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WELCOME TO THE CLINICAL
CENTER GRAND ROUNDS,

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A WEEKLY SERIES OF EDUCATIONAL
LECTURES FOR PHYSICIANS AND

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HEALTH CARE PROFESSIONALS
BROADCAST FROM THE CLINICAL

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CENTER AT THE NATIONAL
INSTITUTES OF HEALTH IN

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BETHESDA, MD.

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THE NIH CLINICAL CENTER IS THE
WORLD'S LARGEST HOSPITAL TOTALLY

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DEDICATED TO INVESTIGATIONAL
RESEARCH AND LEADS THE GLOBAL

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EFFORT IN TRAINING TODAY'S
INVESTIGATORS AND DISCOVERING

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TOMORROW'S CURES.

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LEARN MORE BY VISITING US ONLINE
AT HTTP://CLINICALCENTER.NIH.GOV

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ALL RIGHT, I'M ELIZABETH

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JONES, CHIEF OF RADIOLOGY AND

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IMAMILLIOING SCIENCES AT THE

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CLINICAL TRUSTEES AND I WANT TO

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WELCOME YOU TO THE ANNUAL JOHN

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DOPPMAN MEMORIAL LECTURE AND

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IMAGING SCIENCES.

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THE HOPKINS CLOUD CME ACTIVITY

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CODE IS 50528.

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PLEASE TEXT THE CODE TO THE

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YAWNS HOPKINS CME PHONE NUMBER

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ON THE SLIDE TO RECEIVE CME

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CREDIT.

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WE ALSO INVITE TO YOU PROVIDE

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FEEDBACK ON TODAY'S LECTURE BY

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SCANNING THE QR CODE SHOWN ON

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THE CME SLIDE, FOR THOSE

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APPLYING FOR CME, WILL RECEIVE

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THE FEE BACK SURVEY LINK VIA

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E-MAIL.

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PLEASE COMPLETE THE SURVEY AS IT

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WILL PROVIDE US IMPORTANT

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FEEDBACK ABOUT THE PRESENTATION

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AND ALLOW TO YOU SUBMIT

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SUGGESTIONS FOR GRAND ROUNDS

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TOPICS, FOLLOWING THE

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PRESENTATIONS, QUESTIONS FOR

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SPEAKERS WILL BE TAKEN FROM THE

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MICROPHONES IN THE AISLES AND

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THE VIEDMAN YE CAST VIEWERS MAY

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SUBMIT QUESTIONS AT ANY TIME IN

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A LECTURE BY SCROLLING DOWN AND

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CLICKING LIVE FEEDBACK BUTTON

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LOCATED ON THE VIDEOCAST

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WEBSITE.

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THE QUESTION SHALL BE ANSWERED

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AS TIME PERMITSA THE CONCLUSION

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OF THE PRESENTATION.

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THIS LECTURE HONORS THE MEMORY

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OF DR. JOHN DOPPMAN, WHO WAS A

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SKILLED RADIOLOGIST AND CHAIR OF

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THE RADIO LOGICAL DEPARTMENT OF

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THE CLINICAL CENTER.

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HE WAS HERE FOR 36 YEARS.

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THOSE OF US WHO ANYHOW HIM KNEW

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HIM TO BE A COMPASSION AT

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PHYSICIAN, ENTHUSIASTIC TEACHER

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AND PILLAR OF THE RESEARCH

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COMMUNITY HERE AT NE H.

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I AM ALSO PLEASED TO WELCOME

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MISS ANN MARIE DOPPMAN AND

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DR. DOPPMAN'S FAMILY WHO ARE

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JOINING US TODAY FOR THE LECTURE

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BY VIDEOCAST.

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TODAY WE ARE HONORED TO HAVE

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DR. MARTIN POMPER, PROFESSOR OF

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RADIOLOGY AND ASSOCIATE DEAN FOR

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ENTREPRENEUR HELP AND TECHNOLOGY

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DEVELOP AM AT THE JOHNS HOPKINS

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MEDICAL SCHOOL. 

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DR. POMPER IS ON IN LECULAR

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RESEARCH, HIS FOCUS ON NEW IMAGE

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XG THERAPEUTIC AGENTS FOR

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CANCER, CNS SYSTEM DISEASE AND

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OTHER DISORDERS.

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DR. POMPER EARNED HIS BACHELOR'S

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DEGREE, Ph.D. AND MEDICAL

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DEGREE FROM THE UNIVERSITY OF

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ILLINOIS AT URBANACHAMPAGNE.

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HE COMPLETED HIS INTERN HELP AT

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JOHNS HOPKINS MEDICAL SCHOOL

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WHERE HE ALSO COMPLOATED

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RESIDENCYS IN BIOLOGY AND

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RADIOLOGY, HE'S BEEN ON THE JOHN

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HOPKINS SCHOOL OF MEDICINE SINCE

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1995.

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TODAY HE SERVES AS THE HENRY N.

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PROFESSOR OF NUCLEAR MEDICINE

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AND DIRECTOR OF THE DIVISION OF

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NUCLEAR MEDICINE.

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HE ALSO DIRECTS THE JOHNS

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HOPKINS CENTER FOR TRANSLATIONAL

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MOLECULAR IMAGING, CO-DIRECTS

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FUNCTIONAL AND MOLECULAR IMAGING

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PROGRAM AND CANCER IMAMILLIOING

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CORE AND SERVES AS A CHIEF OF

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THE MOLECULAR IMAGING RESEARCH

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AMONG OTHER APPOINTMENTS.

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DR. POMPER IS ALSO THE CREATOR

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OR CO CREATOR OF MORE THAN 60

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PATENT-PENDING INVENTIONS AND IN

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THE PAST 15 YEARS HE HAS

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CONFOUNDED 6 START-AUTOPSIES.

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HE RECEIVED NUMEROUS AWARDS FOR

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HIS WORK AS AN INVESTIGATOR,

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PHYSICIAN AND TEACHER AND

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ELECTED TO THE NAGGAL ACADEMY OF

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INVENTORS IN 2016.

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AND THE NATIONAL ACADEMY OF

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MEDICINE IN 2017.

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THIS YEAR HE WAS ELECTED AS THE

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FELL OVERLAPPING OF SOCIETY OF

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NUCLEAR MEDICINE CAN MODEL

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CITIZEN LEAKULAR IMAGING AND

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AWARDED THE INNOVATION PRIZE BY

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THE INTERNATIONAL SOCIETY FOR

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STRATEGIC STUDIES IN RADIOLOGY.

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DR. POMPER WILL SPEAK ON

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MOLECULAR IMAGING FOR LIFE,

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PLEASE JOIN ME IN WELCOMING OUR

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SPEAKER.

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NWELL, THANK YOU FOR THE ULTRA

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KIND INTRODUCTION.

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SO YES, MOLECULAR IMANNUALING

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FOR LIFE, THIS IS SORT OF MY

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LIFE'S WORK AND IT'S A

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TREMENDOUS HONOR TO BE HERE, I

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REALLY ALWAYS ENJOY COMING DOWN

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TO THE NIH LAST TIME I WAS HERE

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AND I SPOKE IN THIS ROOM BUT THE

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PODIUM WAS OVER THERE, I

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REMEMBER AND IN ANY EVENT, I

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DON'T HAVE IT ON THE

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ACKNOWLEDGMENT SLIDE BUT ALMOST

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ALL THE WORK I'LL DISCUSS WAS

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FUNDED BY THE NIH, SO IT'S VERY

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IMPORTANT THAT THE BUDGET AT

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LEAST KEEPS UP WITH INFLATION.

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SO I HOPE THAT WE DON'T HAVE TO

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LIVE ON CONTINUING RESOLUTIONS

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BUT THAT SEEMS TO BE HOW IT'S

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BEEN.

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SO I ACTUALLY KNEW DR. DOPPMAN,

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I DIDN'T KNOW HIM WELL, BUT I

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MET HIM A COUPLE TIMES WHEN I

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WAS A TRAINEE AND IN MY EARLY

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YEARS ON THE FACULTY,

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DR. DOPPMAN EVEN THEN WHEN HE

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WAS IN THE MID90S, HE WAS JUST

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TREMENDOUSLY ENERGETIC AND VERY

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POSITIVE AND A VERY KIND PERSON

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WAS MY IMPRESSION.

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AS WE ALL KNOW HE'S AN

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INTERVENTIONAL RADIOLOGIST, HE

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WAS HERE FOR MANY YEARS,

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UNUSUALLY PROLIFIC IF YOU LOOK

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AT HIS RECORD, HE HAD ALL SORTS

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OF AWARDS, NIH DIRECTOR'S AWARD

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AMONG OTHERS AND BASICALLY I

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THINK MOST PEOPLE WILL DESCRIBE

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HIM AS A FORCE OF NATURE.

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ONCE IN A WHILE YOU SEE THESE

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FORCES OF NATURE THAT JUST DON'T

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STOP, THEY HAVE THEIR AGENDA AND

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HE WAS 1 OF THOSE AND HE'S THE

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REASON THAT THE NIH HAS DONE SO

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INCREDIBLY WELL IN IMAGING AND

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WAS A FORERUNNER IN ALWAYS ON

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THE CUTTING EDGE OF WHAT WAS

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HAPPENING IN IMAGING SINCE THE

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MID60S.

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SO, ALL RIGHT, SO HERE'S THE

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OUTLINE.

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I WILL TALK ABOUT PARADIGM

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SHIFTS GOING ON IN MEDICINE AND

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PRECISION MEDICINE.

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YOU CAN GIVE AN EXAMPLE FOR OUR

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WORK IN ANTIGEN TARGETING AND

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TALKED ABOUT THERANOOF THETICS

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WHICH IS NEW BUT OLD AS I WILL

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SHOW AND DPIF A PERSPECTIVE AT

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THE END, SO I THINK WE CAN ALL

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AGREE THAT DAY-TO-DAY, YOU CAN

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TELL IN THE CLINIC THAT TIMES

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ARE DEFINITELY CHANGING EMPLOY

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SO THIS OF COURSE IS

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DR. HOUNDSFIELD AND HIS CT

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SCANNER ISSUES THIS WAS A

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PARADIGM SHIFT NOT ONLY IN

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HIMMAGING BUT MEDICINE.

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FOR THE FIRST TIME WE COULD SEE

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CLEARLY WITHIN A PATIENT'S

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NONINVASIVELY EMPLOY THIS WAS A

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MASSIVE CHANGE, NOBEL PRIZE

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WINNING DISCOVERY, CROSS

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SECTIONAL IMANNUALING BUT I

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THINK NOW, WHAT'S HAPPENING IN

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2023, THAT MAKE HIS DISCOVERY

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ALMOST LOOK MINOR TO A CERTAIN

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EXTENT.

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WE'RE BEGENERATEDDING TO APPLY

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THESE PRECISION TECHNIQUES AND

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CARE AND WE'RE ALSO BEGINNING TO

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KEEP PEOPLE HEALTHY.

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SO WE'RE IMPLEMENTING VALUE

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BASED MEDICINE, PARTICULARLY

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HERE IN THE STATE OF MARYLAND

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FOR REASONS I WON'T DISCUSS BUT

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THESE ARE HUGE PARADIGM SHIFTS.

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SO TO SEE SOMETHING ON A SIMILAR

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SCALE, I THINK WE HAVE TO GO

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BACK TO 1930 WHERE MEDICAL

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EDUCATION WAS BASICALLY SET UP

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IN THE UNITED STATES WHERE

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SCIENCE WAS FIRST SYSTEMATICALLY

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BEING APPLIED TO MEDICAL

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EDUCATION AND MEDICINE.

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I THINK THAT'S THE KIND OF

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CHANGE THAT WE'RE SEEING NOW FOR

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REASONS THAT I WILL DISCUSS.

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ONE OF THE BIG 1S IS PRECISION

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EMPLOY SO PRECISION MEDICINE

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WHEN WE THINK OF THAT, WE THINK

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OF IT OFTEN AS A GENETIC

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PHENOMENA THAT THE PATIENT'S

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GENOME OR EPIGENOME DICTATES

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WHAT KIND OF THERAPY THEY MIGHT

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HAVE, BUT I THINK THAT THAT

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REALLY IS MORE OR LESS JUST ON

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THE GROUND INTELIENCE ABOUT THE

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PATIENT WHEREAS WITH IMAGING WE

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WITH BUILD THESE GUIDED MISSILES

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WHERE WE MAKE PRECISION MEDICINE

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ACTIONABLE BY FINDING AND

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TARGETING DISEASE, VERY

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SPECIFICALLY LEVERAGING THAT

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GENETIC AND OTHER INFORMATION

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ABOUT THE PATIENTS.

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SO AS AN EXAMPLE AND I WILL

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FOCUS ON CANCER IN THIS TALK BUT

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I WILL SHOW A SLIDE HERE FROM

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CENTRAL NERVOUS SYSTEM WORK THAT

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WE'VE DONE, SO HERE WE HAVE 2

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PATIENTS THAT COME INTO THE

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EMERGENCY ROOM, YOUNG PATIENTS

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SO THEY DON'T REALLY HAVE

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MEDICAL RECORD THAT YOU COULD

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LOOK AT BUT 1 HAS AFFECTIVE

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PSYCHOSIS OR DEPRESSION, THE

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OTHER 1 HAS NONAFFECTIVE

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PSYCHOSIS OR SCETS FRENNIA BUT

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WHEN THEY SHOW UP, THEY HAVE THE

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SAME PHENOTYPE.

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THEY'RE BOTH JUST PSYCHOTIC, SO

255
00:09:36,531 --> 00:09:39,134
HOW ARE YOU GOING TO DETERMINE

256
00:09:39,134 --> 00:09:40,569
HOW TO MANAGE THESE PATIENTS.

257
00:09:40,569 --> 00:09:44,205
SO IT TURNS OUT THAT BY LOOKING

258
00:09:44,205 --> 00:09:48,777
AT A VERY SPECIFIC TARGET IN THE

259
00:09:48,777 --> 00:09:50,412
BRAIN, THE ALPHA NICK O TYPIC

260
00:09:50,412 --> 00:09:52,614
RECEPTOR, WE FIND THAT PATIENTS

261
00:09:52,614 --> 00:09:54,149
WITH SCHIZOPHRENIA ACTUALLY HAVE

262
00:09:54,149 --> 00:09:54,649
MUCH LOWER BINDING.

263
00:09:54,649 --> 00:09:56,618
WE DON'T KNOW WHY THAT IS, WE

264
00:09:56,618 --> 00:09:59,321
KNOW IT'S NOT BECAUSE OF VARIOUS

265
00:09:59,321 --> 00:10:00,622
MEDICATIONS, ET CETERA BUT WE

266
00:10:00,622 --> 00:10:02,057
DON'T REALLY KNOW WHY THAT IS

267
00:10:02,057 --> 00:10:03,325
AND WE'RE HOPEFULLY GOING TO

268
00:10:03,325 --> 00:10:04,192
LOOK INTO THAT, OTHERS AND WE

269
00:10:04,192 --> 00:10:07,162
ARE GOING TO LOOK INTO THAT, BUT

270
00:10:07,162 --> 00:10:08,663
THE POINT IS THAT WE COULD TELL

271
00:10:08,663 --> 00:10:11,766
WITH 1 SCAN IN A PATIENT, WE

272
00:10:11,766 --> 00:10:14,269
COULD SUBTYPE THEM BO A

273
00:10:14,269 --> 00:10:14,936
DIFFERENT TREATMENT GROUP.

274
00:10:14,936 --> 00:10:16,838
THEY'RE GOING TO HAVE A MUCH

275
00:10:16,838 --> 00:10:19,107
DIFFERENT JOURNEY WITH THEIR

276
00:10:19,107 --> 00:10:20,175
ILLNESS AND THEY WOULD OTHERWISE

277
00:10:20,175 --> 00:10:23,878
AND THAT'S REALLY WHAT WE TRY DO

278
00:10:23,878 --> 00:10:24,579
WITH PRECISION IMAGING.

279
00:10:24,579 --> 00:10:26,414
IT'S ABOUT TAKING PATIENTS WITH

280
00:10:26,414 --> 00:10:29,250
SIMILAR PHENOTYPES AND SUBTYPING

281
00:10:29,250 --> 00:10:29,451
THEM.

282
00:10:29,451 --> 00:10:31,987
ANOTHER EXAMPLE, IS USING THIS

283
00:10:31,987 --> 00:10:34,723
IMAGING AGENT FOR PROSTATE

284
00:10:34,723 --> 00:10:39,394
CANCER, PYL, WE ARE 2 PATIENTS. 

285
00:10:39,394 --> 00:10:43,898
THEY GO TO THE PRIMARY CARE

286
00:10:43,898 --> 00:10:45,834
PHYSICIAN, PHYSICIAN FEELS A

287
00:10:45,834 --> 00:10:49,204
NODULE ON RECTAL EXAM, THEY HAVE

288
00:10:49,204 --> 00:10:51,106
BIOPSIES, THE BIOPSIES SAY THEY

289
00:10:51,106 --> 00:10:53,375
HAVE FLEECEON 9 PROSTATE CANCER

290
00:10:53,375 --> 00:10:55,410
SO REALLY THE PHENOTYPES ARE

291
00:10:55,410 --> 00:10:57,278
IDENTICAL UNTIL YOU USE A VERY

292
00:10:57,278 --> 00:10:57,946
SPECIFIC IMAGING AGENT LIKE THIS

293
00:10:57,946 --> 00:11:00,649
AND YOU CAN SEE THAT PATIENT A

294
00:11:00,649 --> 00:11:02,951
HAS LOCALIZED DISEASE, PATIENT B

295
00:11:02,951 --> 00:11:03,618
ALREADY HAS METASTATIC DISEASE

296
00:11:03,618 --> 00:11:07,222
SO THEY'RE GOING TO ARE A VERY

297
00:11:07,222 --> 00:11:07,656
DIFFERENT JOURNEYS.

298
00:11:07,656 --> 00:11:08,790
SO HERE IS WHAT WE'RE HOPING TO

299
00:11:08,790 --> 00:11:11,793
DO IN THE FUTURE WITH ALL OF OUR

300
00:11:11,793 --> 00:11:13,294
MOLECULAR IMAGING THAT WE CAN

301
00:11:13,294 --> 00:11:15,130
SUBTYPE PATIENTS AND GET THEM

302
00:11:15,130 --> 00:11:18,233
EXACTLY THE KIND OF THERAPY THAT

303
00:11:18,233 --> 00:11:18,500
THEY NEED.

304
00:11:18,500 --> 00:11:21,569
SO WHEN WE TALK ABOUT IMAGING,

305
00:11:21,569 --> 00:11:26,908
WE THINK ABOUT HOW IT DECREASES

306
00:11:26,908 --> 00:11:28,443
MORTALITY THROUGH SCREEN,

307
00:11:28,443 --> 00:11:30,645
DECREASES COST BY EARLY

308
00:11:30,645 --> 00:11:33,348
DIAGNOSIS, AND DECREASING

309
00:11:33,348 --> 00:11:34,749
CHANCES OF SURGERY AND

310
00:11:34,749 --> 00:11:36,151
THERAPEUTIC CARE AND MONITORING

311
00:11:36,151 --> 00:11:37,585
BUT THESE ARE CONVENTIONAL WAYS

312
00:11:37,585 --> 00:11:40,955
ABOUT THINKING ABOUT IMAGING AND

313
00:11:40,955 --> 00:11:43,058
I COULD SHOW THIS SLIDE 20 YEARS

314
00:11:43,058 --> 00:11:45,026
AGO, SAME THING BUT WHAT'S

315
00:11:45,026 --> 00:11:46,027
HAPPENING NOW?

316
00:11:46,027 --> 00:11:47,429
WHERE DO I EMPHASIZE WE HAVE

317
00:11:47,429 --> 00:11:50,265
THESE PARADIGM SHIFTS THAT ARE

318
00:11:50,265 --> 00:11:51,666
OCCURRING IN WELL IF WE THINK

319
00:11:51,666 --> 00:11:53,301
ABOUT NEXT GENERATION OR

320
00:11:53,301 --> 00:11:55,003
PRECISION IMAGING NOW IN 2023,

321
00:11:55,003 --> 00:11:56,705
WE HAVE PROTEIN COMPLEXIO

322
00:11:56,705 --> 00:11:57,639
GENOMICS FOR IDENTIFYING TARGETS

323
00:11:57,639 --> 00:12:00,775
TO LOOK AT IN PATIENTS, WE

324
00:12:00,775 --> 00:12:02,844
DIDN'T HAVE THAT A FEW YEARS

325
00:12:02,844 --> 00:12:03,111
AGO, EVEN.

326
00:12:03,111 --> 00:12:05,547
WE HAD NEW WAYS OF GENERATING

327
00:12:05,547 --> 00:12:06,981
AFFINITY PROBES TO THOSE

328
00:12:06,981 --> 00:12:10,151
TARGETS, THERE'S ALL SORTS OF

329
00:12:10,151 --> 00:12:10,885
POSSIBILITIES.

330
00:12:10,885 --> 00:12:13,555
THERE'S EASIER WAYS TO MAKE

331
00:12:13,555 --> 00:12:15,657
SMALL MOLECULES, CLICK SO CALLED

332
00:12:15,657 --> 00:12:17,392
CLICK CHEMISTRY, THERE WAS NO

333
00:12:17,392 --> 00:12:18,693
CLICK CHEMISTRY WHEN I WAS IN

334
00:12:18,693 --> 00:12:19,627
GRAD SCHOOL AND 1 OF THE REASONS

335
00:12:19,627 --> 00:12:21,029
THAT I WENT TO GRAD SCHOOL WAS

336
00:12:21,029 --> 00:12:26,835
BECAUSE I WANTED TO USE CHEMICAL

337
00:12:26,835 --> 00:12:27,669
APPROACHES TO THESE KINDS OF

338
00:12:27,669 --> 00:12:30,472
PROBLEMS BUT NOW, THERE'S NOT

339
00:12:30,472 --> 00:12:34,042
JUST ANTIBODIES BUT DIABODIES,

340
00:12:34,042 --> 00:12:35,543
MINIBODIES, THERE'S DARKENS, ALL

341
00:12:35,543 --> 00:12:37,545
SORTS OF DIFFERENT WAYS TO

342
00:12:37,545 --> 00:12:40,281
ENGAGE BIOLOGICAL TARGETS, WE

343
00:12:40,281 --> 00:12:42,617
ALSO HAVE AMAZINGLY RELEVANT

344
00:12:42,617 --> 00:12:44,052
ANIMAL MODELS, GENETIC MODELS OF

345
00:12:44,052 --> 00:12:49,557
DISEASE, WE HAVE NEW EQUIPMENT

346
00:12:49,557 --> 00:12:51,993
AMAZING NEW SCANNERS WE HAVE,

347
00:12:51,993 --> 00:12:53,361
HIGH TENSATIVITY, WE DO

348
00:12:53,361 --> 00:12:56,064
EVERYTHING ON THE INTERNET, MORE

349
00:12:56,064 --> 00:12:58,099
OR LESS SO THESE ARE ALL BIG

350
00:12:58,099 --> 00:13:01,603
ADVANCES BUT THE NUMBER 1

351
00:13:01,603 --> 00:13:02,437
ADVANCE OF EVERYTHING THAT

352
00:13:02,437 --> 00:13:04,105
REALLY HAS MADE THE DIFFERENCE

353
00:13:04,105 --> 00:13:06,274
IN THE LAST, YOU KNOW BETWEEN 5

354
00:13:06,274 --> 00:13:08,543
AND 10 YEARS IS THE FACT THAT

355
00:13:08,543 --> 00:13:11,913
EVERYTHING WE DO, ALL THE

356
00:13:11,913 --> 00:13:12,747
COAALATING, ANNOTATING,

357
00:13:12,747 --> 00:13:15,150
ANALYZING AND UTILIZING IS DONE

358
00:13:15,150 --> 00:13:16,084
THROUGH CLOUD COMPUTING AND

359
00:13:16,084 --> 00:13:18,686
THAT'S WHAT HAS MADE AND IS

360
00:13:18,686 --> 00:13:20,421
GOING TO MAKE THE DIFFERENCE IN

361
00:13:20,421 --> 00:13:22,924
EVERYTHING THAT WE DO, RIGHT

362
00:13:22,924 --> 00:13:24,159
FROM FIGURING OUT WHAT TARGETS

363
00:13:24,159 --> 00:13:27,228
LOOK LIKE, THAT WE WANT TO DRUG

364
00:13:27,228 --> 00:13:31,199
TO COMING UP WITH NEW PROTEINS

365
00:13:31,199 --> 00:13:32,634
WHICH COULDN'T BE DONE ISSUES

366
00:13:32,634 --> 00:13:34,035
JUST LITERALLY AIER AGO.

367
00:13:34,035 --> 00:13:36,971
SO THAT'S WHAT I MEAN BY

368
00:13:36,971 --> 00:13:37,505
PARADIGM SHIFT.

369
00:13:37,505 --> 00:13:38,640
SO THE OTHER THING I WANT TO

370
00:13:38,640 --> 00:13:42,911
MENTION FOR THOSE OF YOU FROM

371
00:13:42,911 --> 00:13:44,078
RADIOLOGY THAT THE GREAT GIFT OF

372
00:13:44,078 --> 00:13:46,281
WHAT WE DO IS THAT WE PROVIDE A

373
00:13:46,281 --> 00:13:49,617
PATH TO CURE BY EARLIER

374
00:13:49,617 --> 00:13:50,885
DETECTION, PARTICULARLY IN

375
00:13:50,885 --> 00:13:52,020
CANCER WHERE THERE ARE AN

376
00:13:52,020 --> 00:13:54,689
INCREASING NUMBER OF THERAPEUTIC

377
00:13:54,689 --> 00:13:54,923
AGENTS.

378
00:13:54,923 --> 00:13:56,457
SO THIS IS A PAPER WRITTEN BOO I

379
00:13:56,457 --> 00:14:03,031
1 OF MY COLLABORATORS, BERT

380
00:14:03,031 --> 00:14:07,135
FOGELSTEIN, IT HAS A COMPLICATED

381
00:14:07,135 --> 00:14:08,336
TITLE BUT WHAT HE SAID IS THAT

382
00:14:08,336 --> 00:14:10,572
ONLY A THIRD OF THE VARIANCE

383
00:14:10,572 --> 00:14:12,941
RISK TISSUES AMONG CANCERS ARE

384
00:14:12,941 --> 00:14:14,542
INHERIT THE PREDISPOSITIONS, THE

385
00:14:14,542 --> 00:14:16,311
MAJORITY IS DO YOU TO BAD LUCK.

386
00:14:16,311 --> 00:14:18,046
SO YOU USUALLY DON'T SEE PHRASES

387
00:14:18,046 --> 00:14:20,548
LIKE BAD LUCK IN SCIENCE PAPERS

388
00:14:20,548 --> 00:14:23,985
BUT WHEN BERT WRITES IT AND

389
00:14:23,985 --> 00:14:25,787
BACKS IT UP WITH ALL SORTS OF

390
00:14:25,787 --> 00:14:26,955
MATH AND VALIDATION, IT SOUNDED

391
00:14:26,955 --> 00:14:29,958
GOOD TO ME BUT WHEN I SAW THAT,

392
00:14:29,958 --> 00:14:31,826
WHAT THAT TELLS ME IS THAT

393
00:14:31,826 --> 00:14:36,698
2/3RDS OF CANCER IS JUST BAD

394
00:14:36,698 --> 00:14:39,934
LUCK SO NO MATTER HOW MUCH KALE

395
00:14:39,934 --> 00:14:44,873
YOU EAT OR HOW MUCH TIME I SPEND

396
00:14:44,873 --> 00:14:45,940
ON AN ELLIPTICAL, WHAT ARE YOU

397
00:14:45,940 --> 00:14:46,374
GOING TO DO?

398
00:14:46,374 --> 00:14:47,575
IT'S GOING TO HAPPEN.

399
00:14:47,575 --> 00:14:49,310
SO WHAT BERT DOES IS HE

400
00:14:49,310 --> 00:14:51,746
DEVELOPED THESE TESTS FOR

401
00:14:51,746 --> 00:14:53,047
CIRCULATING TUMOR DNA TO CATCH

402
00:14:53,047 --> 00:14:56,784
IT EARLY, SO EARLY DETECTION

403
00:14:56,784 --> 00:14:58,052
BEFORE IT BECOMES METASTATIC SO

404
00:14:58,052 --> 00:14:59,254
YOU BEING DO SOMETHING ABOUT IT.

405
00:14:59,254 --> 00:15:00,922
IT TURNS OUT THAT WITH HIS

406
00:15:00,922 --> 00:15:02,323
TECHNIQUE, HE NEEDED ABOUT

407
00:15:02,323 --> 00:15:05,793
50 MILLION CELLS, TO BE ABLE TO

408
00:15:05,793 --> 00:15:06,761
DETECT CIRCULATING TNA SO KEEP

409
00:15:06,761 --> 00:15:08,596
THAT NUMBER IN MIND, 50 MILLION

410
00:15:08,596 --> 00:15:09,964
BUT THE POINT IS, THIS IS WHEN

411
00:15:09,964 --> 00:15:16,938
WE DO, WE DETECT THINGS AS EARLY

412
00:15:16,938 --> 00:15:17,405
AS WE CAN.

413
00:15:17,405 --> 00:15:19,607
SO LOOT ME GIVE YOU XCHS OF

414
00:15:19,607 --> 00:15:20,441
THAT, SO FLUTA MATE.

415
00:15:20,441 --> 00:15:22,176
SO I HAVE A LONG STANDING

416
00:15:22,176 --> 00:15:23,011
INTEREST IN FLUTA MATE.

417
00:15:23,011 --> 00:15:26,447
I DON'T KNOW WHAT YOU WERE DOING

418
00:15:26,447 --> 00:15:29,417
IN 1987, BUT AT THAT TIME I WAS

419
00:15:29,417 --> 00:15:30,451
FINISHING UP IMRAD SCHOOL AND I

420
00:15:30,451 --> 00:15:35,323
WAS ASHES FRAYED I WOULD HAVE TO

421
00:15:35,323 --> 00:15:36,357
START WRITING GRAND ANDS THAT

422
00:15:36,357 --> 00:15:39,694
SORT OF THING AND SO I STARTED

423
00:15:39,694 --> 00:15:42,030
THINK BEING PROJECTS AND SO 1

424
00:15:42,030 --> 00:15:45,066
WAS FLUTA MATE AND I THOUGHT

425
00:15:45,066 --> 00:15:51,039
TOCK ISOTOPITY WAS

426
00:15:51,039 --> 00:15:52,173
BEHIND--TOXICITY WAS BEHIND

427
00:15:52,173 --> 00:15:53,374
ALZHEIMERS AND OTHER DISEASES

428
00:15:53,374 --> 00:15:54,943
AND SO I DID THAT AT UNIVERSITY

429
00:15:54,943 --> 00:15:56,544
OF ILLINOIS AND THEN I HAD TO

430
00:15:56,544 --> 00:15:58,279
FINISH GRAD SCHOOL AND I WENT TO

431
00:15:58,279 --> 00:15:59,681
RESIDENCY AND I LOST TRACK OF

432
00:15:59,681 --> 00:16:01,683
BEING ABLE ON DO THAT BUT ALMOST

433
00:16:01,683 --> 00:16:04,052
10 YEARS LATER, NOW I'M ON THE

434
00:16:04,052 --> 00:16:05,253
FACULTY AS ASSISTANT PROFESSOR

435
00:16:05,253 --> 00:16:06,421
OF JOHNS HOPKINS AND I ALWAYS

436
00:16:06,421 --> 00:16:08,923
HAD MY MIND ON DPLIEWT MATE AND

437
00:16:08,923 --> 00:16:13,194
I SAW THIS PAPER IN 1996 THAT

438
00:16:13,194 --> 00:16:16,531
SHOWED THAT THERE WAS AN ENZYME

439
00:16:16,531 --> 00:16:21,602
INHIBITOR THAT WAS ABLE TO

440
00:16:21,602 --> 00:16:24,072
PREVENT.

441
00:16:24,072 --> 00:16:29,978
IT WAS ACTUALLY AN ALOE DACE

442
00:16:29,978 --> 00:16:30,778
INHIBITOR THAT WORKED ON ROUGH

443
00:16:30,778 --> 00:16:31,579
ATOM DUCK OF FLUTE MATE.

444
00:16:31,579 --> 00:16:33,247
IFFY WOO COULD INLAGE THAT

445
00:16:33,247 --> 00:16:34,983
ENZYME, THAT WE WOULD HAVE A

446
00:16:34,983 --> 00:16:38,586
ENSEL -

447
00:16:38,586 --> 00:16:41,289
-SENSE OF WHAT A PORTION OF

448
00:16:41,289 --> 00:16:43,391
THE FLUTE MATE WAS DOING AND WE

449
00:16:43,391 --> 00:16:44,759
COULD LEARN MORE ABOUT

450
00:16:44,759 --> 00:16:45,460
ALZHEIMER'S DISEASE AND MAYBE

451
00:16:45,460 --> 00:16:46,427
TRY TO TARGETING SYSTEM

452
00:16:46,427 --> 00:16:46,728
THEATSYSTEM.

453
00:16:46,728 --> 00:16:52,700
SO THEY HAD THESE FANTASTIC

454
00:16:52,700 --> 00:16:54,135
INHIBITORS, 275 PICO MOLAR WHICH

455
00:16:54,135 --> 00:16:56,337
IS WHAT YOU WANT FOR A NEW RADIO

456
00:16:56,337 --> 00:17:00,842
TRACER BUT I HAD TO LIKE--I WAS

457
00:17:00,842 --> 00:17:03,878
A NEURORADIOLOGIST WHO WAS VERY

458
00:17:03,878 --> 00:17:04,645
BUSY.

459
00:17:04,645 --> 00:17:05,747
AFTER THIS DEMA CAME ON AND SHE

460
00:17:05,747 --> 00:17:08,082
WAS A FELLOW AND SHE WAS A BIG

461
00:17:08,082 --> 00:17:09,684
HELP SO I COULD THINK MORE ABOUT

462
00:17:09,684 --> 00:17:10,551
THIS KIND OF THING.

463
00:17:10,551 --> 00:17:12,987
BUT IN THE SAME YEAR, SO I SAW

464
00:17:12,987 --> 00:17:14,722
THAT PAPER IN REALTIME IN 1996

465
00:17:14,722 --> 00:17:20,228
AND I ALSO SAW THIS PAPER AND I

466
00:17:20,228 --> 00:17:22,497
LEARNED THAT PSMA, IS AN ENZYME

467
00:17:22,497 --> 00:17:25,466
THAT LOOKS LIKE A NEUROPEPTIDE

468
00:17:25,466 --> 00:17:26,768
ACE SO I WENT BACK AND LOOKEDDA

469
00:17:26,768 --> 00:17:29,437
THIS THE AND IT'S THE SAME

470
00:17:29,437 --> 00:17:29,670
ENZYME.

471
00:17:29,670 --> 00:17:33,174
AND I WAS THRILLED BECAUSE THESE

472
00:17:33,174 --> 00:17:35,476
COMPOUNDS THAT ARE SUCH HIGH

473
00:17:35,476 --> 00:17:37,311
AFEIGNITY WERE VERY HYDROPHILIC

474
00:17:37,311 --> 00:17:38,813
MUCH THEY WEREN'T GOING TO GET

475
00:17:38,813 --> 00:17:40,715
ACROSS THE BLOOD BRAIN BARRIER,

476
00:17:40,715 --> 00:17:42,784
SO I PIVOTED TO PROSTATE CANCER,

477
00:17:42,784 --> 00:17:44,786
I JUST GAVE UP NEURORADIOLOGY

478
00:17:44,786 --> 00:17:47,121
AND ALL THAT I SAID LET'S JUST

479
00:17:47,121 --> 00:17:49,057
WORK ON PROSTATE CANCER AND THIS

480
00:17:49,057 --> 00:17:52,026
CAME OUT OF JOE COILS LAB AT

481
00:17:52,026 --> 00:17:52,660
JOHNS HOPKINS.

482
00:17:52,660 --> 00:17:54,429
I THINK HE HAD JUST LEFT AT THAT

483
00:17:54,429 --> 00:17:54,729
TIME.

484
00:17:54,729 --> 00:17:56,964
AND I WANT TO MENTION ALSO THIS

485
00:17:56,964 --> 00:18:02,437
WAS COMMUNICATED BY

486
00:18:02,437 --> 00:18:03,504
SEYMOR KEDDY, HE WAS A MASSIVE

487
00:18:03,504 --> 00:18:06,040
HERO WHEN I WAS IN GRAD SCHOOL

488
00:18:06,040 --> 00:18:07,108
AND JUNIOR FACULTY BECAUSE HE IS

489
00:18:07,108 --> 00:18:11,446
SORT OF BEHIND A LOT OF THE WORK

490
00:18:11,446 --> 00:18:13,514
IN QUANTITATIVE REGIONAL

491
00:18:13,514 --> 00:18:14,515
CEREBRAL BLOOD FLOW ANALYSIS AND

492
00:18:14,515 --> 00:18:20,388
REALLY JUST AN AMAZING PERSON.

493
00:18:20,388 --> 00:18:22,457
SO BACK THEN IN REALTIME THIS IS

494
00:18:22,457 --> 00:18:23,491
A NEW INVESTIGATOR AWARD, YOU

495
00:18:23,491 --> 00:18:26,961
COULD TELL IT WAS A LONG TIME

496
00:18:26,961 --> 00:18:27,128
AGO.

497
00:18:27,128 --> 00:18:28,729
I DECIDED YOU KNOW WHAT I WILL

498
00:18:28,729 --> 00:18:30,932
PIVOT AND WORK ON PROSTATE

499
00:18:30,932 --> 00:18:33,935
CANCER, THERE'S NO PROSTATE, YOU

500
00:18:33,935 --> 00:18:36,003
KNOW BLOOD BARRIER SO WE CAN GET

501
00:18:36,003 --> 00:18:37,705
THESE HIGH AFFINITY AGENTS

502
00:18:37,705 --> 00:18:39,807
ACROSS AND SO I WROTE A--WHAT I

503
00:18:39,807 --> 00:18:41,542
THOUGHT WAS A REALLY NICE

504
00:18:41,542 --> 00:18:44,512
PROPOSAL AT THE TIME BACK IN THE

505
00:18:44,512 --> 00:18:48,349
MID90S AND I GOT MY USUAL RESULT

506
00:18:48,349 --> 00:18:49,851
AT THE TIME AND I THINK THIS WAS

507
00:18:49,851 --> 00:18:51,018
THE FIRST YEAR THAT THE

508
00:18:51,018 --> 00:18:59,427
DEPARTMENT OF DEFENSE HAD THESE

509
00:18:59,427 --> 00:19:02,830
KIND OF AWARDS ACTUALLY 1997,

510
00:19:02,830 --> 00:19:05,433
98, AND I THOUGHT IT WAS A GOOD

511
00:19:05,433 --> 00:19:07,001
IDEA, APPLIED FOR GRANTS, NEVER

512
00:19:07,001 --> 00:19:07,935
GOT FUNDED AND 1 OF THE REASONS

513
00:19:07,935 --> 00:19:09,704
I WAS TOLD IS THAT WE ALREADY

514
00:19:09,704 --> 00:19:11,539
HAVE ANTIBODIES, YOU KNOW WHAT

515
00:19:11,539 --> 00:19:13,007
ARE YOU WASTING YOUR TIME,

516
00:19:13,007 --> 00:19:13,674
THERE'S ANTIBODIES FOR THIS AND

517
00:19:13,674 --> 00:19:16,110
I WANT TO GIVE A SHOUT OUT TO

518
00:19:16,110 --> 00:19:17,778
GERALD MURPHY WHO DOESN'T GET A

519
00:19:17,778 --> 00:19:19,280
LOT OF CREDIT.

520
00:19:19,280 --> 00:19:23,751
HE IS THE--HE IS THE PARENT OF

521
00:19:23,751 --> 00:19:24,352
PSMA.

522
00:19:24,352 --> 00:19:25,820
HE IN 1987, 10 YEARS BEFORE I

523
00:19:25,820 --> 00:19:27,822
READ THOSE ARTICLES HE DORPHED

524
00:19:27,822 --> 00:19:31,826
PSMA AND HE DEVELOPED THE FIRST

525
00:19:31,826 --> 00:19:35,630
ANTIBODIES AGAINST IT.

526
00:19:35,630 --> 00:19:38,566
AND IN 1996, THERE WAS A WAY TO

527
00:19:38,566 --> 00:19:39,567
IMAGE MSMA BASED ON ANTIBODIES

528
00:19:39,567 --> 00:19:41,235
SO I HAD A LOT OF PEOPLE SAYING,

529
00:19:41,235 --> 00:19:42,236
YOU KNOW WE ALREADY HAVE A WAY

530
00:19:42,236 --> 00:19:50,845
TO LOOK AT IT.

531
00:19:50,845 --> 00:19:53,681
THIS WAS AN INDIAN 1 LEVEL

532
00:19:53,681 --> 00:19:55,950
ANTIBODY, AND FOR THOSE WHO ARE

533
00:19:55,950 --> 00:19:57,051
NOT NUCLEAR MEDICINE

534
00:19:57,051 --> 00:19:57,785
SPECIALISTS, I WILL POINT OUT

535
00:19:57,785 --> 00:19:59,020
THE CANCER IS RIGHT HERE, SO

536
00:19:59,020 --> 00:20:01,689
THERE'S A LOT OF CANCER THERE,

537
00:20:01,689 --> 00:20:04,759
SO, I STILL, EVEN THEN WHEN I

538
00:20:04,759 --> 00:20:08,095
SAW THIS I SAID COME ON.

539
00:20:08,095 --> 00:20:11,032
WE CAN DO BETTER THAN THAT,

540
00:20:11,032 --> 00:20:11,566
RIGHT.

541
00:20:11,566 --> 00:20:14,602
SO WE WANTED SOMETHING WITH

542
00:20:14,602 --> 00:20:15,102
BETTER PHARMAICOLOGGIC

543
00:20:15,102 --> 00:20:16,704
PROPERTIES, I'VE ALWAYS BEEN A

544
00:20:16,704 --> 00:20:18,439
BIG PROPONENT OF SMALL MOLECULES

545
00:20:18,439 --> 00:20:19,640
OR MAYBE TINY PEPTIDES BECAUSE

546
00:20:19,640 --> 00:20:21,609
YOU HIT THE TARGET AND YOU RINSE

547
00:20:21,609 --> 00:20:24,879
AWAY AND YOU GET NICE CLEAR

548
00:20:24,879 --> 00:20:25,413
IMAGES.

549
00:20:25,413 --> 00:20:29,584
SO WE STARTED WORKING ON THESE

550
00:20:29,584 --> 00:20:32,119
UREAs AND I FOUND THEM BY

551
00:20:32,119 --> 00:20:33,454
COINCIDENCE TALKING TO A CHEMIST

552
00:20:33,454 --> 00:20:38,593
AT GEORGE TOWN WHO WAS WORKING

553
00:20:38,593 --> 00:20:40,995
ON NALDACE INHIBITORS ARE AS CNS

554
00:20:40,995 --> 00:20:43,231
PROTECT ANTS AND I SUGGESTED, I

555
00:20:43,231 --> 00:20:44,565
HAVE A WAY BETTER IDEA, WELL

556
00:20:44,565 --> 00:20:47,802
THE'S MOVE IT TO CANCER, SO, I

557
00:20:47,802 --> 00:20:49,470
LOOKED AT HIS PORTFOLIO AND TOOK

558
00:20:49,470 --> 00:20:52,607
THIS COMPOUND AND MADE A CARBON

559
00:20:52,607 --> 00:20:56,143
11 LABELED VERSION FOR PET AND

560
00:20:56,143 --> 00:20:58,679
WE SHOWED AND IN FACT I DID AN

561
00:20:58,679 --> 00:21:01,082
INCREDIBLY THOROUGH STUDY WHERE

562
00:21:01,082 --> 00:21:03,718
WE DID AN IN VIVO SKETCH OR

563
00:21:03,718 --> 00:21:03,985
ANALYSIS.

564
00:21:03,985 --> 00:21:05,253
WE WOULD DO THIS IN THE BRAIN

565
00:21:05,253 --> 00:21:07,588
BUT I WAS STILL THINKING BRAIN

566
00:21:07,588 --> 00:21:08,022
STUFF THEN.

567
00:21:08,022 --> 00:21:09,824
SO WE DID IT IN THE PERIPHERY

568
00:21:09,824 --> 00:21:12,293
AND WE SHOWED THAT THERE WAS--I

569
00:21:12,293 --> 00:21:14,895
COULDN'T BELIEVE WE HAD ALL THIS

570
00:21:14,895 --> 00:21:16,297
SPECIFIC BINDING TO ACTUALLY,

571
00:21:16,297 --> 00:21:19,500
THESE WERE KIDNEYS, THESE WERE

572
00:21:19,500 --> 00:21:20,801
RODENT KIDNEYS, BECAUSE I DIDN'T

573
00:21:20,801 --> 00:21:22,536
REALLY HAVE A CANCER LAB, BUT

574
00:21:22,536 --> 00:21:24,538
THERE'S A LOT OF PSMA IN THE

575
00:21:24,538 --> 00:21:27,675
KIDNEYS AND WE SAW THAT--WE SAW

576
00:21:27,675 --> 00:21:29,543
DECREASED SUBTAKE WITH A BLOCKER

577
00:21:29,543 --> 00:21:32,313
SO THAT INDICATES SPECIFIC

578
00:21:32,313 --> 00:21:33,381
BINDING, AND YOU KNOW EVEN IN

579
00:21:33,381 --> 00:21:37,351
THAT PAPER, YOU KNOW WE

580
00:21:37,351 --> 00:21:39,253
SUGGESTED THAT YOU KNOW WE CAN

581
00:21:39,253 --> 00:21:42,023
MAKE IMAGING AGENTS, WE CAN MAKE

582
00:21:42,023 --> 00:21:44,825
THERAPEUTIC AGENTS, THIS WILL BE

583
00:21:44,825 --> 00:21:47,194
BE A GREAT BOOM TO CANCER

584
00:21:47,194 --> 00:21:48,396
IMAGING AND THERAPY AND THEN A

585
00:21:48,396 --> 00:21:50,398
FEW YEARS LATER I HAD--BY THEN I

586
00:21:50,398 --> 00:21:53,301
HAD A LAB AND I HAD PEOPLE THAT

587
00:21:53,301 --> 00:21:54,268
CAN MAKE XENOGRAPH ANDS WE

588
00:21:54,268 --> 00:21:57,371
SHOWED THAT IT DID WORK IN

589
00:21:57,371 --> 00:21:57,605
TUMORS.

590
00:21:57,605 --> 00:22:01,442
AND THEN WE STARTED WORKING WITH

591
00:22:01,442 --> 00:22:02,443
[INDISCERNIBLE] AND CO

592
00:22:02,443 --> 00:22:04,578
CRYSTALLIZED SOME OF OUR

593
00:22:04,578 --> 00:22:05,713
COMPOUNDS WITH THE RECOMBIN ANT

594
00:22:05,713 --> 00:22:07,715
PROTEIN SO WE GOT A REALLY GOOD

595
00:22:07,715 --> 00:22:11,452
SENSE OF JUST WHAT THE

596
00:22:11,452 --> 00:22:14,088
STRUCTURAL REQUIREMENTS WERE FOR

597
00:22:14,088 --> 00:22:18,292
THAT PARTICULAR TARGET.

598
00:22:18,292 --> 00:22:22,263
BUT WE WERE STICKING WITH HALLOW

599
00:22:22,263 --> 00:22:24,332
JEANS MAINLY, IT WAS A AN

600
00:22:24,332 --> 00:22:25,533
ANOMALY, WE DID IT RIGHT OFF THE

601
00:22:25,533 --> 00:22:28,102
BAT AND THEN WE STARTED MAKING

602
00:22:28,102 --> 00:22:32,640
ALL THESE RADIO COMPOUNDS AND

603
00:22:32,640 --> 00:22:33,574
FLOWERINNATED BACK IN 2003,

604
00:22:33,574 --> 00:22:36,310
SOMETHING LIKE THAT I MET WITH

605
00:22:36,310 --> 00:22:37,578
SHARING AG WHICH DOESN'T EXIST

606
00:22:37,578 --> 00:22:39,313
ANYMORE BUT THEY TOLD ME THAT IF

607
00:22:39,313 --> 00:22:40,848
THEY WERE GOING TO INVEST IN

608
00:22:40,848 --> 00:22:45,953
SOMETHING LIKE THIS THAT HAD TO

609
00:22:45,953 --> 00:22:53,994
BE FLOURIN 18, IN FACT, BEAR,

610
00:22:53,994 --> 00:22:58,399
SIEMENS, THAT'S WHY I STUCK WITH

611
00:22:58,399 --> 00:23:00,267
FLOURING, I THOUGHT THEY MUST BE

612
00:23:00,267 --> 00:23:00,735
ON TO SOMETHING.

613
00:23:00,735 --> 00:23:04,004
BUT IN THE UNITED STATES, FLOURK

614
00:23:04,004 --> 00:23:06,374
R18 IS PART OF THE BUSINESS

615
00:23:06,374 --> 00:23:07,575
MODEL, USING THESE ISOTOPES.

616
00:23:07,575 --> 00:23:10,044
IT'S ALSO A BEAUTIFUL, THE

617
00:23:10,044 --> 00:23:15,549
PERFECT PET ISOTOPE IN TERMS OF

618
00:23:15,549 --> 00:23:16,183
ITS CHEMISTRY, IT'S--THE IMAGE

619
00:23:16,183 --> 00:23:19,086
IT IS ARE NICE AND CRISP, IT HAS

620
00:23:19,086 --> 00:23:20,721
A SHORT POSITRON PATH RAINCHL SO

621
00:23:20,721 --> 00:23:25,025
WE MADE A BUNCH OF THESE RADIO

622
00:23:25,025 --> 00:23:26,127
HALLOW GENERATEDDATED COMPOUNDS.

623
00:23:26,127 --> 00:23:28,362
IN FACT THIS PYL IS THE 1 THAT

624
00:23:28,362 --> 00:23:29,663
WE EVENTUALLY TOOK TO THE

625
00:23:29,663 --> 00:23:35,469
CLINIC, THIS WAS A PRECLINICAL

626
00:23:35,469 --> 00:23:36,003
PAPER IN 2011.

627
00:23:36,003 --> 00:23:37,972
BUT THE OTHER THING WE TRIED TO

628
00:23:37,972 --> 00:23:43,244
DO WAS LEVELS INCREASE RAMMING

629
00:23:43,244 --> 00:23:44,812
THIS FOR THERAPEUTICS.

630
00:23:44,812 --> 00:23:48,182
SO [INDISCERNIBLE] IS A

631
00:23:48,182 --> 00:23:49,483
SYNTHETIC ORGANIC RADIO CHEMIST,

632
00:23:49,483 --> 00:23:51,786
VERY TALENTED AND BY DOING VERY

633
00:23:51,786 --> 00:23:52,520
BASIC DOCKING STUDIES WE SHOWED

634
00:23:52,520 --> 00:23:55,356
THAT YOU NEED TO HAVE ABOUT

635
00:23:55,356 --> 00:23:58,926
TWEBT INCAS TROMS BETWEEN THE

636
00:23:58,926 --> 00:24:02,263
AFFINITY AGENT AND THE KEY LATER

637
00:24:02,263 --> 00:24:05,966
TO GET PRODUCTIVE BINDING TO

638
00:24:05,966 --> 00:24:07,935
PSMA, SO IN 08 WE HAD A COMPOUND

639
00:24:07,935 --> 00:24:10,004
THAT WORKED AND WE PUT RENIUM IN

640
00:24:10,004 --> 00:24:12,973
THERE AND WE SHOWED WE CAN DO

641
00:24:12,973 --> 00:24:14,475
OPTICAL IMAGING, AND WE DIDN'T

642
00:24:14,475 --> 00:24:15,176
DO THERAPEUTIC STUDIES AT THE

643
00:24:15,176 --> 00:24:18,879
TIME BUT THAT IS THE--THIS IS

644
00:24:18,879 --> 00:24:22,750
REALLY THE SCAFFOLD IS BASIS FOR

645
00:24:22,750 --> 00:24:23,451
THE CURRENT THERAPY ANDA NUMBER

646
00:24:23,451 --> 00:24:25,886
OF THETICS IN THE CLINIC BUT WE

647
00:24:25,886 --> 00:24:28,289
DID MAKE A GALLIUM COMPOUND EVEN

648
00:24:28,289 --> 00:24:38,799
THOUGH GALLIUM IS NOT QUITE AS

649
00:24:40,601 --> 00:24:42,636
DESIRED OF AN ISOTOPE FOR A PET.

650
00:24:42,636 --> 00:24:45,506
BUT IN THE UPPER LEFT CORNER WE

651
00:24:45,506 --> 00:24:47,141
MADE A GALLIUM COMPOUND, BUT

652
00:24:47,141 --> 00:24:48,843
THAT'S NOT THE 1 EVERYONE

653
00:24:48,843 --> 00:24:49,577
ADOPTED, EVERYONE ADOPTED THE 1

654
00:24:49,577 --> 00:24:54,715
ON THE RIGHT AND LEFT, WHICH HAS

655
00:24:54,715 --> 00:24:56,550
THE HPDACCKEY-LATER AND THAT'S

656
00:24:56,550 --> 00:25:00,855
BEEN APPROVED AND IS IN CLINICAL

657
00:25:00,855 --> 00:25:01,021
USE.

658
00:25:01,021 --> 00:25:02,756
OUR FIRST HUMAN STUDIES USING

659
00:25:02,756 --> 00:25:04,758
THE INITIAL COMPOUND WHICH LOOKS

660
00:25:04,758 --> 00:25:09,663
A LOT LIKE THE CARBON 11 XIPT WE

661
00:25:09,663 --> 00:25:11,632
PUT A BENZO OUT THERE, BUT WE IT

662
00:25:11,632 --> 00:25:13,968
WORKS WE SAW THE CANCER WITH

663
00:25:13,968 --> 00:25:15,236
VERY HIGH SUVs BUT ALL THAT

664
00:25:15,236 --> 00:25:17,972
OTHER ACTIVITY WAS UNDESIRABLE,

665
00:25:17,972 --> 00:25:20,474
SO WE MADE AN ANALOGUE AND THE

666
00:25:20,474 --> 00:25:23,010
ANALOGUE TOOK AWAY A LOT OF THAT

667
00:25:23,010 --> 00:25:25,179
BINDING AND WE HAD A VERY NICE

668
00:25:25,179 --> 00:25:30,384
COMPOUND WITH THIS PYL.

669
00:25:30,384 --> 00:25:33,254
SO A FEW YEARS LATER, I GAVE A

670
00:25:33,254 --> 00:25:37,925
TALK FOR THE PROSTATE CANCER

671
00:25:37,925 --> 00:25:38,659
FOUNDATION.

672
00:25:38,659 --> 00:25:39,727
AND I SHOWED THE AGENTS.

673
00:25:39,727 --> 00:25:42,363
THIS SHOWS THE IMPORTANCE OF

674
00:25:42,363 --> 00:25:42,897
ACADEMIC-TREY PARTNERSHIP.

675
00:25:42,897 --> 00:25:44,832
SO THIS WAS ALL UROLOGIST ANDS

676
00:25:44,832 --> 00:25:46,834
MEDICAL ONCOLOGISTS AT THIS

677
00:25:46,834 --> 00:25:47,067
RETREAT.

678
00:25:47,067 --> 00:25:50,404
IT WAS RIGHT HERE IN D. C. AND

679
00:25:50,404 --> 00:25:52,306
YOU KNOW I SHOWED THESE NICE

680
00:25:52,306 --> 00:25:55,543
IMAGES WHERE WE COULD--WE HAVE

681
00:25:55,543 --> 00:25:56,577
SUVs OF LIKE A HUNDRED FOR

682
00:25:56,577 --> 00:25:59,747
SOME OF THESE LESIONS AND

683
00:25:59,747 --> 00:26:01,515
SOMEBODY JUST ASKED, YOU KNOW

684
00:26:01,515 --> 00:26:04,685
WELL WHY CAN'T WE USE THIS THING

685
00:26:04,685 --> 00:26:04,852
NOW?

686
00:26:04,852 --> 00:26:06,186
AND I KNEW IN THE AUDIENCE WAS

687
00:26:06,186 --> 00:26:08,322
THE CEO OF COMPANY WHO LICENSES

688
00:26:08,322 --> 00:26:11,191
FROM US AND I SAID WELL, DON'T

689
00:26:11,191 --> 00:26:15,763
CAN ME, ASK MARK BAKER WHY THIS

690
00:26:15,763 --> 00:26:16,096
ISN'T--RIGHT?

691
00:26:16,096 --> 00:26:17,031
AND I LITERALLY DID THAT AND

692
00:26:17,031 --> 00:26:18,699
THERE ARE A FEW HUNDRED PEOPLE

693
00:26:18,699 --> 00:26:20,568
AND THEY LOOKED AT HIM AND HE

694
00:26:20,568 --> 00:26:21,502
COMMITTED TO DOING IT RIGHT

695
00:26:21,502 --> 00:26:26,006
THERE ON THE SPOT.

696
00:26:26,006 --> 00:26:27,741
SO THEN ONCE YOU HAVE THAT SORT

697
00:26:27,741 --> 00:26:29,710
OF COMMITMENT, THEN YOU CAN

698
00:26:29,710 --> 00:26:32,179
ACTUALLY MOVE THINGS BETTER TO

699
00:26:32,179 --> 00:26:35,916
THE CLINIC.

700
00:26:35,916 --> 00:26:37,151
SO HERE MEASURE LET ME SEE IF I

701
00:26:37,151 --> 00:26:39,186
CAN, THERE IT IS, SO THE GOAL

702
00:26:39,186 --> 00:26:41,956
WAS FOR THIS COMPOUND TO PICK UP

703
00:26:41,956 --> 00:26:44,158
LESIONS THAT WERE IN SOFT

704
00:26:44,158 --> 00:26:46,860
TISSUES LIKE IN THESE PERIAORTIC

705
00:26:46,860 --> 00:26:49,096
LIMP NOS AS WELL AS IN BONE SO

706
00:26:49,096 --> 00:26:51,065
WE WOULDN'T HAVE TO DO BONE

707
00:26:51,065 --> 00:26:53,067
SCANS OR CT SCANS SO THAT WE CAN

708
00:26:53,067 --> 00:26:55,936
HAVE A VERY NICE SPECIFIC

709
00:26:55,936 --> 00:27:01,442
MECHANISM BASED TARGETED AGENT

710
00:27:01,442 --> 00:27:02,710
FOR PROSTATE CANCER AND HERE

711
00:27:02,710 --> 00:27:03,911
GERONTOLOGYSTSING BACK TO THE

712
00:27:03,911 --> 00:27:06,447
ORIGINAL PARADIGM IN TERMS OF

713
00:27:06,447 --> 00:27:07,715
HOW WE MANAGE PROSTATE CANCER,

714
00:27:07,715 --> 00:27:09,583
THE IDEA WAS THAT WE COULD SEE

715
00:27:09,583 --> 00:27:12,119
LESIONS NOW THAT ARE ACTUALLY IN

716
00:27:12,119 --> 00:27:13,988
THE MARROW, THIS WOULD BE VERY

717
00:27:13,988 --> 00:27:15,356
HARD, IMPOSSIBLE TO PICK UP

718
00:27:15,356 --> 00:27:17,591
EITHER ON A BONE SCAN OR ON A CT

719
00:27:17,591 --> 00:27:18,792
SCAN BUT YOU WILL SEE THAT WE'RE

720
00:27:18,792 --> 00:27:21,695
IN THE SAME BALLPARK AS THE

721
00:27:21,695 --> 00:27:23,197
CIRCULATING TUMOR DECKER NA SO

722
00:27:23,197 --> 00:27:27,267
YOU MIGHT TAKE A PATIENT FROM A

723
00:27:27,267 --> 00:27:28,769
HIGH RISK GROUP, DETECT THE

724
00:27:28,769 --> 00:27:30,704
CANCER WITH THE INEXPENSIVE

725
00:27:30,704 --> 00:27:31,872
BLOOD TESTS AND DO THE IMAGING

726
00:27:31,872 --> 00:27:33,841
WHERE WE CAN SEE IT AND THEN YOU

727
00:27:33,841 --> 00:27:36,477
CAN CALL YOUR FRIENDS LIKE

728
00:27:36,477 --> 00:27:38,045
FUTRAN WHO'S A RADIATION

729
00:27:38,045 --> 00:27:41,115
ONCOLOGIST AND HE CAN DO STEREO

730
00:27:41,115 --> 00:27:42,316
TACTIC RADIATION AND HE CAN HIT

731
00:27:42,316 --> 00:27:44,385
THAT LESION BEFORE YOU EACH KNOW

732
00:27:44,385 --> 00:27:45,085
YOU'RE SICK.

733
00:27:45,085 --> 00:27:50,124
SO AGAIN, EARLIER DETECTION AND

734
00:27:50,124 --> 00:27:52,359
EARLIER TREATMENT AND YOU CAN

735
00:27:52,359 --> 00:27:54,995
STERILIZE THAT PART OF THE BODY

736
00:27:54,995 --> 00:28:05,506
IN TERMS OF THE CANCER AND YOU

737
00:28:08,008 --> 00:28:08,809
CAN CURE THERE'S VARIOUS

738
00:28:08,809 --> 00:28:11,578
CLINICAL SPACES THAT I WILL NOT

739
00:28:11,578 --> 00:28:13,113
BELABOR PRESURGICAL STAGING AND

740
00:28:13,113 --> 00:28:15,182
HIGH RISK PATIENTS, BIOCHEMICAL

741
00:28:15,182 --> 00:28:16,917
OCCURRENCE ISSUES THESE ARE 2

742
00:28:16,917 --> 00:28:20,187
THE 2 MAIN THINGS FOR THERAPY,

743
00:28:20,187 --> 00:28:22,656
MONITORING, SELECTING FOR THE

744
00:28:22,656 --> 00:28:24,158
THERANOISTICS BUT I WILL ONLY

745
00:28:24,158 --> 00:28:26,093
SHOW 1 MORE NUANCED THING THAT

746
00:28:26,093 --> 00:28:31,098
WE CAN DO WITH AGENTS LIKE THIS.

747
00:28:31,098 --> 00:28:34,435
SO THERE'S SOMEBODY AT HOPKINS

748
00:28:34,435 --> 00:28:35,335
NAMED SAM [INDISCERNIBLE].

749
00:28:35,335 --> 00:28:38,005
HE'S A MEDICAL ONCOLOGIST WHO

750
00:28:38,005 --> 00:28:39,573
FOCUSES ON PROSTATE CANCER AND

751
00:28:39,573 --> 00:28:45,045
HE HAS THIS IDEA OF SORT OF

752
00:28:45,045 --> 00:28:47,881
FREAKING OUT THE CANCER THROUGH

753
00:28:47,881 --> 00:28:50,217
THIS BIPOLAR ANDROGEN THERAPY.

754
00:28:50,217 --> 00:28:52,920
SO PROSTATE CANCER NEEDS

755
00:28:52,920 --> 00:28:53,387
ANDROGENS TO SURVIVE.

756
00:28:53,387 --> 00:29:01,462
IN FACT, EVEN IN  PATIENTS THAT

757
00:29:01,462 --> 00:29:02,863
ARE CASTRATED, THE ANTIGEN WILL

758
00:29:02,863 --> 00:29:04,164
FIGURE OUT HOW TO GET THEM.

759
00:29:04,164 --> 00:29:06,467
BUT HE SAYS, OKAY, I WILL TAKE

760
00:29:06,467 --> 00:29:09,269
PASHT AND I WILL GIVE A PATIENT

761
00:29:09,269 --> 00:29:10,437
WHO'S CASTRATE, AND I WILL GIVE

762
00:29:10,437 --> 00:29:13,240
HYMN A TON OF TESTOSTERONE AND

763
00:29:13,240 --> 00:29:14,508
THEN WHAT'S THE TUMOR GOING TO

764
00:29:14,508 --> 00:29:17,945
DO WITH THAT, AND THEN THE TUMOR

765
00:29:17,945 --> 00:29:19,146
GOES INTO APOPTOSIS BECAUSE IT'S

766
00:29:19,146 --> 00:29:21,749
ALL OF A SUDDEN IT'S ENRICHED

767
00:29:21,749 --> 00:29:24,218
WITH WHAT IT'S ALWAYS WANTED SO

768
00:29:24,218 --> 00:29:25,953
IT KIND OF ODs ON THAT AND

769
00:29:25,953 --> 00:29:26,787
THIS WAS HIS IDEA FOR THERAPY

770
00:29:26,787 --> 00:29:27,588
AND ACTIVITIES AND PROJECTS

771
00:29:27,588 --> 00:29:32,926
COMPETENT IT WORKS SOMETIMES,

772
00:29:32,926 --> 00:29:35,562
BUT WHAT WE CAN DO TO TRY TO

773
00:29:35,562 --> 00:29:36,130
INCORPORATE THAT INTO THIS

774
00:29:36,130 --> 00:29:38,232
THERAPY SO HERE WE HAVE 6

775
00:29:38,232 --> 00:29:41,168
PATIENTS AND THEY GET A BASE

776
00:29:41,168 --> 00:29:42,970
LINE PSN8 PET KAN--KANA AND

777
00:29:42,970 --> 00:29:45,506
FOLLOW UP SCAN FOLLOW UP 3

778
00:29:45,506 --> 00:29:48,041
MONTHS LATER AND SOME PATIENTS

779
00:29:48,041 --> 00:29:49,243
LIKE PATIENTS 1-3 THEY GET

780
00:29:49,243 --> 00:29:51,178
BETTER SO LIKE FOR EXAMPLE,

781
00:29:51,178 --> 00:29:52,613
HERE'S A LESION, IT'S GONE, THAT

782
00:29:52,613 --> 00:29:54,248
PATIENT DID BETTER, HERE'S

783
00:29:54,248 --> 00:29:57,050
LESIONS HERE, THEY'RE GONE,

784
00:29:57,050 --> 00:29:57,818
THESE PATIENTS HOWEVER, 4-6,

785
00:29:57,818 --> 00:30:01,688
THEY TENDED TO GET WORSE, SO, IT

786
00:30:01,688 --> 00:30:09,429
WORKS ON YOU KNOW SOME PATIENTS

787
00:30:09,429 --> 00:30:10,697
BUT NOT EVERYBODY.

788
00:30:10,697 --> 00:30:13,100
SO WHAT'S INTERESTING IF YOU DO

789
00:30:13,100 --> 00:30:16,837
CONVENTIONAL IMAGING AT THE SAME

790
00:30:16,837 --> 00:30:20,107
YOU DO THE SMA PET SCAN,

791
00:30:20,107 --> 00:30:21,341
EVERYBODY LOOKS GOOD EMPLOY SO

792
00:30:21,341 --> 00:30:23,677
WE HAVE 1 PATIENT WITH RESPONSE,

793
00:30:23,677 --> 00:30:25,679
EVERYBODY ELSE WITH STABLE

794
00:30:25,679 --> 00:30:28,115
DISEASE INCLUDING THOSE THAT

795
00:30:28,115 --> 00:30:29,483
PROGRESSED BUT AUTOLEASTOT PSMA

796
00:30:29,483 --> 00:30:31,351
SCAN WE KNEW 3 MONTHS EARLIER

797
00:30:31,351 --> 00:30:32,986
WHO WAS PROGRESS, SO WE COULD

798
00:30:32,986 --> 00:30:35,022
PREDETECTED WHO'S GOING TO

799
00:30:35,022 --> 00:30:37,157
PROGRESS USING THE MOLECULAR

800
00:30:37,157 --> 00:30:40,794
IMAGING AGENT AS OPPOSE TO JUST

801
00:30:40,794 --> 00:30:41,528
CONVENTIONAL IMAGING, SO BUYING

802
00:30:41,528 --> 00:30:43,263
THAT TIME AND GETTING THAT

803
00:30:43,263 --> 00:30:45,666
EARLIER DIAGNOSE REALLY ENABLES

804
00:30:45,666 --> 00:30:47,868
YOU TO MAKE GOOD DECISIONS, SO

805
00:30:47,868 --> 00:30:51,171
WE'VE DONE ALL SORTS OF STUFF

806
00:30:51,171 --> 00:30:53,974
WITH THESE PSMA MOLECULES, WE

807
00:30:53,974 --> 00:30:55,509
HAVE AN OPTICAL AGENT THAT WAS

808
00:30:55,509 --> 00:31:00,247
LICENSED BI A COMMERCIAL CONCERN

809
00:31:00,247 --> 00:31:01,782
THAT IS USED FOR SURGICAL

810
00:31:01,782 --> 00:31:04,918
GUIDANCE AND THERE'S A CLINICAL

811
00:31:04,918 --> 00:31:07,688
TRIAL CAN WE'VE MADE PHOTO

812
00:31:07,688 --> 00:31:09,890
ACOUSTIC IMAGING AGENTS, DUAL

813
00:31:09,890 --> 00:31:11,425
MODALITY AGENTS, SO THAT WE CAN

814
00:31:11,425 --> 00:31:17,731
USE THE OPTICAL OR WE CAN USE

815
00:31:17,731 --> 00:31:18,398
THE RADIO NUCLEOTIDES BASE PART

816
00:31:18,398 --> 00:31:20,100
OF IT TO MAKE THE DIAGNOSIS

817
00:31:20,100 --> 00:31:21,068
AND/OR DETECT THE CANCER AND

818
00:31:21,068 --> 00:31:22,703
THEN THE NEXT DAY IN THE O. R.

819
00:31:22,703 --> 00:31:25,038
WE CAN SEE IT AND MAKE SURE

820
00:31:25,038 --> 00:31:27,140
THERE'S A NEGATIVE SIRNLGICAL

821
00:31:27,140 --> 00:31:27,374
MARGIN.

822
00:31:27,374 --> 00:31:29,943
WE CAN DETECT IT USING

823
00:31:29,943 --> 00:31:32,679
SATURATION TRANSFER OR MR

824
00:31:32,679 --> 00:31:34,214
IMAGING SO WE THOUGHT OF A

825
00:31:34,214 --> 00:31:37,084
NUMBER OF USES FOR THIS, 1 OF

826
00:31:37,084 --> 00:31:38,719
THOSE IS THE THERAPY, SO WE GOT

827
00:31:38,719 --> 00:31:43,257
A LITTLE BIT DEEPER INTO THE

828
00:31:43,257 --> 00:31:45,459
THERAPY, MY INTRODUCTION TO

829
00:31:45,459 --> 00:31:46,360
RADIO FORM SUITICAL THERAPY GOES

830
00:31:46,360 --> 00:31:48,161
WAY BACK AND I LITERALLY I READ

831
00:31:48,161 --> 00:31:51,064
THIS PAPER ALSO IN REALTIME.

832
00:31:51,064 --> 00:31:54,801
THIS PAPER WAS GIVEN TO ME BY MY

833
00:31:54,801 --> 00:31:57,070
RESEARCH ADVISOR IN THE FALL OF

834
00:31:57,070 --> 00:31:59,239
1982 AND ONCE AGAIN, WHERE'S THE

835
00:31:59,239 --> 00:32:09,750
WORK BEING DONE, RIGHT HERE AT

836
00:32:10,550 --> 00:32:10,717
THE NIH.

837
00:32:10,717 --> 00:32:12,819
BUT THEY TOOK CELLS, BREAST

838
00:32:12,819 --> 00:32:22,763
CANCER CELLS AND FROZE THEM DOWN

839
00:32:22,763 --> 00:32:23,196
WITH [INDISCERNIBLE]

840
00:32:23,196 --> 00:32:24,031
IODESTRADISCIPLINARYOLE, THAT

841
00:32:24,031 --> 00:32:25,432
THAT YOU COULD KILL BREAST CANC

842
00:32:25,432 --> 00:32:26,833
THEY'RE WAY SO THE POINT BEHIND

843
00:32:26,833 --> 00:32:28,135
THIS IS WE HAVE BEEN THINKING

844
00:32:28,135 --> 00:32:29,369
ABOUT THIS STUFF FOR A LONG

845
00:32:29,369 --> 00:32:30,904
TIME, OKAY, THIS IS ALREADY, AND

846
00:32:30,904 --> 00:32:33,373
I'M NOT TALKING ABOUT RADIO

847
00:32:33,373 --> 00:32:34,942
IODINE, I'M TALKING ABOUT USING

848
00:32:34,942 --> 00:32:35,943
CHEMIST RADIOY TO GENERATE

849
00:32:35,943 --> 00:32:38,912
COMPOUNDS THAT DIDN'T EXIST TO

850
00:32:38,912 --> 00:32:40,614
TREAT CANCER, YOU KNOW OVER 40

851
00:32:40,614 --> 00:32:41,348
YEARS AGO.

852
00:32:41,348 --> 00:32:46,720
I PERSONALLY HAVE BEEN IN THIS

853
00:32:46,720 --> 00:32:48,288
FOR OVER 40 YEARS, SO WHAT

854
00:32:48,288 --> 00:32:50,757
MAYBES IT DIFFERENT NOW IS THAT

855
00:32:50,757 --> 00:32:52,859
NOW WE ACTUALLY HAVE BUY-IN FROM

856
00:32:52,859 --> 00:32:56,263
THE MEDICAL COMMUNITY AND FROM

857
00:32:56,263 --> 00:32:57,397
INDUSTRY, PARTICULARLY NOVARTIS,

858
00:32:57,397 --> 00:33:00,467
IF IT WASN'T FOR NOVARTIS, THIS

859
00:33:00,467 --> 00:33:04,638
WOULD BE MAINLY IN ACADEMIA.

860
00:33:04,638 --> 00:33:05,939
BUT I'VE LEARNED SOME HARD

861
00:33:05,939 --> 00:33:08,442
LESSONS ALONG THE WAY.

862
00:33:08,442 --> 00:33:12,946
SO WE MADE A COMPOUND, 1 OF OUR

863
00:33:12,946 --> 00:33:14,848
PSMA COMPOUNDS, THIS IS I THINK

864
00:33:14,848 --> 00:33:18,618
THIS IS THE GALLIUM, GALLIUM 68

865
00:33:18,618 --> 00:33:23,757
VERSION AND I CALLED RICHARD

866
00:33:23,757 --> 00:33:25,859
BAUM 1 OF MY FRIENDS IN GERMANY,

867
00:33:25,859 --> 00:33:28,161
I DID THIS WITH AN IMAGING AGENT

868
00:33:28,161 --> 00:33:29,463
BECAUSE I KNEW IT WOULD BE SAFE

869
00:33:29,463 --> 00:33:32,132
AND I DIDN'T HAVE TO WORRY ABOUT

870
00:33:32,132 --> 00:33:33,633
ANY TOXICITY, BUT RICHARD IN

871
00:33:33,633 --> 00:33:37,137
EUROPE, YOU CAN TBIF THINGS TO

872
00:33:37,137 --> 00:33:38,238
PATIENTS WITHOUT

873
00:33:38,238 --> 00:33:40,974
NECESSARILY--IT'S A

874
00:33:40,974 --> 00:33:43,176
DOCTOR-PATIENT RELATIONSHIP

875
00:33:43,176 --> 00:33:45,112
BASICALLY THAT ENABLES YOU TO

876
00:33:45,112 --> 00:33:46,513
GIVE THINGS THAT AREN'T

877
00:33:46,513 --> 00:33:47,914
NECESSARILY APRUFFED BY THE FDA

878
00:33:47,914 --> 00:33:49,816
SO I WAS DYING TO KNOW HOW THIS

879
00:33:49,816 --> 00:33:51,084
COMPOUND WORKED AND I GAVE A

880
00:33:51,084 --> 00:33:52,619
LITTLE BIT TO RICHARD AND HE

881
00:33:52,619 --> 00:33:57,924
GAVE IT TO 1 OF HIS PATIENTS AND

882
00:33:57,924 --> 00:33:59,526
WE HAD BEAUTIFUL IMAGES WITH

883
00:33:59,526 --> 00:34:00,794
THIS COMPOUND.

884
00:34:00,794 --> 00:34:03,330
JUST REALLY GORGEOUS IMAGES SO I

885
00:34:03,330 --> 00:34:06,466
SAID WOW, LET'S PUT LUTECIUM IN

886
00:34:06,466 --> 00:34:14,674
THERE AND SEE IF WE CAN CURE THE

887
00:34:14,674 --> 00:34:19,746
PATIENT SO WE DID THE LUTICIUM,

888
00:34:19,746 --> 00:34:23,417
AND IT DEPARTMENT WORK THAT

889
00:34:23,417 --> 00:34:24,017
IMRAIT.

890
00:34:24,017 --> 00:34:27,054
WE MADE 1 WITH PROVICTO, YOU CAN

891
00:34:27,054 --> 00:34:28,655
SEE IT, WE DON'T SEE MUCH WITH

892
00:34:28,655 --> 00:34:30,524
OUR COMPOUND SO THEN I LEARNED

893
00:34:30,524 --> 00:34:32,826
THAT BY CHANGING OUT THE METAL

894
00:34:32,826 --> 00:34:34,094
AND THE SUBTLE CHANGES YOU HAVE

895
00:34:34,094 --> 00:34:36,430
TO THE KEY LATER, ET CETERA, CAN

896
00:34:36,430 --> 00:34:38,331
YOU TOTALLY 3 OFF YOUR

897
00:34:38,331 --> 00:34:44,704
PHARMACOKINETICS AND NOT HAVE A

898
00:34:44,704 --> 00:34:45,372
GOOD [INDISCERNIBLE] ANYMORE.

899
00:34:45,372 --> 00:34:48,642
SO WE TALK ABOUT THIS AS AN

900
00:34:48,642 --> 00:34:50,010
THERAPY BUT THERE'S MORE TO IT

901
00:34:50,010 --> 00:34:50,577
THAN THAT.

902
00:34:50,577 --> 00:34:53,513
I REMEMBERED THAT PAPER FROM

903
00:34:53,513 --> 00:34:56,917
LIPPMAN, AND I TRIED LET'S TRY

904
00:34:56,917 --> 00:34:57,851
AN ELECTRON EMITTER, FOR THESE

905
00:34:57,851 --> 00:35:00,020
YOU NEED TO BE RIGHT UP AGAINST

906
00:35:00,020 --> 00:35:02,589
THE DNA AND I KNEW FROM OUR

907
00:35:02,589 --> 00:35:03,790
FLUORESCENT COMPOUNDS THAT THE

908
00:35:03,790 --> 00:35:05,459
PSMA WHICH IS THE CELL SURFACE

909
00:35:05,459 --> 00:35:06,993
PROTEIN WOULD BE INTERNALIZED

910
00:35:06,993 --> 00:35:09,629
AND WOULD GET RIGHT UP INTO THE

911
00:35:09,629 --> 00:35:11,865
SENT RHIZOME INTO THE NUCLEUS SO

912
00:35:11,865 --> 00:35:14,734
I THOUGHT IT WOULD WORK IF I PUT

913
00:35:14,734 --> 00:35:17,304
I125, AND I125 IS CHEAP AND EASY

914
00:35:17,304 --> 00:35:19,439
TO GET AND SYNTHESIZED WITH, SO

915
00:35:19,439 --> 00:35:23,443
WE TRIED THAT AND WE HAD ANIMALS

916
00:35:23,443 --> 00:35:25,045
THAT EITHER EXPRESSED PSMA, DOWN

917
00:35:25,045 --> 00:35:26,713
HERE AND THEN OTHER ANIMALS DID

918
00:35:26,713 --> 00:35:26,880
NOT.

919
00:35:26,880 --> 00:35:30,750
SO THIS IS A METASTAT BEING

920
00:35:30,750 --> 00:35:31,518
HUMAN PROSTATE CANCER.

921
00:35:31,518 --> 00:35:33,353
IF YOU EXPRESS THE TARGET, YOU

922
00:35:33,353 --> 00:35:34,488
DON'T DEVELOP THE CANCER BECAUSE

923
00:35:34,488 --> 00:35:39,493
YOU COMBINE TO OUR OJ ELECTRON

924
00:35:39,493 --> 00:35:40,026
EMITTING COMPOUND.

925
00:35:40,026 --> 00:35:42,395
SO I THINK THAT OJ ELECTRONS ARE

926
00:35:42,395 --> 00:35:49,569
SOMETHING WE SHOULD THINK MORE

927
00:35:49,569 --> 00:35:49,903
ABOUT.

928
00:35:49,903 --> 00:35:52,472
THIS IS SOMETHING I GOT FROM

929
00:35:52,472 --> 00:35:54,174
JONATHAN SIMONS, IT HAS BEEN

930
00:35:54,174 --> 00:35:55,909
PUBLISHED, AND THIS NOW MICHAEL

931
00:35:55,909 --> 00:35:57,911
HANDOFF MAN'S WORK IN AUSTRALIA

932
00:35:57,911 --> 00:35:59,746
BUT IT SHOWS HOW YOU CAN TAKE

933
00:35:59,746 --> 00:36:00,847
PATIENTS WITH A PSA OF A

934
00:36:00,847 --> 00:36:02,349
THOUSAND AND YOU CAN TAKE OUT

935
00:36:02,349 --> 00:36:04,985
ALL THEIR TUMOR AND THEY CAN

936
00:36:04,985 --> 00:36:08,054
HAVE A VERY IMPROVED QUALITY OF

937
00:36:08,054 --> 00:36:08,588
LIFE.

938
00:36:08,588 --> 00:36:11,491
AND IF YOU USE AN EVEN STRONGER

939
00:36:11,491 --> 00:36:14,361
COMPOUND, LIKE AN ALPHA PARTICLE

940
00:36:14,361 --> 00:36:17,364
EMITTER LIKE 225, EVEN AFTER

941
00:36:17,364 --> 00:36:18,865
FAILING THE LUTISSUING ICIUM

942
00:36:18,865 --> 00:36:19,399
THERAPY AND ACTIVITIES AND

943
00:36:19,399 --> 00:36:20,033
PROJECTS COMPETENT HAD IS NOT

944
00:36:20,033 --> 00:36:21,768
OUR WORK, BUT YOU CAN ACTUALLY

945
00:36:21,768 --> 00:36:25,705
STILL IMET RID OF ALL THE TUMOR,

946
00:36:25,705 --> 00:36:29,976
THE  TROUBLE HERE IS THAT YOU GT

947
00:36:29,976 --> 00:36:31,711
RID OF THE SALIVARY GRANDS, THIS

948
00:36:31,711 --> 00:36:32,913
IS NOT A STUDY WE COULD HAVE

949
00:36:32,913 --> 00:36:33,747
DONE IN THE UNITED STATES BUT

950
00:36:33,747 --> 00:36:35,715
THIS PEASHT WILL HAVE TO USE A

951
00:36:35,715 --> 00:36:37,250
SQUIRT BOTTLE THE REST OF THEIR

952
00:36:37,250 --> 00:36:40,820
LIFE UNFOR THEINATELY BECAUSE OF

953
00:36:40,820 --> 00:36:41,421
THE--UNFORTUNATELY BECAUSE OF

954
00:36:41,421 --> 00:36:42,088
DOING THAT.

955
00:36:42,088 --> 00:36:44,658
SO WE DEVELOPED OTHER COMPOUNDS

956
00:36:44,658 --> 00:36:46,393
THAT ARE AT LEAST IN ANIMAL

957
00:36:46,393 --> 00:36:50,163
MODELS THEY LOOK JUST AS GOOD AS

958
00:36:50,163 --> 00:36:55,035
THE  PROVICTO, BUT THEY DON'T

959
00:36:55,035 --> 00:37:00,240
BIND TO THE SALIVARY FLANKEDS

960
00:37:00,240 --> 00:37:04,544
AND WE LEARN THAT THANKS TO PETE

961
00:37:04,544 --> 00:37:04,778
TROYKE.

962
00:37:04,778 --> 00:37:06,246
AND WOB OF THE GREAT THINGS AT

963
00:37:06,246 --> 00:37:08,381
THE NIH, IF YOU CAN FIND

964
00:37:08,381 --> 00:37:10,217
SOMEBODY TO WORK WITH IN THERE

965
00:37:10,217 --> 00:37:13,753
LIKE PETE, HE SAID YEAH, LET'S

966
00:37:13,753 --> 00:37:15,021
SCAN SOME PATIENTS WITH YOUR NEW

967
00:37:15,021 --> 00:37:17,457
THING, I SAID WHAT, YOU CAN JUST

968
00:37:17,457 --> 00:37:17,657
SCAN.

969
00:37:17,657 --> 00:37:22,162
HE SAID YEAH, WE'LL DO A HUNDRED

970
00:37:22,162 --> 00:37:23,730
PATIENTS OR SO.

971
00:37:23,730 --> 00:37:25,031
WHICH IS UNIMAGINABLE FOR ME

972
00:37:25,031 --> 00:37:27,834
EMPLOY SO FORTUNATELY PETE DID

973
00:37:27,834 --> 00:37:32,472
THAT AND SHOWED THAT WE DON'T

974
00:37:32,472 --> 00:37:34,374
GET SALIVARY DPLAND UPTAKE WITH

975
00:37:34,374 --> 00:37:36,076
THESE COMPOUNDS BUT WE STILL CAN

976
00:37:36,076 --> 00:37:38,111
SEE ACTIVITY IN THE CANCER, NOT

977
00:37:38,111 --> 00:37:40,180
NICE AND CRISP AS WELL AS THE

978
00:37:40,180 --> 00:37:43,783
617, BUT THIS A VERY IMPORTANT

979
00:37:43,783 --> 00:37:47,420
DETAIL THAT WE DON'T GET, HIT

980
00:37:47,420 --> 00:37:48,855
SALIVARY FLANKEDS AND WE DON'T

981
00:37:48,855 --> 00:37:52,926
HIT THE KIDNEYS AS MUCH SO THIS

982
00:37:52,926 --> 00:37:54,294
COMPOUND, THE ACTINIUM LABELED

983
00:37:54,294 --> 00:37:57,163
VERSION IS JUST BEGINNING NOW.

984
00:37:57,163 --> 00:38:00,166
A CLINICAL TRIAL SPONSORED BY

985
00:38:00,166 --> 00:38:00,433
NOVARTIS.

986
00:38:00,433 --> 00:38:04,237
AND YOU KNOW AGAIN, ALPHAS ARE

987
00:38:04,237 --> 00:38:08,308
GOING TO BE THE WAY TO GO, BUT

988
00:38:08,308 --> 00:38:13,179
WE DID A THERE WAS A LUTICIUM

989
00:38:13,179 --> 00:38:16,716
TRIAL, WAS DONE MANICALLY TO GET

990
00:38:16,716 --> 00:38:17,851
THE DOSEEMETRY FOR THIS TRIAL.

991
00:38:17,851 --> 00:38:19,586
THIS IS JUST BEGINNING AND I

992
00:38:19,586 --> 00:38:21,855
HOPE THAT YOU AND OTHER SITES

993
00:38:21,855 --> 00:38:22,422
WILL BE INTERESTED.

994
00:38:22,422 --> 00:38:27,927
BUT I THINK THAT ACTINIUM IS

995
00:38:27,927 --> 00:38:28,228
OVERKILL.

996
00:38:28,228 --> 00:38:29,896
I THINK IT'S DAUGHTER ALPHA

997
00:38:29,896 --> 00:38:31,531
PARTICLES THAT COME OFF, 4 ALPHA

998
00:38:31,531 --> 00:38:32,332
CERTAINLY--CERTAINLY MISSIONS

999
00:38:32,332 --> 00:38:33,733
AND AFTER THE FIRST EMISSION YOU

1000
00:38:33,733 --> 00:38:35,435
GET A RECOIL EEIVET SO YOU LOSE

1001
00:38:35,435 --> 00:38:38,805
TRACK OF YOUR RECEPTOR AND THEN

1002
00:38:38,805 --> 00:38:40,974
ALL THE OTHER ALPHAS GO WHEREVER

1003
00:38:40,974 --> 00:38:43,843
THEY WANT, SO IT'S NOT REALLY

1004
00:38:43,843 --> 00:38:45,645
THAT GREAT IN TERMS OF TOXICITY

1005
00:38:45,645 --> 00:38:52,886
SO I'VE BEEN WORKING WITH

1006
00:38:52,886 --> 00:38:55,855
MICHAEL ZALUTSKY AND WE'VE BEEN

1007
00:38:55,855 --> 00:38:57,791
WORKING WITH A VERSION OF OUR

1008
00:38:57,791 --> 00:39:01,361
COMPOUNDS IT'S A TAMER KINDER

1009
00:39:01,361 --> 00:39:02,529
GENTLER PARTICLE BECAUSE IT'S

1010
00:39:02,529 --> 00:39:04,064
GOT 1 DECAY AND WE'RE HOPE THOG

1011
00:39:04,064 --> 00:39:05,565
BRING THAT TO THE CLINIC PRETTY

1012
00:39:05,565 --> 00:39:10,270
SOON BUT JUST AS A CAUTIONARY

1013
00:39:10,270 --> 00:39:12,272
TAIL TO MYSELF, WE ALSO

1014
00:39:12,272 --> 00:39:15,141
SYNTHESIZED A DRUG LIKE

1015
00:39:15,141 --> 00:39:15,875
COMPOUND.

1016
00:39:15,875 --> 00:39:17,777
SO ANTIBODY DRUG CONJUGATES

1017
00:39:17,777 --> 00:39:20,980
OFTEN USE HORRIBLE CYTOTOXIN

1018
00:39:20,980 --> 00:39:22,782
KNOWN AS MONOMETHYL ORASTATIN.

1019
00:39:22,782 --> 00:39:26,686
VERY TOXIC AND YOU NEED TO BRING

1020
00:39:26,686 --> 00:39:27,987
AN ANTIBODY TO BRENG IT TO THE

1021
00:39:27,987 --> 00:39:31,725
CANCER BUT STILL IT'S KIND OF

1022
00:39:31,725 --> 00:39:33,626
TOXIC BUT WE MADE A COMPOUND

1023
00:39:33,626 --> 00:39:34,894
THAT HAD 2 LEVELS INCREASES OF

1024
00:39:34,894 --> 00:39:37,564
SECURITY WHERE WE HAD SPECIFIC

1025
00:39:37,564 --> 00:39:38,398
CANCER TARGETING FROM THE

1026
00:39:38,398 --> 00:39:39,866
[INDISCERNIBLE] AND THEN WE PUT

1027
00:39:39,866 --> 00:39:41,201
A CLEAVABLE LINKER THERE SO THAT

1028
00:39:41,201 --> 00:39:43,169
ONCE THIS IS CLEAVED YOU

1029
00:39:43,169 --> 00:39:45,238
ACTIVATE THE TOXIN AND WE FINE

1030
00:39:45,238 --> 00:39:47,107
THAT THIS MOLECULE IS JUST AS

1031
00:39:47,107 --> 00:39:52,579
GOOD, AS ANY OF OUR RADIO

1032
00:39:52,579 --> 00:39:52,912
THERAPEUTICS.

1033
00:39:52,912 --> 00:39:54,748
SO, YOU KNOW THE RADIO

1034
00:39:54,748 --> 00:39:55,715
THERAPEUTICS ARE GREAT, THEY

1035
00:39:55,715 --> 00:39:57,150
PROBABLY HAVE LESS SIDE EFFECTS

1036
00:39:57,150 --> 00:39:59,719
BUT IF YOU DESIGN A DRUG

1037
00:39:59,719 --> 00:40:01,187
CAREFULLY YOU COULD PROBABLY

1038
00:40:01,187 --> 00:40:04,023
ALSO HAVE--THIS IS BEASKLY A

1039
00:40:04,023 --> 00:40:06,459
NONTOXIC DRUG AS WELL, SO JUST

1040
00:40:06,459 --> 00:40:08,695
PIVOT FOR 1-SECOND AWAY FROM THE

1041
00:40:08,695 --> 00:40:09,295
PSMA.

1042
00:40:09,295 --> 00:40:10,897
THERE'S ANOTHER TARGET YOU HEARD

1043
00:40:10,897 --> 00:40:16,102
ABOUT, SO HAD IS A TYPICAL

1044
00:40:16,102 --> 00:40:17,370
PICTURE THAT YOU MIGHT HAVE SEEN

1045
00:40:17,370 --> 00:40:19,672
IN MED SCHOOL IF YOU WENT TO MED

1046
00:40:19,672 --> 00:40:23,543
SCHOOL WHEN PETE AND I DID IN

1047
00:40:23,543 --> 00:40:24,377
THE EARLY 1980S.

1048
00:40:24,377 --> 00:40:28,548
AND YOU KNOW STROMA WHICH WE'VE

1049
00:40:28,548 --> 00:40:31,050
ALL KIND OF--WE WOULD BLOW IT

1050
00:40:31,050 --> 00:40:32,585
OFF, BUT IT TURNS OUT THAT

1051
00:40:32,585 --> 00:40:34,554
STROMA IS THE MOST IMPORTANT

1052
00:40:34,554 --> 00:40:34,821
THING NOW.

1053
00:40:34,821 --> 00:40:35,789
IT'S MAISHZING HOW THAT HAPPENS

1054
00:40:35,789 --> 00:40:38,057
IN MEDICINE, HA'S WHERE THE

1055
00:40:38,057 --> 00:40:38,725
FIBROBLAFS ARE, THE MACROPHAGES

1056
00:40:38,725 --> 00:40:42,228
ARE AND WE'RE SPENNING A LOT OF

1057
00:40:42,228 --> 00:40:44,764
TIME TRYING TO IMAGE THESE AND

1058
00:40:44,764 --> 00:40:52,338
WE ACTUALLY USE THIS 2 C

1059
00:40:52,338 --> 00:40:53,206
YANO-[INDISCERNIBLE], THE BEST

1060
00:40:53,206 --> 00:41:02,015
POST DOCKER NEXT TO DEEMA, BUT

1061
00:41:02,015 --> 00:41:03,483
XING YANG UNBELIEVABLE FOWBD

1062
00:41:03,483 --> 00:41:05,351
THIS AND STARTED

1063
00:41:05,351 --> 00:41:06,252
FUNCTIONALLIZING IT FOR

1064
00:41:06,252 --> 00:41:07,187
FIBROBLAST ACTIVATION PROTEIN

1065
00:41:07,187 --> 00:41:11,157
AND WE GET NICE HIGH PERCENT ID

1066
00:41:11,157 --> 00:41:12,258
PERGRAM EMPLOY WHICH IS WHAT YOU

1067
00:41:12,258 --> 00:41:14,427
WANT ON SEE, WE ALSO FIND THAT

1068
00:41:14,427 --> 00:41:15,161
THE SPECIFIC ACTIVITY IS VERY

1069
00:41:15,161 --> 00:41:18,331
IMPORTANT THAT IF WE HAVE HIGH

1070
00:41:18,331 --> 00:41:20,600
SPECIFIC ACTIVITY WE ACTUALLY

1071
00:41:20,600 --> 00:41:24,003
HAVE MORE UPTAKE IN THE BLOOD.

1072
00:41:24,003 --> 00:41:26,005
SO WE NEED TO HAVE A LINGS

1073
00:41:26,005 --> 00:41:30,210
BIT--IME SORRY, THIS IS THE,

1074
00:41:30,210 --> 00:41:31,177
WE'RE GETTING CARRIER IN THIS

1075
00:41:31,177 --> 00:41:33,246
CASE, SO WE HAVE HIGHER UPTAKE

1076
00:41:33,246 --> 00:41:38,318
IN THE BLOOD WHEN WE DON'T HAVE

1077
00:41:38,318 --> 00:41:39,018
CARRIER.

1078
00:41:39,018 --> 00:41:39,953
SO THERE'S ALL SORTS OF

1079
00:41:39,953 --> 00:41:41,354
CONSIDERATIONS WE TAKE BO EFFECT

1080
00:41:41,354 --> 00:41:42,722
FOR IMAGING AND FOR THERAPY.

1081
00:41:42,722 --> 00:41:50,597
THE OTHER THING IS, THAT WITH

1082
00:41:50,597 --> 00:41:53,933
ENZOLIEWTA MID, AND AGENTS LIKE

1083
00:41:53,933 --> 00:41:55,001
PROVECTO, YOU EVENTUALLY GET RID

1084
00:41:55,001 --> 00:41:57,670
OF ALL YOUR CANCER AND ALL

1085
00:41:57,670 --> 00:42:00,773
YOU'VE GOT LEFT IS CANCER THAT

1086
00:42:00,773 --> 00:42:03,676
YOU CAN'T SEE.

1087
00:42:03,676 --> 00:42:04,777
SO IT'S EITHER NEUROENDOCRINE

1088
00:42:04,777 --> 00:42:06,579
DEDEFERENTIATED OR SOME OTHER

1089
00:42:06,579 --> 00:42:08,882
PHENOTYPE EMPLOY SO WE DEVELOPED

1090
00:42:08,882 --> 00:42:11,584
A COMPOUND THAT WOULD BIND BOTH

1091
00:42:11,584 --> 00:42:13,853
FAP, WHICH HAS BEEN SHOWN TO BE

1092
00:42:13,853 --> 00:42:15,355
TAKEN UP IN NEUROENDOCRINE

1093
00:42:15,355 --> 00:42:21,561
PROSTATE CANCER AS WELL AS PSMA,

1094
00:42:21,561 --> 00:42:23,329
SO THAT WOE CAN HIT, GET JUST

1095
00:42:23,329 --> 00:42:25,265
ABOUT ALL THE CANCER WE CAN

1096
00:42:25,265 --> 00:42:26,666
THINK OF BUT I CAN TELL YOU 1

1097
00:42:26,666 --> 00:42:27,867
THING FOR SURE THAT THE CANCER

1098
00:42:27,867 --> 00:42:31,971
WILL FIGURE OUT ANOTHER WAY,

1099
00:42:31,971 --> 00:42:33,706
EVEN THESE MOLECULAR RADIO

1100
00:42:33,706 --> 00:42:35,808
THERAPEUTICS, WE USED TO SAY YOU

1101
00:42:35,808 --> 00:42:37,010
CAN'T MUTATE AWAY FROM THESE

1102
00:42:37,010 --> 00:42:38,311
THINGS BUT OKAY, WELL, IF YOU

1103
00:42:38,311 --> 00:42:40,647
DON'T DO THAT, THEN YOU JUST

1104
00:42:40,647 --> 00:42:41,781
SELECT FOR THE 1 OR 2 CLONES

1105
00:42:41,781 --> 00:42:44,017
THAT DON'T EXPRESS THE TARGET.

1106
00:42:44,017 --> 00:42:50,723
AND WE WANT TO TRY TO GET AROUND

1107
00:42:50,723 --> 00:42:52,225
THAT ALSO.

1108
00:42:52,225 --> 00:42:52,458
OOPS.

1109
00:42:52,458 --> 00:42:54,594
LET'S SEE IF THIS--THERE WE GO,

1110
00:42:54,594 --> 00:42:57,397
SO IN TERMS OF DRUGS TO TREAT

1111
00:42:57,397 --> 00:42:58,865
PROSTATE CANCER, WE HEAR A LOT

1112
00:42:58,865 --> 00:43:02,302
ABOUT THESE RADIO THERAPEUTICS,

1113
00:43:02,302 --> 00:43:03,369
HERE'S THE--I GUESS IT'S THIS

1114
00:43:03,369 --> 00:43:06,039
KIND OF PINK HERE, IT DOESN'T

1115
00:43:06,039 --> 00:43:07,073
LOOK TOO ENCOURAGING IN TERMS OF

1116
00:43:07,073 --> 00:43:09,342
WHAT'S GOING TO BE USED IN THE

1117
00:43:09,342 --> 00:43:09,809
FUTURE.

1118
00:43:09,809 --> 00:43:12,745
NOW THIS PAPER'S ALREADY A

1119
00:43:12,745 --> 00:43:13,713
COUPLE YEARS OLD BUT YOU KNOW

1120
00:43:13,713 --> 00:43:15,748
FROM WHAT I HEAR FROM PATIENTS

1121
00:43:15,748 --> 00:43:18,418
THEY LOVE THIS STUFF.

1122
00:43:18,418 --> 00:43:19,953
IT'S FLYING OFF THE SHELVES, AND

1123
00:43:19,953 --> 00:43:21,154
THAT'S BECAUSE THE SIDE EFFECT

1124
00:43:21,154 --> 00:43:22,689
PROFILE IS SO MUCH BETTER THAN

1125
00:43:22,689 --> 00:43:24,290
WHAT THEY'RE USED TO WITH CHEMO

1126
00:43:24,290 --> 00:43:26,292
THERAPY, BUT IN THE FUTURE, YOU

1127
00:43:26,292 --> 00:43:29,295
KNOW THERE MIGHT BE P A RP

1128
00:43:29,295 --> 00:43:30,396
INHIBITORS IN CERTAIN

1129
00:43:30,396 --> 00:43:31,431
SUBPOPULATIONS, AGAIN A

1130
00:43:31,431 --> 00:43:32,599
PRECISION TECHNIQUE, BUT WE'LL

1131
00:43:32,599 --> 00:43:34,567
SEE, YOU KNOW WHERE THESE ARE

1132
00:43:34,567 --> 00:43:36,869
GOING TO SHOW UP IN THE FUTURE,

1133
00:43:36,869 --> 00:43:40,206
BUT THE MOST IMPORTANT TARGET

1134
00:43:40,206 --> 00:43:42,475
REMAINS THE ANTIGEN RECEPTOR

1135
00:43:42,475 --> 00:43:45,278
DIRECTED THERAPIES EVEN THOUGH

1136
00:43:45,278 --> 00:43:47,580
THEY DON'T REALLY PROVIDE LONG

1137
00:43:47,580 --> 00:43:48,081
LASTING RESULTS.

1138
00:43:48,081 --> 00:43:50,583
BUT THEN WHAT DOES?

1139
00:43:50,583 --> 00:43:52,785
AND I'LL TALK ABOUT THAT IN A

1140
00:43:52,785 --> 00:43:53,019
MINUTE.

1141
00:43:53,019 --> 00:43:54,587
SO THE LAST COUPLE MINUTES I

1142
00:43:54,587 --> 00:43:58,157
JUST WANT TO SAY THAT, YOU KNOW

1143
00:43:58,157 --> 00:43:59,626
WE'RE BEGINNING TO APPLY MACHINE

1144
00:43:59,626 --> 00:44:02,595
LEARNING TO A CERTAIN EXTENT,

1145
00:44:02,595 --> 00:44:03,563
TRYING TO TRAIN THE MACHINES

1146
00:44:03,563 --> 00:44:05,298
WITH SOME OF OUR NEW AGENTS SO

1147
00:44:05,298 --> 00:44:07,400
WE CAN MAKE VERY SPECIFIC

1148
00:44:07,400 --> 00:44:09,469
RECOMMENDATIONS TO PATES, FIGURE

1149
00:44:09,469 --> 00:44:12,038
OUT SORT OF IN A PRECISION WAY

1150
00:44:12,038 --> 00:44:13,873
WHO'S 2 FRAIL TO UNDERGO THE

1151
00:44:13,873 --> 00:44:14,841
THERAPY, WHAT KIND OF DOSING

1152
00:44:14,841 --> 00:44:16,542
THEY SHOULD HAVE, BUT BEFORE WE

1153
00:44:16,542 --> 00:44:18,745
GO CRAZY WITH MACHINE LEARNING,

1154
00:44:18,745 --> 00:44:22,915
I'D LIKE TO SHOW THIS SLIDE

1155
00:44:22,915 --> 00:44:25,885
WHERE WE CAN TRAIN A

1156
00:44:25,885 --> 00:44:27,387
CONVOLUTIONAL NETWORK ON A

1157
00:44:27,387 --> 00:44:30,023
MILLION BONE SCANS AND THAT

1158
00:44:30,023 --> 00:44:35,695
CNN WILL BE ABLE TO DETECT

1159
00:44:35,695 --> 00:44:37,830
CANCER CERTAINLY BETTER THAN I

1160
00:44:37,830 --> 00:44:40,033
CAN, PROBABLY NOT BETTER THAN

1161
00:44:40,033 --> 00:44:41,034
YOUR NUCLEAR PHYSICIANS MEDICINE

1162
00:44:41,034 --> 00:44:42,268
HERE BUT VERY SMART.

1163
00:44:42,268 --> 00:44:43,870
THE CNN CAN WILL IT THE

1164
00:44:43,870 --> 00:44:47,073
DIFFERENCE BETWEEN A RIB

1165
00:44:47,073 --> 00:44:50,543
FRACTURE AND A METASTASIS, BUT

1166
00:44:50,543 --> 00:44:54,347
IN THIS CASE, OUR FRIEND FROM

1167
00:44:54,347 --> 00:44:56,049
RADIATION ONCOLOGY SAID SHOULD

1168
00:44:56,049 --> 00:44:58,284
WE RADIATE THIS LESIONION, THIS

1169
00:44:58,284 --> 00:44:59,952
METASTATIC FOCUS AND WE

1170
00:44:59,952 --> 00:45:01,988
RECOMMENDED DOING A PSMA PET

1171
00:45:01,988 --> 00:45:03,856
SCAN AND YOU COULD SEE THAT

1172
00:45:03,856 --> 00:45:05,825
WOULD NOT HAVE NOT BEEN--IT

1173
00:45:05,825 --> 00:45:07,360
WOULD HAVE BEEN FUTILE.

1174
00:45:07,360 --> 00:45:09,062
SO WE'RE STILL AHEAD OF THE

1175
00:45:09,062 --> 00:45:10,263
MACHINES SO WE STILL NEED

1176
00:45:10,263 --> 00:45:12,098
DISCOVERY, SO THAT WE CAN

1177
00:45:12,098 --> 00:45:13,099
DISCOVER NEW AGENTS LIKE THIS

1178
00:45:13,099 --> 00:45:14,801
AND THEN WEB CONNECTED TRAIN THE

1179
00:45:14,801 --> 00:45:16,869
MACHINES ON THESE AGENTS WHICH

1180
00:45:16,869 --> 00:45:17,670
IS WHAT'S HAPPENING NOW BUT

1181
00:45:17,670 --> 00:45:20,173
WE'RE ARK HEAD OF THE MACHINES

1182
00:45:20,173 --> 00:45:22,508
BUT NOT BY MUCH, I HAVE TO SAY,

1183
00:45:22,508 --> 00:45:24,343
AND THE GAP IS CLOSING BUT WE

1184
00:45:24,343 --> 00:45:25,211
STILL NEED TO UNDERSTAND THE

1185
00:45:25,211 --> 00:45:28,047
CHEMIST RADIOY AND THE TARGETS.

1186
00:45:28,047 --> 00:45:32,151
--CHEMISTRY AND THE TARGETS.

1187
00:45:32,151 --> 00:45:34,287
STEVE ROW AND OUR GROUP HAS

1188
00:45:34,287 --> 00:45:34,954
DEVELOPED A STRUCTURED REPORTING

1189
00:45:34,954 --> 00:45:37,023
SYSTEM AND NOW WOE HAVE WAYS OF

1190
00:45:37,023 --> 00:45:40,093
AUTOMATICALLY DETECTING AND

1191
00:45:40,093 --> 00:45:41,260
SEGMENTING THESE LESIONS SO THAT

1192
00:45:41,260 --> 00:45:43,996
FOR EXAMPLE, WE CAN JUST LET THE

1193
00:45:43,996 --> 00:45:45,264
ALGORITHM FIND THESE LESION ANDS

1194
00:45:45,264 --> 00:45:48,835
WE CAN GO TO INNER HARBOR, GET

1195
00:45:48,835 --> 00:45:50,770
SOME SOFT SHELL CRABS, COME BACK

1196
00:45:50,770 --> 00:45:52,405
AN HOUR OR 2 LATER AND MAKE SURE

1197
00:45:52,405 --> 00:45:58,711
THE MACHINE WAS CORRECT.

1198
00:45:58,711 --> 00:46:01,013
SO WHAT WE TRY TO DO NEXT IS

1199
00:46:01,013 --> 00:46:06,185
DETECT AND LOCALIZE THEM

1200
00:46:06,185 --> 00:46:09,655
AUTOMATICALLY, DISSECT THEM

1201
00:46:09,655 --> 00:46:10,323
AUTOMATICALLY, EXTRACT FEATURES.

1202
00:46:10,323 --> 00:46:12,158
WHAT WE HAVEN'T DONE YET BECAUSE

1203
00:46:12,158 --> 00:46:13,493
IT'S TAKEN US 2 YEARS TO GET

1204
00:46:13,493 --> 00:46:15,161
PAST THE IRB BUT WE CAN USE

1205
00:46:15,161 --> 00:46:16,562
MEDICAL HISTORY ALSO AND THEN WE

1206
00:46:16,562 --> 00:46:19,232
CAN MAKE REALLY INFORMED

1207
00:46:19,232 --> 00:46:21,434
TREATMENT TECISIONS LIKE WE CAN

1208
00:46:21,434 --> 00:46:23,102
BE REALLY SPECIFIC WITH THE

1209
00:46:23,102 --> 00:46:24,170
PATIENTS THAT WE'RE SEEING,

1210
00:46:24,170 --> 00:46:26,472
WHICH IS SORT OF THE FUTURE, WE

1211
00:46:26,472 --> 00:46:29,442
HAVEN'T DONE THIS YET, BUT THIS

1212
00:46:29,442 --> 00:46:32,578
IS ALL AUTOMATED AND MERELY

1213
00:46:32,578 --> 00:46:34,113
CURATED BY THE RADIOLOGIST.

1214
00:46:34,113 --> 00:46:35,681
I PERSONALLY BELIEVE THAT BY

1215
00:46:35,681 --> 00:46:37,150
KOAM BIENING THE

1216
00:46:37,150 --> 00:46:39,919
POWER--COMBINING THE POWER OF

1217
00:46:39,919 --> 00:46:40,987
ARTIFICIAL INTELLIGENCE AND THE

1218
00:46:40,987 --> 00:46:42,822
SPECIFICITY AND THE SENSITIVITY

1219
00:46:42,822 --> 00:46:44,323
WITH MOLECULAR IMAGING THAT WE

1220
00:46:44,323 --> 00:46:48,528
CAN PROBABLY GET AS CLOSE TO

1221
00:46:48,528 --> 00:46:51,697
HUMAN BIOCHEMISTRY ENVIVO AS YOU

1222
00:46:51,697 --> 00:46:55,868
CAN POSSIBLY GET IN 2023.

1223
00:46:55,868 --> 00:46:57,537
BUT STILL THERE'S SO MUCH FOR US

1224
00:46:57,537 --> 00:46:57,737
TO DO.

1225
00:46:57,737 --> 00:47:01,674
A LOT OF DOORS HAVE OPENED,

1226
00:47:01,674 --> 00:47:03,509
MAINLY THROUGH CLOUD COMPUTING,

1227
00:47:03,509 --> 00:47:04,577
THROUGH DISCOVERY OF NEW

1228
00:47:04,577 --> 00:47:06,546
TARGETS, IN THE OLD DAYS I WOULD

1229
00:47:06,546 --> 00:47:08,247
READ ARTICLES LIKE I SHOWED YOU

1230
00:47:08,247 --> 00:47:09,816
AT THE BEGENERATEDDING IN JMED

1231
00:47:09,816 --> 00:47:11,384
CAM AND I WILL FIND, THAT LOOKS

1232
00:47:11,384 --> 00:47:12,885
LIKE A GOOD TARGET BUT NOW

1233
00:47:12,885 --> 00:47:14,520
THERE'S SO MANY TARGETS, IT'S

1234
00:47:14,520 --> 00:47:15,822
LIKE I DON'T KNOW WHERE TO

1235
00:47:15,822 --> 00:47:19,358
START, I MEAN IF I--1 TRICK CAN

1236
00:47:19,358 --> 00:47:22,161
YOU USE, YOU LOOK AT, WELL WHAT

1237
00:47:22,161 --> 00:47:25,364
ARE THEY MAKING ANTIBODY DRUG

1238
00:47:25,364 --> 00:47:27,400
CONJUGATES TOWARD, SO I LOOK AT

1239
00:47:27,400 --> 00:47:27,600
THAT.

1240
00:47:27,600 --> 00:47:29,602
AND EVEN THAT YOU COULD

1241
00:47:29,602 --> 00:47:31,737
DOWNLOAD, YOU KNOW JUST

1242
00:47:31,737 --> 00:47:32,672
SPREADSHEETS WITH 400 TARGETS

1243
00:47:32,672 --> 00:47:34,440
LIKE WHERE DO YOU PUT YOUR

1244
00:47:34,440 --> 00:47:37,009
NICKEL DOWN, SO WOE GOT LUCKY,

1245
00:47:37,009 --> 00:47:39,111
FRANKLY WITH THIS PSMA.

1246
00:47:39,111 --> 00:47:41,147
BUT STILL, THERE'S SO MUCH TO

1247
00:47:41,147 --> 00:47:46,686
DO, THIS WAS THE REGISTRATION

1248
00:47:46,686 --> 00:47:50,022
TRIAL FOR THE 617, NOW KNOWN AS

1249
00:47:50,022 --> 00:47:57,263
PLUVICTO EMPLOY YOU CAN SEE THEY

1250
00:47:57,263 --> 00:47:59,031
ADDED THE PLUVICTO TO THE

1251
00:47:59,031 --> 00:48:01,000
STANDARD OF CARE AND THEY GOT A

1252
00:48:01,000 --> 00:48:02,602
BUMP PRACTICES 11 MONTHS TO 15

1253
00:48:02,602 --> 00:48:03,336
MONTHS.

1254
00:48:03,336 --> 00:48:04,737
I WAS PERSONALLY DISAPPOINTED.

1255
00:48:04,737 --> 00:48:12,345
I THINK A LOT OF PEOPLE,

1256
00:48:12,345 --> 00:48:13,746
PARTICULARLY AT NOVARTIS, THEY

1257
00:48:13,746 --> 00:48:15,448
WERE THRILLED BUT I'M THINKING

1258
00:48:15,448 --> 00:48:18,251
THAT'S A PRETTY WIMPY RESULT.

1259
00:48:18,251 --> 00:48:19,652
ESPECIALLY IF YOU TAKE PATES AT

1260
00:48:19,652 --> 00:48:21,621
A THOUSAND AND IT MOVINGS TO 0,

1261
00:48:21,621 --> 00:48:24,490
HOW ARE THESE CURVES SO CLOSE?

1262
00:48:24,490 --> 00:48:25,024
IT'S RIDICULOUS.

1263
00:48:25,024 --> 00:48:26,092
BUT IT'S BECAUSE THERE'S CANCER

1264
00:48:26,092 --> 00:48:28,027
THERE, WE SELECT FOR THE CANCER

1265
00:48:28,027 --> 00:48:30,563
THAT YOU CAN'T SEE ANYMORE.

1266
00:48:30,563 --> 00:48:37,570
SO THAT WAS THE RESULT, SO BOTH

1267
00:48:37,570 --> 00:48:39,205
KAPLANMIER KERVES TOO CLOSE FOR

1268
00:48:39,205 --> 00:48:39,672
COMFORT.

1269
00:48:39,672 --> 00:48:42,475
THIS JUST CAME OUT YESTERDAY.

1270
00:48:42,475 --> 00:48:47,113
ANOTHER RESULT WHICH SOUNDS

1271
00:48:47,113 --> 00:48:49,548
IMRAIT ON PAPER, THEY HAD

1272
00:48:49,548 --> 00:48:51,050
A--THEY MET THEIR PRIMARY END

1273
00:48:51,050 --> 00:48:54,420
POINT AGAIN WITH THE PLUVICTO.

1274
00:48:54,420 --> 00:48:55,922
THEY SHOWED THAT YOU KNOW THE

1275
00:48:55,922 --> 00:49:00,359
PRIMARY END POINT IN THIS CASE

1276
00:49:00,359 --> 00:49:01,460
WAS RADIO IMROFFIC PROGRESSION

1277
00:49:01,460 --> 00:49:04,830
FREE SURVERIFIAL WHICH WAS MET

1278
00:49:04,830 --> 00:49:08,367
AND THERE WAS, TREMENDOUSLY NICE

1279
00:49:08,367 --> 00:49:11,671
RESULT TO SEE, YOU KNOW 60% OF

1280
00:49:11,671 --> 00:49:15,374
PATIENTS I THINK HAD EXCELLENT

1281
00:49:15,374 --> 00:49:16,175
PSA RESPONSES, ET CETERA.

1282
00:49:16,175 --> 00:49:18,544
AND IT DID BETTER THAN THE

1283
00:49:18,544 --> 00:49:20,246
THERAPY THAT THEY WERE COMPARING

1284
00:49:20,246 --> 00:49:24,617
IT TO, THEY WERE COMPARING IT TO

1285
00:49:24,617 --> 00:49:26,919
A CHANGE FROM [INDISCERNIBLE],

1286
00:49:26,919 --> 00:49:29,789
WHICH FRANKLY IS A STRAW MAN TO

1287
00:49:29,789 --> 00:49:31,190
PUT YOUR DRUG UPAGAINST, BECAUSE

1288
00:49:31,190 --> 00:49:32,224
IF YOU FAIL 1, YOU'RE PROBABLY

1289
00:49:32,224 --> 00:49:33,993
NOT GOING TO DO THAT GREAT WITH

1290
00:49:33,993 --> 00:49:37,730
THE OTHER, IT'S SORT OF LIKE

1291
00:49:37,730 --> 00:49:40,499
ANOTHER KIND OF--KIND OF A WIMPY

1292
00:49:40,499 --> 00:49:40,800
TRIAL.

1293
00:49:40,800 --> 00:49:42,435
I SHOULDN'T SAY THAT NOW, I'VE

1294
00:49:42,435 --> 00:49:47,606
SAID IT ALL OVER THE INTERNET,

1295
00:49:47,606 --> 00:49:50,743
BUT I'M NOT THE ONLY 1 WHO'S A

1296
00:49:50,743 --> 00:49:52,244
LITTLE BIT SKEPTICAL, IT'S OVER

1297
00:49:52,244 --> 00:49:54,347
ALL VERY POSITIVE, YOU KNOW THEY

1298
00:49:54,347 --> 00:49:58,417
DID, THEY DID DECREASE THE OR

1299
00:49:58,417 --> 00:49:59,685
THEY INCREASED PROGRESS FREE

1300
00:49:59,685 --> 00:50:05,324
SURVIVAL AND THE KAPLAN MIER

1301
00:50:05,324 --> 00:50:06,592
KERVES ARE FURTHER APART,

1302
00:50:06,592 --> 00:50:07,827
INSTEAD OF LIKE THIS, THEY'RE

1303
00:50:07,827 --> 00:50:08,160
LIKE THIS.

1304
00:50:08,160 --> 00:50:09,695
BUT AS FAR AS I'M CONCERNED

1305
00:50:09,695 --> 00:50:11,831
UNTIL THEY'RE LIKE THAT, YOU

1306
00:50:11,831 --> 00:50:15,334
KNOW I'M JUST NOT GOING TO BE

1307
00:50:15,334 --> 00:50:16,102
LIKE MEGAIMPRESSED, OKAY.

1308
00:50:16,102 --> 00:50:18,104
SO THIS IS WHAT WE WANT.

1309
00:50:18,104 --> 00:50:20,206
WE WANT THE LINE TO GO ALL THE

1310
00:50:20,206 --> 00:50:20,506
WAY ACROSS.

1311
00:50:20,506 --> 00:50:22,675
THAT'S WHAT RATS LIKE FOR THE

1312
00:50:22,675 --> 00:50:23,609
CHECK POINT INHIBITORS, SO

1313
00:50:23,609 --> 00:50:25,277
UNFORT MATILY FOR THE CHECK

1314
00:50:25,277 --> 00:50:26,879
POINT INHIBITORS ONLY LIKE THAT

1315
00:50:26,879 --> 00:50:29,015
FOR MAYBE 20% OF THE PATIENTS.

1316
00:50:29,015 --> 00:50:30,149
THAT'S THE PROBLEM.

1317
00:50:30,149 --> 00:50:33,786
SO I ACTUALLY SAW JIM ALLYSON

1318
00:50:33,786 --> 00:50:37,623
GAVE A VERY NICE TALK WHERE THEY

1319
00:50:37,623 --> 00:50:39,492
HAVE THOSE CURVES WHERE MAY IMET

1320
00:50:39,492 --> 00:50:40,126
A DURABLE RESPONSE APPROXIMATE

1321
00:50:40,126 --> 00:50:42,094
HE SAID THAT OKAY, WE ONLY GET

1322
00:50:42,094 --> 00:50:44,430
IT IN 20% OF THE PATIENTS SO YOU

1323
00:50:44,430 --> 00:50:46,132
GIVE ME 5 CHECK POINT

1324
00:50:46,132 --> 00:50:48,167
INHIBITORS, THATIA A HUNDRED%,

1325
00:50:48,167 --> 00:50:49,468
RIGHT?

1326
00:50:49,468 --> 00:50:51,670
BUT, YEAH, UNFORTUNATELY,

1327
00:50:51,670 --> 00:50:52,271
TOXIC--TOXICITY DOESN'T WORK

1328
00:50:52,271 --> 00:50:53,639
LIKE THAT, BUT THIS IS THE GOAL.

1329
00:50:53,639 --> 00:50:56,742
THIS IS STILL A NICE STEP IN THE

1330
00:50:56,742 --> 00:50:59,278
RIGHT DIRECTION OKAY WITH THIS

1331
00:50:59,278 --> 00:51:03,015
PUNISHING SMA 4 TRIAL, IT'S IT

1332
00:51:03,015 --> 00:51:06,152
NEEDS A LITTLE BIT MORE, I

1333
00:51:06,152 --> 00:51:08,254
COMPOUND NEEDS MORE VALIDATION

1334
00:51:08,254 --> 00:51:09,688
AND MORE CHALLENGING CLINICAL

1335
00:51:09,688 --> 00:51:14,593
TRIALS LIKE AGAINST CHEMO

1336
00:51:14,593 --> 00:51:16,295
THERAPY BUT ANYWAY, SO THE WAY I

1337
00:51:16,295 --> 00:51:18,464
LOOK AT WHERE RADIOLOGY'S GOING

1338
00:51:18,464 --> 00:51:20,766
IS THAT SCIENCE ISSUES MEDICINE

1339
00:51:20,766 --> 00:51:22,835
AND IMAGING ARE GOING TOWARD

1340
00:51:22,835 --> 00:51:24,270
HIGH VALUE PRECISION CARE

1341
00:51:24,270 --> 00:51:25,905
AUGMENTED BY RAPIDLY EVOLVING

1342
00:51:25,905 --> 00:51:26,739
MACHINE LEARNING TECHNOLOGY AND

1343
00:51:26,739 --> 00:51:31,177
I WOULD REALLY LIFE TO SEE

1344
00:51:31,177 --> 00:51:33,179
PHYSICIANS MORE ENMESHED IN THIS

1345
00:51:33,179 --> 00:51:35,181
PROCESS BECAUSE IT'S

1346
00:51:35,181 --> 00:51:35,981
REALLY--IT'S OUR FIELD.

1347
00:51:35,981 --> 00:51:38,084
AND WHEN I SAY INNOVATION, I

1348
00:51:38,084 --> 00:51:39,919
WANT TO BE SPECIFIC ABOUT

1349
00:51:39,919 --> 00:51:41,787
INNOVATION, SO PEOPLE THROW THAT

1350
00:51:41,787 --> 00:51:43,889
WORD AROUND A LOT BUT THIS I GOT

1351
00:51:43,889 --> 00:51:51,630
FROM A GUY NAMED ASK WE'RE

1352
00:51:51,630 --> 00:51:52,331
TALKING ABOUT INNOVATION AND THE

1353
00:51:52,331 --> 00:51:54,533
IDEA IS THAT THE CURRENT CULTURE

1354
00:51:54,533 --> 00:52:00,606
IN ACADEMIC MEDICINE IS TO HAVE

1355
00:52:00,606 --> 00:52:03,008
AN IDEA, TEST AS HYPOTHESIS, YOU

1356
00:52:03,008 --> 00:52:04,810
WRITE A PAPER, YOU WRITE A

1357
00:52:04,810 --> 00:52:06,112
GRANT, ET CETERA THAT'S THE

1358
00:52:06,112 --> 00:52:07,546
TRADITIONAL WAY OF DOING THINGS

1359
00:52:07,546 --> 00:52:09,949
BUT WHAT WE NEED TO DO AND

1360
00:52:09,949 --> 00:52:10,649
WHAT'S HAPPENING MORE

1361
00:52:10,649 --> 00:52:11,817
PARTICULARLY BECAUSE OF TECH

1362
00:52:11,817 --> 00:52:14,453
TRANSFER OFFICES AND WHAT NOT,

1363
00:52:14,453 --> 00:52:16,655
WE'RE MOVING FROM THIS SORT OF

1364
00:52:16,655 --> 00:52:18,457
CURRENT CULTURE, THIS LEARNING

1365
00:52:18,457 --> 00:52:21,026
MODEL, TO MORE OF AN INNOVATING

1366
00:52:21,026 --> 00:52:23,496
MODEL WHERE WE WORK BACKWARDS

1367
00:52:23,496 --> 00:52:24,997
FROM UNMET NEEDS, OKAY, WHERE WE

1368
00:52:24,997 --> 00:52:26,165
DEVELOP NEW WORK PROD

1369
00:52:26,165 --> 00:52:28,134
UBIQUITINNATIONS LIKE I CONSIDER

1370
00:52:28,134 --> 00:52:29,401
THE PYL IS SOMETHING THAT YOU

1371
00:52:29,401 --> 00:52:31,937
KNOW THERE WAS AN UNMET NEED AND

1372
00:52:31,937 --> 00:52:33,672
THAT WAS PROSTATE CANCER, YOU

1373
00:52:33,672 --> 00:52:36,575
COULDN'T REALLY DETECT IT WELL

1374
00:52:36,575 --> 00:52:37,610
WITH IMAGING, FDG DIDN'T WORK,

1375
00:52:37,610 --> 00:52:42,715
THEY DIDN'T HAVE A LOT OF MRI AT

1376
00:52:42,715 --> 00:52:46,185
THAT TIME, IT WAS AROUND

1377
00:52:46,185 --> 00:52:47,820
BUT--SO, WORKING BACKWARDS FROM

1378
00:52:47,820 --> 00:52:49,889
AN UPMET NEED, THAT'S AN

1379
00:52:49,889 --> 00:52:50,756
ENGINEERING APPROACH, THAT'S

1380
00:52:50,756 --> 00:52:52,591
WHAT AI DOES, YOU DON'T REALLY

1381
00:52:52,591 --> 00:52:54,126
KNOW HOW AI GETS TO ITS

1382
00:52:54,126 --> 00:52:55,995
SOLUTIONS BUT IT DOES.

1383
00:52:55,995 --> 00:52:59,231
SOMETIMES IT TAKES YOU WAY OFF

1384
00:52:59,231 --> 00:53:01,901
BASE BUT IN ANY EVENT THAT'S THE

1385
00:53:01,901 --> 00:53:02,468
INMODEL CITIZENIVATING MODEL

1386
00:53:02,468 --> 00:53:03,969
THAT I THINK WE WILL BE SEEING

1387
00:53:03,969 --> 00:53:06,472
MORE BECAUSE THAT'S WHERE THE

1388
00:53:06,472 --> 00:53:08,307
TRANSFORMATION OCCURS, SO WHEN

1389
00:53:08,307 --> 00:53:11,911
YOU HAVE FOR EXAMPLE, AMAZON

1390
00:53:11,911 --> 00:53:13,679
RIGHT, STARTED OUT AS A BOOK

1391
00:53:13,679 --> 00:53:15,314
STORE, NOW NOBODY GOES TO

1392
00:53:15,314 --> 00:53:16,715
SHOPPING MAULS, THAT'S

1393
00:53:16,715 --> 00:53:19,552
INNOVATION, THAT'S REALLY

1394
00:53:19,552 --> 00:53:20,386
TRANSFORMATION SO WHAT WE NEED

1395
00:53:20,386 --> 00:53:27,426
TO HAVE HAPPEN IS WE NEED TO

1396
00:53:27,426 --> 00:53:29,795
HAVE PHYSICIANS, GENERATION Z

1397
00:53:29,795 --> 00:53:32,898
PHYSICIANS THAT ARE BORN INTO

1398
00:53:32,898 --> 00:53:35,501
USING IPHONES, LIKE I HAVE A 6

1399
00:53:35,501 --> 00:53:37,269
YEAR-OLD DAUGHTER AND SHE KNOWS

1400
00:53:37,269 --> 00:53:39,638
HOW TO SKOAL AND THERE'S PEP

1401
00:53:39,638 --> 00:53:43,375
A PIG AND SHE WILL HIT THAT AND

1402
00:53:43,375 --> 00:53:44,543
JUST DIGITAL NATIVES, THEY

1403
00:53:44,543 --> 00:53:47,746
SHOULD WORK HAND AND GLOVE WITH

1404
00:53:47,746 --> 00:53:49,982
THE PROFESSIONAL SCIENTISTS HAVE

1405
00:53:49,982 --> 00:53:51,750
YOU HERE AND REALLY KIND OF MOVE

1406
00:53:51,750 --> 00:53:54,286
THINGS OUT INTO THE CLINIC MORE

1407
00:53:54,286 --> 00:53:56,021
QUICKLY THAN THEY CAN BE.

1408
00:53:56,021 --> 00:54:00,693
SO WITH THAT I WANT TO THANK OUR

1409
00:54:00,693 --> 00:54:05,531
COALITION OF MOLECULAR IMAGING

1410
00:54:05,531 --> 00:54:10,302
EXPERTS, THESE ARE ALL FACULTY

1411
00:54:10,302 --> 00:54:12,137
IN THIS COALITION WITH THESE

1412
00:54:12,137 --> 00:54:14,506
STUDENTS AND THANK YOU FOR YOUR

1413
00:54:14,506 --> 00:54:15,841
ATTENTION.

1414
00:54:15,841 --> 00:54:16,075
THANKS.

1415
00:54:16,075 --> 00:54:18,677
[ APPLAUSE ]

1416
00:54:18,677 --> 00:54:20,980
HAPPY TO ANSWER QUESTIONS IF

1417
00:54:20,980 --> 00:54:21,947
THERE ARE ANY OR TIME.

1418
00:54:21,947 --> 00:54:27,119
I GUESS I WENT OVER.

1419
00:54:27,119 --> 00:54:29,488
>> THAT WAS AN EXCELLENT
TALK

1420
00:54:29,488 --> 00:54:31,457
AND 1 OF THE THINGS--I HAVE 2

1421
00:54:31,457 --> 00:54:35,294
QUESTIONS, 1 IS WE'RE TALKING

1422
00:54:35,294 --> 00:54:37,162
ABOUT HOW LET'S SAY UNIMPRESSIVE

1423
00:54:37,162 --> 00:54:39,365
OR NOT AS DPOA AS WE WOULD HAVE

1424
00:54:39,365 --> 00:54:41,267
LIKED THE OUTCOMES TO BE WITH

1425
00:54:41,267 --> 00:54:45,671
RESPECT TO PFS AND OS WITH THE

1426
00:54:45,671 --> 00:54:46,705
PSMA PHARMACEUTICAL THERAPY CAN

1427
00:54:46,705 --> 00:54:50,909
YOU COMMENT ON PERSONALIZED

1428
00:54:50,909 --> 00:54:51,677
DOSEMTREE AS WAY TOY OPTIMIZE

1429
00:54:51,677 --> 00:54:53,712
THAT BET XER THEN THE OTHER

1430
00:54:53,712 --> 00:54:56,615
QUESTION I HAVE SOMEWHAT RELATED

1431
00:54:56,615 --> 00:55:00,019
IS, YOU KNOW DO YOU THINK WE CAN

1432
00:55:00,019 --> 00:55:00,452
SYSTEMATIZE TARGET

1433
00:55:00,452 --> 00:55:01,987
IDENTIFICATION THAT WE CAN

1434
00:55:01,987 --> 00:55:03,489
DEVELOP PROBES AGAINST AND

1435
00:55:03,489 --> 00:55:07,860
ULTIMATELY GO TOWARD RADIO

1436
00:55:07,860 --> 00:55:09,094
PHARMACEUTICALS OR ARE WE

1437
00:55:09,094 --> 00:55:10,963
RELEGATED TO THE SPREADSHEETS

1438
00:55:10,963 --> 00:55:11,297
YOU REFER TO.

1439
00:55:11,297 --> 00:55:12,498
THOSE ARE GREAT, VERY GOOD

1440
00:55:12,498 --> 00:55:14,700
QUESTIONS, SO FOR THE DOSE

1441
00:55:14,700 --> 00:55:20,506
EMTREE IS GOING TO HELP, SO FOR

1442
00:55:20,506 --> 00:55:24,109
EXAMPLE, THE PRUVICTO AND ALL

1443
00:55:24,109 --> 00:55:25,811
THE TRIALS WORE GOING TO DO

1444
00:55:25,811 --> 00:55:28,113
BASED ON SOME ARTIFICIAL NUMBER

1445
00:55:28,113 --> 00:55:29,948
23 GRAY TO THE KIDNEY WAS

1446
00:55:29,948 --> 00:55:32,284
SOMETHING THAT WAS DEVELOPED FOR

1447
00:55:32,284 --> 00:55:33,652
EXTERNAL BEAM RADIATION YEARS

1448
00:55:33,652 --> 00:55:34,386
AGO THAT HASN'T REALLY BEEN

1449
00:55:34,386 --> 00:55:38,157
TESTED AND I THINK THAT WE MAYBE

1450
00:55:38,157 --> 00:55:43,228
UNDERDOING A LOT OF THESE

1451
00:55:43,228 --> 00:55:43,595
PEASHTS.

1452
00:55:43,595 --> 00:55:44,430
BUT THERE'S EVERY INDICATION

1453
00:55:44,430 --> 00:55:45,364
THAT WE'RE NOT BECAUSE NOT

1454
00:55:45,364 --> 00:55:48,033
EVERYBODY IS ABLE TO TOLERATE

1455
00:55:48,033 --> 00:55:50,336
ALL 6 CYCLES OF THE THERAPY.

1456
00:55:50,336 --> 00:55:52,071
SO IF EVERYBODY WHIZZED THROUGH

1457
00:55:52,071 --> 00:55:53,572
THE SICK CYCLES THEN YOU WOULD

1458
00:55:53,572 --> 00:55:56,008
THINK THAT YOU KNOW MAYBE WE ARE

1459
00:55:56,008 --> 00:55:58,010
UNDERDOING BUT AT SAT SAME TIME,

1460
00:55:58,010 --> 00:56:04,616
THESE PATIENTS ARE EXTREMELY ILL

1461
00:56:04,616 --> 00:56:07,886
AND AND NOW AS WE MOVE THIS UP

1462
00:56:07,886 --> 00:56:09,688
FURTHER, PSMA 4 THOSE ARE

1463
00:56:09,688 --> 00:56:11,223
PATIENTS THAT HAD NOT HAD THE

1464
00:56:11,223 --> 00:56:11,957
SAME THERAPY EMPLOY I THINK WE

1465
00:56:11,957 --> 00:56:13,292
WILL SEE THAT WE WILL GET BETTER

1466
00:56:13,292 --> 00:56:17,363
RESULTS AND I THINK THE

1467
00:56:17,363 --> 00:56:19,565
DOSEMTREE WILL HELP IF WE CAN

1468
00:56:19,565 --> 00:56:22,468
HELP TO AN MTD WE HAVEN'T HAD

1469
00:56:22,468 --> 00:56:24,303
EXCEPT A DOSE MITT RICK MTD AND

1470
00:56:24,303 --> 00:56:27,373
I THINK THOSE ARE COMING.

1471
00:56:27,373 --> 00:56:30,509
AND THE SECOND PART ABOUT

1472
00:56:30,509 --> 00:56:31,677
SYSTEMATIZING THE TARGETS IS

1473
00:56:31,677 --> 00:56:35,080
THAT WE CAN USE AI AND WE HAVE

1474
00:56:35,080 --> 00:56:38,851
AN UNDERGRAD IN OUR GROUP NOW

1475
00:56:38,851 --> 00:56:40,152
WHO IS--DOESN'T KNOW ANYTHING

1476
00:56:40,152 --> 00:56:41,420
ABOUT CHEMISTRY SO I PUT HIM TO

1477
00:56:41,420 --> 00:56:42,921
THE TEST, HE'S A BIOMEDICAL

1478
00:56:42,921 --> 00:56:45,724
ENGINEER AND I SAID HERE'S SOME

1479
00:56:45,724 --> 00:56:47,126
COMPOUNDS, I WANT YOU TO MAKE A

1480
00:56:47,126 --> 00:56:48,861
NEW DRUG FOR US ACROSS THE BLOOD

1481
00:56:48,861 --> 00:56:51,764
BRAIN BARRIER AND HE DID, HE HAD

1482
00:56:51,764 --> 00:56:52,297
IN GOOD CANDIDATES.

1483
00:56:52,297 --> 00:56:54,800
NOW WE HAVE TO GO MAKE THEM BUT

1484
00:56:54,800 --> 00:56:57,302
IT'S LIKE HE DID THAT

1485
00:56:57,302 --> 00:56:58,637
WITHOUT--BY BEING ABLE TO

1486
00:56:58,637 --> 00:57:01,340
SYSTEMATICALLY PUT THESE DRUGS

1487
00:57:01,340 --> 00:57:02,741
INTO SMILES CONSTRUCTS AND THEN

1488
00:57:02,741 --> 00:57:03,942
RUNNING THEM THROUGH HIS

1489
00:57:03,942 --> 00:57:07,079
PROGRAMS AND SO I THINK THAT

1490
00:57:07,079 --> 00:57:09,748
THAT KIND OF APPROACH TO VETTING

1491
00:57:09,748 --> 00:57:10,682
TARGETS, YEAH, I'M SURE THE

1492
00:57:10,682 --> 00:57:13,085
CUTCHES ARE ALREADY DOING ALL OF

1493
00:57:13,085 --> 00:57:16,288
THAT BUT THEY CAN DO AS MUCH AS

1494
00:57:16,288 --> 00:57:18,824
THEY WANT BECAUSE IT ALL BOILS

1495
00:57:18,824 --> 00:57:22,027
DOWN TO ACTUALLY TESTING IT AND

1496
00:57:22,027 --> 00:57:24,863
I'VE LEARNED THAT THE HARD WAY,

1497
00:57:24,863 --> 00:57:25,097
TOO.

1498
00:57:25,097 --> 00:57:27,399
NTHANK YOU.

1499
00:57:27,399 --> 00:57:28,400
>> SURE.

1500
00:57:28,400 --> 00:57:30,536
>> YES, SIR NHI,
FASCINATING,

1501
00:57:30,536 --> 00:57:32,471
FASCINATING TALK EMPLOY I WAS

1502
00:57:32,471 --> 00:57:34,139
STRUCK BY YOUR COMMENTS ON HOW

1503
00:57:34,139 --> 00:57:39,178
THE THERAPY AND PEWIC AGENTS ARE

1504
00:57:39,178 --> 00:57:41,046
SELECTING FOR CANCER THAT NO

1505
00:57:41,046 --> 00:57:44,683
LONGER EXPRESSES THE TARGET AND

1506
00:57:44,683 --> 00:57:46,952
SO, THAT MAKES LIFE REALLY

1507
00:57:46,952 --> 00:57:49,221
COMPLICATED FOR HOW YOU FOLLOW

1508
00:57:49,221 --> 00:57:51,190
THE EXAM BECAUSE IF YOU'RE

1509
00:57:51,190 --> 00:57:53,992
FOLLOWING THE PATIENT SO IF

1510
00:57:53,992 --> 00:57:54,726
YOU'RE USING PMSA, IS IT REALLY

1511
00:57:54,726 --> 00:57:59,431
THE CASES THAT THE GUYS FALLING

1512
00:57:59,431 --> 00:58:02,901
OFF YOUR KAPLAN MIER THEY GET

1513
00:58:02,901 --> 00:58:03,969
WORSE AND NEGATIVE OR THEY HAVE

1514
00:58:03,969 --> 00:58:05,771
NO EVIDENT OF PROGRESSION ON

1515
00:58:05,771 --> 00:58:09,508
PSMA, IF THAT'S THE CASE, FIEBD

1516
00:58:09,508 --> 00:58:12,644
AN ORTHOGONAL AGENT LIKE FDG AND

1517
00:58:12,644 --> 00:58:14,046
LOOK FOR DISCORDANCES?

1518
00:58:14,046 --> 00:58:15,581
>> YEAH, THAT'S RIGHT.

1519
00:58:15,581 --> 00:58:16,815
FDG HAS BEEN PROPOSED AS

1520
00:58:16,815 --> 00:58:19,117
SOMETHING TO USE AS SELECT

1521
00:58:19,117 --> 00:58:22,120
PATIENTS THAT WOULD NOT BE GOOD

1522
00:58:22,120 --> 00:58:23,121
CANDIDATES FOR THIS THERAPY.

1523
00:58:23,121 --> 00:58:25,023
I WOULDN'T GO THAT FAR BUT I

1524
00:58:25,023 --> 00:58:26,959
THINK THAT YEAH, WE NEED OTHER

1525
00:58:26,959 --> 00:58:28,727
WAYS TO IMAGE THEM EMPLOY SO WE

1526
00:58:28,727 --> 00:58:31,263
TRY TO HIT 2 TARGETS AT LEAST.

1527
00:58:31,263 --> 00:58:34,366
OR WE CAN BRING IN, YOU KNOW, I

1528
00:58:34,366 --> 00:58:36,535
DON'T KNOW MAYBE DIFFUSION

1529
00:58:36,535 --> 00:58:39,037
WEIGHTED WHOLE BODY EMR IMAGING,

1530
00:58:39,037 --> 00:58:40,739
SO THERE HAVE TO BE OTHER WAYS

1531
00:58:40,739 --> 00:58:42,241
OF FOLLOWING THEIR PEASHTS IF

1532
00:58:42,241 --> 00:58:44,009
YOU WANT TO FOLLOW THEM WITH

1533
00:58:44,009 --> 00:58:45,777
IMAGING RATHER THAN JUST LOOKING

1534
00:58:45,777 --> 00:58:48,080
AT THEIR PSA, BUT YEAH, THAT'S

1535
00:58:48,080 --> 00:58:49,147
KIND OF I THINK WHAT'S HAPPENING

1536
00:58:49,147 --> 00:58:52,718
IS THAT WE'RE JUST SELECTING AND

1537
00:58:52,718 --> 00:58:53,485
THE NEUROENDOCRINE PROSTATE

1538
00:58:53,485 --> 00:58:54,620
CANCER WHEN I FIRST LEARNED

1539
00:58:54,620 --> 00:58:56,388
ABOUT THAT ABOUT 10 YEARS AGO,

1540
00:58:56,388 --> 00:58:58,090
IT WAS SOMEBODY FROM CORNELL, I

1541
00:58:58,090 --> 00:59:00,025
CAN'T REMEMBER WAS TELLING--HE'S

1542
00:59:00,025 --> 00:59:01,860
A MEDICAL ONCOLOGIST AND HE SAID

1543
00:59:01,860 --> 00:59:02,928
THAT YEAH, WE'RE FINDING NOW

1544
00:59:02,928 --> 00:59:07,666
WITH SOME OF THESE NEWER AGENTS

1545
00:59:07,666 --> 00:59:10,702
LIKE [INDISCERNIBLE] AND PATES

1546
00:59:10,702 --> 00:59:11,737
ARE DEVELOPING THIS

1547
00:59:11,737 --> 00:59:13,805
NEUROENDOCRINE PHENOTYPE SO THE

1548
00:59:13,805 --> 00:59:15,908
CANCER, CANCER'S JUST, IT'S

1549
00:59:15,908 --> 00:59:18,277
UNBELIEVABLE, THERE'S THIS WHOLE

1550
00:59:18,277 --> 00:59:23,015
NEW FIELD CALLED WHAT IS IT

1551
00:59:23,015 --> 00:59:26,518
CANCER NEUROSCIENCE WHERE TUMOR

1552
00:59:26,518 --> 00:59:31,156
CELLS IN THE BRAIN GLIOMA WILL

1553
00:59:31,156 --> 00:59:31,990
ACTUALLY CONVINCE THEY'LL

1554
00:59:31,990 --> 00:59:34,860
CONVINCE NEURONS TO FEED THEM

1555
00:59:34,860 --> 00:59:36,094
GLUTAMATE AND THEY CONVINCE THE

1556
00:59:36,094 --> 00:59:39,197
NEURON TO PUT OUT LIKE A LITTLE

1557
00:59:39,197 --> 00:59:41,800
PSEUDOPOD OR SOMETHING AND IT'S

1558
00:59:41,800 --> 00:59:48,473
BASED ON, IT'S A 1 WAY SYNAPSE,

1559
00:59:48,473 --> 00:59:49,875
IT'S A FLUTA MITTURGIC SYNAPSE

1560
00:59:49,875 --> 00:59:52,110
ISSUES IT'S AN AMPA SYNAPSE AND

1561
00:59:52,110 --> 00:59:54,079
IF CANCER CAN DO THAT, RIGHT, I

1562
00:59:54,079 --> 00:59:56,515
MEAN HOW ARE YOU GOING TO--IT'S

1563
00:59:56,515 --> 00:59:58,250
JUST WAY SMARTER THAN I EVER

1564
00:59:58,250 --> 00:59:58,617
THOUGHT.

1565
00:59:58,617 --> 01:00:00,118
I THOUGHT THESE MAGIC BULLETS

1566
01:00:00,118 --> 01:00:02,087
WERE THE ANSWER WHICH IS WHY I

1567
01:00:02,087 --> 01:00:03,889
BECAME A CHEMIST BUT THERE'S A

1568
01:00:03,889 --> 01:00:06,024
LOT MORE TO IT AND I HOPE I LIVE

1569
01:00:06,024 --> 01:00:07,726
LONG ENOUGH TO SEE, MORE OF

1570
01:00:07,726 --> 01:00:14,366
THESE CHECK POINT INHIBITOR TYPE

1571
01:00:14,366 --> 01:00:16,068
RESULTS.

1572
01:00:16,068 --> 01:00:16,635
>> GREAT.

1573
01:00:16,635 --> 01:00:16,902
THANKS.

1574
01:00:16,902 --> 01:00:17,836
>> GOOD SEGUE TO MY
QUESTION,

1575
01:00:17,836 --> 01:00:22,774
YOU KNOW YOU TALKED ABOUT THE

1576
01:00:22,774 --> 01:00:24,009
KAPLAN MEYERS FOR THE CHECK

1577
01:00:24,009 --> 01:00:26,211
BOOKS AND HOW HORIZONTAL THEY

1578
01:00:26,211 --> 01:00:26,878
WERE.

1579
01:00:26,878 --> 01:00:28,513
WHAT ARE YOUR THOUGHTS AROUND

1580
01:00:28,513 --> 01:00:32,818
THE ABILITY OF RADIATION THERAPY

1581
01:00:32,818 --> 01:00:35,020
TO INDUCE IMMUNE ACTIVATION THAT

1582
01:00:35,020 --> 01:00:40,826
CAN BE THEN EXPLOITED BY IMMUNE

1583
01:00:40,826 --> 01:00:41,426
THERAPIES.

1584
01:00:41,426 --> 01:00:42,894
>> YEAH, WE KNOW THAT'S

1585
01:00:42,894 --> 01:00:44,329
HAPPENING, THAT HAS NOT HAPPENED

1586
01:00:44,329 --> 01:00:47,466
IN ANY CLINICAL  TRIALS THAT I

1587
01:00:47,466 --> 01:00:50,335
KNOW OF BUT IT'S LIKE A GIGANTIC

1588
01:00:50,335 --> 01:00:51,670
ABNORMALITIES SCOPAL EFFECT

1589
01:00:51,670 --> 01:00:55,107
WHICH IS SOMETHING THAT I

1590
01:00:55,107 --> 01:00:58,543
BELIEVE DOES OCCUR, I BELIEVE

1591
01:00:58,543 --> 01:00:59,711
THE RADIATION ONCOLOGIST

1592
01:00:59,711 --> 01:01:00,879
BELIEVES CAN COME AND GO EVERY

1593
01:01:00,879 --> 01:01:02,381
FEW YEARS BUT I THINK THAT YOU

1594
01:01:02,381 --> 01:01:05,751
DO STIR UP THE MICROENVIRONMENT

1595
01:01:05,751 --> 01:01:06,752
WITH THE RADIATION.

1596
01:01:06,752 --> 01:01:09,021
THERE'S OTHER THINGS CAN YOU

1597
01:01:09,021 --> 01:01:09,955
DOJ, TOO, SO 1 THING WE'RE

1598
01:01:09,955 --> 01:01:12,724
WORKING ON, WE'RE TAKING SOME OF

1599
01:01:12,724 --> 01:01:14,993
THESE FAP AGENT ANDS WE HAVE

1600
01:01:14,993 --> 01:01:16,395
OTHER AGENTS FOR MACROPHAGES AND

1601
01:01:16,395 --> 01:01:22,834
WE'RE JUST GOING TO WIPE OUT THE

1602
01:01:22,834 --> 01:01:24,436
WHOLE MICROENVIRONMENT AND SEE

1603
01:01:24,436 --> 01:01:26,672
WHAT HAPPENS AND IT HAS NO

1604
01:01:26,672 --> 01:01:27,639
COLLABORATORS, HEY, WHERE IS

1605
01:01:27,639 --> 01:01:28,473
EVERYBODY, RIGHT IN AND IT'S NOT

1606
01:01:28,473 --> 01:01:30,342
GOING TO BE ABLE TO GET THE

1607
01:01:30,342 --> 01:01:32,744
NUCLEOTIDES T-REGENTS OR

1608
01:01:32,744 --> 01:01:35,080
WHATEVER IT IS--I THINK THAT THE

1609
01:01:35,080 --> 01:01:36,481
MACROENVIRONMENT, THERE'S GOOD

1610
01:01:36,481 --> 01:01:37,649
MACROPHAGES AND BAD MACROPHAGES

1611
01:01:37,649 --> 01:01:39,851
BUT THERE'S WAY MORE BAD

1612
01:01:39,851 --> 01:01:43,989
MACROPHAGES, IN MY OPINION, THE

1613
01:01:43,989 --> 01:01:44,156
M2.

1614
01:01:44,156 --> 01:01:45,624
SO I THINK YEAH THERE'S A LOT OF

1615
01:01:45,624 --> 01:01:47,325
STUFF GOING ON IN THAT

1616
01:01:47,325 --> 01:01:49,728
MICROENVIRONMENT THAT WE'RE JUST

1617
01:01:49,728 --> 01:01:52,898
BEGINNING TO THINK ABOUT AND I

1618
01:01:52,898 --> 01:01:55,734
THINK THAT THE RADIATION WHETHER

1619
01:01:55,734 --> 01:01:57,302
IT'S EXTERNAL BEAM RADIATION OR

1620
01:01:57,302 --> 01:02:01,106
ALPHA PARTICLE OR WHATEVER, OR

1621
01:02:01,106 --> 01:02:02,074
INSITU RADIATION WILL BE HELPFUL

1622
01:02:02,074 --> 01:02:06,411
FOR THAT AND I THINK THAT THE

1623
01:02:06,411 --> 01:02:07,879
PDL 1 INHIBITOR IN THERE AND IT

1624
01:02:07,879 --> 01:02:14,653
WILL BE A BIT SYNERGISTIC AND

1625
01:02:14,653 --> 01:02:16,421
CANCER DOESN'T HAVE A LOT OF

1626
01:02:16,421 --> 01:02:17,456
T-CELLS IN ANY EVENT BUT MAYBE

1627
01:02:17,456 --> 01:02:18,657
YOU WOULD HAVE MORE IF YOU

1628
01:02:18,657 --> 01:02:24,663
DEPARTMENT HAVE THESE BAD ACTORS

1629
01:02:24,663 --> 01:02:25,731
IN THE MICROENVIRONMENT.

1630
01:02:25,731 --> 01:02:28,433
ALL RIGHT, THANK YOU VERY MUCH.

1631
01:02:28,433 --> 01:02:38,433
[ APPLAUSE ]