be subject to a 15% and make USD 350bln in investments in the US.European equity futures suggest a mildly positive open. Hang Seng lags post-disappointing Chinese PMIs.DXY rally pauses for breath, EUR/USD remains on a 1.14 handle. USTs rebounded off the lows after post-Powell pressure.Looking ahead, highlights include French CPI, PPI, German Unemployment Rate, CPI, EZ Unemployment Rate, Italian CPI, US Challenger Layoffs, PCE (Jun), Jobless Claims, Employment Wages, Chicago PMI, Atlanta Fed GDPNow, Canadian GDP, SARB Policy Announcement.Earnings from Shell, Unilever, LSE, Haleon, Standard Chartered, Anglo American, Sanofi, Schneider Electric, Safran, Credit Agricole, Saint Gobain, SocGen, Accor, Teleperformance, Air France, AB InBev, BBVA, Holcim Puma, Lufthansa, BMW, Apple, Amazon, Strategy, Coinbase, Reddit, Roku, CVS, Roblox, AbbVie, Norwegian Cruise Line, Cigna, Mastercard & PG&E.Read the full report covering Equities, Forex, Fixed Income, Commodites and more on Newsquawk

Host: Emer Joyce Guest: Christian Hassager Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1812?resource=interview  Want to watch the full episode? Go to: https://esc365.escardio.org/event/1812   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce, Christian Hassager, Nicolle Kraenkel and Theresa McDonagh have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers:  Cardiology this Week: A concise summary of recent studies Atrial fibrillation in heart failure Temperature management following cardiac arrest Statistics Made Easy: Collider bias Host: Emer Joyce Guests: Carlos Aguiar, Christian Hassager, Theresa McDonagh Want to watch that episode? Go to: https://esc365.escardio.org/event/1812 Want to watch that extended interview on temperature management following cardiac arrest? Go to: https://esc365.escardio.org/event/1812?resource=interview   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce, Christian Hassager, Nicolle Kraenkel and Theresa McDonagh have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Javier Etcheverry, analista y trader profesional, analiza con lupa Societe General, Accor, Sanofi y Rolls-Royce.

Hear Christopher McKim's journey with moderate to severe plaque psoriasis and the latest clinical trial results from dermatologist, Dr. Christine Cornejo. Join this discussion with moderator Archie Franklin as Christopher McKim, a BMS employee living with moderate to severe plaque psoriasis, and Dr. Christine Cornejo, Director and US Medical Engagement Lead for Dermatology and Rheumatology at BMS, offer a patient and physician's perspective on treating plaque psoriasis from the inside. Listen as Chris presents his journey along with Dr. Cornejo addressing effectiveness and safety information with clinical trial results for a prescription oral treatment option. The intent of this episode is to encourage those who have moderate to severe plaque psoriasis to work with their health care provider to find a treatment option that is right for them. This episode is sponsored by Bristol Myers Squibb. For more information view Full Prescribing Information and Medication Guide . ·       (0:00)   Intro to Psoriasis Uncovered and guest welcome to Bristol Myers Squibb employee and patient Christopher McKim and Dr. Christine Cornejo, Director and US Medical Engagement Lead for Dermatology and Rheumatology at Bristol Myers Squibb. ·       (2:15)  Where the journey to finding the right treatment option for Chris and his moderate to severe plaque psoriasis began.  ·       (3:09)   The decision by Chris and his provider to try an oral systemic medication. ·       (3:28)  The effects and impact of an oral systemic treatment for Chris and his plaque psoriasis. ·       (4:09)   Dr. Cornejo addresses efficacy and clinical trials results. ·       (5:58)   Common side effects and safety concerns for the treatment Chris and his health care provider decided to try.   ·       (6:28)   Health considerations patients and providers should discuss prior to using a systemic treatment.    ·       (6:54)   What to do should side effects occur. ·       (7:10)   How Chris feels with clearer skin after making a change in treatment. ·       (8:14)   Indication and Important Safety Information. Key Takeaways: ·       Moderate to severe plaque psoriasis is a systemic disease.    ·       If you're ready to treat from the inside there is a treatment option that may help.   ·       Work with a health care provider to find the right treatment for moderate to severe plaque psoriasis.   ·       Be proactive by taking steps to learn about treatment options including effectiveness, side effects, safety concerns, and what should be discussed with a health care provider before beginning a new treatment for plaque psoriasis.  Guest Bios:   Christopher (Chris) McKim joined BMS in June of 2022. In his current role he is a Regional Marketer for the dermatology division, prior to that he provided support for 9 Therapeutic Area Specialists for the Pacific South District in the GI division.  Prior to joining BMS, Chris worked at Sanofi, J&J, Leo Pharma, and Sun Pharma in various field and home office roles. Chris resides in beautiful San Diego with his family Susan (wife), Morgan 18, Maddy 16, Mason 14 and two Golden Retrievers and enjoys traveling, cooking and anything associated with the ocean (Deep Sea Fishing, S.C.U.B.A. diving, snorkeling, and boogie boarding). Dr. Christine Cornejo joined Bristol Myers Squibb in 2024 as Director, Medical Engagement Lead for Dermatology and Rheumatology. Prior to joining BMS, she practiced dermatology at Brigham and Women's Hospital and Dana-Farber Cancer Institute in Boston, MA, where she specialized in melanoma and high-risk skin cancer management and served as the Director of Confocal Microscopy. She also served as an Instructor at Harvard Medical School and led the Immunology and Infectious Diseases course for 1st year medical students. Resources: Current Oral Systemic Treatments For additional questions about treatment options contact the NPF Patient Navigation Center

Today we'll focus on a major shift in the treatment of myasthenia gravis -- as a wave of new therapies is changing how we treat this disease. Who should be considered for these new treatments? And what else is in the pipeline?   Our guest today is Dr.  Gil Wolfe, a neuromuscular neurologist at the University of Buffalo State University of New York, Jacob School of Medicine and Biomedical Sciences. Dr. Wolfe was interviewed by Dr. Ioannis Karakis, adjunct professor of neurology at Emory University School of Medicine.   References: https://www.nature.com/articles/s41598-024-79918-7   Disclosures: Dr. Wolfe discloses: Consultant for: Alexion, Argenx, BPL, Cartesian, Canopy, Grifols, Johnson & Johnson, Takeda, UCB; Speaker Bureau for: Grifols, Alexion, UCB; Grant/Research support from: ArgenX, Ra/UCB, Immunovant, Roche, Alexion, Sanofi

We love to hear from our listeners. Send us a message. On this week's episode, Ebrahim Delpassand, M.D., founder, CEO, and chairman of the board at RadioMedix talks about his personal journey standing up and growing  a radiopharmaceutical company focused on oncology. Dr. Delpassand discusses the current trends in radiopharmaceutical drug development, the differences between alpha- and beta-emitting isotopes, overcoming manufacturing and supply chain challenges and restraints, and building strategic partnerships with companies like Curium, Fusion (now part of AstraZeneca), and Sanofi. He also offers specific advice to physician-entrepreneurs interested in building their own drug development companies. Access this and hundreds of episodes of the Business of Biotech videocast under the Business of Biotech tab at lifescienceleader.com. Subscribe to our monthly Business of Biotech newsletter. Get in touch with guest and topic suggestions: ben.comer@lifescienceleader.comFind Ben Comer on LinkedIn: https://www.linkedin.com/in/bencomer/

Audio roundup of selected biopharma industry content from Scrip over the business week ended July 25, 2025. In this episode: Sanofi's Vicebio buy; Sarepta halts US Elevidys shipments; Novartis warning over Europe; US CRL for Genentech's Columvi; and an interview with Novavax. https://insights.citeline.com/scrip/podcasts/scrips-five-must-know-things/quick-listen-scrips-five-must-know-things-U4IN5X7DRVFLVIBJ4Q72VTAJUY/ This episode was produced with the help of AI text-to-voice and voice emulation tools. Playlist: soundcloud.com/citelinesounds/sets/scrips-five-must-know-things

Analizamos los valores clave en el Viejo Continente de la mano de Pablo García, director general de Diovacons-Alphavalue. Miramos al pacto comercial entre la UE y EE.UU, el sector automovilístico, ST Micro, ASML, Infineon, Roche, Sanofi, Novartis, Heineken, Prosibiensat y Media for Europe.

Please join host Michael S. Lloyd, MD, FHRS at HRS 2025 in San Diego as he discusses this article with Stephanie Wang, MD and Emily Zeitler, MD. The study investigated whether PFA-induced coronary spasms during ablation could cause lasting changes—such as mild lumen narrowing—at the ablation site over a three-month period. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacep.2025.03.014 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): E. Zeitler: Honoraria/Speaking/Consulting: Biosense Webster, Inc., Medtronic Inc., Boston Scientific, Element Science, Inc., Sanofi, V-Wave S. Wang: Nothing to disclose.

Marianne De Backer is the CEO of Vir Biotechnology, a company developing treatments that harness the power of the immune system to fight serious infectious diseases and cancer. Vir Biotechnology's current clinical trials include a registrational program in chronic hepatitis delta, a rare, often fatal liver disease, as well as two Phase 1 trials of PRO-XTEN™ dual-masked T-cell engagers (TCEs), one targeting HER-2 and the other targeting PSMA, each in heavily pre-treated cancer patients. TCEs have shown tremendous potential but have been limited due to toxicity challenges. The PRO-XTEN™ technology keeps the TCEs masked until they reach the tumor microenvironment, potentially mitigating the toxicity of TCEs and allowing them to unleash their tremendous potential to destroy cancer cells.  Marianne explains, “Vir Biotechnology is an immunology company, and that means that we are really developing treatments that take advantage of the power of basically the patient's own immune system to fight a variety of diseases. We have actually four clinical-stage programs in infectious disease and oncology, and a number of preclinical programs as well. And our most advanced program is to treat chronic hepatitis delta. That is actually a disease caused by a tiny virus, but it's causing liver cancer and is often fatal.” “We have recently initiated our registrational phase 3 program. It's called ECLIPSE. We had previously shown some very compelling data with one of our regimens for treating this disease. We're really excited about progressing that program. And the rest of our clinical pipeline includes a series of so-called PRO-XTEN™ masked T-cell engagers, or in short, TCEs, for the treatment of metastatic solid tumors.”   Vir Biotechnology has exclusive rights to the PRO-XTEN™ masking platform for oncology and infectious disease. PRO-XTEN™ is a trademark of Amunix Pharmaceuticals, Inc. a Sanofi company. #VirBiotechnology #MaskedTCellEngagers #TCellEngagers #SolidTumors #MetastaticSolidTumors #Cancer #Immunotherapy #ChronicHepatitisDelta #MedAI #PatientsAreWaiting  vir.bio Download the transcript here  

Marianne De Backer is the CEO of Vir Biotechnology, a company developing treatments that harness the power of the immune system to fight serious infectious diseases and cancer. Vir Biotechnology's current clinical trials include a registrational program in chronic hepatitis delta, a rare, often fatal liver disease, as well as two Phase 1 trials of PRO-XTEN™ dual-masked T-cell engagers (TCEs), one targeting HER-2 and the other targeting PSMA, each in heavily pre-treated cancer patients. TCEs have shown tremendous potential but have been limited due to toxicity challenges. The PRO-XTEN™ technology keeps the TCEs masked until they reach the tumor microenvironment, potentially mitigating the toxicity of TCEs and allowing them to unleash their tremendous potential to destroy cancer cells.  Marianne explains, “Vir Biotechnology is an immunology company, and that means that we are really developing treatments that take advantage of the power of basically the patient's own immune system to fight a variety of diseases. We have actually four clinical-stage programs in infectious disease and oncology, and a number of preclinical programs as well. And our most advanced program is to treat chronic hepatitis delta. That is actually a disease caused by a tiny virus, but it's causing liver cancer and is often fatal.” “We have recently initiated our registrational phase 3 program. It's called ECLIPSE. We had previously shown some very compelling data with one of our regimens for treating this disease. We're really excited about progressing that program. And the rest of our clinical pipeline includes a series of so-called PRO-XTEN™ masked T-cell engagers, or in short, TCEs, for the treatment of metastatic solid tumors.”   Vir Biotechnology has exclusive rights to the PRO-XTEN™ masking platform for oncology and infectious disease. PRO-XTEN™ is a trademark of Amunix Pharmaceuticals, Inc. a Sanofi company. #VirBiotechnology #MaskedTCellEngagers #TCellEngagers #SolidTumors #MetastaticSolidTumors #Cancer #Immunotherapy #ChronicHepatitisDelta #MedAI #PatientsAreWaiting  vir.bio Listen to the podcast here  

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma e Biotech world. Sarepta Therapeutics has halted the distribution of Elevidys in the US after the FDA request, following two deaths. The company's transparency has been called into question, affecting its stock value. Replimmune also faced setbacks after the FDA rejected its melanoma treatment, causing a significant drop in shares. On a more positive note, AstraZeneca has pledged $50 billion for US manufacturing, focusing on drugs like Baxdrostat and oral glp-1 therapies. Sanofi has made a $1.6 billion vaccine acquisition, while Biogen commits $2 billion to expand US drug production. The pharmaceutical industry is seeing various developments and challenges, with companies adapting to regulatory demands and market pressures.

Araceli de Frutos, asesora del fondo Alhaja Inversiones, analiza con lupa los mercados europeos, Sanofi, Astrazeneca, Compass, Sartorius y SAP

This episode covers: Cardiology This Week: A concise summary of recent studies ICD Indications in primary prevention Drug treatment of cardiac amyloidosis Mythbusters Host: Rick Grobbee Guests: Carlos Aguiar, Gerhard Hindricks, Marianna Fontana Want to watch that episode? Go to: https://esc365.escardio.org/event/1810   Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Rick Grobbee, Gerhard Hindricks and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Marianna Fontana has declared to have potential conflicts of interest to report: consultancy for Alnylam, Alexion/Caelum Biosciences, Astrazeneca, Bridgbio/Eidos, Prothena, Attralus, Intellia Therapeutics, Ionis Pharmaceuticals, Cardior, Lexeo Therapeutics, Janssen Pharmaceuticals, Prothena, Pfizer, Novonordisk, Bayer, Mycardium. Research grants from: Alnylam, Bridgbio, Astrazeneca, Pfizer. Share options in LexeoTherapeutics and shares in Mycardium. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Rick Grobbee Guest: Gerhard Hindricks Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1810?r Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Rick Grobbee, Gerhard Hindricks and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world. Johnson & Johnson reported second-quarter earnings of $23.7 billion, driven by cancer and neuroscience drugs, exceeding analyst expectations. CEO Joaquin Duato set a target of $50 billion in oncology sales by 2030. Despite challenges in the industry, Johnson & Johnson remains optimistic about its oncology sales target as the biotech industry continues to navigate the evolving landscape of drug development and funding.In a difficult investing environment where IPOs are not guaranteed, AI-focused biotech unicorns are facing challenges in securing funding. GSK's Blenrep is facing setbacks as the FDA questions its efficacy in treating multiple myeloma, while AstraZeneca's amyloidosis asset failed to improve survival in a late-stage trial. The industry is also seeing the rise of women leaders like Audrey Greenberg and the team at Acadia, who are making significant contributions to the field.Biospace is launching a new weekly newsletter focused on critical manufacturing issues in the biopharma industry, covering developments and impacts on companies such as Roche, Sanofi, and Johnson & Johnson. The newsletter aims to provide deep dives, analysis, and roundups of the biggest manufacturing stories of the week every Tuesday. Stay informed with weekly analysis and updates on the changing landscape of manufacturing in the U.S.

What does it truly mean to lead when the world around you crumbles and rebuilds itself?This episode features host Denis Gianoutsos' most powerful conversations with two extraordinary leaders. Dr. Nadya Zhexembayeva, born to political dissidents in Soviet Kazakhstan, witnessed her world collapse overnight—yet discovered that leadership is a dynamic space we enter and exit, not a fixed title. Ken Miller, a healthcare executive with 32 years of global experience, reveals the athletic mindset required for modern leadership and why our most outstanding teachers are found in our closest relationships, not boardrooms.Join Denis Gianoutsos for this transformative mashup—your perspective on leadership may never be the same.EP 221 - Dr. Nadya Zhexembayeva: Leadership as a Dynamic Space: From Soviet Collapse to Revolutionary ThinkingBorn in Soviet Kazakhstan to political dissidents, witnessed sudden USSR collapse, creating a complete vacuumRedefines leadership as a space you enter and exit daily, not a fixed title or position.Draws from Kazakh nomadic culture,e viewing leadership as a dynamic circle larger than any individualIdentifies daughter and parents as most significant leadership influences, emphasizing self-love before leading othersEP 225 - Ken Miller: Healthcare Leadership and the Athletic Mindset: Building Legacy Through Purpose32 years in healthcare at companies like Sanofi, Pfizer, Roche, choosing impact over just profitDescribes leaders as athletes - highly competitive with a tireless appetite for success and sacrificeEmphasizes continuous learning and personal development rather than relying on organizationsCites Dr. Martin Luther King Jr. as a favorite leader for authenticity and fighting for something bigger than himselfKey Quotes:"Leadership for me is a space. You enter and exit many times a day." - Dr. Nadya Zhexembayeva"You've gotta have a work ethic, which is second to none, to really have an impact around the world." - Ken MillerThe 10 Proven Ways to Lead and Thrive in Today's World - FREE Executive Guide Download https://crm.leadingchangepartners.com/10-ways-to-lead Connect with Denis:Email: denis@leadingchangepartners.comWebsite: www.LeadingChangePartners.com Facebook: https://www.facebook.com/denisgianoutsos LinkedIn: https://www.linkedin.com/in/denisgianoutsos/ Instagram: https://www.instagram.com/leadershipischanging/ YouTube Channel: https://www.youtube.com/@DenisGianoutsos

What is the environmental impact of respiratory illness? Find out in this episode of the EMJ GOLD podcast, where Shish Patel, Medical Director, Chiesi UK, joins Isabel to discuss the rising burden of COPD and the impact of respiratory care on the planet.  Together, the two explore the diagnostic gap in COPD, improving the experience of people living with the disease, balancing health innovation with climate concerns and much more.   A little more on EMJ GOLD's guest…  Shish Patel trained as a pharmacist and has worked in the pharmaceutical industry for over 30 years. Currently, he serves as Medical Director at Chiesi UK and Ireland, and he has held senior positions within medical and scientific functions at both affiliate and global level throughout his career. In addition to his significant time at Chiesi, Shish has held positions at GSK and Sanofi. Shish also holds key industry board positions including at the Prescription Medicines Code of Practice Authority and the ABPI.   

Drs. Hope Rugo, Sheri Brenner, and Mikolaj Slawkowski-Rode discuss the struggle that health care professionals experience when terminally ill patients are suffering and approaches to help clinicians understand and respond to suffering in a more patient-centered and therapeutic way. TRANSCRIPT Dr. Hope Rugo: Hello, and welcome to By the Book, a monthly podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book.  I'm your host, Dr. Hope Rugo. I'm director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. On today's episode, we'll be exploring the complexities of grief and oncology and the struggle we experience as healthcare professionals when terminally ill patients are suffering. Our guests will discuss approaches to help clinicians understand and respond to suffering in a more patient-centered and therapeutic way, as outlined in their recently published article titled, “Oncology and Suffering: Strategies on Coping With Grief for Healthcare Professionals.” I'm delighted today to welcome Dr. Keri Brenner, a clinical associate professor of medicine, palliative care attending, and psychiatrist at Stanford University, and Dr. Mikołaj Sławkowski-Rode, a senior research fellow in philosophy in the Humanities Research Institute at the University of Buckingham, where he also serves as director of graduate research in p hilosophy. He is also a research fellow in philosophy at Blackfriars Hall at the University of Oxford and associate professor at the University of Warsaw.  Our full disclosures are available in the transcript of this episode. Dr. Brenner and Dr. Sławkowski-Rode, thanks for being on the podcast today. Dr. Keri Brenner: Great to be here, Dr. Rugo. Thank you so much for that kind introduction. Dr. Mikołaj Sławkowski-Rode: Thank you very much, Dr. Rugo. It's a pleasure and an honor. Dr. Hope Rugo: So I'm going to start with some questions for both of you. I'll start with Dr. Brenner. You've spoken and written about the concept of suffering when there is no cure. For oncologists, what does it mean to attune to suffering, not just disease? And how might this impact the way they show up in difficult conversations with patients? Dr. Keri Brenner: Suffering is something that's so omnipresent in the work of clinical oncology, and I like to begin by just thinking about what is suffering, because it's a word that we use so commonly, and yet, it's important to know what we're talking about. I think about the definition of Eric Cassell, who was a beloved mentor of mine for decades, and he defined suffering as the state of severe distress that's associated with events that threaten the intactness of a person. And my colleague here at Stanford, Tyler Tate, has been working on a definition of suffering that encompasses the experience of a gap between how things are versus how things ought to be. Both of these definitions really touch upon suffering in a person-centered way that's relational about one's identity, meaning, autonomy, and connectedness with others. So these definitions alone remind us that suffering calls for a person-centered response, not the patient as a pathology, but the panoramic view of who the patient is as a person and their lived reality of illness. And in this light, the therapeutic alliance becomes one of our most active ingredients in care. The therapeutic alliance is that collaborative, trusting bond as persons that we have between clinician and patient, and it's actually one of the most powerful predictors of meaningful outcomes in our care, especially in oncologic care.  You know, I'll never forget my first day of internship at Massachusetts General Hospital. A faculty lecturer shared this really sage insight with us that left this indelible mark. She shared, “As physicians and healers, your very self is the primary instrument of healing. Our being is the median of the medicine.” So, our very selves as embodied, relationally grounded people, that's the median of the medicine and the first most enduring medicine that we offer. That has really borne fruit in the evidence that we see around the therapeutic alliance. And we see this in oncologic care, that in advanced cancer, a strong alliance with one's oncologist truly improves a patient's quality of life, treatment adherence, emotional well-being, and even surpasses structured interventions like psychotherapeutic interventions. Dr. Hope Rugo: That's just incredibly helpful information and actually terminology as well, and I think the concept of suffering differs so much. Suffering comes in many shapes and forms, and I think you really have highlighted that. But many oncologists struggle with knowing what to do when patients are suffering but can't be fixed, and I think a lot of times that has to do with oncologists when patients have pain or shortness of breath or issues like that. There are obviously many ways people suffer. But I think what's really challenging is how clinicians understand suffering and what the best approaches to respond to suffering are in the best patient-centered and therapeutic way. Dr. Keri Brenner: I get that question a lot from my trainees in palliative care, not knowing what to do. And my first response is, this is about how to be, not about knowing what to do, but how to be. In our medical training, we're trained often how to think and treat, but rarely how to be, how to accompany others. And I often have this image that I tell my trainees of, instead of this hierarchical approach of a fix-it mentality of all we're going to do, when it comes to elements of unavoidable loss, mortality, unavoidable sufferings, I imagine something more like accompaniment, a patient walking through some dark caverns, and I am accompanying them, trying to walk beside them, shining a light as a guide throughout that darkness. So it's a spirit of being and walking with. And it's so tempting in medicine to either avoid the suffering altogether or potentially overidentify with it, where the suffering just becomes so all-consuming like it's our own. And we're taught to instead strike a balance of authentic accompaniment through it. I often teach this key concept in my palli-psych work with my team about formulation. Formulation is a working hypothesis. It's taking a step back and asking, “Why? Why is this patient behaving in this manner? What might the patient's core inner struggle be?” Because asking that “why” and understanding the nuanced dimensions of a patient's core inner struggle will really help guide our therapeutic interactions and guide the way that we accompany them and where we choose to shine that light as we're walking with them. And oftentimes people think, “Well Keri, that sounds so sappy or oversentimental,” and it's not. You know, I'm just thinking about a case that I had a couple months ago, and it was a 28-year-old man with gastric cancer, metastatic disease, and that 28-year-old man, he was actually a college Division I athlete, and his dad was an acclaimed Division I coach. And our typical open-ended palliative care questions, that approach, infuriated them. They needed to know that I was showing up confident, competent, and that I was ready, on my A-game, with a real plan for them to follow through. And so my formulation about them was they needed somebody to show up with that confidence and competence, like the Division I athletes that they were, to really meet them and accompany them where they were on how they were going to walk through that experience of illness. Dr. Hope Rugo: These kinds of insights are so helpful to think about how we manage something that we face every day in oncology care. And I think that there are many ways to manage this.  Maybe I'll ask Dr. Sławkowski-Rode one question just that I think sequences nicely with what you're talking about.  A lot of our patients are trying to think about sort of the bigger picture and how that might help clinicians understand and support patients. So, the whole concept of spirituality, you know, how can we really use that as oncology clinicians to better understand and support patients with advanced illness, and how can that help patients themselves? And we'll talk about that in two different ways, but we'll just start with this broader question. Dr. Mikołaj Sławkowski-Rode: I think spirituality, and here, I usually refer to spirituality in terms of religious belief. Most people in the world are religious believers, and it is very intuitive and natural that religious beliefs would be a resource that people who help patients with a terminal diagnosis and healthcare professionals who work with those patients appeal to when they try to help them deal with the trauma and the stress of these situations.  Now, I think that the interesting thing there is that very often the benefit of appealing to a religious belief is misunderstood in terms of what it delivers. And there are many, many studies on how religious belief can be used to support therapy and to support patients in getting through the experience of suffering and defeating cancer or facing a terminal diagnosis. There's a wealth of literature on this. But most of the literature focuses on this idea that by appealing to religious belief, we help patients and healthcare practitioners who are working with them get over the fact and that there's a terminal diagnosis determining the course of someone's life and get on with our lives and engaging with whatever other pursuits we might have, with our job if we're healthcare practitioners, and with the other things that we might be passionate about in our lives. And the idea here is that this is what religion allows us to do because we sort of defer the need to worry about what's going to happen to us until the afterlife or some perspective beyond the horizon of our life here.  However, my view is – I have worked beyond philosophy also with theologians from many traditions, and my view here is that religion is something that does allow us to get on with our life but not because we're able to move on or move past the concerns that are being threatened by illness or death, but by forming stronger bonds with these things that we value in our life in a way and to have a sense of hope that these will be things that we will be able to keep an attachment to despite the threat to our life. So, in a sense, I think very many approaches in the field have the benefit of religion upside down, as it were, when it comes to helping patients and healthcare professionals who are engaged with their illness and treating it. Dr. Hope Rugo: You know, it's really interesting the points that you make, and I think really important, but, you know, sometimes the oncologists are really struggling with their own emotional reactions, how they are reacting to patients, and dealing with sort of taking on the burden, which, Dr. Brenner, you were mentioning earlier. How can oncologists be aware of their own emotional reactions? You know, they're struggling with this patient who they're very attached to who's dying or whatever the situation is, but you want to avoid burnout as an oncologist but also understand the patient's inner world and support them. Dr. Keri Brenner: I believe that these affective, emotional states, they're contagious. As we accompany patients through these tragic losses, it's very normal and expected that we ourselves will experience that full range of the human experience as we accompany the patients. And so the more that we can recognize that this is a normative dimension of our work, to have a nonjudgmental stance about the whole panoramic set of emotions that we'll experience as we accompany patients with curiosity and openness about that, the more sustainable the work will become. And I often think about the concept of countertransference given to us by Sigmund Freud over 100 years ago. Countertransference is the clinician's response to the patient, the thoughts, feelings, associations that come up within us, shaped by our own history, our own life events, those unconscious processes that come to the foreground as we are accompanying patients with illness. And that is a natural part of the human experience. Historically, countertransference was viewed as something negative, and now it's actually seen as a key that can unlock and enlighten the formulation about what might be going on within the patient themselves even. You know, I was with a patient a couple weeks ago, and I found myself feeling pretty helpless and hopeless in the encounter as I was trying to care for them. And I recognized that countertransference within myself that I was feeling demoralized. It was a prompt for me to take a step back, get on the balcony, and be curious about that because I normally don't feel helpless and hopeless caring for my patients. Well, ultimately, I discovered through processing it with my interdisciplinary team that the patient likely had demoralization as a clinical syndrome, and so it's natural many of us were feeling helpless and hopeless also accompanying them with their care. And it allowed us to have a greater interdisciplinary approach and a more therapeutic response and deeper empathy for the patient's plight. And we can really be curious about our countertransferences. You know, a few months ago, I was feeling bored and distracted in a family meeting, which is quite atypical for me when I'm sharing serious illness news. And it was actually a key that allowed me to recognize that the patient was trying to distract all of us talking about inconsequential facts and details rather than the gravitas of her illness.  Being curious about these affective states really allows us to have greater sustainability within our own practice because it normalizes that human spectrum of emotions and also allows us to reduce unconscious bias and have greater inclusivity with our practice because what Freud also said is that what we can't recognize and say within our own selves, if we don't have that self-reflective capacity, it will come out in what we do. So really recognizing and having the self-awareness and naming some of these emotions with trusted colleagues or even within our own selves allows us to ensure that it doesn't come out in aberrant behaviors like avoiding the patient, staving off that patient till the end of the day, or overtreating, offering more chemotherapy or not having the goals of care, doing everything possible when we know that that might result in medically ineffective care. Dr. Hope Rugo: Yeah, I love the comments that you made, sort of weaving in Freud, but also, I think the importance of talking to colleagues and to sharing some of these issues because I do think that oncologists suffer from the fact that no one else in your life wants to hear about dying people. They don't really want to hear about the tragic cases either. So, I think that using your community, your oncology community and greater community within medicine, is an important part of being able to sort of process. Dr. Keri Brenner: Yes, and Dr. Rugo, this came up in our ASCO [Education] Session. I'd love to double click into some of those ways that we can do this that aren't too time consuming in our everyday practice. You know, within palliative care, we have interdisciplinary rounds where we process complex cases. Some of us do case supervision with a trusted mentor or colleague where we bring complex cases to them. My team and I offer process rounds virtually where we go through countertransference, formulation, and therapeutic responses on some tough cases.  You know, on a personal note, just last week when I left a family meeting feeling really depleted and stuck, I called one of my trusted colleagues and just for 3 minutes constructively, sort of cathartically vented what was coming up within me after that family meeting, which allowed me to have more of an enlightened stance on what to do next and how to be therapeutically helpful for the case. One of my colleagues calls this "friend-tors." They coined the phrase, and they actually wrote a paper about it. Who within your peer group of trusted colleagues can you utilize and phone in real time or have process opportunities with to get a pulse check on where what's coming up within us as we're doing this work? Dr. Hope Rugo: Yeah, and it's an interesting question about how one does that and, you know, maintaining that as you move institutions or change places or become more senior, it's really important.  One of the, I think, the challenges sometimes is that we come from different places from our patients, and that can be an issue, I think when our patients are very religious and the provider is not, or the reverse, patients who don't have religious beliefs and you're trying to sort of focus on the spirituality, but it doesn't really ring true. So, Dr. Sławkowski-Rode, what resources can patients and practitioners draw on when they're facing death and loss in the absence of, or just different religious beliefs that don't fit into the standard model? Dr. Mikołaj Sławkowski-Rode: You're absolutely right that this can be an extremely problematic situation to be in when there is that disconnect of religious belief or more generally spiritual engagement with the situation that we're in. But I just wanted to tie into what Dr. Brenner was saying just before. I couldn't agree more, and I think that a lot of healthcare practitioners, oncologists in particular who I've had the pleasure to talk to at ASCO and at other events as well, are very often quite skeptical about emotional engagement in their profession. They feel as though this is something to be managed, as it were, and something that gets in the way. And they can often be very critical of methods that help them understand the emotions and extend them towards patients because they feel that this will be an obstacle to doing their job and potentially an obstacle also to helping patients to their full ability if they focus on their own emotions or the burden that emotionally, spiritually, and in other ways the illness is for the patient. They feel that they should be focusing on the cancer rather than on the patient's emotions. And I think that a useful comparison, although, you know, perhaps slightly drastic, is that of combat experience of soldiers. They also need to be up and running and can't be too emotionally invested in the situation that they're in. But there's a crucial difference, which is that soldiers are usually engaged in very short bursts of activity with the time to go back and rethink, and they often have a lot of support for this in between. Whereas doctors are in a profession where their exposure to the emotions of patients and their own emotions, the emotions of families of patients is constant. And I think that there's a great danger in thinking that this is something to be avoided and something to compartmentalize in order to avoid burnout. I think, in a way, burnout is more sure to happen if your emotions and your attachment to your patients goes ignored for too long. So that's just following up on Keri's absolutely excellent points. As far as the disconnect is concerned, that's, in fact, an area in which I'm particularly interested in. That's where my research comes in. I'm interested in the kinds of connections that we have with other people, especially in terms of maintaining bonds when there is no spiritual belief, no spiritual backdrop to support this connection. In most religious traditions, we have the framework of the religious belief that tells us that the person who we've lost or the values that have become undermined in our life are something that hasn't been destroyed permanently but something that we can still believe we have a deep connection to despite its absence from our life. And how do you rebuild that sense of the existence of the things that you have perceivably lost without the appeal to some sort of transcendent realm which is defined by a given religion? And that is a hard question. That's a question, I think, that can be answered partly by psychology but also partly by philosophy in terms of looking at who we are as human beings and our nature as people who are essentially, or as entities that are essentially connected to one another. That connection, I believe, is more direct than the mediation of religion might at first suggest. I think that we essentially share the world not only physically, it's not just the case that we're all here, but more importantly, the world that we live in is not just the physical world but the world of meanings and values that helps us orient ourselves in society and amongst one another as friends and foes. And it is that shared sense of the world that we can appeal to when we're thinking about retaining the value or retaining the connection with the people who we have lost or the people who are helping through, go through an experience of facing death. And just to finish, there's a very interesting question, I think, something that we possibly don't have time to explore, about the degree of connection that we have with other people. So, what I've just been saying is something that rings more true or is more intuitive when we think about the connections that we have to our closest ones. We share a similar outlook onto the world, and our preferences and our moods and our emotions and our values are shaped by life with the other person. And so, appealing to these values can give us a sense of a continued presence. But what in those relationships where the connection isn't that close? For example, given the topic of this podcast, the connection that a patient has with their doctor and vice versa. In what sense can we talk about a shared world of experience? Well, I think, obviously, we should admit degrees to the kind of relationship that can sustain our connection with another person. But at the same time, I don't think there's a clear cutoff point. And I think part of emotional engagement in medical practice is finding yourself somewhere on that spectrum rather than thinking you're completely off of it. That's what I would say. Dr. Hope Rugo: That's very helpful and I think a very helpful way of thinking about how to manage this challenging situation for all of us.  One of the things that really, I think, is a big question for all of us throughout our careers, is when to address the dying process and how to do that. Dr. Brenner, you know, I still struggle with this – what to do when patients refuse to discuss end-of-life but they're very close to end of life? They don't want to talk about it. It's very stressful for all of us, even where you're going to be, how you're going to manage this. They're just absolutely opposed to that discussion. How should we approach those kinds of discussions? How do we manage that? How do you address the code discussion, which is so important? You know, these patients are not able to stay at home at end-of-life in general, so you really do need to have a code discussion before you're admitting them. It actually ends up being kind of a challenge and a mess all around. You know, I would love your advice about how to manage those situations. Dr. Keri Brenner: I think that's one of the most piercing and relevant inquiries we have within our clinical work and challenges. I often think of denial not as an all-or-nothing concept but rather as parts of self. There's a part of everyone's being where the unconscious believes it's immortal and will live on forever, and yet we all know intellectually that we all have mortality and finitude and transience, and that time will end. We often think of this work as more iterative and gradual and exposure based. There's potency to words. Saying, “You are dying within days,” is a lot higher potency of a phrase to share than, “This is serious illness. This illness is incurable. Time might be shorter than we hoped.” And so the earlier and more upstream we begin to have these conversations, even in small, subtle ways, it starts to begin to expose the patient to the concept so they can go from the head to the heart, not only knowing their prognosis intellectually but also affectively, to integrate it into who they are as a person because all patients are trying to live well while also we're gradually exposing them to this awareness of mortality within their own lived experience of illness. And that, ideally, happens gradually over time. Now, there are moments where the medical frame is very limited, and we might have short days, and we have to uptitrate those words and really accompany them more radically through those high-affective moments. And that's when we have to take a lot of more nuanced approaches, but I would say the more earlier and upstream the better. And then the second piece to that question as well is coping with our own mortality. The more we can be comfortable with our own transience and finitude and limitations, the more we will be able to accompany others through that. And even within my own life, I've had to integrate losses in a way where before I go in to talk to one of my own palliative care patients, one mantra I often say to myself is, “I'm just a few steps behind you. I don't know if it's going to be 30 days or 30 years, but I'm just a few steps behind you on this finite, transient road of life that is the human experience.” And that creates a stance of accompaniment that patients really can experience as they're traversing these tragedies. Dr. Hope Rugo: That's great. And I think those are really important points and actually some pearls, which I think we can take into the clinic. I think being really concrete when really the expected life expectancy is a few days to a couple of weeks can be very, very helpful. And making sure the patients hear you, but also continuing to let them know that, as oncologists, we're here for them. We're not abandoning them. I think that's a big worry for many, certainly of my patients, is that somehow when they would go to hospice or be a ‘no code', that we're not going to support them anymore or treat them anymore. That is a really important process of that as well. And of course, engaging the team makes a big difference because the whole oncology team can help to manage situations that are particularly challenging like that. And just as we close, I wanted to ask one last question of you, Dr. Brenner, that suffering, grief, and burnout, you've really made the point that these are not problems to fix but dimensions that we want to attend to and acknowledge as part of our lives, the dying process is part of all of our lives. It's just dealing with this in the unexpected and the, I think, unpredictability of life, you know, that people take on a lot of guilt and all sorts of things about, all sorts of emotions. And the question is now, people have listened to this podcast, what can they take back to their oncology teams to build a culture that supports clinicians and their team at large to engage with these realities in a meaningful and sustainable way? I really feel like if we could build the whole team approach where we're supporting each other and supporting the patients together, that that will help this process immeasurably. Dr. Keri Brenner: Yes, and I'm thinking about Dr. Sławkowski-Rode's observation about the combat analogy, and it made me recognize this distinction between suppression and repression. Repression is this unconscious process, and this is what we're taught to do in medical training all the time, to just involuntarily shove that tragedy under the rug, just forget about it and see the next patient and move on. And we know that if we keep unconsciously shoving things under the rug, that it will lead to burnout and lack of sustainability for our clinical teams. Suppression is a more conscious process. That deliberate effort to say, “This was a tragedy that I bore witness to. I know I need to put that in a box on the shelf for now because I have 10 other patients I have to see.” And yet, do I work in a culture where I can take that off the shelf during particular moments and process it with my interdisciplinary team, phone a friend, talk to a trusted colleague, have some trusted case supervision around it, or process rounds around it, talk to my social worker? And I think the more that we model this type of self-reflective capacity as attendings, folks who have been in the field for decades, the more we create that ethos and culture that is sustainable because clinician self-reflection is never a weakness, rather it's a silent strength. Clinician self-reflection is this portal for wisdom, connectedness, sustainability, and ultimately transformative growth within ourselves. Dr. Hope Rugo: That's such a great point, and I think this whole discussion has been so helpful for me and I hope for our audience that we really can take these points and bring them to our practice. I think, “Wow, this is such a great conversation. I'd like to have the team as a whole listen to this as ways to sort of strategize talking about the process, our patients, and being supportive as a team, understanding how we manage spirituality when it connects and when it doesn't.” All of these points, they're bringing in how we process these issues and the whole idea of suppressing versus sort of deciding that it never happened at all is, I think, very important because that's just a tool for managing our daily lives, our busy clinics, and everything we manage. Dr. Keri Brenner: And Dr. Rugo, it's reminding me at Stanford, you know, we have this weekly practice that's just a ritual where every Friday morning for 30 minutes, our social worker leads a process rounds with us as a team, where we talk about how the work that we're doing clinically is affecting us in our lives in ways that have joy and greater meaning and connectedness and other ways that might be depleting. And that kind of authentic vulnerability with one another allows us to show up more authentically for our patients. So those rituals, that small 30 minutes once a week, goes a long way. And it reminds me that sometimes slowing things down with those rituals can really get us to more meaningful, transformative places ultimately. Dr. Hope Rugo: It's a great idea, and I think, you know, making time for that in everybody's busy days where they just don't have any time anymore is important. And you don't have to do it weekly, you could even do something monthly. I think there's a lot of options, and that's a great suggestion. I want to thank you both for taking your time out for this enriching and incredibly helpful conversation. Our listeners will find a link to the Ed Book article we discussed today, which is excellent, in the transcript of this episode. I want to thank you again, Dr. Brenner and Dr. Sławkowski-Rode, for your time and for your excellent thoughts and advice and direction. Dr. Mikołaj Sławkowski-Rode: Thank you very much, Dr. Rugo. Dr. Keri Brenner: Thank you. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at the education sessions from ASCO meetings and our deep dives on new approaches that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:      Dr. Hope Rugo @hope.rugo Dr. Keri Brenner @keri_brenner Dr. Mikolaj Slawkowski-Rode @MikolajRode Follow ASCO on social media:      @ASCO on X (formerly Twitter)      ASCO on Bluesky     ASCO on Facebook      ASCO on LinkedIn      Disclosures:     Dr. Hope Rugo: Honoraria: Mylan/Viatris, Chugai Pharma Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx Dr. Keri Brenner: No relationships to disclose Dr. Mikolaj Slawkowski-Rode: No relationships to disclose    

Screening has moved front and center in the conversation around type 1 diabetes. But we're just at the very beginning of this – what do we really need to know? I'm talking to Dr. Shara Bialo – she's a pediatric endocrinologist who lives with type 1. She was diagnosed as a kid while in DKA. She's working with Sanofi to push for screening, but this is personal – we talk about wanting better guidelines, and more mental health support. And how do we move this research into the general population, where it can have the greatest impact? More about screening here  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with Ben Mar here Join us at an upcoming Moms' Night Out event! Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.

This episode covers: Cardiology This Week: A concise summary of recent studies Big data in cardiology Measuring lipids: what clinicians need to know Milestones Host: Perry Elliott Guests: Carlos Aguiar, Karim Lekadir, Kostas Koskinas Want to watch that episode? Go to: https://esc365.escardio.org/event/1808 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Nicolle Kraenkel and Karim Lekadir have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Kostas Koskinas has declared to have potential conflicts of interest to report: speaker fees / honoraria from MSD, Daiichi-Sankyo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Perry Elliott Guest: Karim Lekadir Want to watch that episode? Go to: https://esc365.escardio.org/event/1808?r Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Nicolle Kraenkel and Karim Lekadir have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson."

Ep.250 Valerie A. Francis is the Founding Director of Knowhere Art Gallery, an independent gallery based on Martha's Vineyard dedicated to showcasing emerging and mid-career artists from diverse backgrounds. The gallery champions inclusive narratives and celebrates the cultural intersections that shape contemporary art today. With a career that bridges global technology innovation and entrepreneurial ventures in the arts, Valerie brings a rare and dynamic blend of strategy, creativity, and cultural insight to every endeavor she leads. Originally trained as an artist, Valerie earned a BFA in Fine Arts from Hunter College CUNY and later an MBA from Rutgers University, specializing in Marketing. Her professional journey took a transformative turn when she entered the world of global healthcare technology at Sanofi, where she rose to serve as a Technology Head leading digital strategy and analytics for teams across North America, Latin America, and Asia. Immersed in a melting pot of cultures and perspectives, she thrived on the diversity and camaraderie forged across continents. Valerie's unwavering commitment to her artistic roots led her to co-found Knowhere Art Gallery in 2019 — a haven where creativity flourishes and artists find their voice. Since its inception, the gallery has achieved remarkable success, becoming a destination for collectors and cultural leaders alike. Under her curatorial direction, Knowhere has presented more than twenty-five exhibitions and introduced the work of over thirty artists. Signature moments include its participation in SCOPE Art Fair (2021–2023) and an acclaimed presentation during the 60th Venice Biennale in 2024 with A Common Thread That Binds Us. As a board member of Artists for Humanity in Boston, Valerie has further committed her passion to action, supporting youth empowerment through creativity and entrepreneurship. She is also dedicated to mentoring artists, cultivating private and corporate art collections, and building institutional collaborations that elevate voices from across the art world. Valerie often describes the founding of Knowhere—conceived on Martha's Vineyard, where she met her partner—as “the nexus of Knowhere,” a place where art, identity, and knowledge converge. Through her work, she continues to sow the seeds of cultural legacy and foster environments where art becomes a catalyst for discovery, connection, and transformation. Website https://knowhereart.com/ 1-54 2025 NYC https://www.1-54.com/new-york/exhibitor-list/knowhere-art-gallery/ artcloud https://artcloud.market/show/knowhere-art-llc-women-rising MV Arts & Ideas https://www.mvartsandideas.com/2024/07/the-road-to-enlightenment-starts-at-knowhere/ Vineyard Gazette https://vineyardgazette.com/news/2024/05/05/knowhere-gallery-showcased-venice-biennale Vineyard Visitor https://vineyardvisitor.com/2024/08/08/art-in-oak-bluffs/knowhere-gallery/ Martha's Vineyard Times https://hype.co/@themarthasvineyardtimes/2z7j289w | https://www.mvtimes.com/2024/06/12/meets-eye-knowhere-art-cousen-rose-galleries/ Martha's Vineyard Arts and Ideas https://www.mvartsandideas.com/2024/07/the-road-to-enlightenment-starts-at-knowhere/ Artsy https://www.artsy.net/partner/knowhere-art

Dr. Neeraj Agarwal and Dr. Jeanny Aragon-Ching discuss important advances in the treatment of prostate, bladder, and kidney cancers that were presented at the 2025 ASCO Annual Meeting. TRANSCRIPT Dr. Neeraj Agarwal: Hello, and welcome to the ASCO Daily News Podcast. I am Dr. Neeraj Agarwal, your guest host of the ASCO Daily News Podcast today. I am the director of the Genitourinary Oncology Program and a professor of medicine at the University of Utah Huntsman Cancer Institute and editor-in-chief of the ASCO Daily News.  I am delighted to be joined by Dr. Jeanny Aragon-Ching, a GU medical oncologist and the clinical program director of the GU Center at the Inova Schar Cancer Institute in Virginia. Today, we will be discussing some key abstracts in GU oncology that were presented at the 2025 ASCO Annual Meeting.  Our full disclosures are available in the transcript of this episode.  Jeanny, it is great to have you on the podcast. Dr. Jeanny Aragon-Ching: Oh, thank you so much, Neeraj. Dr. Neeraj Agarwal: Jeanny, let's begin with some prostate cancer abstracts. Let's begin with Abstract 5017 titled, “Phase 1 study results of JNJ-78278343 (pasritamig) in metastatic castration-resistant prostate cancer.” Can you walk us through the design and the key findings of this first-in-human trial? Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So this study, presented by Dr. Capucine Baldini, introduces pasritamig, a first-in-class T-cell redirecting bispecific antibody that simultaneously binds KLK2 on prostate cancer cells and CD3 receptor complexes on T cells. KLK2 is also known as human kallikrein 2, which is selectively expressed in prostate tissue. And for reference, KLK3 is what we now know as the PSA, prostate-specific antigen, therefore making it an attractive and specific target for therapeutic engagement. Now, while this was an early, first-in-human, phase 1 study, it enrolled 174 heavily pretreated metastatic CRPC patients. So many were previously treated with ARPIs, taxanes, and radioligand therapy. So given the phase 1 nature of this study, the primary objective was to determine the safety and the RP2D, which is the recommended phase 2 dose. Secondary objectives included preliminary assessment of antitumor activity. So, pasritamig was generally well tolerated. There were no treatment-related deaths. Serious adverse events were rare. And in the RP2D safety cohort, where patients received the step-up dosing up to 300 mg of IV every 6 weeks, the most common treatment-related adverse events were low-grade infusion reactions. There was fatigue and grade 1 cytokine release syndrome, what we call CRS. And no cases of neurotoxicity, or what we call ICANS, the immune effector cell-associated neurotoxicity syndrome, reported. Importantly, the CRS occurred in just about 8.9% of patients. All were grade 1. No patients required tocilizumab or discontinued treatment due to adverse events. So, this suggests a favorable safety profile, allowing hopefully for outpatient administration without hospitalization, which will be very important when we're thinking about bispecifics moving forward. In terms of efficacy, pasritamig showed promising activity. About 42.4% of evaluable patients achieved a PSA50 response. Radiographic PFS was about 6.8 months. And among patients with measurable disease, the objective response rate was about 16.1% in those with lymph node or bone metastases, and about 3.7% in those with visceral disease, with a median duration of response of about 11.3 months. So, altogether, this data suggests that pasritamig may offer a well-tolerated and active new potential option for patients with metastatic CRPC.   Again, as a reminder, with the caveat that this is still an early phase 1 study. Dr. Neeraj Agarwal: Thank you, Jeanny. These are promising results for a bispecific T-cell engager, pasritamig, in prostate cancer. I agree, the safety and durability observed here stand out, and this opens the door for further development, possibly even in earlier disease settings.  So, shifting now from immunotherapy to the evolving role of genomics in prostate cancer. So let's discuss Abstract 5094, a real-world, retrospective analysis exploring the prognostic impact of homologous recombination repair gene mutations, especially BRCA1 and BRCA2 mutations, in metastatic hormone-sensitive prostate cancer. Can you tell us more about this abstract, Jeanny? Dr. Jeanny Aragon-Ching: Sure, Neeraj. So this study was presented by Dr. David Olmos, represents one of the largest real-world analyses we have evaluating the impact of homologous recombination repair, or what we would call HRR, alterations in metastatic hormone-sensitive prostate cancer. So, this cohort included 556 men who underwent paired germline and somatic testing. Now, about 30% of patients had HRR alterations, with about 12% harboring BRCA1 or BRCA2 mutations and 16% having alterations in other HRR genes. Importantly, patients were stratified via CHAARTED disease volume, and outcomes were examined across treatment approaches, including ADT alone, doublet therapy, and triplet therapy. The prevalence of BRCA and HRR alterations were about similar between the metastatic hormone-sensitive prostate cancer and the metastatic castrate-resistant prostate cancer, with no differences observed, actually, between the patients with high volume versus low volume disease.  So, the key finding was that BRCA and HRR alterations were associated with poor clinical outcomes in metastatic hormone-sensitive prostate cancer. And notably, the impact of these alterations may actually be even greater in metastatic hormone-sensitive prostate cancer than previously reported in metastatic CRPC. So, the data showed that when BRCA mutations are present, the impact of the volume of disease is actually limited. So, poor outcomes were observed across the board for both high-volume and low-volume groups. So, the analysis showed that patients with HRR alterations had significantly worse outcomes compared to patients without HRR alterations. Median radiographic progression-free survival was about 20.5 months for the HRR-altered patients versus 30.6 months for the non-HRR patients, with a hazard ratio of 1.6. Median overall survival was 39 months for HRR-altered patients compared to 55.7 months for the non-HRR patients, with a hazard ratio of 1.5. Similar significant differences were observed when BRCA-mutant patients were compared with patients harboring non-BRCA HRR mutations. Overall, poor outcomes were independent of treatment of ARPI or taxanes. Dr. Neeraj Agarwal: Thank you, Jeanny. So, these data reinforce homologous recombination repair mutations as both a predictive and prognostic biomarker, not only in the mCRPC, but also in the metastatic hormone-sensitive setting as well. It also makes a strong case for incorporating genomic testing early in the disease course and not waiting until our patients have castration-resistant disease. Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. And I think this really brings home the point and the lead up to the AMPLITUDE trial, which is LBA5006, a phase 3 trial that builds on this very concept of testing with a PARP inhibitor, niraparib, in the hormone-sensitive space. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the AMPLITUDE trial, a phase 3 trial presented by Dr. Gerhardt Attard, enrolled 696 patients with metastatic hormone-sensitive prostate cancer and HRR gene alterations. 56% of these patients had BRCA1 and BRCA2 mutations. Patients were randomized to receive abiraterone with or without niraparib, a PARP inhibitor. The majority of patients, 78% of these patients, had high-volume metastatic hormone-sensitive prostate cancer, and 87% of these patients had de novo metastatic HSPC. And 16% of these patients received prior docetaxel, which was allowed in the clinical trial. So, with a median follow-up of nearly 31 months, radiographic progression-free survival was significantly prolonged with the niraparib plus abiraterone combination, and median was not reached in this arm, compared to abiraterone alone, which was 29.5 months, with a hazard ratio of 0.63, translating to a 37% reduction in risk of progression or death. This benefit was even more pronounced in the BRCA1 and BRCA2 subgroup, with a 48% reduction in risk of progression, with a hazard ratio of 0.52. Time to symptomatic progression also improved significantly across all patients, including patients with BRCA1, BRCA2, and HRR mutations. Although overall survival data remain immature, early trends favored the niraparib plus abiraterone combination. The safety profile was consistent with prior PARP inhibitor studies, with grade 3 or higher anemia and hypertension were more common but manageable. Treatment discontinuation due to adverse events remained low at 11%, suggesting that timely dose modifications when our patients experience grade 3 side effects may allow our patients to continue treatment without discontinuation. These findings support niraparib plus abiraterone as a potential new standard of care in our patients with metastatic hormone-sensitive prostate cancer with HRR alterations, and especially in those who had BRCA1 and BRCA2 mutations. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. This trial is especially exciting because it brings PARP inhibitors earlier into the treatment paradigm. Dr. Neeraj Agarwal: Exactly. And it is exciting to see the effect of PARP inhibitors in the earlier setting.  So Jeanny, now let's switch gears a bit to bladder cancer, which also saw several impactful studies. Could you tell us about Abstract 4502, an exploratory analysis from the EV-302 trial, which led to approval of enfortumab vedotin plus pembrolizumab for our patients with newly diagnosed metastatic bladder cancer? So here, the authors looked at the outcomes in patients who achieved a confirmed complete response with EV plus pembrolizumab. Dr. Jeanny Aragon-Ching: Sure, Neeraj. So, EV-302 demonstrated significant improvements in progression-free and overall survival for patients previously treated locally advanced or metastatic urothelial cancer, I'll just call it metastatic UC, as a frontline strategy, establishing EV, which is enfortumab vedotin, plus pembro, with pembrolizumab as standard of care in this setting.  So, this year at ASCO, Dr Shilpa Gupta presented this exploratory responder analysis from the phase 3 EV-302 trial. Among 886 randomized patients, about 30.4% of patients, this is about 133, in the EV+P arm, and 14.5% of the patients in the chemotherapy arm, achieved a confirmed complete response. They call it the CCR rates. So for patients who achieved this, median PFS was not reached with EV+P compared to 26.9 months with chemotherapy, with a hazard ratio of 0.36, translating to a 64% reduction in the risk of progression. Overall survival was also improved. So the median OS was not reached in either arm, but the hazard ratio favored the EV+P at 0.37, translating to a 63% reduction in the risk of death. The median duration of complete response was not reached with EV+P compared to 15.2 months with chemotherapy. And among those patients who had confirmed CRs at 24 months, 78% of patients with the EV+P arm remained progression-free, and around 95% of the patients were alive, compared to 54% of patients who were progression-free and 86% alive of the patients in the chemotherapy arm. Safety among responders were also consistent with prior reports. Grade 3 or higher treatment-related adverse events occurred in 62% of EV+P responders and 72% of chemotherapy responders. Most adverse events were managed with dose modifications, and importantly, no treatment-related deaths were reported among those who were able to achieve complete response.  So these findings further reinforce EV and pembro as the preferred first-line therapy for metastatic urothelial carcinoma, offering a higher likelihood of deep, durable responses with a fairly manageable safety profile. Dr. Neeraj Agarwal: Thank you for the great summary, Jeanny. These findings underscore the depth and durability of responses achievable with this combination and also suggest that achieving a response may be a surrogate for long-term benefit in patients with metastatic urothelial carcinoma.  So now, let's move to Abstract 4503, an exploratory ctDNA analysis from the NIAGARA trial, which evaluated perioperative durvalumab, an immune checkpoint inhibitor, in muscle-invasive bladder cancer. So what can you tell us about this abstract? Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. So, in NIAGARA, presented by Dr. Tom Powles, the addition of perioperative durvalumab to neoadjuvant chemotherapy, gem/cis, significantly improved event-free survival, overall survival, and pathologic complete response in patients with cisplatin-eligible muscle-invasive bladder cancer. Recall that this led to the U.S. FDA approval of this treatment regimen on March 28, 2025.  So, a planned exploratory analysis evaluated the ctDNA dynamics and their association with clinical outcomes, which was the one presented recently at ASCO. So, the study found that the incidence of finding ctDNA positivity in these patients was about 57%. Following neoadjuvant treatment, this dropped to about 22%, with ctDNA clearance being more common in the durvalumab arm, about 41%, compared to the chemotherapy control arm of 31%. Notably, 97% of patients who remained ctDNA positive prior to surgery failed to achieve a pathologic CR. So, this indicates a strong association between ctDNA persistence and lack of tumor eradication. So, postoperatively, only about 9% of patients were ctDNA positive. So, importantly, durvalumab conferred an event-free survival benefit regardless of ctDNA status at both baseline and post-surgery. Among patients who were ctDNA positive at baseline, durvalumab led to a hazard ratio of 0.73 for EFS. So, this translates to a 27% reduction in the risk of disease recurrence, progression, or death compared to the control arm. In the post-surgical ctDNA-positive group, the disease-free survival was also improved with a hazard ratio of 0.49, translating to a 51% reduction in the risk of recurrence.  So, these findings underscore the prognostic value of ctDNA and suggest that durvalumab provides clinical benefit irrespective of molecular residual disease status. So, the data also supports that ctDNA is a promising biomarker for future personalized strategies in the perioperative treatment of muscle-invasive bladder cancer. Dr. Neeraj Agarwal: Thank you, Jeanny. It is great to see that durvalumab is improving outcomes in these patients regardless of ctDNA status. However, based on these data, presence of ctDNA in our patients warrants a closer follow-up with imaging studies, because these patients with positive ctDNA seem to have a higher risk of recurrence. Dr. Jeanny Aragon-Ching: I agree, Neeraj.  Let's round out the bladder cancer discussion with Abstract 4518, which reported the interim results of SURE-02, which is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab in cisplatin-ineligible muscle-invasive bladder cancer. Can you tell us more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure, Jeanny. So, Dr Andrea Necchi presented interim results from the SURE-02 trial. This is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab, followed by a response-adapted bladder-sparing treatment and adjuvant pembrolizumab in patients with muscle-invasive bladder cancer.  So, in this interim analysis, 40 patients were treated and 31 patients were evaluable for efficacy. So, the clinical complete response rate was 38.7%. All patients achieving clinical complete response underwent bladder-sparing approach with a repeat TURBT instead of radical cystectomy. Additionally, 51.6% of patients achieved excellent pathologic response with a T stage of 1 or less after neoadjuvant therapy. The treatment was well tolerated, with only 12.9% of patients experiencing grade 3 or higher adverse events without needing dose reduction of sacituzumab. Molecular profiling, interestingly, showed that clinical complete response correlated with luminal and genomically unstable subtypes, while high stromal gene expression was associated with lack of response.  These results suggest that sacituzumab plus pembrolizumab combination has promising activity in this setting, and tolerability, and along with other factors may potentially allow a bladder preservation approach in a substantial number of patients down the line. Dr. Jeanny Aragon-Ching: Yeah, agree with you, Neeraj. And the findings are very provocative and support completing the full trial enrollment and further exploration of this strategy in muscle-invasive bladder cancer in order to improve and provide further bladder-sparing strategies. Dr. Neeraj Agarwal: Agree. So, let's now turn to the kidney cancer, starting with Abstract 4505, the final overall analysis from CheckMate-214 trial, which evaluated nivolumab plus ipilimumab, so dual checkpoint inhibition strategy, versus sunitinib in our patients with metastatic clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So, the final 9-year analysis of the phase 3 CheckMate-214 trial confirms the long-term superiority of nivolumab and ipilimumab over sunitinib for first-line treatment of advanced metastatic renal cell carcinoma. So, this has a median follow-up of 9 years. Overall survival remains significantly improved with the combination. So, in the ITT patient population, the intention-to-treat, the hazard ratio for overall survival was 0.71. So, this translates to a 29% reduction in the risk of death. 31% of patients were alive at this 108-month follow-up compared to 20% only in those who got sunitinib. So, similar benefits were observed in the intermediate- and poor-risk groups with a hazard ratio of 0.69, and 30% versus 19% survival at 108 months.  Importantly, a delayed benefit was also seen in those favorable-risk patients. So, the hazard ratio for overall survival improved from 1.45 in the initial report and now at 0.8 at 9 years follow-up, with 35% of patients alive at 108 months compared to 22% in those who got sunitinib. Progression-free survival also favored the nivo-ipi arm across all risk groups. At 96 months, the probability of remaining progression-free was about 23% compared to 9% in the sunitinib arm in the ITT patient population, 25% versus 9% in the intermediate- and poor-risk patients, and 13% compared to 11% in the favorable-risk patients. Importantly, at 96 months, 48% of patients in the nivo-ipi responders remained in response compared to just 19% in those who got sunitinib. And in the favorable-risk group, 36% of patients who responded remained in response, although data were not available for sunitinib in this subgroup.  So, this data reinforces the use of nivolumab and ipilimumab as a durable and effective first-line effective strategy for standard of care across all risk groups for advanced renal cell carcinoma. Dr. Neeraj Agarwal: Thank you, Jeanny. And of course, since ipi-nivo data were presented, several other novel ICI-TKI combinations have emerged. And I'm really hoping to see very similar data with TKI-ICI combinations down the line. It is really important to note that we are not seeing any new safety signals with the ICI combinations or ICI-based therapies, which is very reassuring given the extended exposure. Dr. Jeanny Aragon-Ching: Absolutely agree with you there, Neeraj.  Now, going on and moving on to Abstract 4514, which is the KEYNOTE-564 trial, and they reported on the 5-year outcomes of adjuvant pembrolizumab in clear cell RCC in patients who are at high risk for recurrence. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the KEYNOTE-564 trial established pembrolizumab monotherapy as the first adjuvant regimen to significantly improve both disease-free survival and overall survival compared to placebo after surgery for patients with clear cell renal cell carcinoma. So, Dr Naomi Haas presented the 5-year update from this landmark trial.  A total of 994 patients were randomized to receive either pembrolizumab or placebo. The median follow-up at the time of this analysis was approximately 70 months. Disease-free survival remained significantly improved with pembrolizumab. The median DFS was not reached with pembrolizumab compared to 68.3 months with placebo, with a hazard ratio of 0.71, translating to a 29% reduction in risk of recurrence. At 5 years, 60.9% of patients receiving pembrolizumab remained disease-free compared to 52.2% with placebo. Overall survival also favored pembrolizumab. The hazard ratio for OS was 0.66, translating to a 34% reduction in risk of death, with an estimated 5-year overall survival rate of 87.7% with pembrolizumab compared to 82.3% for placebo. Importantly, these benefits were consistent across all key subgroups, including patients with sarcomatoid features. In addition, no new serious treatment-related adverse events have been reported in the 3 years since treatment completion.  So, these long-term data confirm pembrolizumab as a durable and effective standard adjuvant therapy for patients with resected, high-risk clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Thank you for that wonderful summary, Neeraj. Dr. Neeraj Agarwal: That wraps up our kidney cancer highlights. Any closing thoughts, Jeanny, before we conclude? Dr. Jeanny Aragon-Ching: It's been so wonderful reviewing these abstracts with you, Neeraj. So, the 2025 ASCO Annual Meeting showcased a lot of transformative data across GU cancers, from first-in-class bispecifics to long-term survival in RCC. And these findings are already shaping our clinical practices. Dr. Neeraj Agarwal: I agree. And we have covered a broad spectrum of innovations in GU cancers with strong clinical relevance.  So, thank you, Jeanny, for joining me today and sharing your insights.  And thank you to our listeners for joining us. You will find links to the abstracts discussed today in the transcript of this episode. If you find these conversations valuable, please take a moment to rate, review, and subscribe to the ASCO Daily News Podcast wherever you listen. Thank you so much. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:    Dr. Neeraj Agarwal     @neerajaiims     Dr. Jeanny Aragon-Ching   Follow ASCO on social media:       @ASCO on Twitter       ASCO on Bluesky   ASCO on Facebook       ASCO on LinkedIn       Disclosures:   Dr. Neeraj Agarwal:   Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences  Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas  Dr. Jeanny Aragon-Ching:   Honoraria: Bristol-Myers Squibb, EMD Serono, Astellas Scientific and Medical Affairs Inc., Pfizer/EMD Serono   Consulting or Advisory Role: Algeta/Bayer, Dendreon, AstraZeneca, Janssen Biotech, Sanofi, EMD Serono, MedImmune, Bayer, Merck, Seattle Genetics, Pfizer, Immunomedics, Amgen, AVEO, Pfizer/Myovant, Exelixis,    Speakers' Bureau: Astellas Pharma, Janssen-Ortho, Bristol-Myers Squibb, Astellas/Seattle Genetics

In this podcast episode, Miguel Regueiro, MD, discusses developing the medical home model for patients with IBD, technological advances for patients in GI and more. •    Intro :58 •    The interview/about Regueiro 1:03 •    Tell us about your family and where you grew up. 1:24 •    How did you get interested in medicine? 2:16 •    Who were your early influences?  4:18 •    What is the medical home? 5:57 •    How did you develop the idea to apply the medical home model to IBD? 7:45 •    Did you get any funding from the payers for this model to keep costs under control for this patient population? 10:57 •    Why hasn't this model become standard of care for patients with complex IBD? 14:13 •    What has worked, and what hasn't worked when it comes to adopting an integrative care medical home model? 18:15 •    Are there themes patients share as to why they wouldn't want to be enrolled in a medical home? 21:28 •    What motivated your change to go from UPMC to become the GI Chief of Cleveland Clinic? 23:09 •    What have you learned in this position at Cleveland Clinic? 25:23 •    Are you spending a lot of time on the business side of care as opposed to the patient side? 26:34 •    How would you recommend that people prepare for having a position like this? 27:34 •    Are you seeing a shift in excitement over taking on leadership roles outside of traditional academics? 30:02 •    With our clinical tool chest changing so rapidly, is there a common theme that you use to guide the strategy of the institute on what to invest in? 35:06 •    What are the challenges that you still see in the ways we are using telehealth? 39:05 •    What are some of the most exciting things you see on the horizon in the realm of IBD management? 40:26 •    Thank you, Miguel 42:55 •    Thanks for listening 45:11 Miguel Regueiro, MD, is the chief of the Digestive Disease Institute at Cleveland Clinic, and professor in the department of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. We'd love to hear from you! Send your comments/questions to guttalkpodcast@healio.com. Follow us on X @HealioGastro @sameerkberry @umfoodoc. For more from Regueiro, follow @MRegueiroMD on X. Disclosures: Berry and Chey report no relevant financial disclosures. Regueiro reports being on the advisory boards of and consulting for Abavax, Abbvie, Amgen, Biocon, BMS, Boehringer Ingelheim Pharmaceuticals Inc. (BIPI), Celgene, Celltrion, Gilead, Genentech, Johnson and Johnson, Lilly, Merck, Organon, Pfizer, Prometheus, Roche, Salix, Sanofi, Takeda and UBC.

Episode 178 with Estelle Dogbo, systems strategist, healthcare executive, and founder of BioVana Research. Estelle has spent her career at the intersection of biotechnology, digital health, and pharmaceutical development building adaptive health systems across African markets and beyond. From commercial leadership roles at Sanofi and Roche to co-founding 54gene and Syndicate Bio, Estelle has been a quiet force behind Africa's genomics and health data infrastructure.Now, as CEO and Founding Partner of BioVana Research, Estelle is reimagining how African health data is valued, governed, and transformed into powerful R&D assets. BioVana partners with hospitals, universities, and research institutions to bring structure, visibility, and trust to African biobanking ensuring local data is ethically sourced, verifiable, and globally competitive. Their model turns fragmented sample collections into strategic platforms for precision medicine, AI diagnostics, and responsible global collaboration.In this episode, Estelle shares her bold vision for African data sovereignty, why health systems must be built from the inside out, and how BioVana is helping African institutions shift from being invisible custodians to confident stewards of their own scientific future.What We Discuss With EstelleWhy Africa's vast health datasets have remained invisible in global R&D, and how BioVana is changing that through ethical, locally rooted data governance.The critical role of biobanking infrastructure in unlocking breakthroughs in precision medicine, AI diagnostics, and clinical research across the continent.How BioVana is helping African hospitals and research institutions move from passive data custodians to active stewards in the global health ecosystem.What it means to build health systems “from the inside out” and why imported solutions often fail in high-complexity, low-resource environments.The risks of data extraction and decoupling in African research, and how BioVana ensures that local data remains connected to local value.Did you miss my previous episode where I discuss The Future of Fashion Is African: Building an Ethical Clothing Factory in Rural Kenya? Make sure to check it out!Like this show? Please leave us a review here -- even one sentence helps!Connect with Terser:LinkedIn - Terser AdamuInstagram - unlockingafricaTwitter (X) - @TerserAdamuConnect with Estelle:LinkedIn - Estelle Dogbo MSc and BioVana ResearchDo you want to do business in Africa? Explore the vast business opportunities in African markets and increase your success with ETK Group. Connect with us at www.etkgroup.co.uk or reach out via email at info@etkgroup.co.ukSubscribe to our newsletter for exclusive content, behind-the-scenes insights, and bonus material - Unlocking Africa Newsletter