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You've probably heard that authoritarianism is on the rise across the globe. Increasingly, countries are adopting policies that undermine democracy, reduce accountability, and erode civil liberties and human rights. But why is authoritarianism on the rise, and how do authoritarian leaders come to power? Lauded by Donald Trump and condemned by rights-defenders, Hungary's Prime Minister Viktor Orban provides a useful case study for those hoping to better understand the authoritarians' playbook. This week, host Ngofeen Mputubwele speaks to a Hungarian journalist and civil liberties strategist to map Orban's journey to autocracy, and how his lurch towards authoritarianism has decimated civil liberties and allowed him to exert a stranglehold on Hungarian politics for more than 15 years. Stefania Kopronczay: Former director of the Hungarian Civil Liberties Union; visiting scholar at Columbia University Viktória Serdült: Journalist at HVG.HU
Llegamos al noveno paso en este camino llamado Historia y Teología de la Reforma Radical. En este episodio, el maestro Fabián Cabezas, especialmente aborda el testimonio de las iglesias anabautistas como discípulas del Señor en medio de un contexto de persecución y de sismos sociales. Un Momento de Anabautismo se ha ido al podcast Textos IBA y traemos esta bella serie que nos cuenta sobre las bases históricas, comunales y teológicas de las iglesias Anabautistas.
Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Evaluating first-line treatment of metastatic ER-positive, HER2-positive breast cancer: heredERA Breast Cancer study (0:00) Kuemmel S et al. heredERA Breast Cancer: A phase III, randomized, open-label study evaluating the efficacy and safety of giredestrant plus the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with previously untreated HER2-positive, estrogen receptor-positive locally advanced or metastatic breast cancer. BMC Cancer 2024;24(1):641. Abstract Treatment outcomes with CDK4/6 inhibitors and with elacestrant in real-world studies (4:13) Lloyd MR et al. CDK4/6 inhibitor efficacy in ESR1-mutant metastatic breast cancer. NEJM Evid 2024;3(5). Abstract Lloyd M et al. Impact of prior treatment, ESR1 mutational (ESR1m) landscape, and co-occurring PI3K pathway status on real-world (RW) elacestrant outcomes in patients (pts) with hormone receptor-positive (HR+)/HER2-negative advanced breast cancer (aBC). San Antonio Breast Cancer Symposium 2024;Abstract PS7-05. Evaluating the CNS activity of imlunestrant, an oral selective estrogen receptor degrader (SERD) (8:06) VandeKopple M et al. Preclinical characterization of imlunestrant, an oral brain-penetrant selective estrogen receptor degrader with activity in a brain metastasis (BM) model. ESMO Breast 2023;Abstract 41P. Selective review of trials of oral SERDs in the adjuvant setting (11:27) A study of imlunestrant versus standard endocrine therapy in participants with early breast cancer (EMBER-4). NCT05514054 CME information and select publications
Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Imlunestrant with or without abemaciclib in advanced breast cancer: Results of the Phase III EMBER-3 trial (0:00) Jhaveri KL et al. Imlunestrant with or without abemaciclib in advanced breast cancer. N Engl J Med 2025;392(12):1189-202. Abstract Jhaveri KL et al. Imlunestrant, an oral selective estrogen receptor degrader (SERD), as monotherapy & combined with abemaciclib, for patients with ER+, HER2- advanced breast cancer (ABC), pretreated with endocrine therapy (ET): Results of the Phase 3 EMBER-3 trial. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1 and PTEN in HR-positive, HER2-negative metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice (7:00) Bhave MA et al. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(-) metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice. Breast Cancer Res Treat 2024;207(3):599-609. Abstract Camizestrant, a next-generation oral selective estrogen receptor degrader (SERD), versus fulvestrant for postmenopausal women with estrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomized, Phase II trial (10:25) Oliveira M et al. Camizestrant, a next-generation oral SERD, versus fulvestrant in post-menopausal women with oestrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomised, phase 2 trial. Lancet Oncol 2024;25(11):1424-39. Abstract Latest on SERDs: An education session at San Antonio Breast Cancer Symposium 2024 (13:57) Jeselsohn RM. Latest on selective estrogen receptor degraders (SERDs). San Antonio Breast Cancer Symposium 2024;Education Session 5. CME information and select publications
Elvitelre – a podcast, amelyben a hét legjobb HVG hetilapos és hvg360-as anyagaiból válogatunk. Csak indítsa el a háttérben és hallgassa meg szerzőink legjobb írásait! A héten: üldözési törvényjavaslat Magyarországon. Iratkozz fel a hvg360-ra! hvg.hu/360/elofizetes A mai menü: 00:00 Intro 00:16 Elmagyarázzuk, mivel jár és mi a legveszélyesebb a Fidesz új üldözési törvényében – kérdések, válaszok és kétségek (Serdült Viktória, Lengyel Tibor)
Jesús utiliza a menudo comparaciones con mucha simbología para enseñar. En este episodio intentamos profundizar en una de las muchas comparaciones que hace el Señor de sí mismo y que podéis leer en el capítulo 10 del Evangelio de Juan, Jesús como El Buen Pastor. Comentamos también el camino de la nada, de San Juan de la Cruz.
In Italia, la dipendenza da sostanze è un fenomeno che coinvolge sempre più donne e che spesso resta sommerso. Secondo le statistiche, una persona su tre che consuma sostanze è donna, ma solo il 14% delle persone in carico ai Serd - servizi per le dipendenze - è di genere femminile. Violenza di genere, vulnerabilità economiche, contesto famigliare sono tra le cause della dipendenza al femminile. Qual è, dunque, il modo corretto di dare supporto a questo donne? Come sostenerle? Ne parliamo con le responsabili della cooperativa Dianova e con le donne del centro di Garbagnate milanese.
Il fenomeno della dipendenza, intesa come ricerca esagerata e patologica del piacere tramite sostanze o comportamenti, ha assunto ormai i connotati di un'autentica emergenza. Una piaga che, nel caso dei giovanissimi, è fonte di allarme. Diventa quindi fondamentale dare risalto e visibilità a quelle realtà impegnate nel contrasto a tale tendenza. Una di queste, nel Vicentino, è il Servizio Dipendenze (Serd) dell'Ulss 7 Pedemontana. Giovanni Greco, direttore del Servizio, ne ha parlato con Mariagrazia Bonollo e Gianni Manuel ai microfoni di Radio Eco Vicentino.
Featuring an interview with Dr Komal Jhaveri, including the following topics: Imlunestrant, an oral selective estrogen receptor degrader (SERD), with and without abemaciclib for ER-positive, HER2-negative advanced or metastatic breast cancer (0:00) Jhaveri KL et al. Imlunestrant, an oral selective estrogen receptor degrader (SERD), as monotherapy & combined with abemaciclib, for patients with ER+, HER2- advanced breast cancer (ABC), pretreated with endocrine therapy (ET): Results of the phase 3 EMBER-3 trial. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01. Jhaveri KL et al. Imlunestrant with or without abemaciclib in advanced breast cancer. N Engl J Med 2024;[Online ahead of print]. Abstract Rugo HS et al. Elacestrant abemaciclib (abema) combination in patients (pts) with estrogen receptor-positive (ER+), HER2-negative (HER2-) advanced or metastatic breast cancer (mBC). San Antonio Breast Cancer Symposium 2024; Abstract PS7-07. Elacestrant for ER-positive, HER2-negative metastatic breast cancer with ESR1-mutated tumors: Subgroup analyses from the Phase III EMERALD trial by duration of prior endocrine therapy with a CDK4/6 inhibitor and in clinical subgroups (7:40) Bardia A et al. Elacestrant in ER+, HER2- MBC with ESR1-mutated tumors: Subgroup analyses from the phase III EMERALD trial by prior duration of endocrine therapy plus CDK4/6 inhibitor and in clinical subgroups. Clin Cancer Res 2024;30(19):4299-309. Abstract Pharmacokinetics and safety of imlunestrant in patients with hepatic impairment (11:25) Wang XA et al. Evaluation of pharmacokinetics and safety of imlunestrant in participants with hepatic impairment. San Antonio Breast Cancer Symposium 2024;Abstract P4-10-07. Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer (13:15) Lloyd MR et al. Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer. Nat Rev Clin Oncol 2024;21(10):743-61. Abstract CME information and select publications
Featuring an interview with Dr Seth Wander, including the following topics: Therapy selection after CDK4/6 inhibitor failure: A review of current and investigational treatment for HR-positive, HER2-negative breast cancer Astore S et al. A therapeutic algorithm guiding subsequent therapy selection after CDK4/6 inhibitors' failure: A review of current and investigational treatment for HR+/Her2- breast cancer. Crit Rev Oncol Hematol 2024;204:104535. Abstract (0:00) A preoperative window-of-opportunity study of the oral SERD imlunestrant for newly diagnosed ER-positive, HER2-negative localized breast cancer Neven P et al. A preoperative window-of-opportunity study of oral SERD, imlunestrant, in newly diagnosed ER-positive, HER2-negative early breast cancer: Results from the EMBER-2 Study. Clin Cancer Res 2024;30(23):5304-13. Abstract (3:30) An assessment of an exosome-based ESR1-monitoring RT-qPCR kit that detects acquired resistance variants in liquid biopsy samples Statt S et al. An exosome-based ESR1 monitoring RT-qPCR kit that rapidly and accurately detects acquired resistance variants at ≤ 0.1% frequency in liquid biopsy samples. ESMO 2024;Abstract 420P. (7:08) CME information and select publications
Catch up on new data from San Antonio on innovative treatments and patient-centered management strategies for estrogen receptor (ER)-positive metastatic breast cancer (MBC). Credit available for this activity expires: 01/13/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002163?ecd=bdc_podcast_libsyn_mscpedu
Somos dóciles al Espíritu Santo haciendo nuestro cuerpo grato a Él, al pedirle que nos afiance en los misterios de la fe y al orar junto a María, los santos, el ángel de la guarda y en comunidad.
* El debate sobre cómo se cocina el fentanilo * Año empieza con impuesto a comercio electrónico * Y no puede ser Día de Reyes sin la rosca del Costco
In this JCO Article Insights episode, Giselle de Souza Carvalho provides a summary on "Navigating Treatment Pathways in Metastatic Hormone Receptor–Positive, HER2-Negative Breast Cancer: Optimizing Second-Line Endocrine and Targeted Therapies" by Bhardwarj, et al and "US Food and Drug Administration Approval Summary: Capivasertib With Fulvestrant for Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Locally Advanced or Metastatic Breast Cancer With PIK3CA/AKT1/PTEN Alterations" by Dilawari et al published in the Journal of Clinical Oncology. TRANSCRIPT Giselle Carvalho: Hello and welcome to JCO Article Insights episode for the December issue of the Journal of Clinical Oncology. I'm your host Giselle Carvalho, Medical Oncologist in Brazil focusing on breast cancer and melanoma skin cancers and one of the ASCO Editorial Fellows at JCO this year. Today, I will be discussing two articles. The first one is “Navigating Treatment Pathways in Metastatic Hormone Receptor–Positive, HER2-Negative Breast Cancer: Optimizing Second-Line Endocrine and Targeted Therapies,” and the second one is the “US FDA Approval Summary on Capivasertib with Fulvestrant for HR-positive HER2-negative Locally Advanced or Metastatic Breast Cancer with PIK3CA/AKT1/PTEN Alteration.” As we know, 65% to 70% of all breast cancers are HR-positive HER2-negative and this is also the most common subtype of metastatic breast cancer. The current standard of care for frontline therapy of patients with luminal metastatic disease is a CDK4/6 inhibitor in combination with endocrine therapy. However, as new endocrine and targeted therapies gain approval, choosing the best systemic therapy upon disease progression after frontline therapy is a topic of ongoing debate. Nearly 40 to 50% of HR-positive breast cancers have actionable genomic alterations and molecular testing should be a routine recommendation for patients with metastatic HR-positive HER2-negative disease. This can be performed repeating tissue biopsy at the time of progression or from archival tissue. Treatment options after progression on CDK4/6 inhibitors include alpelisib in combination with fulvestrant in patients with PIK3CA mutant tumors as seen in the SOLAR-1 trial, or capivasertib with fulvestrant in patients with a tumor mutation in (PI3K)–AKT–PTEN pathway as seen in the CAPItello-291 study, which will be discussed further. In approximately 30% of patients, progression on frontline endocrine plus CDK4/6 inhibitor treatment is caused by endocrine resistance, frequently involving activating mutations in ESR1. For those tumors, elacestrant, an oral SERD is an option as demonstrated in the EMERALD trial. For patients with a BRCA mutation, PARP inhibitors represent another option. If no mutations are detected, everolimus, an mTOR inhibitor, can be used based on the BOLERO-2 results. The phase 2 MAINTAIN and PACE trials, along with the phase 3 postMONARCH trial support changing the endocrine therapy backbone with or without switching the CDK4/6 inhibitor. In less resourced areas, fulvestrant monotherapy is still an option to delay cytotoxic chemotherapy, though its efficacy is limited when used as a single agent. Finally, after progression on at least one line of chemotherapy, antibody drug conjugates including sacituzumab govitecan or trastuzumab deruxtecan may be an option. Now focusing on the PI3K AKT PTEN signaling pathway, activating mutations in PIK3CA and AKT1 and inactivating alterations in PTEN occur in approximately half of luminal breast cancers. In June 2023, the CAPItello-291 trial was published and treatment with fulvestrant plus capivasertib, a PTEN AKT inhibitor, demonstrated a 3.6 month PFS benefit compared to fulvestrant alone, regardless of the presence of AKT pathway alterations. However, for those with tumors without AKT pathway alteration, an exploratory analysis showed that although there was a numerical improvement in PFS, it did not meet statistical significance, indicating that the biomarker positive population primarily drove the positive results noted in the overall population. Therefore, capivasertib plus fulvestrant was approved by the US FDA in November 2023 exclusively for patients with PI3K/AKT1/PTEN tumor alterations after progression on an aromatized inhibitor with or without a CDK4/6 inhibitor. The approved schedule of capivasertib is slightly different from that of other agents used in breast cancer. It is 400 milligrams taken orally twice a day for four days per week every week in a 28-day cycle in combination with fulvestrant. Diarrhea, rash and hyperglycemia were the most commonly reported grade three or four adverse events in the interventional group. I would like to highlight that even though the CAPItello trial excluded patients with glycosylated hemoglobin levels higher than 8% or those diagnosed with diabetes who required insulin, hyperglycemia occurred in 19% of biomarker positive patients treated with capivasertib, with nearly 2% of this population experiencing grade 3 or 4 hyperglycemia and some patients experiencing life threatening outcomes such as diabetic ketoacidosis. By way of comparison, hyperglycemia of any grade was three times higher with alpelisib therapy in the SOLAR-1 trial, occurring in 64% of the patients and grade three or higher hyperglycemia was seen in 37% of the patients. Diarrhea was the most common treatment related adverse event experienced by 77% of the biomarker positive population. Prompt use of the antidiarrheal drugs when needed, such as loperamide must be encouraged as untreated diarrhea can lead to dehydration and renal injury. Cutaneous rash occurred in 56% of the biomarker positive population in the interventional group and 15% experienced a grade 3 or 4 rash. Nearly half of the patients with cutaneous adverse reactions required treatment and this was the leading reason for dose reduction of capivasertib. In the biomarker positive population, the improvement in medium PFS were 4.3 months by investigator assessment. Overall survival data from the CAPItello-291 trial is still immature, but quality of life data was recently published in September this year and was assessed by the 30 item QLQ C30 questionnaire and the QLQ BR23, the breast module. According to Oliveira et al, global health status and quality of life were maintained for a longer period with capivasertib fulvestrant than with placebo fulvestrant except for symptoms of diarrhea which were significantly worse in the capivasertib group. The median time of deterioration of global health status and quality of life was twice as long in the capivasertib group being almost 25 months versus 12 months in the placebo fulvestrant group. These data reinforced the use of capivasertib in combination with fulvestrant for the treatment of HR-positive HER2-negative advanced breast cancer patients with PIK3CA/AKT1/PTEN tumor alterations who have progressed after an aromatase inhibitor-based therapy with or without a CDK4/6 inhibitor. Thank you for listening to JCO Article Insights. This is Giselle Carvalho. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts. See you next time. 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.
Featuring an interview with Dr Seth Wander, including the following topics: Design of SERENA-6, a Phase III switching trial of camizestrant for ESR1-mutant breast cancer during first-line treatment Turner N et al. Design of SERENA-6, a phase III switching trial of camizestrant in ESR1-mutant breast cancer during first-line treatment. Future Oncol 2023;19(8):559-73. Abstract (0:00) EMERALD trial analysis of patient-reported outcomes with oral elacestrant compared to standard of care endocrine therapy for ER-positive, HER2-negative advanced or metastatic breast cancer Cortes J et al. EMERALD trial analysis of patient-reported outcomes (PROs) in patients with ER+/HER2− advanced or metastatic breast cancer (mBC) comparing oral elacestrant vs standard of care (SoC) endocrine therapy. ESMO Breast 2023;Abstract 188O. (5:50) Imlunestrant, an oral selective estrogen receptor degrader, in combination with HER2-directed therapy, with or without abemaciclib, for ER-positive, HER2-positive advanced breast cancer Bhave MA et al. Imlunestrant, an oral selective estrogen receptor degrader (SERD), in combination with human epidermal growth factor receptor 2 (HER2) directed therapy, with or without abemaciclib, in estrogen receptor (ER) positive, HER2 positive advanced breast cancer (aBC): EMBER phase 1a/1b study. ASCO 2024;Abstract 1027. (9:43) CME information and select publications
In Veneto ogni anno spesi nel gioco d'azzardo più di 1.200 euro per abitante (neonati inclusi). Un'emergenza che distrugge intere famiglie. NUmerose le azioni terapeutiche dell'Ulss 7 Pedemontana. Nei prossimi giorni previsti una serie di open day: martedì 10 a Thiene e Schio, sabato 14 dicembre a Bassano
Sean Penn páros lábbal szállt bele az Oscarba Mafab 2024-12-04 04:00:02 Film Fesztiválok Díjátadó Marokkó Erős kritikát fogalmazott meg a marrákesi filmfesztiválon Sean Penn az Oscar-díjátadóval kapcsolatban. Kiss Heni: Ha akar valaki gyereket, akkor vágjon bele! Könyves Magazin 2024-12-03 17:18:17 Könyv Kiss Heni mindig hagyományos, nagy családra vágyott, de 36 évesen mégis egyedülálló. Elhatározza, hogy belevág, gyereket vállal, de szeretné, hogy a gyerekének apja is legyen. Egy különleges családmodell az Ezt senki nem mondta! következő részében. A Hófehérke nagy előzetesében Gal Gadot Rachel Zegler szépségére irigykedik Player 2024-12-04 07:36:07 Film Disney Gal Gadot Megérekezett a Disney élőszereplős Hófehérke és a hét törpe-remake-je, a Hófehérke teljes előzetese, amit szokás szerint már most körberöhögnek a woke-ellenesek, és jobbára azok is, akik már kiütéseket kapnak attól, hogy a Disney szórakoztatás helyett rendszeresen politikai üzeneteket akar letolni a torkukon. Jeff Bridges, A nagy Lebowski léhűtő poszthippije zenél, fest, fotózik és könyvet ír a filmezés mellett kultura.hu 2024-12-04 06:03:02 Film USA Mozi December 4-én ünnepli hetvenötödik születésnapját Jeff Bridges Oscar-díjas amerikai színész, többek között Az utolsó mozielőadás, az Azok a csodálatos Baker fiúk, A halászkirály legendája, A nagy Lebowski, az Őrült szív és A félszemű című filmek főszereplője. Vámos Miklós visszatért a szigligeti alkotóházba: Azt jósolják, nem sokáig lesz az íróké Librarius 2024-12-04 10:00:29 Könyv Vámos Miklós: szeretném megírni az alkotóházi élményeimet és emlékeimet, elvégre 19 éves korom óta járok le. Egysnittes krimisorozat jön jövőre a Netflixre, amit nem akarsz kihagyni in.hu 2024-12-03 18:21:04 Film Anglia Koronavírus Netflix Megjelentek az első képek a Netflix új krimisorozatáról, az Adolescence-ről (Serdülőkor), és már ezek alapján is ígéretesnek tűnik a sorozat.Az Ez itt Anglia és a Peaky Blinders sztárja, Stephen Graham és a Joy írója, Jack Thorne − aki a Help című Covid-19-es gondozóházi drámát is írta Graham és Jodie Comer főszereplésével − fogtak össze az új soro Ha pusztul a világ, a halálunkon már minek spórolni Telex 2024-12-04 10:21:01 Film Eutanázia Pedro Almodóvar az eutanázia legalizálása mellett érvel új filmjében, A szomszéd szobában. A film fontos morális kérdést feszeget, de hiába Tilda Swinton és Julianne Moore, a végeredmény csapongó és felszínes. Novák Irén: A vallásos könnyűzene közösségeket teremt Magyar Hírlap 2024-12-03 19:01:00 Zene Innováció Vallás Hankó Balázs Hankó Balázs kulturális és innovációs miniszter vasárnap jelentette be, hogy a tárca idén is 350 millió forinttal támogatja a vallásos könnyűzenét. Alighogy bemutatták, máris az év egyik legnézettebb magyar filmje Igényesférfi.hu 2024-12-04 03:34:52 Film Párkapcsolat Mozi Herendi Gábor Herendi Gábor új romantikus vígjátéka, a Futni mentem, tíz nap alatt átlépte a százezres nézőszámot, ezzel hatalmas sikert aratva a magyar mozikban. Kulcsár Edináéknál már november közepe óta áll a karácsonyfa rtl.hu 2024-12-04 09:37:30 Karácsony Kulcsár Edina Egyre többen már hetekkel Szenteste előtt díszítek fel a fát. Kulcsár Edináéknál már november közepe óta áll a karácsonyfa. A szépségkirálynő a gyerekei miatt a műfenyőre esküszik. A Fókusz ellátogatott a karácsonyfák szülőhazájába és annak jártunk utána, hogy vajon emelkedtek-e idén a fenyők árai. Rubint Réka: 12 évre börtönbe kerül a rosszakarója? Story 2024-12-04 04:00:04 Bulvár Börtön Rubint Réka Egyáltalán nem kizárt, hogy valóban rács mögé kerül az az ember, aki több mint tíz éve megkeseríti a fitneszedző életét. A további adásainkat keresd a podcast.hirstart.hu oldalunkon.
Sean Penn páros lábbal szállt bele az Oscarba Mafab 2024-12-04 04:00:02 Film Fesztiválok Díjátadó Marokkó Erős kritikát fogalmazott meg a marrákesi filmfesztiválon Sean Penn az Oscar-díjátadóval kapcsolatban. Kiss Heni: Ha akar valaki gyereket, akkor vágjon bele! Könyves Magazin 2024-12-03 17:18:17 Könyv Kiss Heni mindig hagyományos, nagy családra vágyott, de 36 évesen mégis egyedülálló. Elhatározza, hogy belevág, gyereket vállal, de szeretné, hogy a gyerekének apja is legyen. Egy különleges családmodell az Ezt senki nem mondta! következő részében. A Hófehérke nagy előzetesében Gal Gadot Rachel Zegler szépségére irigykedik Player 2024-12-04 07:36:07 Film Disney Gal Gadot Megérekezett a Disney élőszereplős Hófehérke és a hét törpe-remake-je, a Hófehérke teljes előzetese, amit szokás szerint már most körberöhögnek a woke-ellenesek, és jobbára azok is, akik már kiütéseket kapnak attól, hogy a Disney szórakoztatás helyett rendszeresen politikai üzeneteket akar letolni a torkukon. Jeff Bridges, A nagy Lebowski léhűtő poszthippije zenél, fest, fotózik és könyvet ír a filmezés mellett kultura.hu 2024-12-04 06:03:02 Film USA Mozi December 4-én ünnepli hetvenötödik születésnapját Jeff Bridges Oscar-díjas amerikai színész, többek között Az utolsó mozielőadás, az Azok a csodálatos Baker fiúk, A halászkirály legendája, A nagy Lebowski, az Őrült szív és A félszemű című filmek főszereplője. Vámos Miklós visszatért a szigligeti alkotóházba: Azt jósolják, nem sokáig lesz az íróké Librarius 2024-12-04 10:00:29 Könyv Vámos Miklós: szeretném megírni az alkotóházi élményeimet és emlékeimet, elvégre 19 éves korom óta járok le. Egysnittes krimisorozat jön jövőre a Netflixre, amit nem akarsz kihagyni in.hu 2024-12-03 18:21:04 Film Anglia Koronavírus Netflix Megjelentek az első képek a Netflix új krimisorozatáról, az Adolescence-ről (Serdülőkor), és már ezek alapján is ígéretesnek tűnik a sorozat.Az Ez itt Anglia és a Peaky Blinders sztárja, Stephen Graham és a Joy írója, Jack Thorne − aki a Help című Covid-19-es gondozóházi drámát is írta Graham és Jodie Comer főszereplésével − fogtak össze az új soro Ha pusztul a világ, a halálunkon már minek spórolni Telex 2024-12-04 10:21:01 Film Eutanázia Pedro Almodóvar az eutanázia legalizálása mellett érvel új filmjében, A szomszéd szobában. A film fontos morális kérdést feszeget, de hiába Tilda Swinton és Julianne Moore, a végeredmény csapongó és felszínes. Novák Irén: A vallásos könnyűzene közösségeket teremt Magyar Hírlap 2024-12-03 19:01:00 Zene Innováció Vallás Hankó Balázs Hankó Balázs kulturális és innovációs miniszter vasárnap jelentette be, hogy a tárca idén is 350 millió forinttal támogatja a vallásos könnyűzenét. Alighogy bemutatták, máris az év egyik legnézettebb magyar filmje Igényesférfi.hu 2024-12-04 03:34:52 Film Párkapcsolat Mozi Herendi Gábor Herendi Gábor új romantikus vígjátéka, a Futni mentem, tíz nap alatt átlépte a százezres nézőszámot, ezzel hatalmas sikert aratva a magyar mozikban. Kulcsár Edináéknál már november közepe óta áll a karácsonyfa rtl.hu 2024-12-04 09:37:30 Karácsony Kulcsár Edina Egyre többen már hetekkel Szenteste előtt díszítek fel a fát. Kulcsár Edináéknál már november közepe óta áll a karácsonyfa. A szépségkirálynő a gyerekei miatt a műfenyőre esküszik. A Fókusz ellátogatott a karácsonyfák szülőhazájába és annak jártunk utána, hogy vajon emelkedtek-e idén a fenyők árai. Rubint Réka: 12 évre börtönbe kerül a rosszakarója? Story 2024-12-04 04:00:04 Bulvár Börtön Rubint Réka Egyáltalán nem kizárt, hogy valóban rács mögé kerül az az ember, aki több mint tíz éve megkeseríti a fitneszedző életét. A további adásainkat keresd a podcast.hirstart.hu oldalunkon.
Las calles más ANTIGUAS y MISTERIOSAS del Zócalo de CDMX Rafa Serdán nos cuenta su historiaSee omnystudio.com/listener for privacy information.
●Presentación de la Agencia de Transformación Digital y Telecomunicaciones: La conferencia se enfocó en presentar esta nueva agencia, liderada por José Antonio Peña Merino. Su objetivo principal es centralizar y optimizar las capacidades tecnológicas del gobierno federal, buscando un mejor uso de recursos, fomentar la autonomía tecnológica y lograr la austeridad presupuestaria. ●Principios de la Agencia: Se basa en 7 puntos clave: digitalización de trámites presenciales, reducción de regulaciones para personas y empresas, generación de ahorros, combate a la corrupción, interoperabilidad entre sistemas de información, un número único de atención ciudadana y la declaración de internet como un derecho en México. ●Estructura de la Agencia: Se compone de dos pilares: "Transformación Digital" (enfocado en servicios para la ciudadanía) e "Infraestructura Pública Digital" (el área técnica de desarrollo). ●Ley de Simplificación y Digitalización: Se anunció la sustitución de la Ley General de Mejora Regulatoria por esta nueva ley. ●Puntos clave de la nueva ley: Reducción de trámites, requisitos y tiempos de resolución; eliminación de barreras burocráticas; homologación de procesos; digitalización agresiva; uso de Llave MX y Expediente Digital; desarrollo de tecnología propia; catálogo único de trámites; repositorio de código público; y mecanismos de atención ciudadana. ●Proyectos estratégicos: Se detallaron proyectos como Llave MX (identidad digital única para acceder a servicios), la "fábrica de software" (desarrollo de soluciones propias), la Plataforma Pública de Digitalización (para digitalizar trámites de forma automatizada), el Programa Espacial Mexicano (con un nuevo satélite para 2027-2028), el Centro de Atención para el Bienestar (CABI, número único de atención no urgente), el Centro Nacional de Tecnología Pública (extensión del modelo a estados y municipios), Inteligencia de Datos, Plan Nacional de Ciberseguridad y Nube México. ●Ejemplos de simplificación: Se dieron ejemplos concretos de cómo se reducirán trámites y requisitos en áreas como servicios consulares, Conagua, sistema de compras públicas, Cofepris, expediente clínico digital y pasaportes. ●Ahorros y combate a la corrupción: Se enfatizó cómo la digitalización genera ahorros, elimina la discrecionalidad y deja registro de los procesos, lo que ayuda a combatir la corrupción. ●Relación con Estados Unidos: La Presidenta abordó la relación con Estados Unidos a raíz de declaraciones del embajador Ken Salazar, enfatizando la coordinación entre ambos países pero con base en el respeto a la soberanía de México. ●Otros temas: Se abordaron otros temas como la necesidad de reducir el presupuesto solicitado por el INE, la importancia de la prevención y detección temprana de la diabetes, la promoción del arte popular y la defensa de los diseños originales, la soberanía alimentaria en materia de maíz y frijol, la necesidad de fortalecer la investigación del caso Ayotzinapa y la importancia de las Escuelas Normales Rurales. ●Mujeres en la historia: La sección "Mujeres en la historia" se dedicó a las hermanas Serdán y a Sor Juana Inés de la Cruz, destacando su lucha por la transformación social y el derecho al conocimiento, respectivamente.
Ez az Elvitelre, a hvg.hu hétzáró podcastja. A 92. adásban: Spermadonorok és a Magyar Kereskedelmi és Iparkamara. Iratkozz fel a hvg360-ra! hvg.hu/360/elofizetes Az e heti menü: 00:00 Intro 00:32 Magyarországon is akkorát zuhant a férfiak nemzőképessége, hogy már alig akad spermadonor (Serdült Viktória) 06:44 Parragh megbuktatása is Orbánnak szóló üzenet lehet a gazdaságpolitika bírálóitól (Szabó Yvette)
En la sesión de hoy, reflexionamos sobre la importancia de reconocer nuestro valor esencial, ese valor que no depende de lo que hacemos o de cómo nos perciben los demás, sino que existe simplemente por ser quienes somos. Acompáñame en un viaje de autovaloración y aceptación, donde nos liberamos de la necesidad de validación externa y abrazamos nuestra esencia con amor y autenticidad.¿Te gustó está sesión? Compártela con un ser querido, ayúdanos a expandir la energía de la gratitud para que todes disfrutemos los beneficios de los increíbles beneficios de esta práctica.Descarga tu Diario de Gratitud: www.mardelcerro.com/gratitudConecta con nosotres más allá del Podcast nos encuentras en:Instagram: www.instagram.com/meditaconmigocastInstagram: www.instagram.com/mardelcerroCorreo: mar@mardelcerro.com Gracias siempre por ser parte de este proyecto.AGRADECIDA es un podcast de Medita Conmigo CastProducción, guión y voz: Marimar del Cerro Coordinación general: Fernanda VargasEdición, diseño de sonido y música original: Silver Media StudioImágen y redes sociales: Zayuri Vargas, Valery Martinez, Mariana Torres y Daniela Calderón.¡Gracias equipo por hacer esto posible! Hosted on Acast. See acast.com/privacy for more information.
Orbán Viktort szerdán összeszidták. Adósa kritikusainak ő sem maradt, de magasról kapott ki, hiszen Manfred Weber mellett Ursula von der Leyen is perceken keresztül őt ostorozta. A miniszterelnök és kormánya strasbourgi tudósítónk szerint átlépett egy olyan vörös vonalat, amit már az EU nem hagyhatott szó nélkül, ezért hányták a szemére órákon keresztül a kínai és az orosz kapcsolatokat, a korrupciót, sőt, még a kivándorlást is. Mindez pedig meglephette a miniszterelnököt, akinek válaszai egy ponton szokatlan személyeskedésbe csúsztak át. A szerdai nap másik nagy attrakciójának előzetesen Magyar Pétert hittük – Magyar azonban öt percében egyszerre hadart el mindent, amit a kormány hibájának vélt, de nem mondott szinte semmit arról, hogy mit akar ezzel a helyzettel kezdeni. Az Európai Parlament szerdai plenáris üléséről, a magyar uniós elnökségről, a Draghi-jelentésről, Magyar Péterről, valamint Orbán vélt, vagy valós elszigetelődéséről beszélgetett a HVG-t Strasbourgból tudósító Serdült Viktóriával, valamint Arató Lászlóval, az Eurologus újságírójával Kacskovics Mihály Béla. Iratkozz fel a Fülke csatornájára! Spotify: tiny.cc/FulkeSpotify Apple Podcasts: tiny.cc/FulkeApple Hallgasd meg a HVG többi podcastját: Spotify: tiny.cc/HVGpodcastokSpotify Apple Podcasts: tiny.cc/HVGpodcastokApple SoundCloud: tiny.cc/HVGpodcastokSC 00:00 Mit tartalmaz a Draghi-jelentés? 01:32 Hogyan viszonyul a jelentéshez Magyarország? 05:29 Hogy telt eddig Magyarország uniós elnöksége? 07:46 Mitől függ, hogy mennyire sikeres egy uniós elnökség? 09:33 Milyen szerepe lehet az uniós pozíciók kiosztásában soros elnökként Magyarországnak? 10:25 Mi a „Schengen summit”, amit Orbán Viktor a keddi sajtótájékoztatóján jelentett be? 13:23 Miért érezte szükségét Ursula Von der Leyen annak, hogy párhuzamot vonjon az '56-os forradalom és az ukrán védekezés között? 17:32 Milyen újabb eszközöket vethet be az EP a jogállamiság védelmére? 18:57 Mivel kritizálta Orbán Viktort Manfred Weber, és hogyan reagált erre a magyar miniszterelnök? 21:16 Hogyan csaptak össze a Tisza-párt képviselői Orbán Viktorral? 24:05 Mivel kritizálta Orbánt Valéria Hayer, a Renew frakció vezetője? 27:56 Miért nem reagált a Néppárt és Magyar Péter Ilaria Salis megszólalására? 30:38 Mennyire elszigetelt jelenleg az EP-ben Orbán Viktor?
Az e heti podcastban: a Fidesz legújabb sztárigazolása az amerikai republikánusok jobbszéléről, áldatlan állapotok a bíróságokon, és mindenki kedvence: a ledolgozós szombati munkanap. Iratkozz fel a hvg360-ra, az első hónapban csupán 360 forintért! hvg.hu/360/elofizetes Az e heti menü: 00:32 Egy a jelszó: a harc (Martini Noémi, Szentirmai Áron) 08:00 „Éhen halok, ha nem mondok fel a bíróságon” (Serdült Viktória) 16:28 Megint melózni kellett a négynapos ünnepért – de van bármi értelme egy ledolgozós szombati munkanapnak? (Sztojcsev Iván)
„A maga természetességében mutatja meg az erdő, hogy mit jelent a természeti törvények áthágása” – mondta az 1992-es interjúban Balogh János zoológus, ökológus. Trópusi őserdők talajfaunáját vizsgálva az elsők között figyelmeztetett az emberiség fennmaradását veszélyeztető káros folyamatokra.
Békemisszióval, védelmi hozzájárulással és a háborús propaganda elleni leszámolással (tetszőleges számú idézőjel kihelyezése indokolt) ágyazott meg a kormány nyáron egy sűrű ősznek: készül az újabb sajtóellenes leszámolás és folytatódik a gazdaság összefoltozása, de sem a békenarratíva, sem a nagy tusványosi víziók, sem a Patrióták összeboronálása nem változtat a képen, hogy a kormány nehezebb hónapok elé néz a politikai élet újraéledésével, mint bármikor az elmúlt 14 év során. Hogyan fektette le az alapokat Lánczi Tamás, milyen „háborúspropaganda-ellenes” törvényt találhat ki az Igazságügyi Minisztérium és milyen célt szolgálna, ha tényleg elfogadnák? Tényleg lesznek-e határon túli választókerületek és valójában hol kell megerősödnie a Tiszának 2026-ra? Mit jelentenek a kötelezettségszegési- és túlzottdeficit-eljárások? Hogyan csapódhatnak le a megszorítások és készül-e jövő évi pénzosztásra a kormány? Miért nem indul be igazán az európai politikai élet 2024 végéig és mire számíthatunk az új önkormányzatok felállásával? Közéleti podcastunkban erről beszélgettek a HVG újságírói, Serdült Viktória, Kacskovics Mihály Béla és Kovács Gábor Nagy Iván Lászlóval – akinek ez volt az utolsó adása a Fülke házigazdájaként, így az adásból az is kiderül, hogyan folytatódik a műsor a jövőben. Iratkozz fel a Fülke csatornájára! Spotify: https://tiny.cc/FulkeSpotify Apple Podcasts: https://tiny.cc/FulkeApple Hallgasd meg a HVG többi podcastját: Spotify: https://tiny.cc/HVGpodcastokSpotify Apple Podcasts: https://tiny.cc/HVGpodcastokApple SoundCloud: https://tiny.cc/HVGpodcastokSC 00:00 Intro 02:18 Hogyan alapozta meg Lánczi Tamás a háborúspropaganda-törvényt? 13:54 Hogy csúszhatna át az EU-n egy ilyen törvény? 18:55 Mire elegendőek a megszorítások, és mit fogunk érezni belőle? 23:22 Hogyan érintheti a magyar gazdaságot Donald Trump visszatérése? 26:06 Miért nem költenek a magyarok? 28:07 Lesz-e pénzeső 2025 végén? 30:13 Lehetnek-e egyéni választókerületek a határon túl? 36:10 Mekkora siker valójában a Patrióták összeállása? 39:56 Mi várható még a soros elnökség alatt? 41:47 Hol tart most a Tisza az EU-ban? 47:51 Mi történt eddig, és mi várható októberig az önkormányzatokban? 52:00 Búcsú
Hétvégi podcastunk, az Elvitelre legfrissebb adásában megnéztük, kikkel haverkodik Magyar Péter és Orbán Viktor az új Európai Parlamentben. Iratkozz fel a hvg360-ra, az első hónapban csupán 360 forintért! https://hvg.hu/360/elofizetes Az e heti menü: 0:00 Intro 0:32 A Tisza Európában: a Fidesz mocskolódása célját tévesztette, Magyar Péterék élvezik az újakkal szembeni előzékenységet (Serdült Viktória) 8:23 Akikre a Fidesz büszke: az FPÖ útja a nemzetiszocialista múlttól a sörsátoron át a sporttáskában kihordott pénzig (Bábel Vilmos) Iratkozz fel a HVG Podcastokra és kapcsold be az értesítéseket, hogy egyetlen műsorunkról se maradj le!
Wojciech Przybylski talks with Hungarian journalist Viktória Serdült about PM Viktor Orbán's meetings with Vladimir Putin and Xi Jinping as well as his success in forming the Patriots for Europe group in the EU parliament.
Nagy dobra vert szövetség Brüsszelben, sunnyogás Moszkvában és Pekingben – így telt a magyar miniszterelnök első hete az EU soros elnökeként. A Patrióták Európáért valóban az Európai Parlament harmadik legnagyobb frakciója lett, a sajátos „békemisszió” mégis távolabb lökte szövetségeseitől Magyarországot. Sikerről beszélünk-e, ha összeáll egy nagy, de megkerülhető, és belülről az első perctől széthúzó frakció? Kik lesznek a Fidesz új barátai és számíthat-e arra a miniszterelnök, hogy idővel az EU-csúcsokon is bomlaszthat velük együtt? Van-e bármi ráció Orbán béketervei között, az Orosz Föderáción túl? Milyen lehet az uniós elnökség hátralévő 25 hete, ha az első ilyen volt? Ezekről kérdezte Nagy Iván László Serdült Viktóriát, a hvg.hu újságíróját és Gergely Mártont, a HVG főszerkesztőjét. Iratkozz fel a Fülke csatornájára! Spotify: tiny.cc/FulkeSpotify Apple Podcasts: tiny.cc/FulkeApple Hallgasd meg a HVG többi podcastját: Spotify: tiny.cc/HVGpodcastokSpotify Apple Podcasts: tiny.cc/HVGpodcastokApple SoundCloud: tiny.cc/HVGpodcastokSC 0:00 Intro 0:53 Mekkora siker a Fidesznek a Patrióták Európáért? 5:47 Mit lehet tudni a Patrióták tagjairól? 9:50 Hogy jönnek össze az oroszbarát és -ellenes nézetek a pártcsoportban? 12:31 Hogyan reagált a többi frakció a Patriótákra? 17:17 Tényleges szélsőjobboldali erősödés ez, vagy a számkivetettek klubja? 21:39 Hogyan lehet értelmezni Orbán moszkvai és pekingi látogatását a kijevi után? 29:33 Miért maradt el a német-magyar külügyi találkozó? 33:06 Mennyire szólhat a soros elnökség Orbánról?
Hétvégi podcastunk, az Elvitelre legfrissebb adásában a repülési káoszt, a budapesti pénzügyi káoszt, és a politikusi partikáoszt járjuk körül. Iratkozz fel a hvg360-ra, az első hónapban csupán 360 forintért! https://hvg.hu/360/elofizetes Az e heti menü: 0:00 Intro 0:32 Serdült Viktória, Imre Réka: Káosz a légi közlekedésben: nincs más megoldás, csak felkészülni rá 8:37 Szabó Yvette: Fojtogató szeretet 14:41 Parászka Boróka: Szabad a tánc? Iratkozz fel a HVG Podcastokra és kapcsold be az értesítéseket, hogy egyetlen műsorunkról se maradj le!Iratkozz fel a HVG Podcastokra és kapcsold be az értesítéseket, hogy egyetlen műsorunkról se maradj le!
El audio incluido corresponde a las noticias del miércoles 3 de julio.
Hay una guerra cultural contra los hombres, una guerra que busca hacer que los hombres sean débiles y menos masculinos. ¿Cómo deberían reaccionar los cristianos ante este asalto? ¿Estamos llamados a debilitarnos y quedarnos al margen o estamos llamados a la acción para proceder y defender a nuestras familias y a nuestra nación? Hablemos de ello. HECHOS 16:6-25 --- Send in a voice message: https://podcasters.spotify.com/pod/show/amado/message
Békemenet, vitasorozat, Rogán Londonban – sűrű volt a választások előtti utolsó hétvége, választási podcastunk pedig ehhez hasonlóan, sűrűbben is jelentkezik: ezen a héten a szokásos, pénteki adás mellett szerdán is készültünk egy műsorral, hogy a kampányhajrá egyetlen pillanatát se szalasszuk el. A legfrissebb adásban annak jártunk utána, miért ütemezi máshogy a kampányát a Fidesz, a Tisza és a többiek, ki választott jó taktikát a Partizán- és ATV-vitákon, miért fújja be a bennfentes infókat a szél egyre gyakrabban az oknyomozó újságírók ablakán, melyik országban szavazzon egy külföldön élő ellenzéki az EP-választáson, és végül megvizsgáltuk azt, miért kulcsfontosságú Magyar Péternek, hogy politikája hasonlítson a kormányéra, és tulajdonképpen kit és mit nevezünk bal- vagy jobboldalinak ma Magyarországon. Pénteken folytatjuk, június 9-én 18:30-tól pedig élő műsorban követjük az önkormányzati- és EP-választás eredményeit a HVG Facebookján és YouTube-csatornáján! NIL elemzése az Orbán-beszédről: https://hvg.hu/360/20240601_orban-viktor-bekemenet-putyin-orosz-propaganda-haboru-velemeny Serdült Viktória cikke a Tisza európai programjáról: https://hvg.hu/360/20240603_tisza-part-magyar-peter-europai-program Kínai Fidesz-levelek https://www.reddit.com/r/hungary/comments/1d1scqv/comment/l5zwea4/ Töltsd ki a hallgatói kérdőívet! https://forms.gle/R1s4Pc9bV8mM8PsQ7 Küldd be kérdésedet a következő heti adásra! https://forms.gle/LHzj6N2XNRPBaQi16 Iratkozz fel a (Szavazó)Fülke csatornájára! Spotify: http://tiny.cc/FulkeSpotify Apple Podcasts: http://tiny.cc/FulkeApple Google Podcasts: http://tiny.cc/FulkeGoogle Hallgasd meg a HVG többi podcastját: Spotify: http://tiny.cc/HVGpodcastokSpotify Apple Podcasts: http://tiny.cc/HVGpodcastokApple Google Podcasts: http://tiny.cc/HVGpodcastokGoogle SoundCloud: http://tiny.cc/HVGpodcastokSC Kövesd a Múzsát! https://hungarianmuse.substack.com/ https://www.facebook.com/dmagyarmuzsa 0:00 Intro 2:01 Békemenet 8:51 A Fidesz kampányhajrája 20:23 Az ATV-s budapesti listavezetői vita 38:40 Kérdezz-felelek 50:41 Magyar Péter a jó Fidesz? 1:00:39 A jobb- és baloldal magyarországi kontextusban
In this episode, Manali Bhave, MD; Annalise Labatut, PharmD, BCOP; and nurse practitioner Jamie L. Carroll, CNP, APRN, MSN, begin by discussing the landmark EMERALD study that led to FDA approval of elacestrant, the first oral selective estrogen receptor degrader (SERD) for treatment of hormone receptor–positive/HER2-negative metastatic breast cancer. Dr. Bhave also briefly reviews ongoing clinical trials of other oral SERDs for estrogen receptor–positive/HER2-negative metastatic breast cancer. Next, the panel discusses the possible adverse effects with elacestrant, potential drug–drug interactions, and their personal experiences with managing adverse effects in their patients. Finally, the discussion turns to methods for promoting treatment adherence and persistence and briefly touches on insurance coverage and affordability, including ways that patients and providers can work together to ensure access to approved oral SERDs.Presenters:Manali Bhave, MDPhase I Medical DirectorAssistant ProfessorDepartment of Hematology & Medical OncologyWinship Cancer InstituteEmory UniversityAtlanta, GeorgiaAnnalise Labatut, PharmD, BCOPOncology Clinical Pharmacy Specialist – Breast OncologyEmory Healthcare/Winship Cancer InstituteAtlanta, GeorgiaJamie L. Carroll, CNP, APRN, MSNAssistant Professor of Medical OncologyMayo ClinicRochester, MinnesotaLink to the full program:https://bit.ly/3UT5Be8Claim CME Credit:https://bit.ly/4dBuxhx
Hétvégi podcastunk, az Elvitelre legfrissebb adásában a demenciában szenvedő betegek családjának mindennapjait, és a szlovák belpolitika legfrissebb eseményeit mutatjuk be. Iratkozzon fel a hvg360-ra, az első hónapban csupán 360 forintért! https://hvg.hu/360/elofizetes Az e heti menü: 1) Demencia a családban: „Anyukám már nem az az ember, akit korábban ismertem" (Serdült Viktória) – 0:32 2) Szeretettel Pozsonyból: Saját és társai bőrét menti Fico a büntető törvénykönyv módosításával (Molnár Norbert) – 14:56 Iratkozzon fel a HVG Podcastokra és kapcsolja be az értesítéseket, hogy egyetlen műsorunkról se maradjon le!
Hungary has seen its biggest anti-government protests in years over the past couple of weeks. But just how dangerous is this moment for Viktor Orbán? This week our favourite Hungarysplainer Viktória Serdült joins us to decipher the scandal that has shaken his government. We're also talking about the legalisation of gay marriage in Greece (finally!) and a Dutch court case that could have far-reaching consequences for the war in Gaza. FULL EPISODE TRANSCRIPT HERE: https://europeanspodcast.com/episodes/orbans-biggest-crisis Viktória is a journalist at hvg.hu. You can find her on Twitter here and her article about Hungary's EU elections can be found here in EUObserver. This week's Inspiration Station offerings: 'Navalny' and 'Lost on Me' (Niente di vero) by Veronica Raimo. The Dutch court ruling can be found here and Euronews' piece on European military supplies to Israel can be found here. Thanks for listening! If you enjoy our podcast, we'd love it if you'd consider chipping in a few bucks a month at patreon.com/europeanspodcast (many currencies are available). You can also help new listeners find the show by leaving us a review or giving us five stars on Spotify. 00:22 Spending *most* of the week reading about Europe 02:29 Good Week: Gay marriage is now legal in Greece 07:47 Bad Week: European defence companies? 17:01 Interview: Viktória Serdült on Hungary's pardoning scandal 32:33 The Inspiration Station: 'Lost on Me' by Veronica Raimo and 'Navalny' 36:33 Happy Ending: Why kids monkey around Producers: Katy Lee and Wojciech Oleksiak Mixing and mastering: Wojciech Oleksiak Music: Jim Barne and Mariska Martina Instagram | Threads | Twitter | Mastodon | hello@europeanspodcast.com
En 'Más de uno' hablamos de las personas altamente sensibles, un rasgo de la personalidad que condiciona la vida de muchas personas que tienen una gran empatía, creatividad, emocionalidad, pensamiento profundo y analítico.
In Part 1, you learned how illiberal regimes have used the political tools at their disposal – and their rich friends – to turn the media outlets of democratic European countries into propaganda machines. In Part 2 we're exploring the legal tools needed to complete the job and talking to local journalists who found themselves on the receiving end of these takeovers. Finally, we're asking: how can you stop a wannabe autocrat doing this in *your* country? This series was funded by Journalism Fund Europe, the Allianz Foundation, and supporters of The Europeans. Thanks for listening. If you enjoy our podcast and would like to help us keep making it, we'd love it if you'd consider chipping in a few bucks a month at patreon.com/europeanspodcast (many currencies are available). You can also help new listeners find the show by leaving us a review or giving us five stars on Spotify. Credits Reporters: Viktória Serdült, Dimitar Ganev and Wojciech Oleksiak Writers: Wojciech Oleksiak and Dimitar Ganev Production, scoring, sound design and mixing: Wojciech Oleksiak Editors: Adam Zulawski and Katy Lee Editorial support: Katz Laszlo and Dominic Kraemer Director of recording sessions: Dominic Kraemer Artwork: RTiiiKA Thanks for talking to us: Vesislava Antonova, Ervin Gűth, Antal Józing, Zuzanna Nowicka, Venelina Popova, Anna Wójcik, Spas Spassov, Marek Twaróg, Ágnes Urbán, and Cezary Węgliński.Instagram | Bluesky | Twitter | hello@europeanspodcast.com
It's a playbook that's been used by illiberal governments across Central and Eastern Europe: muzzling the media until it resembles little more than propaganda. But how exactly does one go about dismantling the free press, in a democratic country within the European Union? In Part 1 of this two-part special, Viktória Serdült, Dimitar Ganev and our producer Wojciech Oleksiak ask: how the hell did we get here? And how did the local press become such a powerful political weapon? This series was funded by Journalism Fund Europe, the Allianz Foundation, and supporters of The Europeans. Thanks for listening. If you enjoy our podcast and would like to help us keep making it, we'd love it if you'd consider chipping in a few bucks a month at patreon.com/europeanspodcast (many currencies are available). You can also help new listeners find the show by leaving us a review or giving us five stars on Spotify. Credits Reporters: Viktória Serdült, Dimitar Ganev and Wojciech Oleksiak Writers: Wojciech Oleksiak and Dimitar Ganev Production, scoring, sound design and mixing: Wojciech Oleksiak Editors: Adam Zulawski and Katy Lee Editorial support: Katz Laszlo and Dominic Kraemer Director of recording sessions: Dominic Kraemer Artwork: RTiiiKA Thanks for talking to us: Vesislava Antonova, Ervin Gűth, Antal Józing, Zuzanna Nowicka, Venelina Popova, Anna Wójcik, Spas Spassov, Marek Twaróg, Ágnes Urbán, and Cezary Węgliński. Instagram | Bluesky | Twitter | hello@europeanspodcast.com
CDK4/6 inhibitors are used to treat both early-stage and advanced-stage hormone receptor-positive, HER2-negative breast cancer. The CDK4/6 inhibitors are: Ibrance (chemical name: palbociclib) Kisqali (chemical name: ribociclib) Verzenio (chemical name: abemaciclib) At the 2023 San Antonio Breast Cancer Symposium, Dr. Stephanie Graff moderated an educational session to help people and their doctors decide on treatments after a CDK4/6 inhibitor has stopped working. Listen to the podcast to hear Dr. Graff explain: how the oral SERD, Orserdu (chemical name: elacestrant), might be used how PARP inhibitors, such as Lynparza (chemical name: olaparib) or Talzenna (chemical name: talazoparib) might be used why using a CDK4/6 inhibitor after another CDK4/6 inhibitor probably won't be used
Drs. Hope Rugo and Nancy Davidson discuss the next generation of endocrine therapy in hormone receptor-positive breast cancer – SERDs, SERMs, CERANs, and PROTACs – and challenges relating to the optimal sequence of therapeutic options. TRANSCRIPT Dr. Hope Rugo: Hello, I'm Dr. Hope Rugo, your guest host of the ASCO Daily News Podcast today. I'm a professor of medicine and director of breast oncology and clinical trials education at the University of California San Francisco's Comprehensive Cancer Center. Hormone receptor-positive (HR+) breast cancer is the most common subset of this disease and breast cancer is the most common cancer diagnosed in women worldwide. Endocrine therapy (ET) is the cornerstone of management in hormone receptor-positive breast cancer and may involve suppressing estrogen production with aromatase inhibitors in the cancer cell itself, or directly blocking the estrogen receptor pathway through selective estrogen receptor modulators, such as tamoxifen, or the injectable selective estrogen receptor degrader, fulvestrant. However, despite the availability of these therapies, the largest unmet need lies in treatment of HR-positive HER-negative disease lies after progression on endocrine therapy. On today's episode, we'll be discussing the emerging generation of endocrine therapies in breast cancer, some of which were designed to overcome common mechanisms of endocrine resistance, and the challenges relating to the optimal sequence of therapeutic options. Today, I'm delighted to welcome the world-renowned breast cancer researcher, Dr. Nancy Davidson, to the podcast. She's a professor and the executive vice president for clinical affairs at the Fred Hutchinson Cancer Center and professor of medicine at the University of Washington as well as past president of ASCO and AACR. You'll find our full disclosures in the transcript of this episode and disclosures of all guests on the podcast can be found in our transcripts at asco.org/DNpod. Nancy, it's great to have you on the podcast today. Thanks so much for being here. Dr. Nancy Davidson: Thank you so much, Hope, for the opportunity. Dr. Hope Rugo: You've done incredible work in the area of treating HR+ disease, but also in understanding some of the agents and pathways that are most important to our understanding of how we treat and really think about developing new drugs for HR+ breast cancer. The first generation of anti-estrogen drugs really included selective estrogen receptor modulators, but now we have a new generation of these anti-estrogen drugs. And there's also orally administered selective estrogen receptor degraders, so-called SERDs, that we hope someday will be an alternative with already one approved for the injectable SERD, fulvestrant. But there's a whole additional class of drugs, complete estrogen receptor antagonists, referred to as CERANs, and proteolysis targeting chimerics, PROTACs. These agents are all at various stages of development in both early and metastatic settings and really represent, I think, a confusing array of different treatments that are being studied, some of which of course are approved. Nancy, it would be great if you could tell us some about these exciting new agents, starting with our approved drugs and moving on to the agents that we're studying in clinical trials. Dr. Nancy Davidson: Hope, this is a terrific example of how basic science has really begun to inform clinical practice. For us as breast cancer practitioners, it was really easy for a long time because we only had tamoxifen. And then things like the aromatase inhibitors as a means of decreasing the estrogen ligand came into practice, as did fulvestrant, as you mentioned, a selective estrogen receptor degrader. Thanks though to a lot of understanding about estrogen receptor biology, and specifically, the discovery about a decade ago of estrogen receptor mutations, something that we didn't think exist ed for a long time, but which we now know exists in maybe a third to a half of breast cancers after exposure to aromatase inhibitors, that's led to really an explosion, this alphabet soup of possibilities that you talked about. SERMs, selective estrogen receptor modulators, tamoxifen is the classic one—something that acts as an agonist and as an antagonist, depending on the tissue. The SERDs, the selective estrogen receptor degraders, lead to estrogen receptor destruction. Fulvestrant is the classic example of this right now. But we're very excited that a second one has been FDA approved. That's elacestrant that was approved earlier this year, and it has specifically been developed to try to target those estrogen receptor mutant breast cancers because those are the ones that are particularly resistant. So that's the first of this new generation of SERDs that's coming on the market, has come on the market. As you say, a key advantage there is that it's oral, unlike fulvestrant, which requires 2 monthly injections and is very, very inconvenient and uncomfortable for patients. Other SERDs are coming along. I think another one that is well along in clinical development is giredestrant, which is in the same family and being tested in clinical trials of the classic varieties. It's been tested in a window trial, looking at its ability to down-regulate Ki67. It's being tested against standard of care in first-line metastatic breast cancer. And there are some studies that are going to begin looking at it in the adjuvant setting as well. There are other members of this particular family, but I think that elacestrant is the one that we have at our fingertips right now, and giredestrant is one that's certainly coming along in clinical trials, and we should look forward to those results. For those who are interested in the giredestrant, the trials in question right now that are going on are persevERA, which is in stage 4 breast cancer, and lidERA, which is in the adjuvant setting. Now that's one new category, or it's an old category with a new twist. A second is these agents that are called complete estrogen receptor antagonists, CERANs, as you talked about them. The key here is that what they do is, the estrogen receptor has a couple of domains, and in particular, it has 2 different activation domains, AFT1 and AFT2. And these CERANs are complete estrogen receptor antagonists, so they block both of those domains. And the hope would be that they might end up being more effective than the other agents that we have available to us right now. So those are also in clinical trial at the present time, and we're waiting to see whether or not there's going be any value in that particular area that's going to able to go forward for us. Another area that I think we want to talk about is the PROTACs, as you mentioned. These are proteolysis targeting chimeric entities. So, this is a kind of a complicated situation where you have a kind of bivalent situation where you have something that binds both to the estrogen receptor and then also to E3 ubiquinase. So, it leads to degradation again of the agents; that's another area for us to be watching. And then finally the SERCAs. So those are the selective estrogen receptor covalent antagonists, and what they do is they bind very specifically to a cysteine 530 that exists in the estrogen receptor but not in other steroid receptors. So that's where the selective part of this comes along. Now these are all in various stages of clinical investigation. Some of them are pretty early at this point, but I think the ones that are well established are elacestrant, giredestrant is coming along as we just talked about. Camizestrant is also coming along through the SERENA series of trials, and imlunestrant is also coming on through the EMBER series of trials. Hope, I would also be remiss if I didn't go back to an old drug that's a new drug, and that's lasofoxifene, which is also in the SERM family. Those who have been in our field for a while will remember that lasofoxifene was actually originally kind of tested in the prevention setting, where it seemed to have some activity. It came back into our interest because it has really strong activity against estrogen receptor mutant breast cancer models in the laboratory. And as a consequence of that, it's coming back into the clinic through a series of trials that are called the ELAINE trials, where we're looking to see whether or not it might also be better than fulvestrant. It too is an oral agent, so that's a real plus for us, and the first set of ELAINE trials would suggest that there's some nice activity without a lot of toxicity. So, lots going on in this field. You know, I think for all of these things, obviously, we're also working very hard to think about the toxicities. All of these, as I recall, are oral agents. So that gets rid of 1 huge toxicity, which is you don't have the need for some sort of injection. But they all do have some side effects. Frequently, [the toxicities] are like GI side effects or fatigue. In a couple of cases, there might be some concern about cardiac arrhythmias, but I think GI turns out to be one of the most important things that we have seen in some of these trials. Generally, it's very well tolerated, though. I think another important question, which I'm sure is in your head and is in mine, is that how are we going to integrate these into what we already have? And so, I think a lot of the work right now is looking at patients who have already received an aromatase inhibitor plus a CDK4/6 inhibitor and are now going on to one of these new agents. But you might wonder, if they turn out to be effective and well-tolerated, whether they too should be perhaps combined with CDK4/6 inhibitors in place of the aromatase inhibitors or the fulvestrant that we use now. So, I think that we can imagine that those clinical trials are either in progress in some cases or will be coming on as we try to think about how to integrate these new approaches into our existing standard of care, which is already quite complicated, right? We've gone far from tamoxifen, which was good for everybody, to now a really complex algorithm about how we think about hormone therapy, both in early breast cancer and in metastatic breast cancer. Dr. Hope Rugo: Well, that was a fabulous discussion about the new agents and our existing agents and both the exciting aspects, as well as the challenges. One question that comes up, I think a lot, and this is of course a huge question in many ways, but for ER-positive metastatic breast cancer, where these drugs are first being tested, maybe we'll talk about that first. There's one trial at SERENA-6, looking at camizestrant in patients who have developed evidence of an ESR1 mutation in circulating tumor DNA, who are on first-line therapy with an AI and a CDK4/6 inhibitor. What do you think about that study and where do you think that progress might go? Of course, that's based on data from another trial, which wasn't definitive, but suggested, had sort of a suggestion, you know, without studying the sequencing in detail that maybe you would have improved progression-free survival with that approach. Dr. Nancy Davidson: Yeah, by which you mean the idea of monitoring pre-ESR1 mutations and circulating DNA and then making therapy changes based on that? Is that what you're talking about? Dr. Hope Rugo: The PADA-1 trial, yes, and that led to this huge SERENA-6 trial, which of course is now accruing. Dr. Nancy Davidson: So, you know, we would love that, right? I think that obviously breast cancer for many years has been interested in trying to have circulating markers that we could use to help to guide our therapy in a more meaningful way than we have in the past. And I think that the trial that you've talked about is certainly one that's trying to make that see whether that's a possibility for us based on information like the PADA trial. I'm hopeful it's going to work out. I would say, let's see what that looks like, whether it's going to be useful or not. It seems to me in some cases, some of these trials have not been quite what we hoped for, but I don't think we necessarily had the molecular techniques or the sensitivity, nor did we necessarily have other things to move to because, you know, those two approaches require both a really good test, but also the ability to use the test to define a new therapy that's going to lead to improved patient outcomes. And I think that these are ingredients that we now have available to us at our fingertips more than we did, say, a decade or 2 decades ago. Exciting approach. Dr. Hope Rugo: I do think there's a lot of challenges inherent in this process, monitoring blood on a regular basis and following up and then randomizing based on results. But I think [SERENA-6] is an incredibly important trial, as you have mentioned, to try and think about moving past using circulating tumor cells, which didn't work, to just change blindly to the next therapy, but more have a rational reason to change to a drug that may be more effective before the disease itself progresses. And just for our listeners, the unique aspect of trials like this in SERENA-6 is that you change therapy before you have evidence of disease progression, but only this molecular evidence of a mutation that is associated with resistance to the therapy you're on. So, it's a really important question. We'll see what happens, as you mentioned, sometimes we're not clever enough to really get around the fact that there are multiple mutations driving resistance in this setting, so we'll see how straightforward this is. The question also comes up, and I think that's a question with many of these trials now, is they're randomizing patients after a progression on an AI and CDK4/6 inhibitor to receive the novel endocrine therapy or fulvestrant. One of, I think, the concerns of treating oncologists is that then you're sort of eliminating the possibility of a targeted agent in that setting. And of course, we have new targeted agents we're studying as well, AKT inhibitors and new inhibitors of the PI3 kinase pathway. So, the newer trials are now combining, as you mentioned. There's a lot of concerns about drug-drug interactions here and how you might really combine them. And then there are triplet studies looking at CDK4/6 inhibitors, oral SERDs primarily, and pi3-kinase and CDK4/6 inhibitors. What's your thought on these and will they really help to move the needle forward? Dr. Nancy Davidson: I think that's a really interesting question, Hope, is whether or not we're going to find that combination therapies from the get-go are the way to go, or whether we're going to end up having to use maybe more serial therapies. Because not only is it a question about whether or not you can tackle all of these different resistance mechanisms simultaneously, but I think the other question is, as you say, are there negative drug-drug interactions, and are there toxicities that are intolerable? Although these are targeted in all cases and they're relatively benign in terms of side effects from the breast cancer perspective, they're not devoid of toxicity. And so, I think that's going to be another issue for us – whether they're well tolerated during the time that patients are taking them. I guess the other thing I always think about, Hope, is that it's hard to know about value of cancer care, but you know, we are talking about agents that are not inexpensive. You know, when you think about the financial toxicity, in addition to the side effect toxicity that you and I just talked about, trying to think about what that value is going to look like is going to be very important for us. Also, as somebody who worked for a long time in the lab and in the clinic, you know, there are an infinite number of combinations that you and I could think about that are rational. And so, the question is, how are we going to pick the ones that are the most rational, if you will, the ones that seem to be the most promising, and take them forward into clinical trials? Because patients are our most precious resource. And so, we want to make sure that we are bringing forward only those things that really seem to have a very strong foundation and the opportunity to improve outcomes over time. Tough, tough question for us to try to think about, as you've talked about. The other thing is that, you know, these trials are not only for postmenopausal women, who are the majority of patients, but we also want to target them to premenopausal women. So, in those women, we're also looking at using an LHRH agonist on top of this, right, because many of these things are really at least so far designed for the postmenopausal state. So stay tuned. Lots of work going on. I think one of the interesting things will be making the leap from using these in metastatic disease at time of progression to taking them forward into the early breast cancer space. And several of the agents are now beginning to do that because of very strong preclinical and clinical data to date. Dr. Hope Rugo: So, we have new agents that we're studying in the metastatic setting, and we've seen a trend to move fairly rapidly from phase 1B trials directly into phase 3 trials, because as you pointed out so clearly, there are a number of drugs in this setting, and we don't really know not only which agent is better, but even what class of agents is better. So, as we move more quickly from phase 1B to phase 3, the question comes up about how we're going to study these agents optimally in the early-stage setting. They, I think we all thought that maybe changing based on ctDNA evidence of a mutation might be an approach, but that's complicated. A big question for you is whether or not you think that's ready for prime time as it's being marketed as such. And then the second question is really, are we better changing our whole approach upfront in high-risk disease or should we wait until after patients are exposed to their endocrine therapy and then switch as we go along; the EMBER-4 trial is looking at that switching approach? Dr. Nancy Davidson: Yeah, I think that this is obviously the billion-dollar question for many companies and for many of us as investigators. I don't know that I have a crystal ball into what the best approach might be. We know that already some of these have been abandoned. For example, amcenestrant. So, I don't even have to learn how to say it because it has been abandoned. It did go to phase 3, as you pointed out, in the advanced setting, looking at it with palbo vs letrozole plus palbo, and it didn't really show a whole lot that the company wanted to pursue. So, I think that sometimes these things are going to be abandoned based on the metastatic setting, which is a large trial, and that's a trial where obviously it might be a little easier to the circulating markers, as you talked about, than maybe in the early-stage breast cancer setting. I think that probably these early-stage trials are going to end up being big; they're going to have be clean. I'm guessing that most companies and most investigators will want to target them towards high-risk individuals, as you talked about, for 2 reasons. One is that ethically, I think we feel more comfortable with that. These are individuals where standard therapies are maybe not serving them as well as we would like and where we have information to think that we can at least have equipoise about a new approach. And the second is that from a trial design point of view, the event rate is likely to be higher, and therefore you might get answers earlier and with a smaller clinical trial. So that's where I suspect we're going to go. But it's a challenging question, and I think that many investigators and many companies are really trying to struggle with that right now because we do have so many options. And we're not quite sure how to, first, develop these new drugs, but then really importantly, put them in the context of our existing drugs. And as you say, we're also simultaneously trying to develop superior molecular or circulating markers to guide us. So, there's so many variables that are going on right now in this field that, from my point of view, itmakes it really exciting, but it also makes it pretty complicated, both for investigators and for pharma as we try to think about how to position these going forward. But what a great problem to have, Hope, because remember when you and I started in breast cancer, pretty much all you needed to know was tamoxifen. And I think you and I also probably started at the tail end of the time when we were using androgens and progestins and agents that now have basically completely fallen out of favor. Dr. Hope Rugo: Estrogen Dr. Nancy Davidson: Estrogen, yeah, and your side effect profiles were not as good. So, it's a good problem to have. It's a nice situation when science can inform our clinical investigation, our clinical practice. Dr. Hope Rugo: Yes, I think it'll be fascinating to see where we end up at the end, but of course, the complexities of this include the fact that sometimes just the clinical trial design leads to a less than positive result because of the way the trial itself has been designed, which I think is the nice part about moving these earlier into treatment of high-risk disease, but also brings up the question of all sorts of areas we're not really a place to discuss today, like how the statistical design is made, et cetera, that can sometimes result in poor evaluation of excellent agents. One of the questions that comes up, and you brought this up earlier, which I think is really important, is that we are in the era of combining our endocrine agents with targeted agents, and, oral agents, in a fascinating way, really bring up drug-drug interactions in a way that the injectable fulvestrant hasn't, and aromatase inhibitors were kind of quiet on the impacting metabolism, unlike tamoxifen. But we are seeing some drug-drug interactions and certainly the discussions about using these agents may include the question about whether or not you're having more diarrhea or nausea or fatigue or one drug causes photopsia, flashing lights, things like that. Keratitis is becoming a new toxicity to follow. How are we going to figure out how to sequence these drugs and are they only going to work better all of them as a class in patients with ESR1 mutations in their tumors? Dr. Nancy Davidson: I think we don't know the answer to the second question yet. That's something that really needs to be sorted out. Even if they do, that's still a really important subset of patients, assuming that we continue to start with the aromatase inhibitors, right? That's where those things really seem to emerge right now. I don't know how we're going to figure those things out. I guess that I'm hoping that maybe a couple of agents in these classes will become kind of the lead agents. And so, we'll be able to do this work with a handful of things as opposed to a whole array of things. But we'll see. I think that even within classes, obviously, these agents are going be slightly different, probably. And so it may be that one member of a class may be slightly better from a, maybe not from an efficacy point of view, but from a toxicity point of view. And we'll just have to see how it goes. I don't think I have any magic answers about that. Dr. Hope Rugo: Yes, it'll be interesting to see whether or not the agents work in sequence too. You know, could you use a PROTAC after an oral SERD, for example, or a CERAN? That'll be fascinating to see. Dr. Nancy Davidson: I'm hoping that preclinical modeling may help with that a little bit, though of course we all know that there are plenty of things that do well in preclinical models, GEMS and rodent models and PDXs, and sometimes those things translate nicely into clinical practice, but sometimes they don't. Dr. Hope Rugo: You mentioned, Nancy, that when we started out, that it was a fairly simple decision about what endocrine therapies, and we ran out very quickly. We're seeing some of those old classes come up with new agents. And you mentioned lasofoxifene, the oral SERM that seems to have some benefits and works in the later-line setting and also can be combined with a CDK4/6 inhibitor; [and also] has data with abemaciclib. There's also a new androgen receptor agonist, enobosarm, that's being tested as well. Do you think that these older mechanisms have a future as well? Dr. Nancy Davidson: I do. I think that because we'll be able to understand the biology better than we did in the past. A lot of our hormone therapy was pretty empiric several decades ago. But I think with better understanding of mechanisms and better understanding of what the patterns of resistance might be for a particular tumor, that we might be able to think about those things. You're right that there's a whole parallel universe right now in androgen receptor targeted therapies that we're not talking about today, both in perhaps in hormone-responsive breast cancers, but also in triple-negative breast cancers in a certain subset. And so that's an area where we probably need to be watching what our prostate cancer colleagues are doing as they develop these agents and thinking about where they might mechanistically make sense to apply in the breast cancer field. It won't be the first time that we've received insights from them because remember, prostate cancer people knew about androgen receptor mutations a really long time before we figured out that they existed in estrogen receptor as well. So, there's a nice cross talk, I think, between the prostate cancer field and the breast cancer field in that regard. Dr. Hope Rugo: That's an excellent point. And we learn a lot from our colleagues studying other malignancies, and prostate cancer has been a big area there for us and hopefully will help us with studying these agents because there's different toxicity profiles, of course, as well. And then you mentioned the approval of elacestrant, the first oral SERD to have regulatory approval, and it's approved in patients who have ESR1 mutations in their tumors. We're also studying it in the ELEVATE trial in combination with all of the different targeted agents, the CDK4/6 inhibitors, mTOR inhibitor, everolimus, and the PI3 kinase inhibitor, alpelisib, to really try and understand how these can be optimally combined. Would you check for ESR1 mutations at diagnosis of metastatic disease, or would you do this more after progression or start of progression of disease on an aromatase inhibitor? Dr. Nancy Davidson: I tend to be a conservative, Hope, and so unless there's a clinical trial that might be able to be considered, I would tend to check it only after progression on the aromatase inhibitor. But I think some people are earlier adopters, and I suppose it's possible that they might want to know from the get-go. Having said that, I do think elacestrant has an approval after aromatase inhibitor, as I recall. So, presumably the patient would have to have that exposure before you would be able to act on the ESR1 mutation by administering the oral SERD. This is also a new area that may well change with time, right? You know, as we develop different agents, as the agents have different requirements or different indications, and as we perhaps have better tests, it may be things that we don't do routinely now will become very routine in the future. And perhaps in series like you talked about in a serial fashion. Dr. Hope Rugo: Absolutely. I think that's a really important comment about how we're going to think about treating hormone receptor positive disease and potentially, you know, we have new chemo options, of course, not part of our talk discussion today and antibody drug conjugates. So, the future is certainly challenging in terms of understanding this appropriate sequencing. We need data, but it's exciting to have these options. As you pointed out, this is this is a great problem to have, you know, too many drugs with efficacy to try and understand how to use these in the most appropriate way. And as you also pointed out, the use in young women is particularly important. Whether or not you need to suppress the ovaries with all of these new agents is going to be important to understand as well as a next step. I don't know if you have specific thoughts on that area as well. I mean, that may reduce toxicity for younger women. Dr. Nancy Davidson: I guess our approach right now has been to suppress them, but I agree with you; you wonder if you look at some of the mechanisms of action, whether that's really a requirement biologically and medically, or whether it's something that's kind of a leftover from the approval process. You know, that for the drug approval, these women were suppressed. I think we need to work that out because that's another area where certainly women could have ovaries removed. That's pretty straightforward, although it requires a surgical procedure. But otherwise use of LHRH agonists continues to be injections, right? And so, if we're trying to minimize convenience or maximize convenience and minimize toxicity for women with any stage of breast cancer, anything we can do, it seems to me to eliminate an injection is going to be a good thing. So important for us to be able to work that out as well, even though numerically it's a smaller number of women, it's obviously a very important number. population of women. Dr. Hope Rugo: Last question for you. One question that comes up and sent to me and panels all the time is, if you have done your next generation sequencing and you see an ESR1 mutation and a P13CA mutation, what do you prioritize in terms of your choice of treatment, because we have the choice of either using elacestrant or a fulvestrant in combination with an agent targeting the PI3 kinase pathway? Dr. Nancy Davidson: I don't know that there's a right answer to that medically right now. So, when I talk about it with patients, I suggest to them that it's probably not one or the other. It's kind of the question of which one to use first. So, we talk a little bit about side effect profiles. We talk a little bit about patient preference and neither of these drugs is devoid of problems, but sometimes patients have pretty strong feelings about which set of side effects seems the least unattractive to them or the possibility of having those side effects. And I know that if one isn't well tolerated, you can swap over to the other. Dr. Hope Rugo: Absolutely. I think that's a very important way to think about next therapies in our era of not really knowing what's right. And this idea of shared decision-making is so incredibly important. Nancy, thank you so much for sharing your insights and knowledge with us today. I could talk to you for hours about this. Dr. Nancy Davidson: Hope, thank you so much for the opportunity. It is an exciting area and I really enjoyed talking with you about what we know and the many things that we don't yet know, but we're working on. Dr. Hope Rugo: Indeed, it's certainly an exciting time. Thank you to our listeners for joining us today. And thanks to the ASCO Daily News Podcast for highlighting this important area. You'll find a link to all of the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Thanks 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. Follow today's speakers: Dr. Hope Rugo @hoperugo Dr. Nancy Davidson Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Hope Rugo: Consulting or Advisory Role: Napo Pharmaceuticals, Puma Biotechnology, Mylan, Eisai, Daiichi Sankyo Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Genentech, Merck, Daiichi Sankyo, Sermonix Pharmaceuticals, AstraZeneca, Gilead Sciences, Astellas Pharma, Talho Oncology, Veru, GlaxoSmithKline, Hoffmann-LaRoche AG/Genentech, Inc Travel, Accommodations, Expenses: Merck, AstraZeneca Dr. Nancy Davidson: No Relationships to Disclose
¿Qué pasaría si la iglesia de hoy comprendiera firmemente la realidad de que hay que ser débil para ser santificado?
In today's conversation, we're delving into the world of nutrition with Garret Serd, and we go on a journey through various dietary approaches. From the concept of reverse dieting to the intriguingly named Million Dollar Body Program, Nate discusses the perks and drawbacks of each nutritional framework. Ever wondered what happens when you step away from these frameworks? We're also diving into the realm of setting yourself up for nutritional success, as well as the intricacies of the Macro-Based Eating Framework for long-term triumph. But that's not all – stay tuned as Garrett chimes in on the metabolic reset vs reverse dieting debate. Is reverse dieting truly a futile effort? Join us as we unravel the mysteries of conquering cravings, balancing hunger, and restoring healthy calorie levels, all while exploring the flexible realm of calorie tracking. And let's not forget the incredible journey of Tandem, an empowering coaching ally since 2012, and Garrett's reflections on wrangling chaos amidst the bustling domains of life and business. Get ready for a riveting nutritional odyssey! [0:00 - 9:44] Nate talks about the pros and cons of different styles of nutrition. Exploring Nutritional Frameworks: From Reverse Dieting to the Million Dollar Body Program. What happens when you stop the framework? Is it impossible to do intuitive eating when your diet includes hyper palatable foods? Setting yourself up for success with nutrition. [9:45 - 19:24] Optimizing Nutrition within the Macro-Based Eating Framework for Long-Term Success. Garrett shares his thoughts on metabolic reset vs reverse dieting. Why is reverse dieting a waste of time? What is metabolic reset and why does it matter? [19:25 - 27:07] Overcoming Cravings and Hunger to Restore Healthy Calorie Levels. Flexible calorie tracking approach. Tandem: Empowering Clients through Active Coaching since 2012. Balancing Chaos: Garrett's Struggle with Busyness in Life and Business.
Welcome to this episode on how to change your identity around exercise. In today's conversation, I'm thrilled to welcome our special guest, Garrett Surd. We'll be exploring the transformative power of mindset and identity when it comes to achieving our fitness goals. It's not just about nutrition; it's about reshaping how we see ourselves and our relationship with exercise. We'll delve into the idea of emulating successful strategies, utilizing repetition through automation, and understanding why consistency is the key to mastery. Moreover, we'll discuss the challenges of battling societal expectations and the benefits of borrowing from others' experiences. Knowing who your role models are plays a significant role in this process, and we'll uncover the importance of finding the right inspirations for your unique journey. Get ready to unlock the secrets of transforming your exercise identity for a healthier, fitter you. Let 's dive in! [0:00 - 8:30] How to change your identity around exercise. Introduction of the episode and what to expect. Changing mindset and identity is crucial for achieving desired results, not solely dependent on nutrition. How can we emulate the results of their work? The power of repetition through automation. [8:31 - 15:50] Why consistency is the mother of mastery? Battling societal expectations of what is acceptable. Borrowing from other people. The importance of knowing who your role models are.
Hoy reconocemos que el amor es libre y que no se trata de cambiar a las personas para que cumplan nuestras expectativas, sino de verles y amarles por quienes son.En este episodio hablamos de:El amor verdadero implica aceptar a alguien tal cual es, sin querer cambiar nada en esa personaAmar es renunciar a nuestras expectativas y permitir que la otra persona sea quien realmente esEl amor saludable se basa en la aceptación mutua y el crecimiento conjuntoSi quieres conocer más de Despertando Podcast síguenos en nuestras redes sociales:Instagram: https://www.instagram.com/despertandodurmiendo Facebook: https://www.facebook.com/despertandopodcast TikTok: https://www.tiktok.com/@despertandodurmiendo YouTube: https://www.youtube.com/c/DespertandoDurmiendoPodcastSi quieres conocer más sobre nuestros podcasts visita https://www.dudasmedia.com/Voz: Aura RamírezGuion: Alis EscobarDirección Creativa: Alis EscobarDiseño Sonoro: Alfredo CruzDiseño Gráfico: Beca SánchezÁrea Digital: Nancy EdidÁrea Digital (YouTube): Camila MorenoÁrea Digital (TikTok): Yexa Vega Hosted on Acast. See acast.com/privacy for more information.
Discussing the EMERALD Phase III study which resulted in the FDA approval of the first oral selective estrogen receptor degrader (SERD) after demonstrating statistically significant and clinically meaningful benefit in postmenopausal women and men, with ER+, HER2- metastatic breast cancer patients, post progression in first line with endocrine therapy and CDK4/6i. In discussion with Dr. Virginia Kaklamani - Professor of Medicine - Leader of Breast Oncology Program UT Health San Antonio MD Anderson Cancer Center. Website: http://www.oncbrothers.com/ Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com
Dr. Angie DeMichele and Dr. Lynn Henry present the latest rapid recommendation impacting two ASCO guidelines. This update focuses on testing for ESR1 mutations in patients with hormone receptor-positive, HER2-negative metastatic breast cancer, and presents treatment recommendations for patients with a detectable ESR1 mutation. Dr. DeMichele and Dr. Henry review the recent data from the EMERALD trial, discuss it's implications for practice, and ongoing developments they're monitoring for more effective therapeutic options. Read the latest update, "Testing for ESR1 Mutations to Guide Therapy for Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: ASCO Guideline Rapid Recommendation Update at www.asco.org/breast-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/breast-cancer-guidelines. Read the full text of the update and review authors' disclosures of potential conflicts of interest disclosures in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.2300638 Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Angie DeMichele from University of Pennsylvania, and Dr. Lynn Henry from the University of Michigan, authors on ‘Testing for ESR1 Mutations to Guide Therapy for Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: ASCO Guideline Rapid Recommendation Update'. Thank you for being here, Dr. DeMichele and Dr. Henry. Dr. Angie DeMichele: It's a pleasure. Dr. Lynn Henry: Thank you. Brittany Harvey: Then, before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including our guests on this podcast episode today, are available online with a publication of the rapid recommendation update in the Journal of Clinical Oncology, which is linked in the show notes. So then, getting into the content of this rapid recommendation first, Dr. Henry, what prompted this rapid update, which provides updated recommendations for two ASCO guidelines? First, the ‘Biomarkers for Systemic Therapy and Metastatic Breast Cancer Guideline', last published in 2022, and the ‘Endocrine Treatment and Targeted Therapy for Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer Guideline', which was last updated in 2021. Dr. Lynn Henry: Thank you, Brittany. There's been a lot of exciting news for the treatment of metastatic breast cancer in the last few years. This particular update reflects the results of the phase III EMERALD trial. This trial compared the new oral selective estrogen receptor degrader, elacestrant, to standard-of-care endocrine therapy with either fulvestrant or an aromatase inhibitor in patients with hormone receptor-positive, HER2-negative metastatic breast cancer that had previously progressed during treatment with a CDK4/6 inhibitor in combination with endocrine therapy. Compared to standard-of-care, in this trial, they showed improved progression-free survival in both the overall study population as well as specifically in the patients who had a detectable ESR1 mutation in their circulating tumor DNA. These findings were published in the Journal of Clinical Oncology in 2022, and the drug was subsequently approved by the US Food and Drug Administration in January 2023. Therefore, we felt that it was important to update the guidelines to reflect the results of this trial and the new drug approval. Brittany Harvey: Excellent. Thank you for describing the results of that trial and the new approval. So then, based on this data, Dr. DeMichele, what is the updated recommendation from the guideline expert panel for testing for ESR1 mutations? Dr. Angie DeMichele: So, the guideline panel has now recommended that ESR1 mutation testing occur for any patient who develops a recurrence or progression on endocrine therapy. And this is specifically in reference to the development of ESR1 mutations that can occur after a patient has been exposed to aromatase inhibitors. The guideline itself recommends that this testing be done on either tumor or blood, but blood is preferable because there is increased sensitivity using ctDNA testing over tumor testing. So this was an important component of the change in the recommendation because it's linked to the approval of elacestrant as a therapy. Patients are only eligible to receive elacestrant if they harbor an ESR1 mutation. Brittany Harvey: Understood. I appreciate that explanation. So then, Dr. Henry, following that recommendation for testing, what is the new recommendation for treatment for patients with a detectable ESR1 mutation? Dr. Lynn Henry: Yes. So patients who have a detectable ESR1 mutation and who have previously received treatment with endocrine therapy in combination with the CDK4/6 inhibitor for advanced breast cancer now have multiple treatment options. The newest option is this new drug, elacestrant, which is given 345 milligrams orally daily. There are still the other options that we already knew about, which include a different endocrine therapy alone, such as fulvestrant or an aromatase inhibitor, or possibly an endocrine therapy in combination with a targeted agent, such as alpelisib or everolimus. And those decisions really need to be based on what other mutations are present in the patient's cancer. Importantly, at this time, there are no safety or efficacy data to support using elacestrant in combination with targeted agents. Therefore, to date, it has only been approved to be used as monotherapy. But really, this is an exciting new potential option for treatment for patients whose tumors have a detectable ESR1 mutation. Brittany Harvey: Yes, this is an exciting option, and I appreciate you describing how this fits in with the existing treatment paradigm for these patients. So then, Dr. DeMichele, as these new recommendations are implemented, what should clinicians know? Dr. Angie DeMichele: I think this is a really important new step in breast cancer in testing for ESR1 mutations. We've not previously had a medication that required the existence of an ESR1 mutation for patients to be eligible for therapy. So obtaining ESR1 mutation testing may be new for some clinicians. As I stated earlier, this can be done either on a tumor biopsy or on blood testing using the Guardant360 ctDNA test, which is the test that was used in the clinical trial. And it was stated that the ctDNA test is more sensitive than the tumor test. But what's really important here is that the testing occur at the time that the clinician is considering switching therapies, because it's important to find that ESR1 mutation prior to starting the next therapy. ESR1 mutations don't typically exist in a tumor at the time it's diagnosed. They only emerge over time after patients have been exposed to different endocrine therapies, particularly aromatase inhibitors. It's also possible that at the time of a recurrence after aromatase inhibitor therapy or progression on an aromatase inhibitor, there will not be any detectable ESR1 mutation. However, with subsequent therapy, an ESR1 mutation can occur. So a patient may need serial testing over time to determine whether an ESR1 mutation has developed. Brittany Harvey: Understood. Those are important clinical implications. So then, Dr. Henry, Dr. DeMichele just described some of the testing implications for patients. But in your view, how does this rapid update impact patients with hormone receptor-positive, HER2-negative metastatic breast cancer? Dr. Lynn Henry: So as Dr. DeMichele mentioned, this update specifically highlights approval of a new drug, oral SERD elacestrant. This is an exciting new option for treatment of patients whose tumors have an ESR1 mutation. So previous data have demonstrated that cancers with ESR1 mutations do not respond as well to previously available standard-of-care treatments such as aromatase inhibitors. It's nice to have a drug that may be a better option than some of the previously existing treatments for hormone receptor-positive, HER2-negative metastatic breast cancer. Brittany Harvey: Definitely. That's great to hear. So then, finally, Dr. DeMichele, are there ongoing research developments that the panel is monitoring for future updates to these guidelines? Dr. Angie DeMichele: We certainly are monitoring additional research developments, Brittany. Specifically, there are numerous other selective estrogen receptor degraders that are being tested, and these also may ultimately require ESR1 mutation testing and detection for therapies. So we'll be monitoring the results of those clinical trials. We'll also be watching for additional trials that help us understand how to best utilize elacestrant and whether it can be combined with other therapies. And then, finally, I think we have to think about how to place this in the context of other types of molecular changes that we may detect in metastatic breast cancer, such as PIK3CA mutations and others. And as we move forward, I anticipate that we will have additional therapies that are specifically targeted to molecular changes in the tumor. And I think this is a really exciting development because this is a major step forward toward precision medicine, where we're really tailoring the therapy to the specific biology of the patient's tumor and actually responding to the ways in which the tumor is evolving over time and in response to treatment. So as tumors become increasingly resistant to therapies, we can actually take advantage of those resistance mechanisms to develop therapies that will be more effective. Brittany Harvey: Yes, we'll look forward to those new therapies and research developments and then updated guidelines in the future. So I want to thank you both so much for your work on this rapid recommendation update and for your time today, Dr. DeMichele and Dr. Henry. Dr. Angie DeMichele: Thank you. Dr. Lynn Henry: Thank you very much. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast. To read the full guidelines, go to www.asco.org/breast-cancer-guidelines. You can also find many of our guidelines and interactive resources in the newly redesigned ASCO Guidelines app, available for free in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this Podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
¿Quién se inventó que cada final y que cada nuevo comienzo tiene que ser difícil? a través de este episodio te cuento sobre mi nueva vida en Barcelona y por medio de esa historia te llevo a ser consciente de como cada creencia que tenemos se va manifestando en nuestra realidad.
In this episode, Garrett discusses the truth about reverse dieting and shares ways to optimize training and recovery. He emphasizes the importance of the post-dieting phase in boosting metabolism and preventing yo-yo dieting and explains his approach to fat loss and intuitive eating. The episode also explores immunity hacks and highlights the crucial role of sleep in promoting overall well-being. Overall, the episode provides valuable guidance for anyone looking to achieve long-term success in their nutrition and fitness journey. Garrett Serd, also known as Coach G, is a registered dietitian, certified personal trainer, and certified wellness coach. His passion for nutrition and fitness began in 2004 when he battled anorexia nervosa at 16 years old. He spent every waking minute learning about nutrition, fitness, and healthy living. He earned a Bachelor of Science degree in Nutrition and Dietetics from Louisiana Tech University and a Master of Science degree in Nutrition & Exercise from the University of Nebraska-Lincoln. Garrett founded Tandem Nutrition in 2012, where he serves as a women's fat loss expert and continues to inspire and motivate individuals to lead healthier and happier lives. Key Highlights: [00:01 - 08:31] Diet and Weight Training in Fat Loss and Metabolism ● The purpose of weight training is to maintain or grow muscle mass. ● Diet is the main driver for fat loss, but weight training helps maintain muscle mass, which is important for a healthy metabolism. ● Garrette advises going to the gym with the mindset of progressively overloading muscles with challenging weights rather than trying to burn as many calories as possible. ● Garrett explains that soreness and being out of breath are not indicators of a great workout. [08:32 - 18:52] Exploring Immunity Hacks ● Garrett asks some questions to Nate about the aura ring, wearing socks to bed, and cold water therapy. ● They discuss using the "Aura Ring" to track trends in their sleep, recovery, and health markers like respiratory rate and heart rate variability. ● Nate talks about cryotherapy and cold water therapy, including their benefits for mental health and stress management. ● Garrettes immunity hack is taking athletic greens and eating a lot of fruits and veggies to optimize nutrient intake and reduce exposure to toxins. ● They emphasize the importance of sleep and how it helps them manage anxiety and stress. [18:53 - 20:16] 5-Step Guide for Effective Strength Training Workouts ● Garrett has a five-step guide to help women set up strength training workouts ● The guide breaks down the steps to create effective fat-burning and muscle-building workouts ● The guide takes readers through the process of determining the number of sets and reps and which exercises to do, with notes on rep ranges, rest, and soreness ● Garrett encourages people to try the guide for six weeks, even if it doesn't seem "sexy," as it's better than a boot camp. [20:17 - 26:52] Closing Segment ● Nate throws some hard-hitting questions to Garrett: The next big thing in fitness? If you needed to make a thousand dollars as fast as possible, you would do…? The number one physical possession I own is…? If I could have one superpower, it would be…? If you could completely delete one song from existence and human memory, it would be..? The strangest thing I've ever been asked at the gym is…? Key Quotes: “The purpose of weight training is to maintain muscle mass, to grow muscle mass.” - Garrett Serd “You should not leave a workout feeling annihilated. You should feel a workout feeling stimulated.” - Garrett Serd “Soreness is not an indicator of a great workout.” - Garrett Serd “The reason why the body fights back is, because, again, it wants to have more body fat, but when you give it ample, no calories, there's a difference in what it sees and what it gets.” - Garrett Serd CONNECT WITH COACH G: https://tandemnutrition.com/online-coaching/ Getnatesbook - This book is a must-have for anyone looking to drop belly fat and eliminate love handles permanently with expert tips on the 7 daily investments for health and wealth, the one type of cardio you need to include, and a handy checklist to hold yourself accountable to your goals. Don't miss out on this game-changing resource - get your copy today! Here's how I can help you reach your goals! Get leaner. Live Longer. Be Legendary. 1. Visit N8training.com - mastermind 2. Join our 5-Day Morning Routine Challenge 3. Get my super easy and accessible FREE 5-Day Sugar Detox Program. All you have to do is put in your email and receive access together with a handbook! Thefreesugardetox.com 4. Start by understanding the science and simplicity of carb backloading for fat loss - go to GetNatesBook.Com. to get a free copy of Nate's bestseller “The Million Dollar Body Method” 5. Get more great tips to get leaner by connecting with me on Instagram @lowcarbhustle 6. Join the MDB Mastermind for just a buck! If you want accountability, coaching, and an amazing training program to get leaner, this is what you need. Go to nate.fit to find out more and get your first 2 weeks for just 1 dollar. 7. Follow us on our Youtube channel: Youtube.com/@n8training If you liked the show, please LEAVE A 5-STAR REVIEW, and share it on social media to get reposted to over 12k of the homies.
In this episode, Garrett discusses the truth about reverse dieting and shares ways to optimize training and recovery. He emphasizes the importance of the post-dieting phase in boosting metabolism and preventing yo-yo dieting and explains his approach to fat loss and intuitive eating. The episode also explores immunity hacks and highlights the crucial role of sleep in promoting overall well-being. Overall, the episode provides valuable guidance for anyone looking to achieve long-term success in their nutrition and fitness journey. Garrett Serd, also known as Coach G, is a registered dietitian, certified personal trainer, and certified wellness coach. His passion for nutrition and fitness began in 2004 when he battled anorexia nervosa at 16 years old. He spent every waking minute learning about nutrition, fitness, and healthy living. He earned a Bachelor of Science degree in Nutrition and Dietetics from Louisiana Tech University and a Master of Science degree in Nutrition & Exercise from the University of Nebraska-Lincoln. Garrett founded Tandem Nutrition in 2012, where he serves as a women's fat loss expert and continues to inspire and motivate individuals to lead healthier and happier lives. Key Highlights: [00:01 - 09:16] Opening Segment ● One of the biggest nutrition myths that drive Garrett absolutely bonkers is the belief that once you are done dieting, you are done with your fat-loss journey. ● Garrette stresses the post-dieting phase's significance in boosting metabolism and avoiding yoyo dieting. ● Garrett Serd recounts his experience of overcoming a decade-long eating disorder and becoming a dietician. In 2012, he founded Tandem Nutrition, where he specializes in creating fat loss strategies for women. ● He works with women exclusively, offering specific strategies that work well for them, especially with the different age changes, menopause, and hormones. [09:17 - 16:35] Diet Phases and Maintenance ● Four dieting phases: fat loss, metabolic reset, next phase, and intuitive eating approach. ● Clients are guided to lose weight at a controlled rate while preserving muscle mass during a 12-16 week fat loss phase, followed by transitioning to an intuitive eating approach through a metabolic reset phase. ● Reverse dieting can have a negative impact on an individual's health and decrease their long-term muscle gain potential. ● Going back to the maintenance level after a diet is important because the maintenance level changes due to adaptation. ● Increasing calories can decrease stress hormones and water retention and give more energy for physical activity. [16:36 - 25:41] Transitioning to Intuitive Eating Without Calorie Counting ● Garrett explains maintenance phase is shorter because we tend to diet. To reset the metabolism, we need at least half the time of the previous diet. ● Intuitive dieting aims to fit within a certain framework, but portion sizes and calorie counting are not emphasized. ● The maintenance phase is important for the body to reset and adjust to a new calorie level, allowing hunger hormones to return to normal levels before moving into intuitive eating. ● Garrett explains transitioning from tracking to intuitive eating involves choosing a meal or day each week not to track and build confidence in achieving results without tracking every day in four steps. Key Quotes: “The purpose of weight training is to maintain muscle mass, to grow muscle mass.” - Garrett Serd “You should not leave a workout feeling annihilated. You should feel a workout feeling stimulated.” - Garrett Serd “Soreness is not an indicator of a great workout.” - Garrett Serd “The reason why the body fights back is, because, again, it wants to have more body fat, but when you give it ample, no calories, there's a difference in what it sees and what it gets.” - Garrett Serd CONNECT WITH COACH G: https://tandemnutrition.com/online-coaching/ Getnatesbook - This book is a must-have for anyone looking to drop belly fat and eliminate love handles permanently with expert tips on the 7 daily investments for health and wealth, the one type of cardio you need to include, and a handy checklist to hold yourself accountable to your goals. Don't miss out on this game-changing resource - get your copy today! Here's how I can help you reach your goals! Get leaner. Live Longer. Be Legendary. 1. Visit N8training.com - mastermind 2. Join our 5-Day Morning Routine Challenge 3. Get my super easy and accessible FREE 5-Day Sugar Detox Program. All you have to do is put in your email and receive access together with a handbook! Thefreesugardetox.com 4. Start by understanding the science and simplicity of carb backloading for fat loss - go to GetNatesBook.Com. to get a free copy of Nate's bestseller “The Million Dollar Body Method” 5. Get more great tips to get leaner by connecting with me on Instagram @lowcarbhustle 6. Join the MDB Mastermind for just a buck! If you want accountability, coaching, and an amazing training program to get leaner, this is what you need. Go to nate.fit to find out more and get your first 2 weeks for just 1 dollar. 7. Follow us on our Youtube channel: Youtube.com/@n8training If you liked the show, please LEAVE A 5-STAR REVIEW, and share it on social media to get reposted to over 12k of the homies.
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