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I'D LIKE TO

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WELCOME THE MEMBERS OF THE

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NATIONAL CANCER ADVISORY BOARD,

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EX-OFFICIO MEMBERS, STAFF AND

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GUESTS.

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SPECIAL WELCOME TO DR. RATHMELL

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SINCE THIS IS HER FIRST NCAB

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MEETING AS THE NEW NCI DIRECTOR.

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SO WELCOME, KIM.

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LOOKING FORWARD TO WORKING WITH

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YOU.

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MEMBERS OF THE PUBLIC WHO MAY

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WISH TO DISCUSS THEIR VIEWS, MAY

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DO SO BY WRITING TO THE

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EXECUTIVE SECRETARY OF THE BOARD

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WITHIN 10-DAYS FOLLOWING THE

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MEETING.

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ANY WRITTEN STATEMENTS OR

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QUESTIONS SUBMITTED BY MEMBERS

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OF THE PUBLIC WILL RECEIVE

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CAREFUL CONSIDERATION.

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AS BOARD MEMBERS, I WANT TO

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REMIND YOU THAT YOU MUST ABSENT

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YOURSELF VIRTUALLY DURING

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SPECIFIC DISCUSSIONS WHENEVER

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YOUR PARTICIPATION AND

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DELIBERATIONS ON A PARTICULAR

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PRODUCT, PROGRAM OR OTHER

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SPECIFIC MATTER WOULD CONSTITUTE

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A CONFLICT OF INTEREST OR EVEN

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CREATE THE APPEARANCE OR

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PERCEPTION OF ONE.

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IT IS INCUMBENT UPON YOU OR US

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TO ADVISE THE EXECUTIVE

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SECRETARY, DR. GRAY, AND ABSTAIN

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FROM ANY PARTICIPATION AND

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DISCUSSION OR ACTION REGARDING

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THAT MATTER.

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IN LIGHT OF THE CURRENT POLICIES

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GOVERNING CONFLICT OF INTEREST

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BASED ON FINANCIAL HOLDINGS OF

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SPECIAL GOVERNMENT EMPLOYEES,

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WHICH INCLUDES ALL OF THE

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MEMBERS OF THE BOARD, WE MUST

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DEPEND ON YOU AND OURSELVES TO

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VOLUNTARILY ABSENT DURING ANY

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AND ALL DISCUSSIONS OR MATTERS

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THAT COULD CONCEIVABLY IMPACT

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THE STATUS OF THESE HOLDINGS OR

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THOSE HOLDINGS.

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WE TRUST YOUR JUDGMENT IN THESE

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INSTANCES.

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DURING ANY CLOSED SESSIONS, ANY

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MATERIALS OR DISCUSSIONS OF A

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CONFIDENTIAL NATURE DELIBERATED

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ON TODAY ARE PRIVILEGED

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INFORMATION AND ARE MADE

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AVAILABLE TO US ON A NEED-TO

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KNOW-BASIS.

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SUCH ARE PRIVATE AND THEIR

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CONTENTS SHOULD NOT BE DIVULGED.

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FUTURE MEETING DATES HAVE BEEN

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PROVIDED AND LISTED ON THE

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AGENDA.

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FIRST WE NEED TO APPROVE THE

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NOVEMBER 29-30, 2023 JOINT

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BSANCAB VIRTUAL MEETING SUMMARY.

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SO WE NEED TO CALLOY MENTION TO

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APPROVE THE MEETING SUMMARY.

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DO WE HAVE A MOTION?

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>> SO MOVED.

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>> SECOND?

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>> SECOND.

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>> ANY FURTHER DISCUSSION?

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SO WE NEED TO VOTE TO APPROVE

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THE MEETING SUMMARY.

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ARE THERE ANY NEIGHS?

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ANY ABSTENTIONS?

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-- ANY NAYs?

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PAULETTE?

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BY LAW, A QUORUM OF BOARD

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MEMBERS IS REQUIRED FOR EACH

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INSTANCE IN WHICH A VOTE MAY

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OCCUR, WHETHER IN OPEN OR CLOSE

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SESSION.

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DURING THIS MEETING A MINIMUM OF

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10 APPOINTED MEMBERS MUST BE

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PRESENT TO VOICE THEIR VOTES

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SINCE WE CAN'T PREDICT THE TIME

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OR OCCURRENCE OF ANY MOTION OUR

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PRESENCE IN THE VIRTUAL ROOM FOR

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ALL SEGMENTS OF THE MEETING IS A

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REQUIREMENT.

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PAULETTE, DO WE HAVE A QUORUM?

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>> YES WE DO.

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>> GREAT.

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TO ENSURE THAT WE DON'T HAVE ANY

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INTERRUPTIONS, PLEASE ENSURE

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THAT YOUR MIC IS MUTED AND

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REMAINS SO UNTIL RECOGNIZED BY

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EITHER ME, PAULETTE, KIM OR THE

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SPEAKER AT THAT GIVEN TIME OF

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THE MEETING OR AGENDA.

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SO WE'LL NOW MOVE INTO THE FIRST

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AGENDA ITEM, WHICH WILL BE THE

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DIRECTOR'S REPORT GIVEN TO US BY

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DR. RATHMELL.

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KIM?

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>> GREAT.

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THANK YOU VERY MUCH.

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REALLY GLAD TO BE HERE AND

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EXCITING TO BE ON THIS SIDE OF

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THINGS.

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I HAVE BEEN A BSA MEMBER SO I

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HAVE GOTTEN TO SEE PART OF YOUR

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WORK IN ACTION AND EXCITING TO

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SEE WHAT THIS MEETING HOLDS.

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I WANT TO SAY FIRST, IT HAS BEEN

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AN EXCITING SIX WEEKS THAT I

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HAVE BEEN IN THE JOB AND SO I'M

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REALLY STILL LEARNING AND

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LISTENING AND SO, PART OF THIS

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MEETING IS REALLY STILL ME

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WANTING TO HEAR FROM YOU.

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THAT WILL BE A THEME THROUGHOUT

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MY TENURE BUT ESPECIALLY SO

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CURRENTLY.

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I ALSO HAVE TO SAY THAT MONICA

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BERTAGNOLLI HAS BEEN FANTASTIC

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IN HER NEW ROLE IN GIVING ME

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SOME POINTERS.

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I'M SO GLAD SHE'S IN HER ROLE

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AND I'M IN MINE AND SHE'S DOING

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A GREAT JOB.

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AND ANGEL LOAND A DOUG LOWY HASN

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FANTASTIC.

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THE NEXT SLIDE WILL TELL US WHAT

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WE'RE GOING TO DO.

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SOME OF YOU KNOW ME BUT MAYBE

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SOME NOT.

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SO SOME DISCUSSION ABOUT SOME

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NEWS AND EVENTS AND FOCUS WILL

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BE ON THE BUDGET AND THEN I DO

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WANT TO END ON A POSITIVE NOTE,

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WHICH IS THAT THE RESEARCH

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CONTINUES TO BE FANTASTIC.

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SO WE HAVE HIGHLIGHTS TO SHARE.

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SO FIRST OFF, IN MOVING INTO

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THIS ROLE, I SPENT TIME AS WELL

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AS GETTING TO KNOW THE NCI AND

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THE HISTORY OF THE NCI.

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AS YOU KNOW, IT DATES TO A

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LANDMARK EVENT IN 1971 WITH THE

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SIGNING OF THE NATIONAL CANCER

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ACT THE INTENT OF HOW WE UTILIZE

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NATIONAL RESOURCES TO CHANGE

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CANCER IS AS A PARTNERSHIP, SO I

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WANT TO EMPHASIZE HOW IMPORTANT

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IT IS I GET TO KNOW THIS

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COMMITTEE AND HEAR FROM ALL OF

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YOU.

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I ALSO WANT TO JUST MAKE MENTION

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BECAUSE WE JUST LOST A LUMINAIRE

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IN THE FIELD.

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MANY OF YOU PROBABLY KNEW

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DR. EDITH MITCHELL.

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SHE WAS AN NCI BLUE RIBBON PANEL

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MEMBER AND NATIONAL CANCER PANEL

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MEMBER OF THE WHITE HOUSE AND

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SHE WAS TRAGICALLY LOST TO US

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JUST A COUPLE OF WEEKS AGO.

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SO A BIG LOSS TO OUR FIELD.

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SO A LITTLE BIT ABOUT ME.

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SO FOR THOSE WHO DON'T KNOW ME

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AT ALL, I'M A PHYSICIAN

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SCIENTIST.

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I CAME MOST RECENTLY FROM

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VANDERBILT UNIVERSITY MEDICAL

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CENTER.

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MY BACKGROUND IS TRAINING IN

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BIOPHYSICS AND REALLY AN

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INTEREST IN MOLECULES AND HOW

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PATHWAYS GO WRONG IN CANCER.

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I RUN A LABORATORY FOR OVER 20

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YEARS WITH TRANSLATIONAL

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ELEMENTS ALL AROUND QUESTIONS

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RELEVANT TO KIDNEY CANCER.

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I'M A MEDICAL ONCOLOGIST AND I

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TREATED AND SEEN PATIENTS WITH

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KIDNEY CANCER FOR THE LAST 20

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PLUS YEARS, PARTICULARLY

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INTERESTED IN RARE TUMORS OF THE

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KIDNEY AND HEREDITARY TUMORS.

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WITH THAT BACKGROUND, I ALSO

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SPENT A GOOD AMOUNT OF TIME

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TRAINING STUDENTS IN MY LAB AND

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OTHER SPACES.

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FOUND MYSELF INTERESTED IN

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TRAINING PROGRAMS.

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I BRIEFLY HELPED TO RUN THE

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M.D., PH.D. PROGRAM AT UNC

202
00:07:38,549 --> 00:07:41,852
CHAPEL HILL AND THAT COMBINED

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EXPERIENCE WAS WHAT LED ME TO

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MOVE OVER TO VANDERBILT ABOUT

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NOW ALMOST NINE YEARS AGO WHERE

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I WAS THE DIVISION CHIEF WHERE I

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COULD PUT TOGETHER ALL OF THOSE

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COMPONENTS, RESEARCH, CLINICAL

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COMPONENTS AND THE EDUCATION.

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I ENJOY ADMINISTRATION SO MUCH

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SO THAT IN 2021, I WENT BACK AND

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GOT MY MASTER'S DEGREE FROM THE

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OWEN SCHOOL OF BUSINESS AT

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VANDERBILT TO REALLY BE ABLE TO

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UNDERSTAND SOME OF THE BUSINESS

216
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OF HEALTH CARE.

217
00:08:34,371 --> 00:08:36,674
MY JOURNEY HAS REALLY MADE ME

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WELL PREPARED TO BE IN THIS

219
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ROLE.

220
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SO THAT'S MY CV, ESSENTIALLY.

221
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A LITTLE BIT MORE ABOUT ME IS

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THAT I DO REALLY VALUE LISTENING

223
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AND WANT TO HEAR FROM YOU.

224
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I SAID THAT FIVE TIMES TODAY.

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I WANT TO DEMONSTRATE THAT IN A

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COUPLE OF DIFFERENT WAYS.

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FIRST, YOU WILL PROBABLY NOTICE

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THERE WILL BE SOME SUBTLE

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CHANGES IN THE WAY THIS MEETING

230
00:09:01,298 --> 00:09:02,533
IS ORGANIZED.

231
00:09:02,533 --> 00:09:05,302
SO DR. GRAY AND I WORKED

232
00:09:05,302 --> 00:09:06,303
TOGETHER TO CHANGE SOMETHING SO

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00:09:06,303 --> 00:09:11,008
THERE IS MORE TIME FOR QUESTION

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AND ANSWER PERIODS.

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I WILL KEEP MY REMARKS ON THE

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BRIEF SIDE SO WE HAVE TIME.

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WE ARE ALSO DOING THAT WITH THE

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00:09:16,747 --> 00:09:18,482
OTHER TALKS AND IN PARTICULAR

239
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WITH THE SPECIAL PRESENTATIONS

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00:09:19,817 --> 00:09:21,218
THAT WE HAVE.

241
00:09:21,218 --> 00:09:27,157
WE ARE ASKING THEM TO GIVE TIME

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00:09:27,157 --> 00:09:33,430
FOR THAT THERE IS USUALLY TWO

243
00:09:33,430 --> 00:09:35,666
PRESENTATIONS OF PROGRAMS OF

244
00:09:35,666 --> 00:09:37,334
INTEREST OR PARTICULAR NCI

245
00:09:37,334 --> 00:09:38,335
INVESTIGATORS THAT WE REALLY

246
00:09:38,335 --> 00:09:39,837
WANT YOU TO HEAR FROM.

247
00:09:39,837 --> 00:09:42,539
I HAVE INTENTIONALLY SELECTED

248
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THIS TIME, ONE INTRAMURAL

249
00:09:44,541 --> 00:09:45,542
INVESTIGATOR AT THE MID CAREER

250
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STAGE AND ONE EXTRAMURAL

251
00:09:47,745 --> 00:09:48,946
INVESTIGATOR AT THE MID CAREER

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STAGE.

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BOTH DOING PHENOMENAL VERY

254
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DIFFERENT WORK.

255
00:09:52,649 --> 00:09:56,320
JUST TO HIGHLIGHT THAT BREADTH

256
00:09:56,320 --> 00:09:57,955
OF WHAT THE NCI REALLY IS.

257
00:09:57,955 --> 00:09:59,823
AND THEN YOU WILL ALSO SEE OTHER

258
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PLACES WHERE I'M LOOKING FOR

259
00:10:01,959 --> 00:10:03,060
SOLICITING INPUT.

260
00:10:03,060 --> 00:10:04,394
I HAVE BEEN PRETTY ACTIVE ON

261
00:10:04,394 --> 00:10:08,132
SOCIAL MEDIA AND I ASKED PEOPLE,

262
00:10:08,132 --> 00:10:09,733
INCLUDING ON TWITTER, TO TELL ME

263
00:10:09,733 --> 00:10:11,735
WHAT THEY THOUGHT AND I GOT

264
00:10:11,735 --> 00:10:13,270
INCREDIBLY VALUABLE FEEDBACK.

265
00:10:13,270 --> 00:10:15,272
IT'S UNSCIENTIFIC, I KNOW THAT,

266
00:10:15,272 --> 00:10:17,174
BUT IT WAS REALLY TERRIFIC.

267
00:10:17,174 --> 00:10:19,376
SO WE'LL CONTINUE TO KEEP TRYING

268
00:10:19,376 --> 00:10:25,082
TO GET INPUT FROM EVERY PLACE WE

269
00:10:25,082 --> 00:10:25,349
CAN.

270
00:10:25,349 --> 00:10:27,351
I LOVE BASKETBALL SO I LIKE TO

271
00:10:27,351 --> 00:10:28,752
USE BASKETBALL ANALOGIES BUT I

272
00:10:28,752 --> 00:10:32,356
LOVE TEAM WORK AND THE CONCEPT

273
00:10:32,356 --> 00:10:35,492
OF HOW VERY DIVERSE A TEAM IS

274
00:10:35,492 --> 00:10:37,461
NECESSARY TO BE TO BE SUCCESSFUL

275
00:10:37,461 --> 00:10:40,264
AND HOW MUCH WE HAVE TO CONSIDER

276
00:10:40,264 --> 00:10:42,065
HOW THE INDIVIDUAL PLAYERS WORK

277
00:10:42,065 --> 00:10:43,767
TOGETHER TO BE ABLE TO MAKE A

278
00:10:43,767 --> 00:10:45,969
TEAM THAT WINS.

279
00:10:45,969 --> 00:10:51,175
SO, THAT'S COLLABORATION, THAT'S

280
00:10:51,175 --> 00:10:51,475
PRACTICE.

281
00:10:51,475 --> 00:10:55,279
THAT'S ROLE DEFINITION AND I

282
00:10:55,279 --> 00:10:56,680
LEARNED MORE THAN MY MANY YEARS

283
00:10:56,680 --> 00:10:58,282
OF PLAYING BASKETBALL OR

284
00:10:58,282 --> 00:10:59,082
WATCHING BASKETBALL ABOUT TEAM

285
00:10:59,082 --> 00:11:02,286
WORK FROM WORKING ON THE CANCER

286
00:11:02,286 --> 00:11:02,686
GENOME ATLAS.

287
00:11:02,686 --> 00:11:04,188
THERE YOU HAVE 300 PEOPLE WITH

288
00:11:04,188 --> 00:11:06,223
ALL VARYING DIFFERENT EXPERTISE

289
00:11:06,223 --> 00:11:07,991
WHO ARE WORKING TOGETHER TO COME

290
00:11:07,991 --> 00:11:12,529
UP WITH A FINAL PRODUCT.

291
00:11:12,529 --> 00:11:14,398
AND THE PICTURE OF THE TANGLED

292
00:11:14,398 --> 00:11:18,502
UP WIRES IS TO SHARE THAT I

293
00:11:18,502 --> 00:11:25,876
REALLY DO LIKE UNTANGLING A GOOD

294
00:11:25,876 --> 00:11:26,109
TANGLE.

295
00:11:26,109 --> 00:11:27,578
NOTHING MAKES ME MORE EXCITED

296
00:11:27,578 --> 00:11:29,179
THAN TO PUT A PATHWAY TOGETHER

297
00:11:29,179 --> 00:11:31,281
AND KNOW WHO TALKS TO WHO IN

298
00:11:31,281 --> 00:11:32,249
WHAT SEQUENCE.

299
00:11:32,249 --> 00:11:33,483
THAT ALSO EXTENDS TO

300
00:11:33,483 --> 00:11:34,685
ORGANIZATIONS WHEN I WAS DOING

301
00:11:34,685 --> 00:11:35,919
THAT MASTER'S DEGREE, MY

302
00:11:35,919 --> 00:11:37,387
FAVORITE CLASS WAS SOMETHING I

303
00:11:37,387 --> 00:11:40,824
DIDN'T EACH KNOW EXISTED,

304
00:11:40,824 --> 00:11:48,899
OPERATIONS.

305
00:11:48,899 --> 00:11:53,871
WITH THAT, THAT'S ME AND THE

306
00:11:53,871 --> 00:11:56,340
DESIRE TO HEAR FROM YOU AND ALSO

307
00:11:56,340 --> 00:12:05,282
TO UNTANGLE SOME GOOD TANGLES --

308
00:12:05,282 --> 00:12:06,016
NEXT SLIDE.

309
00:12:06,016 --> 00:12:08,185
WE'RE GOING TO TALK ABOUT

310
00:12:08,185 --> 00:12:08,418
BUDGET.

311
00:12:08,418 --> 00:12:10,721
SO WE JUST CAME OUT OF THE

312
00:12:10,721 --> 00:12:11,788
BUDGET SUBCOMMITTEE MEETING SO

313
00:12:11,788 --> 00:12:13,323
THOSE OF YOU WHO ARE ON THE

314
00:12:13,323 --> 00:12:14,458
SUBCOMMITTEE, THIS IS GOING TO

315
00:12:14,458 --> 00:12:15,525
BE A HIGHER LEVEL.

316
00:12:15,525 --> 00:12:17,160
YOU WERE DOWN IN THE WEEDS A

317
00:12:17,160 --> 00:12:18,929
LITTLE BIT MORE, BUT NEXT SLIDE.

318
00:12:18,929 --> 00:12:21,498
I THINK IT IS IMPORTANT THAT WE

319
00:12:21,498 --> 00:12:24,635
ALL KNOW WHERE WE ARE AND WHAT

320
00:12:24,635 --> 00:12:26,703
IS GOING ON IN MAKING SOME OF

321
00:12:26,703 --> 00:12:28,805
THE DECISIONS THAT ARE NECESSARY

322
00:12:28,805 --> 00:12:30,507
HERE AT THE NCI.

323
00:12:30,507 --> 00:12:33,911
SO FIRST OF ALL, YOU ALL KNOW

324
00:12:33,911 --> 00:12:36,013
THAT WE STILL DON'T HAVE A

325
00:12:36,013 --> 00:12:38,715
BUDGET BUT HAVE NOT -- HAD A

326
00:12:38,715 --> 00:12:40,717
GOVERNMENT SHUTDOWN THIS YEAR.

327
00:12:40,717 --> 00:12:42,319
SO THREE TIMES SO FAR,

328
00:12:42,319 --> 00:12:44,821
SEPTEMBER, NOVEMBER AND IN

329
00:12:44,821 --> 00:12:47,925
FEBRUARY WE AVERTED HAVING A

330
00:12:47,925 --> 00:12:48,325
SHUTDOWN.

331
00:12:48,325 --> 00:12:50,193
THE NEXT DATE ON OUR CALENDAR IS

332
00:12:50,193 --> 00:12:52,362
MARCH 8, WHICH WILL BE A FULL

333
00:12:52,362 --> 00:12:54,131
HALFWAY THROUGH OUR FISCAL YEAR.

334
00:12:54,131 --> 00:12:55,432
OUR FISCAL YEAR BEGINS OCTOBER 1

335
00:12:55,432 --> 00:12:59,536
AND SO WE ARE WATCHING VERY

336
00:12:59,536 --> 00:13:01,238
CLOSELY TO SEE WHAT HAPPENS IN

337
00:13:01,238 --> 00:13:01,571
MARCH.

338
00:13:01,571 --> 00:13:02,839
I HAVE ANOTHER SLIDE IN A MINUTE

339
00:13:02,839 --> 00:13:06,944
THAT WILL GET TO THAT.

340
00:13:06,944 --> 00:13:08,145
BUT, RUNNING A BUSINESS, WHERE

341
00:13:08,145 --> 00:13:09,813
YOU DON'T KNOW YOUR BUDGET, AS

342
00:13:09,813 --> 00:13:12,316
YOU CAN IMAGINE, IS PRETTY

343
00:13:12,316 --> 00:13:12,616
CHALLENGING.

344
00:13:12,616 --> 00:13:16,253
WE HAVE MADE SOME ASSUMPTIONS

345
00:13:16,253 --> 00:13:18,956
BASED ON WHAT ARE NOT OVERLY

346
00:13:18,956 --> 00:13:20,657
CONSERVATIVE BUT ARE HOPEFULLY

347
00:13:20,657 --> 00:13:29,666
CONSERVATIVE ENOUGH TO BE ABLE

348
00:13:29,666 --> 00:13:31,935
TO CONTINUE TO WAIT ON THE

349
00:13:31,935 --> 00:13:32,269
BUDGET.

350
00:13:32,269 --> 00:13:33,570
WE CAN TALK ABOUT THAT MORE

351
00:13:33,570 --> 00:13:35,839
LATER IF YOU WANT BUT WE ARE

352
00:13:35,839 --> 00:13:37,374
BASICALLY OPERATING UNDER AN

353
00:13:37,374 --> 00:13:38,875
ASSUMPTION THAT THINGS WILL BE

354
00:13:38,875 --> 00:13:40,077
PRETTY MUCH LIKE THEY WERE LAST

355
00:13:40,077 --> 00:13:40,944
YEAR.

356
00:13:40,944 --> 00:13:42,479
NEXT SLIDE.

357
00:13:42,479 --> 00:13:44,481
SO, WHEN AND HOW DOES THIS

358
00:13:44,481 --> 00:13:45,148
DECISION GET MADE?

359
00:13:45,148 --> 00:13:47,451
WE LIVE IN A VERY COMPLICATED

360
00:13:47,451 --> 00:13:47,718
ECOSYSTEM.

361
00:13:47,718 --> 00:13:48,952
THE APPROPRIATIONS FROM CONGRESS

362
00:13:48,952 --> 00:13:51,788
HAVE TO COVER A HUGE PART OF THE

363
00:13:51,788 --> 00:13:53,357
NATIONAL LANDSCAPE, NOT

364
00:13:53,357 --> 00:13:53,657
SURPRISING.

365
00:13:53,657 --> 00:13:58,962
WE THINK THAT CANCER IS A VERY

366
00:13:58,962 --> 00:14:05,802
IMPORTANT PART BUT IT ALSO

367
00:14:05,802 --> 00:14:06,670
INTERCONNECTS WITH OTHER

368
00:14:06,670 --> 00:14:06,970
COMPONENTS.

369
00:14:06,970 --> 00:14:09,573
AT THE LAST CONTINUING

370
00:14:09,573 --> 00:14:11,074
RESOLUTION, ACTUALLY TWO BEFORE,

371
00:14:11,074 --> 00:14:13,076
IT WAS SPLIT SO WE HAVE NOW

372
00:14:13,076 --> 00:14:14,978
SEPARATE APPROPRIATIONS BILLS.

373
00:14:14,978 --> 00:14:19,750
SO ON MARCH 1, THE FIRST SET

374
00:14:19,750 --> 00:14:23,020
WILL BE UP FOR, HOPEFULLY,

375
00:14:23,020 --> 00:14:24,121
GETTING A BILL PASSED.

376
00:14:24,121 --> 00:14:25,589
AND WE ARE IN THE SECOND SET.

377
00:14:25,589 --> 00:14:27,591
YOU CAN SEE WHO THEY ARE IN

378
00:14:27,591 --> 00:14:27,791
WITH.

379
00:14:27,791 --> 00:14:30,527
WE ARE IN WITH COMMERCE,

380
00:14:30,527 --> 00:14:31,361
DEFENSE, HOMELAND SECURITY, THE

381
00:14:31,361 --> 00:14:34,398
OFFICE OF THE INTERIOR, THE

382
00:14:34,398 --> 00:14:36,800
LEGISLATIVE BRANCH, ET CETERA.

383
00:14:36,800 --> 00:14:39,202
SO THAT IS OUR TRAUNCH OF

384
00:14:39,202 --> 00:14:41,805
APPROPRIATIONS THAT WILL ALL BE

385
00:14:41,805 --> 00:14:42,706
CONSIDERED IN BULK.

386
00:14:42,706 --> 00:14:44,608
SO HOPEFULLY, ON MARCH 8, WE'LL

387
00:14:44,608 --> 00:14:47,677
GET A BUDGET.

388
00:14:47,677 --> 00:14:49,813
NEXT SLIDE.

389
00:14:49,813 --> 00:14:51,515
HOW DO WE SPEND OUR BUDGET?

390
00:14:51,515 --> 00:14:52,582
THIS IS A CONSISTENT BREAKDOWN

391
00:14:52,582 --> 00:14:54,785
OF WHAT WE DO OVERALL.

392
00:14:54,785 --> 00:14:57,120
WE USUALLY SPEND ROUGHLY

393
00:14:57,120 --> 00:14:59,089
THREE-QUARTERS ON EXTRAMURAL

394
00:14:59,089 --> 00:14:59,456
GRANTS.

395
00:14:59,456 --> 00:15:01,224
SO THE MAJORITY IS RESEARCH

396
00:15:01,224 --> 00:15:04,161
PROJECT GRANTS, TRADITIONALLY

397
00:15:04,161 --> 00:15:04,594
RO1s.

398
00:15:04,594 --> 00:15:07,597
ABOUT 8% OF OUR BUDGET GOES TO

399
00:15:07,597 --> 00:15:08,031
CENTERS AND SPORES.

400
00:15:08,031 --> 00:15:10,700
SO THE CANCER CENTER PROGRAM IS

401
00:15:10,700 --> 00:15:13,036
A MAJOR VERY IMPORTANT PART OF

402
00:15:13,036 --> 00:15:15,939
OUR OVERALL PORTFOLIO 1/4 GOES

403
00:15:15,939 --> 00:15:17,874
TO INTRAMURAL RESEARCH, RESEARCH

404
00:15:17,874 --> 00:15:18,608
MANAGEMENT AND SUPPORT AND

405
00:15:18,608 --> 00:15:21,578
BUILDINGS AND FACILITIES.

406
00:15:21,578 --> 00:15:30,387
NEXT SLIDE.

407
00:15:30,387 --> 00:15:31,455
THERE ARE A COUPLE OF NUMBERS

408
00:15:31,455 --> 00:15:32,823
FOR YOU TO HAVE IN MIND.

409
00:15:32,823 --> 00:15:36,226
LAST YEAR'S BUDGET, FY23, WAS

410
00:15:36,226 --> 00:15:39,129
ROUGHLY 7.3 BILLION DOLLARS.

411
00:15:39,129 --> 00:15:42,132
SO IF WE LOOK AT FY24, THE WAY

412
00:15:42,132 --> 00:15:44,734
THE PROCESS WORKS IS THE NCI,

413
00:15:44,734 --> 00:15:46,136
BECAUSE OF THE 1971 NATIONAL

414
00:15:46,136 --> 00:15:48,238
CANCER ACT, HAS THE ABILITY TO

415
00:15:48,238 --> 00:15:49,673
PUT FORWARD A PROFESSIONAL

416
00:15:49,673 --> 00:15:59,983
JUDGMENT PROPOSAL.

417
00:16:00,817 --> 00:16:03,954
SO FIRST INCREASING AT LESS THAN

418
00:16:03,954 --> 00:16:06,056
THE OVERALL COST OF INFLATION,

419
00:16:06,056 --> 00:16:08,125
FOR MANY, MANY YEARS, SO WE ARE

420
00:16:08,125 --> 00:16:10,060
ALREADY BEHIND, AND WE'RE BEING

421
00:16:10,060 --> 00:16:11,862
ASKED TO DO A LOT OF NEW THINGS.

422
00:16:11,862 --> 00:16:14,397
THINGS WE REALLY WANT TO DO TO

423
00:16:14,397 --> 00:16:15,699
IMPROVE HEALTH CARE IN THE

424
00:16:15,699 --> 00:16:25,942
CANCER ARENA.

425
00:16:40,257 --> 00:16:41,224
THE WHOLE PROCESS HAPPENS AGAIN

426
00:16:41,224 --> 00:16:43,393
FOR THIS YEAR, WE ARE PLANNING

427
00:16:43,393 --> 00:16:48,064
FOR NEXT YEAR FOR FY25, STARTING

428
00:16:48,064 --> 00:16:50,033
OCTOBER 1 OF' 24.

429
00:16:50,033 --> 00:16:51,801
AND THE PROFESSIONAL JUDGMENT

430
00:16:51,801 --> 00:16:55,172
BUDGET BASED ON INFLATION AND

431
00:16:55,172 --> 00:16:56,907
COSTS THAT ARE INCURRED AND I

432
00:16:56,907 --> 00:16:58,608
HAVE A LITTLE BIT OF INFORMATION

433
00:16:58,608 --> 00:16:59,609
ON THE NEXT SLIDE.

434
00:16:59,609 --> 00:17:01,011
ESTIMATES THAT IT WILL CONTINUE

435
00:17:01,011 --> 00:17:03,313
TO INCREASE, NOT SURPRISING.

436
00:17:03,313 --> 00:17:06,016
SO THE CURRENT REFLECTION OF THE

437
00:17:06,016 --> 00:17:07,517
PROFESSIONAL JUDGMENT BUDGET IS

438
00:17:07,517 --> 00:17:08,251
11 BILLION DOLLARS.

439
00:17:08,251 --> 00:17:09,719
WE ARE WAITING TO SEE WHAT THE

440
00:17:09,719 --> 00:17:11,154
PRESIDENT'S PROPOSAL WILL BE,

441
00:17:11,154 --> 00:17:14,925
THAT WILL COME LATER THIS SPRING

442
00:17:14,925 --> 00:17:16,626
AND THEN SOME TIME A WAYS FROM

443
00:17:16,626 --> 00:17:18,428
NOW BEFORE WE FIND OUT WHAT OUR

444
00:17:18,428 --> 00:17:22,666
BUDGET WILL BE FOR FISCAL YEAR

445
00:17:22,666 --> 00:17:23,934
'25.

446
00:17:23,934 --> 00:17:24,935
NEXT SLIDE.

447
00:17:24,935 --> 00:17:26,870
SO, THOSE NUMBERS, THE 9 BILLION

448
00:17:26,870 --> 00:17:28,838
AND 11 BILLION, PROFESSIONAL

449
00:17:28,838 --> 00:17:30,740
JUDGMENT BUDGET PROPOSAL, I

450
00:17:30,740 --> 00:17:32,242
WOULD ENCOURAGE YOU TO TAKE A

451
00:17:32,242 --> 00:17:35,445
LOOK AT WHAT GOES INTO THAT,

452
00:17:35,445 --> 00:17:38,148
THIS WEBSITE ON THE BOTTOM LEFT

453
00:17:38,148 --> 00:17:40,050
IS A DESCRIPTION OF WHY THOSE

454
00:17:40,050 --> 00:17:41,351
NUMBERS CAME TO BE AND WHERE

455
00:17:41,351 --> 00:17:42,419
THEY COME FROM.

456
00:17:42,419 --> 00:17:43,620
THERE ARE MANY THINGS THAT WE

457
00:17:43,620 --> 00:17:46,156
WOULD DO IF WE HAD ENOUGH MONEY,

458
00:17:46,156 --> 00:17:47,457
PARTICULARLY AROUND CLINICAL

459
00:17:47,457 --> 00:17:50,660
TRIALS AND PARTICULARLY AROUND

460
00:17:50,660 --> 00:17:54,097
CANCER DATA AND USING DATA TO

461
00:17:54,097 --> 00:17:58,134
BEST SERVE OUR COMMUNITIES.

462
00:17:58,134 --> 00:17:58,668
NEXT SLIDE.

463
00:17:58,668 --> 00:18:01,538
I WANT TO ASSURE YOU, IN SPITE

464
00:18:01,538 --> 00:18:03,540
OF ALL OF THESE HEADWINDS AND

465
00:18:03,540 --> 00:18:06,343
THIS IS NOT COMPLETELY NEW,

466
00:18:06,343 --> 00:18:08,845
ALTHOUGH IT FEELS TITER THAN IN

467
00:18:08,845 --> 00:18:11,848
PRIOR YEARS, THAT THE NCI HAS

468
00:18:11,848 --> 00:18:14,351
BEEN FUNDING EFFECTIVELY FOR

469
00:18:14,351 --> 00:18:15,151
EXTRAMURAL AWARDS.

470
00:18:15,151 --> 00:18:17,087
THIS SHOWS OUR FUNDING HISTORY

471
00:18:17,087 --> 00:18:18,121
TO FY23.

472
00:18:18,121 --> 00:18:20,857
ON THE LEFT IS IN DOLLARS.

473
00:18:20,857 --> 00:18:25,262
SO YOU CAN SEE THAT ENACTED

474
00:18:25,262 --> 00:18:26,563
AWARDS THAT WERE GOING OUT,

475
00:18:26,563 --> 00:18:27,697
INCLUDING MOONSHOT MONEY SHOWN

476
00:18:27,697 --> 00:18:30,166
IN YELLOW, BUT IS INCREASING

477
00:18:30,166 --> 00:18:30,533
YEAR-OVER-YEAR.

478
00:18:30,533 --> 00:18:33,403
SO WE ARE SENDING MORE MONEY OUT

479
00:18:33,403 --> 00:18:33,937
THE DOOR.

480
00:18:33,937 --> 00:18:35,872
IN A SLIDE IN A MINUTE, SOME

481
00:18:35,872 --> 00:18:37,574
GRANTS ARE GETTING BIGGER IN

482
00:18:37,574 --> 00:18:37,874
SIZE.

483
00:18:37,874 --> 00:18:39,576
BUT THE TOTAL NUMBER OF AWARDS

484
00:18:39,576 --> 00:18:40,677
IS ALSO GOING UP.

485
00:18:40,677 --> 00:18:43,613
YOU CAN SEE THAT ON THE RIGHT IN

486
00:18:43,613 --> 00:18:46,082
THE BLUE BARS IS THE EASIEST ONE

487
00:18:46,082 --> 00:18:46,683
TO LOOK AT.

488
00:18:46,683 --> 00:18:49,919
ALL NCI AWARDS, BUT TRUE FOR THE

489
00:18:49,919 --> 00:18:51,588
OTHERS AS WELL, ARE INCREASING.

490
00:18:51,588 --> 00:18:52,756
WE KNOW THERE ARE INVESTIGATORS

491
00:18:52,756 --> 00:18:55,892
IN THE COMMUNITY WHO NEED TO DO

492
00:18:55,892 --> 00:18:58,895
WORK THAT IS VITAL TO THE WHOLE

493
00:18:58,895 --> 00:19:03,600
NATIONAL EFFORT OF THE NCI.

494
00:19:03,600 --> 00:19:07,203
SO, THE DIRECTORS BEFORE ME HAVE

495
00:19:07,203 --> 00:19:11,341
ALSO HAD A REAL MANDATE TO

496
00:19:11,341 --> 00:19:14,311
CONTINUE TO GROW THIS

497
00:19:14,311 --> 00:19:15,011
ENTERPRISE.

498
00:19:15,011 --> 00:19:16,212
NEXT SLIDE.

499
00:19:16,212 --> 00:19:17,514
SO, MORE GRANTS GOING OUT THE

500
00:19:17,514 --> 00:19:19,049
DOOR BUT THEY ARE BIGGER.

501
00:19:19,049 --> 00:19:21,017
THIS IS JUST TO GIVE YOU SOME

502
00:19:21,017 --> 00:19:22,218
PERSPECTIVE ABOUT HOW MUCH

503
00:19:22,218 --> 00:19:23,720
BIGGER THE GRANTS ARE STARTING

504
00:19:23,720 --> 00:19:24,454
TO BECOME.

505
00:19:24,454 --> 00:19:26,990
WE COULD LOOK AT IT IN LOTS OF

506
00:19:26,990 --> 00:19:28,725
DIFFERENT MECHANISMS BUT OUR

507
00:19:28,725 --> 00:19:31,995
BULK MECHANISM, 25-30% OF OUR

508
00:19:31,995 --> 00:19:34,531
GRANTS BEING IN THE RO1 POOL,

509
00:19:34,531 --> 00:19:37,100
THE RO1 MODULAR GRANT THAT WE

510
00:19:37,100 --> 00:19:39,502
ALL PROBABLY STARTED OUT WITH A

511
00:19:39,502 --> 00:19:42,605
LONG TIME AGO, USED TO BE THE

512
00:19:42,605 --> 00:19:44,341
NORM.

513
00:19:44,341 --> 00:19:45,842
250,000 DOLLAR DIRECT COST.

514
00:19:45,842 --> 00:19:51,314
IN 2012, 63% OF GRANTS WERE

515
00:19:51,314 --> 00:19:52,816
COMING IN AS MODULAR.

516
00:19:52,816 --> 00:19:55,719
THAT HAS BECOME REALLY NOT A

517
00:19:55,719 --> 00:19:57,120
SUSTAINABLE NUMBER FOR FOLKS AND

518
00:19:57,120 --> 00:20:00,824
ONLY 17% OF GRANTS ARE COMING IN

519
00:20:00,824 --> 00:20:01,925
MODULAR.

520
00:20:01,925 --> 00:20:02,959
83% ARE NON-MODULAR.

521
00:20:02,959 --> 00:20:05,028
AND THEY ARE NOT COMING IN AT

522
00:20:05,028 --> 00:20:05,662
260,000 DOLLARS.

523
00:20:05,662 --> 00:20:08,832
THEY ARE COMING IN AT 450 AND

524
00:20:08,832 --> 00:20:09,699
490.

525
00:20:09,699 --> 00:20:13,536
BECAUSE 500,000 IS THE CAP.

526
00:20:13,536 --> 00:20:16,439
SO, IN PUTTING OUT MORE AWARDS,

527
00:20:16,439 --> 00:20:17,941
IT COSTS MORE BECAUSE EACH GRANT

528
00:20:17,941 --> 00:20:23,780
IS A BIGGER CHUNK.

529
00:20:23,780 --> 00:20:26,716
NEXT SLIDE.

530
00:20:26,716 --> 00:20:28,952
SO AS WE TRY TO GUESS WHAT OUR

531
00:20:28,952 --> 00:20:31,554
BUDGET MIGHT LOOK LIKE, IF OUR

532
00:20:31,554 --> 00:20:33,356
BUDGET COMES IN FLAT T WILL BE

533
00:20:33,356 --> 00:20:34,758
VERY, VERY HARD TO MAINTAIN THE

534
00:20:34,758 --> 00:20:36,659
THINGS THAT WE'RE DOING HERE

535
00:20:36,659 --> 00:20:37,560
TODAY.

536
00:20:37,560 --> 00:20:39,496
FIRST OF ALL, A FLAT BUDGET

537
00:20:39,496 --> 00:20:39,963
ISN'T FLAT.

538
00:20:39,963 --> 00:20:41,164
WE KNOW ABOUT INFLATION.

539
00:20:41,164 --> 00:20:43,266
WE ALL KNOW ABOUT THE INCREASE

540
00:20:43,266 --> 00:20:44,768
COSTS POSTDOC SALARIES AND OTHER

541
00:20:44,768 --> 00:20:45,769
STAFF SALARIES.

542
00:20:45,769 --> 00:20:47,470
WE ALL KNOW THAT THERE ARE ARE

543
00:20:47,470 --> 00:20:49,873
EXPENSES THAT WILL JUST GO UP.

544
00:20:49,873 --> 00:20:52,142
OUR AVERAGE NCI INCREASE OF

545
00:20:52,142 --> 00:20:54,677
MANDATED EXPENSES, THINGS AROUND

546
00:20:54,677 --> 00:20:55,979
CYBERSECURITY AND BASIC

547
00:20:55,979 --> 00:20:58,081
INFRASTRUCTURE, IS 100 MILLION

548
00:20:58,081 --> 00:20:58,748
DOLLARS.

549
00:20:58,748 --> 00:21:02,018
JUST TO MAINTAIN THE FUNDING AT

550
00:21:02,018 --> 00:21:06,489
THE CURRENT LEVEL FOR RO1s AND

551
00:21:06,489 --> 00:21:09,192
TO PAY OUT EXISTING AWARDS AT

552
00:21:09,192 --> 00:21:10,593
100%, WOULD ADD 250 MILLION

553
00:21:10,593 --> 00:21:13,296
DOLLARS TO OUR BUDGET.

554
00:21:13,296 --> 00:21:15,665
SO, EVEN MODEST INCREASES ARE

555
00:21:15,665 --> 00:21:16,199
ESSENTIALLY FLAT.

556
00:21:16,199 --> 00:21:18,101
IF WE COME IN AT FLAT, THIS IS

557
00:21:18,101 --> 00:21:20,770
WHAT I JUST HAVE TO HAVE YOU

558
00:21:20,770 --> 00:21:20,970
KNOW.

559
00:21:20,970 --> 00:21:24,174
I DON'T WANT TO DO ANY OF THESE

560
00:21:24,174 --> 00:21:24,774
THINGS.

561
00:21:24,774 --> 00:21:26,876
BUT, THE CUTS THAT YOU MAY BE

562
00:21:26,876 --> 00:21:29,779
FEELING AT YOUR INSTITUTIONS

563
00:21:29,779 --> 00:21:32,582
ALREADY THAT ARE ANTICIPATORY,

564
00:21:32,582 --> 00:21:34,284
WE WILL HOPEFULLY NOT HAVE TO

565
00:21:34,284 --> 00:21:36,019
BUT MIGHT HAVE TO DECREASE THE

566
00:21:36,019 --> 00:21:41,357
PAY LINE FOR NEW AWARDS OR NOT

567
00:21:41,357 --> 00:21:42,392
FUND NONCOMPETING AWARDS AT

568
00:21:42,392 --> 00:21:44,994
THEIR FULL BUDGET 100%.

569
00:21:44,994 --> 00:21:46,463
THE CANCER CENTER SUPPORT GRANTS

570
00:21:46,463 --> 00:21:49,699
HAVE NOT BEEN TOUCHED

571
00:21:49,699 --> 00:21:52,469
HISTORICALLY, USUALLY, BUT WE

572
00:21:52,469 --> 00:21:55,004
MAY HAVE TO CHANGE PLANS TO

573
00:21:55,004 --> 00:21:58,107
INCREASE THE NUMBERS OR DECREASE

574
00:21:58,107 --> 00:22:00,810
THE AMOUNT IN 91 COMPETING CCSG

575
00:22:00,810 --> 00:22:01,077
AWARDS.

576
00:22:01,077 --> 00:22:03,313
I'M JUST TELLING YOU WHAT LEVERS

577
00:22:03,313 --> 00:22:04,080
I HAVE TO PULL.

578
00:22:04,080 --> 00:22:07,116
I'M NOT TRY TO FRIGHTEN PEOPLE,

579
00:22:07,116 --> 00:22:09,986
JUST LET YOU ALL KNOW WHAT WE

580
00:22:09,986 --> 00:22:12,422
CAN DO IF WE HAVE TO.

581
00:22:12,422 --> 00:22:13,990
THIS ONE WOULD HURT ME THE MOST.

582
00:22:13,990 --> 00:22:15,225
CANCER TRAINING AWARDS.

583
00:22:15,225 --> 00:22:18,495
THOSE ARE NOT RENEWABLE.

584
00:22:18,495 --> 00:22:19,996
INDIVIDUAL CANCER TRAINING AWARD

585
00:22:19,996 --> 00:22:22,899
IS FIVE YEARS AND THAT'S ALL.

586
00:22:22,899 --> 00:22:25,001
SO IT'S EASIER PLACE TO MAKE A

587
00:22:25,001 --> 00:22:25,502
CUT.

588
00:22:25,502 --> 00:22:28,605
BELIEVE ME, THAT ONE WOULD HURT

589
00:22:28,605 --> 00:22:30,206
MY SOUL.

590
00:22:30,206 --> 00:22:33,042
BUT SPORES ARE SIMILAR TO

591
00:22:33,042 --> 00:22:34,611
CCSGs, OTHER BIG PROGRAMS

592
00:22:34,611 --> 00:22:36,913
WHERE WE MAY JUST HAVE TO MAKE

593
00:22:36,913 --> 00:22:38,014
HARDER CHOICES.

594
00:22:38,014 --> 00:22:40,717
AND I WANT TO LET YOU KNOW THAT

595
00:22:40,717 --> 00:22:43,319
OUR PHILOSOPHY HERE, AND I

596
00:22:43,319 --> 00:22:44,721
MAINTAIN, IS THAT WHEN WE MAKE

597
00:22:44,721 --> 00:22:46,523
CUTS THAT HIT THE EXTRAMURAL

598
00:22:46,523 --> 00:22:49,025
PROGRAM, THEY ARE COMMENSURATELY

599
00:22:49,025 --> 00:22:50,393
TAKEN ON THE INTRAMURAL PROGRAM.

600
00:22:50,393 --> 00:22:52,128
SO IT'S ACROSS-THE-BOARD.

601
00:22:52,128 --> 00:22:55,865
SO, THIS IS MY WORST SLIDE.

602
00:22:55,865 --> 00:23:00,503
NEXT SLIDE.

603
00:23:00,503 --> 00:23:03,239
SO, IF YOU WANT MORE

604
00:23:03,239 --> 00:23:04,641
INFORMATION, WE HAVE LOTS OF IT.

605
00:23:04,641 --> 00:23:07,644
AND IF YOU WANT TO TAKE A LOOK

606
00:23:07,644 --> 00:23:10,213
AT DETAILS ABOUT PAY LINES AND

607
00:23:10,213 --> 00:23:12,415
BUDGETS AND HOW WE COME TO SOME

608
00:23:12,415 --> 00:23:14,017
OF THESE NUMBERS, WE HAVE LOTS

609
00:23:14,017 --> 00:23:15,752
OF RESOURCES AND YOU HAVE SHOULD

610
00:23:15,752 --> 00:23:17,320
ALL THESE SLIDES.

611
00:23:17,320 --> 00:23:19,522
NEXT SLIDE.

612
00:23:19,522 --> 00:23:21,190
OKAY, SO, I JUST GOT HERE AND

613
00:23:21,190 --> 00:23:23,826
MIGHT BE SAYING OH, MY GOSH, WHY

614
00:23:23,826 --> 00:23:25,528
IS SHE STILL HERE SIX WEEKS IN

615
00:23:25,528 --> 00:23:27,163
AND THIS IS THE JOB.

616
00:23:27,163 --> 00:23:32,835
SO, LET ME JUST TELL YOU -- I

617
00:23:32,835 --> 00:23:34,938
CAME TO VANDERBILT TO RUN THE

618
00:23:34,938 --> 00:23:36,072
HEMATOLOGY AND ONCOLOGY

619
00:23:36,072 --> 00:23:36,506
DIVISION.

620
00:23:36,506 --> 00:23:38,841
I NEVER EXPECTED I MIGHT BECOME

621
00:23:38,841 --> 00:23:47,050
A DEPARTMENT OF MEDICINE CHAIR.

622
00:23:47,050 --> 00:23:50,820
IN JANUARY OF 2020, AND IN

623
00:23:50,820 --> 00:23:54,357
FEBRUARY OF 2020, I WAS VERY

624
00:23:54,357 --> 00:23:56,225
INTERESTED IN TRYING TO HELP

625
00:23:56,225 --> 00:23:58,761
MOVE SOME THINGS BUT IT WAS

626
00:23:58,761 --> 00:23:58,962
HARD.

627
00:23:58,962 --> 00:24:00,663
AND IT GOT A WHOLE LOT EASIER IN

628
00:24:00,663 --> 00:24:04,300
MARCH OF 2020.

629
00:24:04,300 --> 00:24:08,805
NOW, THE DEPARTMENT OF MEDICINE,

630
00:24:08,805 --> 00:24:09,839
THIS IS COVID.

631
00:24:09,839 --> 00:24:13,076
THE DEPARTMENT OF MEDICINE

632
00:24:13,076 --> 00:24:15,078
COVERS URGENT CARE CLINICS,

633
00:24:15,078 --> 00:24:18,481
WALK-IN CLINICS, WE HAD A

634
00:24:18,481 --> 00:24:20,783
WALGREENS GROUP.

635
00:24:20,783 --> 00:24:21,951
WE HAD EXTERNAL HOSPITALS.

636
00:24:21,951 --> 00:24:23,486
WE HAD PRIMARY CARE.

637
00:24:23,486 --> 00:24:24,687
WE HAD HOSPITAL MEDICINE.

638
00:24:24,687 --> 00:24:26,856
WE HAD INTENSIVE CARE AND

639
00:24:26,856 --> 00:24:28,825
PALLIATIVE CARE WITH ALL THE

640
00:24:28,825 --> 00:24:30,760
SPECIALTIES, PULMONARY AND ID.

641
00:24:30,760 --> 00:24:37,433
SO COVID WAS OUR DISEASE.

642
00:24:37,433 --> 00:24:38,768
IT WAS THE MOST INTENSE PERIOD

643
00:24:38,768 --> 00:24:42,872
OF MY ENTIRE PROFESSIONAL

644
00:24:42,872 --> 00:24:44,674
EXPERIENCE TO DATE.

645
00:24:44,674 --> 00:24:46,175
AND THE ABILITY TO CHANGE ON A

646
00:24:46,175 --> 00:24:47,877
DIME AND TO HAVE PEOPLE BE

647
00:24:47,877 --> 00:24:55,685
ALIGNED WITH A MISSION AND TO DO

648
00:24:55,685 --> 00:24:58,988
WHAT IT TOOK IN NASHVILLE

649
00:24:58,988 --> 00:25:02,659
TENNESSEE, WAS INCREDIBLE.

650
00:25:02,659 --> 00:25:10,166
IT WAS BREATH TAKING AND IT WAS

651
00:25:10,166 --> 00:25:14,070
SO EXCITING.

652
00:25:14,070 --> 00:25:16,205
AND IN THE END, WHEN IT'S NEVER

653
00:25:16,205 --> 00:25:18,441
QUITE ENDED, BUT WHEN COVID

654
00:25:18,441 --> 00:25:19,776
STARTED TO RECEDE, WE HAD THE

655
00:25:19,776 --> 00:25:21,277
OPPORTUNITY TO STOP AND SAY,

656
00:25:21,277 --> 00:25:22,779
WHAT THINGS HAVE WE DONE HERE WE

657
00:25:22,779 --> 00:25:24,113
WANT TO KEEP?

658
00:25:24,113 --> 00:25:25,882
AND WE LEARNED THAT THERE WERE

659
00:25:25,882 --> 00:25:28,184
LOTS OF OPPORTUNITIES TO KEEP.

660
00:25:28,184 --> 00:25:30,386
AND IN THE END, OUR ABILITY TO

661
00:25:30,386 --> 00:25:33,589
DELIVER CARE, PARTICULARLY TO

662
00:25:33,589 --> 00:25:35,391
THE BROAD AREA AROUND NASHVILLE

663
00:25:35,391 --> 00:25:38,895
WAS ENORMOUSLY PRESERVED AND

664
00:25:38,895 --> 00:25:39,328
EXPANDED.

665
00:25:39,328 --> 00:25:42,198
AND WE LEARNED THAT WE WERE ABLE

666
00:25:42,198 --> 00:25:44,934
TO DELIVER CARE MUCH MORE

667
00:25:44,934 --> 00:25:46,502
EFFICIENTLY IN SOME OF OUR

668
00:25:46,502 --> 00:25:47,704
COMPONENTS OF THE MAIN CAMPUS

669
00:25:47,704 --> 00:25:49,505
AND WE WERE ABLE TO COLLABORATE

670
00:25:49,505 --> 00:25:51,541
WITH TEAMS THAT PREVIOUSLY HAD

671
00:25:51,541 --> 00:25:52,809
NEVER HAD ANY OPPORTUNITY TO

672
00:25:52,809 --> 00:26:00,683
INTERACT WITH EACH OTHER.

673
00:26:00,683 --> 00:26:02,618
AND THE WHOLE PROGRESS WAS

674
00:26:02,618 --> 00:26:03,419
IMPROVED DRAMATICALLY BECAUSE OF

675
00:26:03,419 --> 00:26:06,789
THIS REALLY INTENSE CRISIS.

676
00:26:06,789 --> 00:26:09,826
AND YOU ALL LIVED THIS

677
00:26:09,826 --> 00:26:11,327
EXPERIENCE AS WELL AND PROBABLY

678
00:26:11,327 --> 00:26:15,631
HAVE SOME OUTCOMES.

679
00:26:15,631 --> 00:26:17,700
THIS FEELS THE SAME.

680
00:26:17,700 --> 00:26:20,336
AND PEOPLE ARE ALSO LINING UP

681
00:26:20,336 --> 00:26:22,138
AND WILLING TO REALLY THINK

682
00:26:22,138 --> 00:26:23,740
CAREFULLY ABOUT WHAT WE ARE

683
00:26:23,740 --> 00:26:26,109
DOING, HOW WE ARE GOING TO

684
00:26:26,109 --> 00:26:27,810
MANAGE, AND WE WILL HAVE A

685
00:26:27,810 --> 00:26:29,445
BUDGET SOME DAY AND WE WILL BE

686
00:26:29,445 --> 00:26:32,515
ABLE TO CARRY ON THE MISSION OF

687
00:26:32,515 --> 00:26:35,017
THE NCI WITH THAT BUDGET AND IN

688
00:26:35,017 --> 00:26:36,619
SOME THINGS WE DO, WE WILL DO

689
00:26:36,619 --> 00:26:37,019
BETTER.

690
00:26:37,019 --> 00:26:40,556
AND SO, I'M EXCITED TO SEE HOW

691
00:26:40,556 --> 00:26:44,327
THIS GOES.

692
00:26:44,327 --> 00:26:49,031
NEXT SLIDE.

693
00:26:49,031 --> 00:26:52,335
SO, TO DO THAT, WE NEED A

694
00:26:52,335 --> 00:26:52,568
ROADMAP.

695
00:26:52,568 --> 00:26:54,637
I'M A BIG FAN OF THE NATIONAL

696
00:26:54,637 --> 00:26:56,139
CANCER PLAN THAT DR. MONICA

697
00:26:56,139 --> 00:26:57,540
BERTAGNOLLI PUT OUT THIS TIME

698
00:26:57,540 --> 00:26:58,474
LAST YEAR.

699
00:26:58,474 --> 00:27:00,443
THIS ENCOMPASSES WORK WE HAVE

700
00:27:00,443 --> 00:27:02,078
ALWAYS DONE.

701
00:27:02,078 --> 00:27:03,546
THE EIGHT GOALS OF THE NATIONAL

702
00:27:03,546 --> 00:27:06,883
CANCER PLAN ENCOMPASS THE

703
00:27:06,883 --> 00:27:10,353
EXPERIENCE OF CANCER, PREVENTS

704
00:27:10,353 --> 00:27:12,655
CANCER, DETECT CANCERS EARLY,

705
00:27:12,655 --> 00:27:14,757
DELIVER OPTIMAL CARE AND THEN AN

706
00:27:14,757 --> 00:27:16,726
ECOSYSTEM AROUND IT ELIMINATING

707
00:27:16,726 --> 00:27:18,127
EQUALITIES, UTILIZING THE DATA

708
00:27:18,127 --> 00:27:20,029
THAT IS AVAILABLE IN ALL OF

709
00:27:20,029 --> 00:27:21,364
THESE DIFFERENT SPACES AND

710
00:27:21,364 --> 00:27:23,633
COLLABORATING WELL TO USE DATA.

711
00:27:23,633 --> 00:27:27,069
OPTIMIZING THE WORKFORCE SO WE

712
00:27:27,069 --> 00:27:30,773
CAN BEST MEET THE NEEDS OF

713
00:27:30,773 --> 00:27:33,142
PATIENTS AND PROVIDE THE

714
00:27:33,142 --> 00:27:35,077
SCIENTIFIC POWER BEHIND THE

715
00:27:35,077 --> 00:27:36,479
ADVANCES WE MAKE AT THE NCI AND

716
00:27:36,479 --> 00:27:37,747
MOST IMPORTANTLY, MY FAVORITE

717
00:27:37,747 --> 00:27:39,248
PART OF THE NATIONAL CANCER PLAN

718
00:27:39,248 --> 00:27:41,450
IS THE POINT TO ENGAGE EVERY

719
00:27:41,450 --> 00:27:42,819
PERSON, THAT THE WORK THAT WE DO

720
00:27:42,819 --> 00:27:45,755
AT THE NCI IS EVERYONE'S WORK

721
00:27:45,755 --> 00:27:49,559
AND WE REALLY WILL CHANGE CANCER

722
00:27:49,559 --> 00:27:51,861
AND END CANCER AS WE KNOW IT,

723
00:27:51,861 --> 00:27:54,564
WHEN EVERY PERSON IS ENGAGED

724
00:27:54,564 --> 00:27:56,766
FULLY IN THIS OVERALL MISSION.

725
00:27:56,766 --> 00:28:01,470
SO, WITH THAT ROADMAP, NEXT

726
00:28:01,470 --> 00:28:01,671
SLIDE.

727
00:28:01,671 --> 00:28:03,306
WE ALSO NEED A SET OF GOALS.

728
00:28:03,306 --> 00:28:07,877
THOSE GOALS WERE PUT IN PLACE BY

729
00:28:07,877 --> 00:28:10,746
OUR WHITE HOUSE, PRESIDENT BIDEN

730
00:28:10,746 --> 00:28:12,582
REIGNITED THE CANCER MOONSHOT

731
00:28:12,582 --> 00:28:14,483
WITH THE TWO-YEAR ANNIVERSARY

732
00:28:14,483 --> 00:28:17,653
BEING JUST LAST WEEK.

733
00:28:17,653 --> 00:28:21,190
SETTING REALLY BOLD BUT

734
00:28:21,190 --> 00:28:24,560
ACHIEVABLE GOALS.

735
00:28:24,560 --> 00:28:26,395
TO CUT THE CANCER DEATH RATE IN

736
00:28:26,395 --> 00:28:30,299
HALF BY 2027 AND END CANCER AS

737
00:28:30,299 --> 00:28:30,967
WE KNOW IT.

738
00:28:30,967 --> 00:28:33,402
IT'S GOING TO INVOLVE ALL OF OUR

739
00:28:33,402 --> 00:28:33,936
WORK.

740
00:28:33,936 --> 00:28:35,972
THIS IS GOING TO BE

741
00:28:35,972 --> 00:28:38,007
UNDERSTANDING CANCER BETTER.

742
00:28:38,007 --> 00:28:39,709
ALLOWING PEOPLE TO APPROACH A

743
00:28:39,709 --> 00:28:41,644
CANCER DIAGNOSIS WITHOUT AS MUCH

744
00:28:41,644 --> 00:28:43,913
FEAR PREVENTING A LOT OF CANCERS

745
00:28:43,913 --> 00:28:45,114
AND BEING ABLE TO REACH

746
00:28:45,114 --> 00:28:46,415
COMMUNITIES THAT PREVIOUSLY HAVE

747
00:28:46,415 --> 00:28:49,318
NOT HAD THE KINDS OF ACCESS WE

748
00:28:49,318 --> 00:28:50,820
NEED TO DO.

749
00:28:50,820 --> 00:28:55,825
WE CAN USE DATA AND SCIENCE AND

750
00:28:55,825 --> 00:28:58,461
GOOD INVESTIGATIVE SKILLS TO BE

751
00:28:58,461 --> 00:29:00,229
ABLE TO TACKLE WELL.

752
00:29:00,229 --> 00:29:02,031
SO THERE CAN'T EVER BE A BETTER

753
00:29:02,031 --> 00:29:04,000
TIME TO BE ENGAGED IN CANCER

754
00:29:04,000 --> 00:29:05,935
RESEARCH THAN TODAY WHEN WE HAVE

755
00:29:05,935 --> 00:29:07,536
A PRESIDENT AND A WHITE HOUSE

756
00:29:07,536 --> 00:29:09,472
THAT IS THIS BEHIND THE WORK

757
00:29:09,472 --> 00:29:11,607
THAT WE WANT TO DO AND NIH

758
00:29:11,607 --> 00:29:13,042
DIRECTOR, WE KNOW IS PASSIONATE

759
00:29:13,042 --> 00:29:14,343
ABOUT CANCER AS WELL.

760
00:29:14,343 --> 00:29:16,913
AND AN AMAZING NUMBER OF TOOLS

761
00:29:16,913 --> 00:29:20,016
TOGETHER TO BE ABLE TO ADDRESS

762
00:29:20,016 --> 00:29:22,785
THIS MAJOR PROBLEM.

763
00:29:22,785 --> 00:29:28,624
NEXT SLIDE.

764
00:29:28,624 --> 00:29:31,093
SO HOW DO WE BE WE ARE MAKING

765
00:29:31,093 --> 00:29:31,427
IMPROVEMENTS?

766
00:29:31,427 --> 00:29:33,296
WHEN FEWER PEOPLE DIE FROM

767
00:29:33,296 --> 00:29:33,529
CANCER.

768
00:29:33,529 --> 00:29:36,933
I WANT TO PUT A SLIDE UP FROM

769
00:29:36,933 --> 00:29:37,934
THE SEER DATABASE THAT SHOWS

770
00:29:37,934 --> 00:29:39,035
DECLINE IN LUNG CANCER.

771
00:29:39,035 --> 00:29:41,671
YOU CAN SEE DECLINES IN BREAST

772
00:29:41,671 --> 00:29:42,004
CANCER.

773
00:29:42,004 --> 00:29:43,940
A RECENT PUBLICATION I DIDN'T

774
00:29:43,940 --> 00:29:45,541
HAVE TIME TO PUT IN MY TALK

775
00:29:45,541 --> 00:29:47,109
TODAY, SHOWS IMPROVEMENTS IN

776
00:29:47,109 --> 00:29:48,811
MORTALITY THAT COME NOT ONLY

777
00:29:48,811 --> 00:29:50,346
FROM PREVENTION AND EARLY

778
00:29:50,346 --> 00:29:51,614
DETECTION BUT ALSO FROM

779
00:29:51,614 --> 00:29:58,721
MANAGEMENT OF METASTATIC DISEASE

780
00:29:58,721 --> 00:30:01,624
AND PEOPLE ARE ALSO LIVING

781
00:30:01,624 --> 00:30:02,625
LONGER, INCLUDING IMPROVEMENTS

782
00:30:02,625 --> 00:30:04,560
IN COLORECTAL MORTALITY AS WELL.

783
00:30:04,560 --> 00:30:06,128
I'M JUST GOING TO GIVE YOU A

784
00:30:06,128 --> 00:30:08,564
COUPLE OF GOOD WINS.

785
00:30:08,564 --> 00:30:09,298
NEXT SLIDE.

786
00:30:09,298 --> 00:30:12,935
SO WE JUST ANNOUNCED A COUPLE OF

787
00:30:12,935 --> 00:30:16,339
WEEKS AGO, THE NETWORK.

788
00:30:16,339 --> 00:30:18,040
THIS IS IN THE NATIONAL CANCER

789
00:30:18,040 --> 00:30:22,645
PLAN THEME OF EARLY DETECTION.

790
00:30:22,645 --> 00:30:23,746
SOCIAL EARLY DETECTION CAN ONLY

791
00:30:23,746 --> 00:30:25,982
HAPPEN WHEN PEOPLE HAVE ACCESS

792
00:30:25,982 --> 00:30:27,583
TO THE TOOLS TO BE DOING THE

793
00:30:27,583 --> 00:30:29,151
EARLY DETECTION TESTING

794
00:30:29,151 --> 00:30:29,852
NECESSARY.

795
00:30:29,852 --> 00:30:32,355
SO THIS IS A SELF COLLECTION FOR

796
00:30:32,355 --> 00:30:35,958
HPB TESTING TO IMPROVE SERVING

797
00:30:35,958 --> 00:30:37,560
CALL CANCER PREVENTION.

798
00:30:37,560 --> 00:30:39,996
THAT'S THE SHIP TRIAL NETWORK.

799
00:30:39,996 --> 00:30:41,964
IT'S INTENTIONALLY DEVELOPED

800
00:30:41,964 --> 00:30:44,367
WITH COLLABORATION FROM FEDERAL

801
00:30:44,367 --> 00:30:47,803
AND PRIVATE SECTOR PARTNERS WITH

802
00:30:47,803 --> 00:30:50,439
PATIENT ADVOCACY GROUPS AS WELL

803
00:30:50,439 --> 00:30:51,540
ADDRESSING DISPARITIES.

804
00:30:51,540 --> 00:30:54,276
THE GROUPS THAT WERE SELECTED TO

805
00:30:54,276 --> 00:30:59,582
PILOT THE NETWORK ALL HAVE

806
00:30:59,582 --> 00:31:01,083
POPULATIONS WHO NEED TO HAVE

807
00:31:01,083 --> 00:31:03,786
ACCESS TO TESTING FOR HPV SO

808
00:31:03,786 --> 00:31:06,188
THEY CAN BE RISK ASSESSED AND

809
00:31:06,188 --> 00:31:08,057
MANAGED EFFECTIVELY BEYOND THAT.

810
00:31:08,057 --> 00:31:09,592
AND THIS IS A TRIAL THAT I'M

811
00:31:09,592 --> 00:31:11,894
REALLY EXCITED ABOUT BECAUSE IT

812
00:31:11,894 --> 00:31:13,195
ENGAGES THE COMMUNITY DIRECTLY.

813
00:31:13,195 --> 00:31:16,298
THE OTHER COMPONENT IS ENGAGE

814
00:31:16,298 --> 00:31:22,004
EVERY PERSON, IS RIGHT HERE.

815
00:31:22,004 --> 00:31:23,472
THERE ARE SO MANY BIG WINS.

816
00:31:23,472 --> 00:31:25,608
I COULD SPEND MY WHOLE TALK

817
00:31:25,608 --> 00:31:27,410
TELLING YOU ABOUT NEW ADVANCES

818
00:31:27,410 --> 00:31:28,878
SINCE THE LAST MEETING.

819
00:31:28,878 --> 00:31:29,979
I'M NOT GOING TO GO THROUGH ANY

820
00:31:29,979 --> 00:31:30,513
OF THESE.

821
00:31:30,513 --> 00:31:32,014
I WANT TO POINT OUT THAT WE DO

822
00:31:32,014 --> 00:31:34,817
TRY TO KEEP UP WITH SOME OF THE

823
00:31:34,817 --> 00:31:37,186
HIGHER LEVEL THINGS ON A

824
00:31:37,186 --> 00:31:37,553
CANCER.GOV BLOG.

825
00:31:37,553 --> 00:31:38,921
SO IF YOU'RE INTERESTED OR WANT

826
00:31:38,921 --> 00:31:40,689
SOME GOOD STORIES TO TELL,

827
00:31:40,689 --> 00:31:43,559
THAT'S A GOOD PLACE TO GO.

828
00:31:43,559 --> 00:31:44,894
NEXT SLIDE.

829
00:31:44,894 --> 00:31:46,228
ANOTHER COUPLE OF THINGS THAT I

830
00:31:46,228 --> 00:31:49,131
JUST WANT TO SHARE.

831
00:31:49,131 --> 00:31:51,500
THIS ONE IS DATA THAT JUST COMES

832
00:31:51,500 --> 00:31:54,303
FROM TAKING A LOOK AT OUR FUNDED

833
00:31:54,303 --> 00:31:57,039
NCI CANCER EPIDEMIOLOGY COHORTS.

834
00:31:57,039 --> 00:32:00,609
SO, THIS IS JUST COMPARING THE

835
00:32:00,609 --> 00:32:02,711
PATIENTS OR INDIVIDUALS WHO ARE

836
00:32:02,711 --> 00:32:05,948
A PART OF THE COHORTS FROM

837
00:32:05,948 --> 00:32:07,416
HISTORICAL COHORTS TO MORE

838
00:32:07,416 --> 00:32:09,552
RECENT COHORTS.

839
00:32:09,552 --> 00:32:10,386
AND WHEN WE THINK ABOUT THE

840
00:32:10,386 --> 00:32:12,221
NATIONAL CANCER PLAN AND ITS

841
00:32:12,221 --> 00:32:14,824
GOAL TO ELIMINATE INEQUITIES, WE

842
00:32:14,824 --> 00:32:18,227
CAN SEE THAT MODERN NCI FUNDED

843
00:32:18,227 --> 00:32:20,329
CANCER EPIDEMIOLOGY COHORTS HAVE

844
00:32:20,329 --> 00:32:23,933
A MUCH BROADER DISTRIBUTION OF

845
00:32:23,933 --> 00:32:24,233
PATIENTS.

846
00:32:24,233 --> 00:32:26,268
YOU CAN SEE THE SHIFT FROM

847
00:32:26,268 --> 00:32:33,843
PREVIOUSLY 63% WHITE AND VERY

848
00:32:33,843 --> 00:32:37,546
FEW RACIAL OR ETHNIC MINORITIES,

849
00:32:37,546 --> 00:32:40,416
TO NOW BEING NICELY DIVERSE

850
00:32:40,416 --> 00:32:42,518
GROUP THAT HAS OCCURRED PARTLY

851
00:32:42,518 --> 00:32:44,120
INTENTIONS AND PARTLY

852
00:32:44,120 --> 00:32:44,620
ORGANICALLY.

853
00:32:44,620 --> 00:32:46,822
SO WE WILL HAVE BETTER DATA AND

854
00:32:46,822 --> 00:32:50,559
BETTER ABLE TO SERVE ALL OF OUR

855
00:32:50,559 --> 00:32:53,362
POPULATIONS.

856
00:32:53,362 --> 00:32:54,930
ANOTHER EPIDEMIOLOGY STUDY TOOK

857
00:32:54,930 --> 00:32:57,600
A LOOK AT CIGARETTE SMOKING.

858
00:32:57,600 --> 00:32:58,567
THIS WAS AN INTERESTING

859
00:32:58,567 --> 00:33:00,069
PARTNERSHIP BETWEEN THE NCI AND

860
00:33:00,069 --> 00:33:01,937
THE U.S. CENSUS BUREAU TO TAKE A

861
00:33:01,937 --> 00:33:04,940
LOOK AT CIGARETTE SMOKING AMONG

862
00:33:04,940 --> 00:33:05,241
TEENAGERS.

863
00:33:05,241 --> 00:33:07,376
IN THE ARENA OF PREVENTION, AND

864
00:33:07,376 --> 00:33:09,111
ALSO MAXIMIZING DATA UTILITY,

865
00:33:09,111 --> 00:33:13,549
YOU CAN SEE THAT ONE OF THE

866
00:33:13,549 --> 00:33:15,851
MAJOR DRIVERS OF CANCER IS

867
00:33:15,851 --> 00:33:17,353
UNDERGOING A GENERATIONAL

868
00:33:17,353 --> 00:33:17,586
CHANGE.

869
00:33:17,586 --> 00:33:19,655
AND WITH TEENAGERS NOT SMOKING,

870
00:33:19,655 --> 00:33:21,357
WE KNOW THAT THEY ARE LESS

871
00:33:21,357 --> 00:33:23,259
LIKELY TO TAKE UP CIGARETTE

872
00:33:23,259 --> 00:33:24,360
SMOKING LATER IN LIFE.

873
00:33:24,360 --> 00:33:26,061
WE CAN EXPECT THAT IN THE NOT

874
00:33:26,061 --> 00:33:28,564
THAT DISTANT FUTURE, OUR

875
00:33:28,564 --> 00:33:29,532
DEMOGRAPHICS OF CANCERS ARE

876
00:33:29,532 --> 00:33:31,467
GOING TO SHIFT BECAUSE OF THIS

877
00:33:31,467 --> 00:33:31,867
CHANGE.

878
00:33:31,867 --> 00:33:34,236
NOW, YOU CAN ALSO SEE A REALLY

879
00:33:34,236 --> 00:33:35,971
INTERESTING LINE, GOLD AND

880
00:33:35,971 --> 00:33:37,873
YELLOW LINES ARE THE DOWNWARD

881
00:33:37,873 --> 00:33:41,143
CIGARETTE SMOKING BUT AT THE END

882
00:33:41,143 --> 00:33:42,978
IN THE TEAL AND BLUE IS VAPING.

883
00:33:42,978 --> 00:33:46,682
SO THERE IS A WHOLE SHIFT IN

884
00:33:46,682 --> 00:33:48,083
WHAT PEOPLE ARE DOING IN TERMS

885
00:33:48,083 --> 00:33:49,585
OF THEIR EXPOSURES.

886
00:33:49,585 --> 00:33:51,220
AND WE WILL HAVE TO FOLLOW WHAT

887
00:33:51,220 --> 00:33:52,788
IT DOES AND WE WILL BE THERE TO

888
00:33:52,788 --> 00:33:55,958
KEEP UP WITH IT.

889
00:33:55,958 --> 00:33:58,060
NEXT SLIDE.

890
00:33:58,060 --> 00:34:01,530
SO, WITH THAT, I'M GOING TO

891
00:34:01,530 --> 00:34:01,730
CLOSE.

892
00:34:01,730 --> 00:34:03,465
THE TAKEAWAYS ARE THE BUDGET

893
00:34:03,465 --> 00:34:05,768
OUTLOOK IS TIGHT.

894
00:34:05,768 --> 00:34:08,971
THIS IS A AI-GENERATED IMAGE OF

895
00:34:08,971 --> 00:34:10,172
A PRESSURE COOKER TO POINT OUT

896
00:34:10,172 --> 00:34:12,508
THAT WE HAVE SOME HEADWINDS.

897
00:34:12,508 --> 00:34:13,509
WE HAVE SOME CHALLENGING

898
00:34:13,509 --> 00:34:15,010
SITUATIONS AND THAT IS WHERE IT

899
00:34:15,010 --> 00:34:16,512
WILL FORCE US TO THINK

900
00:34:16,512 --> 00:34:17,980
CREATIVELY AND THOSE CREATIVE

901
00:34:17,980 --> 00:34:19,582
SOLUTIONS ARE GOING TO BE THE

902
00:34:19,582 --> 00:34:21,984
FUTURE OF WHAT WE DO HERE AT THE

903
00:34:21,984 --> 00:34:22,184
NCI.

904
00:34:22,184 --> 00:34:24,086
IT WILL INVOLVE COLLABORATION.

905
00:34:24,086 --> 00:34:25,621
IT WILL INVOLVE EFFICIENTLY

906
00:34:25,621 --> 00:34:27,189
STEWARDING RESOURCES AND REALLY

907
00:34:27,189 --> 00:34:30,893
THINKING ABOUT WHAT WE CAN DO.

908
00:34:30,893 --> 00:34:32,695
OUR WORK WILL BENEFIT PEOPLE,

909
00:34:32,695 --> 00:34:33,796
PATIENTS AND FAMILIES THAT ARE

910
00:34:33,796 --> 00:34:35,097
TOUCHED BY CANCER.

911
00:34:35,097 --> 00:34:36,599
AND WE USE THE NATIONAL CANCER

912
00:34:36,599 --> 00:34:38,000
PLAN AS OUR ROADMAP.

913
00:34:38,000 --> 00:34:40,002
THE MOONSHOT AS OUR GOALPOST AND

914
00:34:40,002 --> 00:34:41,737
WITH THAT, WE CAN END CANCER AS

915
00:34:41,737 --> 00:34:42,605
WE KNOW IT.

916
00:34:42,605 --> 00:34:44,707
AND EVERYONE HAS A ROLE.

917
00:34:44,707 --> 00:34:46,609
SO I WANT TO THANK YOU AND I

918
00:34:46,609 --> 00:34:48,811
HOPE I SAVED TIME FOR QUESTIONS

919
00:34:48,811 --> 00:34:52,214
AND I'D LOVE IT HEAR FROM YOU.

920
00:34:52,214 --> 00:34:57,086
>> THAT WAS FANTASTIC,.

921
00:34:57,086 --> 00:34:59,922
THAT WAS A GREAT INAUGURAL NCAB

922
00:34:59,922 --> 00:35:00,723
DIRECTOR'S REPORT.

923
00:35:00,723 --> 00:35:01,523
VERY GOOD.

924
00:35:01,523 --> 00:35:06,061
ANY QUESTIONS FROM THE

925
00:35:06,061 --> 00:35:06,428
COMMITTEE?

926
00:35:06,428 --> 00:35:09,798
I CAN START WITH - YOU CAPTURED

927
00:35:09,798 --> 00:35:12,534
MY THOUGHTS AND IMAGINATION WITH

928
00:35:12,534 --> 00:35:13,669
YOUR COMMENTS RELATED TO

929
00:35:13,669 --> 00:35:17,106
CLINICAL TRIALS AND DATA.

930
00:35:17,106 --> 00:35:21,844
AND BUT YOU KNOW, WE WANT TO

931
00:35:21,844 --> 00:35:23,712
SORT OF INTEGRATE THAT WITH

932
00:35:23,712 --> 00:35:24,346
ACCESS, RIGHT?

933
00:35:24,346 --> 00:35:26,949
SO I'D LOVE TO GET YOUR THOUGHTS

934
00:35:26,949 --> 00:35:30,619
ON SORT OF THE NCI'S DIRECTION

935
00:35:30,619 --> 00:35:33,589
AND EXPANDING AND EXTENDING

936
00:35:33,589 --> 00:35:35,724
CLINICAL TRIALS.

937
00:35:35,724 --> 00:35:36,325
>> ABSOLUTELY.

938
00:35:36,325 --> 00:35:37,726
SO, I WAS LOOKING TO SEE WHERE

939
00:35:37,726 --> 00:35:39,728
IT LANDED ON THE COMMITTEE.

940
00:35:39,728 --> 00:35:42,331
WE ARE GOING TO TALK ABOUT THAT

941
00:35:42,331 --> 00:35:46,335
A LITTLE BIT LATER, LATE IN THE

942
00:35:46,335 --> 00:35:46,635
AFTERNOON.

943
00:35:46,635 --> 00:35:49,138
SO, THERE IS A LOT -- THAT IS A

944
00:35:49,138 --> 00:35:50,339
BIG QUESTION WITH LOTS OF

945
00:35:50,339 --> 00:35:52,041
DIFFERENT ANSWERS TO GIVE.

946
00:35:52,041 --> 00:35:53,242
BUT, ONE OF THE THINGS THAT

947
00:35:53,242 --> 00:35:55,844
WE'LL TALK ABOUT IS TRYING TO

948
00:35:55,844 --> 00:35:56,945
GET MORE INFORMATION ABOUT WHERE

949
00:35:56,945 --> 00:35:59,548
THE REAL NEEDS ARE AND WHERE THE

950
00:35:59,548 --> 00:36:03,052
NCI HAS OPPORTUNITIES FOR

951
00:36:03,052 --> 00:36:06,488
PARTNERSHIP AND WHERE USING NCOR

952
00:36:06,488 --> 00:36:09,591
OR WORKING WITH THE V.A. OR

953
00:36:09,591 --> 00:36:10,192
WORKING ACROSS VASE SPACES TO

954
00:36:10,192 --> 00:36:12,061
TRY TO MAKE SURE WE CAN MAKE

955
00:36:12,061 --> 00:36:14,430
ACCESS REAL SO WE CAN -- THE

956
00:36:14,430 --> 00:36:15,864
FUNDAMENTAL PROBLEM WE ARE

957
00:36:15,864 --> 00:36:17,199
TRYING TO ADDRESS IS THAT

958
00:36:17,199 --> 00:36:19,568
OUTCOMES ARE POORER IN CERTAIN

959
00:36:19,568 --> 00:36:23,572
REGIONS, RURAL, URBAN CORE,

960
00:36:23,572 --> 00:36:25,674
OTHER COMPONENTS OF AMERICAN

961
00:36:25,674 --> 00:36:26,575
LIFE.

962
00:36:26,575 --> 00:36:28,410
SO, WHAT IS THE PROBLEM WE CAN

963
00:36:28,410 --> 00:36:29,645
ADDRESS AND WHAT IS THE BEST WAY

964
00:36:29,645 --> 00:36:31,313
TO ADDRESS THAT AS A COMMITTEE

965
00:36:31,313 --> 00:36:33,482
I'M PLANNING TO CHARGE?

966
00:36:33,482 --> 00:36:34,016
>> SO THANKS.

967
00:36:34,016 --> 00:36:34,950
AND YOU'RE RIGHT.

968
00:36:34,950 --> 00:36:36,785
I KNOW WE'RE GOING IT HAVE SOME

969
00:36:36,785 --> 00:36:37,553
ADDITIONAL TIME TO CHAT ABOUT

970
00:36:37,553 --> 00:36:38,687
THAT LATER IN THE DAY.

971
00:36:38,687 --> 00:36:41,023
I DO HAVE ONE OTHER QUESTION.

972
00:36:41,023 --> 00:36:42,858
I THINK WE ALL HAVE SEEN ALL OF

973
00:36:42,858 --> 00:36:45,361
THE ACTIVITY AROUND AI AND

974
00:36:45,361 --> 00:36:46,962
MACHINE LEARNING AND LARGE

975
00:36:46,962 --> 00:36:49,264
LANGUAGE MODELS.

976
00:36:49,264 --> 00:36:51,333
OF COURSE IN THE PRIVATE SECTOR

977
00:36:51,333 --> 00:36:53,369
THERE IS JUST TREMENDOUS

978
00:36:53,369 --> 00:36:53,802
ACTIVITY.

979
00:36:53,802 --> 00:36:55,371
SO I WANTED TO GET YOUR THOUGHTS

980
00:36:55,371 --> 00:36:58,674
ON WHAT DO YOU THINK THE ROLE OF

981
00:36:58,674 --> 00:37:00,075
ACADEMIC RESEARCH AND HOW THAT

982
00:37:00,075 --> 00:37:02,578
WILL BE BROUGHT TO BEAR?

983
00:37:02,578 --> 00:37:03,779
I THINK ONE OF THE CHALLENGES

984
00:37:03,779 --> 00:37:07,082
WITH AI, LOOK TAT LIKE A CHILD.

985
00:37:07,082 --> 00:37:10,085
YOU TEACH IT, IT WILL LEARN ONLY

986
00:37:10,085 --> 00:37:11,086
WHAT INFORMATION THAT ITS FED

987
00:37:11,086 --> 00:37:13,989
AND IF IT'S NOT FED ALL OF THE

988
00:37:13,989 --> 00:37:15,524
INFORMATION, THEN THE MODELS MAY

989
00:37:15,524 --> 00:37:16,992
NOT NECESSARILY BE OPTIMAL.

990
00:37:16,992 --> 00:37:19,294
SO I WANTED TO GET YOUR

991
00:37:19,294 --> 00:37:19,561
THOUGHTS.

992
00:37:19,561 --> 00:37:21,497
AND THE WHAT ACTIVITIES ARE

993
00:37:21,497 --> 00:37:23,298
ONGOING INSIDE OF NCI TO HELP

994
00:37:23,298 --> 00:37:26,402
ADDRESS SOME OF THESE ISSUES

995
00:37:26,402 --> 00:37:29,037
WITH THE -- IT'S NOT IN THE

996
00:37:29,037 --> 00:37:29,271
FUTURE.

997
00:37:29,271 --> 00:37:29,705
WE'RE HERE.

998
00:37:29,705 --> 00:37:33,208
>> I AGREE WITH YOU 100%.

999
00:37:33,208 --> 00:37:34,009
IT'S HERE.

1000
00:37:34,009 --> 00:37:36,678
I EXPECT IT WILL HAVE THE SAME

1001
00:37:36,678 --> 00:37:39,715
IMPACT ON OUR LIVES THAT THE

1002
00:37:39,715 --> 00:37:40,449
TRANSITION BEFORE THERE WAS

1003
00:37:40,449 --> 00:37:42,351
INTERNET AND THEN AFTER

1004
00:37:42,351 --> 00:37:42,618
INTERNET.

1005
00:37:42,618 --> 00:37:44,720
AND I CAN'T EVEN QUITE IMAGINE

1006
00:37:44,720 --> 00:37:46,021
WHAT IT'S GOING TO BE LIKE 10

1007
00:37:46,021 --> 00:37:47,723
YEARS FROM NOW WHEN WE'RE USING

1008
00:37:47,723 --> 00:37:48,357
IT WELL.

1009
00:37:48,357 --> 00:37:51,560
WHAT I WORRY ABOUT IS THAT THE

1010
00:37:51,560 --> 00:37:54,329
HEALTH CARE FIELDS WILL BE SLOW

1011
00:37:54,329 --> 00:37:56,632
TO UPTAKE AND BUT THERE IS SO

1012
00:37:56,632 --> 00:37:58,000
MUCH ENERGY IN THIS SPACE, I

1013
00:37:58,000 --> 00:37:58,801
DON'T THINK THAT THAT WILL BE

1014
00:37:58,801 --> 00:38:00,369
THE CASE.

1015
00:38:00,369 --> 00:38:03,839
SO, THE NCI HAS SEVERAL WORKING

1016
00:38:03,839 --> 00:38:06,241
GROUPS THAT WORK WITHIN IT,

1017
00:38:06,241 --> 00:38:08,343
WITHIN OUR CURRENT IT

1018
00:38:08,343 --> 00:38:10,846
STRUCTURES, AND BIOINFORMATIC

1019
00:38:10,846 --> 00:38:15,217
STRUCTURES WHO ARE WORKING ON

1020
00:38:15,217 --> 00:38:16,952
OPPORTUNITIES IN THE AI SPACE.

1021
00:38:16,952 --> 00:38:18,887
THIS IS NOT MY ZONE SO I DON'T

1022
00:38:18,887 --> 00:38:23,192
HAVE QUITE ALL THE WORDS FOR IT,

1023
00:38:23,192 --> 00:38:24,259
BUT THERE ARE THINK TANKS

1024
00:38:24,259 --> 00:38:25,360
HAPPENING AROUND THE COUNTRY AND

1025
00:38:25,360 --> 00:38:28,030
WE ARE MAKING SURE THAT WE ARE

1026
00:38:28,030 --> 00:38:29,097
REPRESENTATIVE OF THOSE THINK

1027
00:38:29,097 --> 00:38:30,432
TANKS AND WE HAVE PEOPLE WHO CAN

1028
00:38:30,432 --> 00:38:32,234
SHARE WHAT WE ARE DOING AT THE

1029
00:38:32,234 --> 00:38:33,969
NCI AND BRINGING THINGS BACK AS

1030
00:38:33,969 --> 00:38:34,169
WELL.

1031
00:38:34,169 --> 00:38:36,672
CERTAINLY THERE IS A LOT OF

1032
00:38:36,672 --> 00:38:38,440
FUNDED RESEARCH GOING ON IN THIS

1033
00:38:38,440 --> 00:38:42,411
SPACE, AND A LOT OF EXCITEMENT

1034
00:38:42,411 --> 00:38:44,646
AROUND SIMPER THINGS THAT IT CAN

1035
00:38:44,646 --> 00:38:48,250
DO IN IMAGE ANALYSIS.

1036
00:38:48,250 --> 00:38:50,552
BUT ALSO GETTING INTO NATURAL

1037
00:38:50,552 --> 00:38:52,187
LANGUAGE PROCESSING AND BEING

1038
00:38:52,187 --> 00:38:55,090
ABLE TO UTILIZE THESE LARGE

1039
00:38:55,090 --> 00:38:55,457
DATASETS.

1040
00:38:55,457 --> 00:38:56,458
AND THEN THE OTHER THING I'LL

1041
00:38:56,458 --> 00:38:59,595
SAY IS, THIS IS NOT AN

1042
00:38:59,595 --> 00:39:01,163
NCI-UNIQUE THING.

1043
00:39:01,163 --> 00:39:02,764
IT WILL BE PARTNERSHIPS WITH THE

1044
00:39:02,764 --> 00:39:05,000
GREATER NIH, WHICH I'M REALLY

1045
00:39:05,000 --> 00:39:05,901
EXCITED ABOUT.

1046
00:39:05,901 --> 00:39:08,470
MONICA IS A HUGE CHAMPION OF

1047
00:39:08,470 --> 00:39:11,473
DATA UTILIZATION DATA ACCESS.

1048
00:39:11,473 --> 00:39:15,077
AND USING BIG DATA TO ANSWER

1049
00:39:15,077 --> 00:39:15,344
QUESTIONS.

1050
00:39:15,344 --> 00:39:19,581
AND SO SHE, I'M SURE, WILL BE A

1051
00:39:19,581 --> 00:39:20,582
CHAMPION FOR BRINGING THESE

1052
00:39:20,582 --> 00:39:23,018
KINDS OF DATASETS TOGETHER.

1053
00:39:23,018 --> 00:39:25,921
>> MAYBE A TOPIC FOR
FUTURE

1054
00:39:25,921 --> 00:39:27,222
MEETING FOR SURE.

1055
00:39:27,222 --> 00:39:29,157
SORT OF INTERNAL INITIATIVES.

1056
00:39:29,157 --> 00:39:32,327
FOR ME, I'M NOT AS AFRAID OF

1057
00:39:32,327 --> 00:39:33,128
SLOW UPTAKE.

1058
00:39:33,128 --> 00:39:36,865
I'M AFRAID THERE WILL BE SWIFT

1059
00:39:36,865 --> 00:39:38,800
UPTAKE OF SUBOPTIMAL APPROACHES.

1060
00:39:38,800 --> 00:39:42,771
THAT'S WHAT SCARES ME THE MOST.

1061
00:39:42,771 --> 00:39:43,839
ISABEL?

1062
00:39:43,839 --> 00:39:54,316
MAKE SURE YOU'RE UNMUTED.

1063
00:39:54,316 --> 00:39:55,417
>> I APPRECIATE YOU
BRINGING UP

1064
00:39:55,417 --> 00:39:57,653
THIS TOPIC BECAUSE THIS IS

1065
00:39:57,653 --> 00:39:59,555
ALREADY A HUGE SUBJECT WITH

1066
00:39:59,555 --> 00:40:00,923
PATIENT ADVOCATES WHO ARE EVEN

1067
00:40:00,923 --> 00:40:05,327
NOW AS WE SPEAK, CRAFTING AN AI

1068
00:40:05,327 --> 00:40:05,961
PATIENT BILL OF RIGHTS BECAUSE

1069
00:40:05,961 --> 00:40:07,429
THEY ARE REALLY CONCERNED ABOUT

1070
00:40:07,429 --> 00:40:10,566
LOSING CONTROL OF THEIR DATA, OF

1071
00:40:10,566 --> 00:40:14,136
IT BEING USED, ABUSED,

1072
00:40:14,136 --> 00:40:14,403
ET CETERA.

1073
00:40:14,403 --> 00:40:17,573
SO WHAT I ENCOURAGE YOU TO DO,

1074
00:40:17,573 --> 00:40:19,241
EVEN WITH INTERNAL COMMITTEES,

1075
00:40:19,241 --> 00:40:20,809
TO PLEASE BRING THOSE VOICES TO

1076
00:40:20,809 --> 00:40:21,843
THE TABLE BECAUSE THAT'S WHAT

1077
00:40:21,843 --> 00:40:22,544
THEY WANT.

1078
00:40:22,544 --> 00:40:24,513
THEY WANT A VOICE AT EVERY TABLE

1079
00:40:24,513 --> 00:40:25,714
THAT IS GOING TO BE UTILIZING

1080
00:40:25,714 --> 00:40:27,950
THEIR DATA AND THEY WANT IT TO

1081
00:40:27,950 --> 00:40:29,551
BE DONE FOR THE GREATER GOOD AND

1082
00:40:29,551 --> 00:40:31,019
FOR THEIR OWN GOOD HEALTH.

1083
00:40:31,019 --> 00:40:32,754
AND THEY FEAR THAT WITHOUT BEING

1084
00:40:32,754 --> 00:40:34,256
THERE, PEOPLE ARE GOING TO MISS

1085
00:40:34,256 --> 00:40:36,959
SOME VERY IMPORTANT ISSUES THAT

1086
00:40:36,959 --> 00:40:39,428
NEED TO BE ADDRESSED.

1087
00:40:39,428 --> 00:40:43,165
SO, I INVITE YOU, I'LL SEND YOU

1088
00:40:43,165 --> 00:40:45,467
MY GROUP.

1089
00:40:45,467 --> 00:40:45,734
>> OKAY.

1090
00:40:45,734 --> 00:40:46,168
>> THANK YOU.

1091
00:40:46,168 --> 00:40:48,170
BECAUSE THOSE OF US OUTSIDE ARE

1092
00:40:48,170 --> 00:40:51,873
VERY CONCERNED ABOUT THIS ISSUE.

1093
00:40:51,873 --> 00:40:52,641
>> OKAY.

1094
00:40:52,641 --> 00:40:52,941
UNDERSTOOD.

1095
00:40:52,941 --> 00:40:56,778
>> I GUESS ONE OTHER
QUESTION, I

1096
00:40:56,778 --> 00:40:58,780
DON'T SEE HANDS ON THE FIRST

1097
00:40:58,780 --> 00:40:59,648
PAGE.

1098
00:40:59,648 --> 00:41:01,650
I'M TRYING TO MAKE SURE I SCAN

1099
00:41:01,650 --> 00:41:02,417
THE ENTIRE.

1100
00:41:02,417 --> 00:41:04,753
>> I THINK THERE IS SOME
CHATS.

1101
00:41:04,753 --> 00:41:05,587
>> -- VIRTUAL TABLE.

1102
00:41:05,587 --> 00:41:06,755
THERE IS A LOT OF ACTIVITY IN

1103
00:41:06,755 --> 00:41:08,290
THE CHAT.

1104
00:41:08,290 --> 00:41:09,658
JUST ONE OTHER QUESTION.

1105
00:41:09,658 --> 00:41:11,927
WHAT ARE YOUR THOUGHTS ABOUT

1106
00:41:11,927 --> 00:41:14,196
SORT OF THE INTEGRATIONS AND

1107
00:41:14,196 --> 00:41:17,499
DISCUSSIONS WITH CMS AND TRYING

1108
00:41:17,499 --> 00:41:19,901
TO UNDERSTAND PAY AND

1109
00:41:19,901 --> 00:41:22,871
REIMBURSEMENT AND ACCESS?

1110
00:41:22,871 --> 00:41:24,673
>> I WORRIED ABOUT THAT A
LOT

1111
00:41:24,673 --> 00:41:25,674
WHEN I WAS A DEPARTMENT OF

1112
00:41:25,674 --> 00:41:26,975
MEDICINE CHAIR SO I WORRY ABOUT

1113
00:41:26,975 --> 00:41:30,479
IT A LOT HERE AS WELL.

1114
00:41:30,479 --> 00:41:34,316
DO I HAVE MORE INTEL ON THAT?

1115
00:41:34,316 --> 00:41:36,184
THAT ANSWER IS NO.

1116
00:41:36,184 --> 00:41:36,785
NOT YET.

1117
00:41:36,785 --> 00:41:39,421
I'LL GO WITH NOT YET BECAUSE

1118
00:41:39,421 --> 00:41:42,758
IT'S STILL EARLY.

1119
00:41:42,758 --> 00:41:44,660
I THINK THAT WHEN WE LOOK AT

1120
00:41:44,660 --> 00:41:47,295
WHAT THE END GOAL OF THIS IS,

1121
00:41:47,295 --> 00:41:50,866
WE'RE GOING TO MAKE REALLY BIG

1122
00:41:50,866 --> 00:41:52,334
END ROADS WITH RESEARCH, BASIC

1123
00:41:52,334 --> 00:41:53,769
SCIENCE AND TRANSLATION AND

1124
00:41:53,769 --> 00:41:55,704
DISCOVERY ABOUT YOU THE BIGGEST

1125
00:41:55,704 --> 00:41:57,973
ONES WILL BE WITH ACCESS TO

1126
00:41:57,973 --> 00:41:58,540
CARE.

1127
00:41:58,540 --> 00:41:59,908
AND WITH A HEALTH CARE SYSTEM

1128
00:41:59,908 --> 00:42:02,210
THAT ALLOWS OUR PATIENTS TO GET

1129
00:42:02,210 --> 00:42:03,011
THE CARE THEY NEED WHEN THEY

1130
00:42:03,011 --> 00:42:06,615
NEED IT, WHERE THEY NEED IT.

1131
00:42:06,615 --> 00:42:09,584
SO, WE WANT TO BE PARTNERS IN

1132
00:42:09,584 --> 00:42:12,020
THAT TO EVERY BIT WE CAN.

1133
00:42:12,020 --> 00:42:14,623
>> SO WITH MOONSHOT AND
THE

1134
00:42:14,623 --> 00:42:16,692
CANCER CABINET, PERHAPS

1135
00:42:16,692 --> 00:42:18,827
OPPORTUNITIES ARE THERE TO

1136
00:42:18,827 --> 00:42:20,128
ENGAGE WITH THE WHITE HOUSE AND

1137
00:42:20,128 --> 00:42:23,398
BRING NCI CLOSER TO THE TABLE IN

1138
00:42:23,398 --> 00:42:25,233
THOSE DISCUSSIONS.

1139
00:42:25,233 --> 00:42:28,704
ADDITIONAL QUESTIONS?

1140
00:42:28,704 --> 00:42:32,040
>> YOU CAN TAKE A COUPLE
FROM

1141
00:42:32,040 --> 00:42:33,041
THE CHAT.

1142
00:42:33,041 --> 00:42:43,351
>> I CAN DO THAT.

1143
00:42:43,351 --> 00:42:49,591
SO, CAN WE TALK ABOUT -- HOWARD

1144
00:42:49,591 --> 00:42:52,227
FINGER HAD A COMMENT ABOUT BEING

1145
00:42:52,227 --> 00:42:53,328
IMPRESSED WITH THE FUNDING

1146
00:42:53,328 --> 00:42:54,930
ANNOUNCEMENT ABOUT PRAGMATIC

1147
00:42:54,930 --> 00:42:58,266
CLINICAL TRIALS AS NCAB

1148
00:42:58,266 --> 00:42:58,967
UNDERSTANDS THIS EXEMPLIFIES OUR

1149
00:42:58,967 --> 00:43:01,336
GOALS TO INNOVATIVE THOUGHT

1150
00:43:01,336 --> 00:43:05,240
MECHANISMS TO EXPAND ACCESS AND

1151
00:43:05,240 --> 00:43:07,275
OPPORTUNITY TO CONDUCT RESEARCH

1152
00:43:07,275 --> 00:43:07,943
ABOUT RESEARCH.

1153
00:43:07,943 --> 00:43:16,551
HOWARD, DO YOU WANT TO EXPAND ON

1154
00:43:16,551 --> 00:43:17,152
THAT?

1155
00:43:17,152 --> 00:43:21,656
>> I MEAN, AS I READ THAT

1156
00:43:21,656 --> 00:43:22,858
ANNOUNCEMENT LAST YEAR, IT

1157
00:43:22,858 --> 00:43:27,028
REALLY IMPRESSED ME.

1158
00:43:27,028 --> 00:43:30,065
IT WAS KIND OF AN INNOVATIVE

1159
00:43:30,065 --> 00:43:31,366
BECAUSE SOMETIMES WE KNOWLEDGE

1160
00:43:31,366 --> 00:43:32,868
ABOUT PRAGMATIC IN TERMS OF

1161
00:43:32,868 --> 00:43:34,469
COSTS AND MONEY AND THIS AND

1162
00:43:34,469 --> 00:43:34,770
THAT.

1163
00:43:34,770 --> 00:43:36,371
THE WAY THEY DESCRIBED IT IN THE

1164
00:43:36,371 --> 00:43:38,073
ANNOUNCEMENT, IT REALLY WAS

1165
00:43:38,073 --> 00:43:42,677
TRYING TO FOCUS ON PRAGMATIC TO

1166
00:43:42,677 --> 00:43:47,282
ACHIEVE AND HELP UNDERSERVED

1167
00:43:47,282 --> 00:43:48,984
POPULATIONS.

1168
00:43:48,984 --> 00:43:53,789
AND -- I JUST WANTED TO SORT OF

1169
00:43:53,789 --> 00:43:57,626
CLARIFY THAT AND WHEN WE ARE

1170
00:43:57,626 --> 00:43:59,961
GOING TO GET MORE LEARNINGS

1171
00:43:59,961 --> 00:44:04,366
ABOUT THE APPROACH TO USE THE

1172
00:44:04,366 --> 00:44:05,567
CLINICAL TRIAL ENTERPRISE IN A

1173
00:44:05,567 --> 00:44:10,338
WAY THAT IS INNOVATIVE AND

1174
00:44:10,338 --> 00:44:12,174
INVITES MORE, EVEN GRANT SUPPORT

1175
00:44:12,174 --> 00:44:15,310
FOR IT IF NEEDED.

1176
00:44:15,310 --> 00:44:16,778
>> YES, I THINK THAT --

1177
00:44:16,778 --> 00:44:18,113
PRAGMATIC TRIALS CAN MEAN A LOT

1178
00:44:18,113 --> 00:44:18,914
OF DIFFERENT THINGS.

1179
00:44:18,914 --> 00:44:22,551
I LOVE THEM BEST WHEN IT IS LIKE

1180
00:44:22,551 --> 00:44:24,586
COMMON SENSE CLINICAL TRIALS.

1181
00:44:24,586 --> 00:44:27,389
AND TRIALS THAT MEAN SOMETHING

1182
00:44:27,389 --> 00:44:28,723
TO PEOPLE IMMEDIATELY.

1183
00:44:28,723 --> 00:44:33,061
SO I THINK THAT IS WHAT THE

1184
00:44:33,061 --> 00:44:37,098
CURRENT ROUND SPEAKS TO ME WITH.

1185
00:44:37,098 --> 00:44:38,600
HERE AGAIN IT IS INTERESTING

1186
00:44:38,600 --> 00:44:40,202
COMING FROM SPENDING FOUR YEARS

1187
00:44:40,202 --> 00:44:41,837
A LITTLE BIT OUTSIDE OF CANCER

1188
00:44:41,837 --> 00:44:44,439
IN THE DEPARTMENT OF MEDICINE

1189
00:44:44,439 --> 00:44:47,509
WHERE A LOT OF OTHER ARENAS USE

1190
00:44:47,509 --> 00:44:49,411
PRAGMATIC TRIALS A LOT MORE

1191
00:44:49,411 --> 00:44:54,082
OFTEN TO MAKE SORT OF MEANINGFUL

1192
00:44:54,082 --> 00:44:57,085
DISCOVERIES THAT WILL CHANGE

1193
00:44:57,085 --> 00:44:58,086
PATIENT CARE FOR THE BETTER.

1194
00:44:58,086 --> 00:45:00,255
SOMETIMES THEY CAN SEEM ALMOST

1195
00:45:00,255 --> 00:45:01,223
LIKE MUNDANE QUESTIONS BUT IF

1196
00:45:01,223 --> 00:45:02,824
NOBODY KNOWS THE ANSWER, NOBODY

1197
00:45:02,824 --> 00:45:04,960
IS DOING THE RIGHT THING.

1198
00:45:04,960 --> 00:45:07,028
I THINK THOSE KINDS OF RESEARCH

1199
00:45:07,028 --> 00:45:08,330
AND THEN I THINK THE RESEARCH

1200
00:45:08,330 --> 00:45:09,798
ABOUT RESEARCH TO ME, I DON'T

1201
00:45:09,798 --> 00:45:14,336
KNOW IF YOU MEAN IMPLEMENTATION

1202
00:45:14,336 --> 00:45:16,438
RESEARCH OR RESEARCHING HOW WE

1203
00:45:16,438 --> 00:45:17,639
BEST ASK SOME OF THESE

1204
00:45:17,639 --> 00:45:21,743
QUESTIONS, THOSE ARE ALL SUPER

1205
00:45:21,743 --> 00:45:22,444
IMPORTANT.

1206
00:45:22,444 --> 00:45:25,146
>> AND I THINK STAYING
WITH THE

1207
00:45:25,146 --> 00:45:27,082
THEME OF CLINICAL TRIALS, I

1208
00:45:27,082 --> 00:45:27,916
THINK ANOTHER THING THAT WOULD

1209
00:45:27,916 --> 00:45:30,852
BE GREAT IS TO MAYBE AN UPCOMING

1210
00:45:30,852 --> 00:45:34,322
MEETING, GET UPDATES ON NCOR.

1211
00:45:34,322 --> 00:45:37,659
WE ALL KNOW IT'S AN AMAZING

1212
00:45:37,659 --> 00:45:39,027
PROGRAM AND IT WOULD BE GREAT TO

1213
00:45:39,027 --> 00:45:40,662
SEE WHERE THINGS ARE NOW AND

1214
00:45:40,662 --> 00:45:42,530
WHAT THE PLANS ARE FOR THE

1215
00:45:42,530 --> 00:45:42,864
FUTURE.

1216
00:45:42,864 --> 00:45:44,532
THAT MIGHT BE A GOOD FUTURE

1217
00:45:44,532 --> 00:45:45,166
TOPIC.

1218
00:45:45,166 --> 00:45:46,167
>> SOUNDS GOOD.

1219
00:45:46,167 --> 00:45:49,571
>> SO WE'LL MOVE ON TO THE
NEXT

1220
00:45:49,571 --> 00:45:51,539
AGENDA ITEM.

1221
00:45:51,539 --> 00:46:00,715
THAT IS LEGISLATIVE REPORT.

1222
00:46:00,715 --> 00:46:02,050
>> I WANT TO REMIND
EVERYONE

1223
00:46:02,050 --> 00:46:05,020
THERE IS A DETAILED LEGISLATIVE

1224
00:46:05,020 --> 00:46:06,354
UPDATE IN YOUR MEETING

1225
00:46:06,354 --> 00:46:06,688
MATERIALS.

1226
00:46:06,688 --> 00:46:10,358
WE ARE GOING TO FOCUS ON THE

1227
00:46:10,358 --> 00:46:12,227
HIGHLIGHTS TODAY.

1228
00:46:12,227 --> 00:46:13,828
I'D LIKE TO FOCUS ON WHAT IS

1229
00:46:13,828 --> 00:46:15,363
HAPPENING IN CONGRESS RIGHT NOW,

1230
00:46:15,363 --> 00:46:17,666
THE DEADLINES AND LEGISLATIVE

1231
00:46:17,666 --> 00:46:17,999
COMPLICATIONS.

1232
00:46:17,999 --> 00:46:20,135
IT IS A TENSE TIME ON CAPITOL

1233
00:46:20,135 --> 00:46:20,969
HILL.

1234
00:46:20,969 --> 00:46:21,636
CONGRESS IS FEEL CAN THE

1235
00:46:21,636 --> 00:46:23,738
PRESSURE OF A LOT OF DEADLINES

1236
00:46:23,738 --> 00:46:25,540
CONVERGING AT ONCE AND SOME

1237
00:46:25,540 --> 00:46:35,583
PRETTY SPECTACULAR IMPLOSIONS OF

1238
00:46:35,583 --> 00:46:35,884
LEGISLATION.

1239
00:46:35,884 --> 00:46:37,585
IT'S NOT AN EASY WEEK IN

1240
00:46:37,585 --> 00:46:38,086
CONGRESS.

1241
00:46:38,086 --> 00:46:40,055
POTENTIAL OUTCOMES OF FY24

1242
00:46:40,055 --> 00:46:41,056
APPROPRIATIONS IS ON EVERYONE'S

1243
00:46:41,056 --> 00:46:41,323
MIND.

1244
00:46:41,323 --> 00:46:42,824
I WANT TO WALK THROUGH SOME OF

1245
00:46:42,824 --> 00:46:43,491
THE POSSIBILITIES.

1246
00:46:43,491 --> 00:46:45,293
AND THEN REALLY TALK ABOUT

1247
00:46:45,293 --> 00:46:46,161
CONGRESSIONAL ENGAGEMENT AND WHY

1248
00:46:46,161 --> 00:46:47,562
IT'S SO IMPORTANT THAT THE

1249
00:46:47,562 --> 00:46:52,000
CANCER RESEARCH COMMUNITY BE

1250
00:46:52,000 --> 00:46:52,200
HEARD.

1251
00:46:52,200 --> 00:46:53,368
NEXT SLIDE.

1252
00:46:53,368 --> 00:46:55,170
SO I HAVE SHOWN THE BOARD THIS

1253
00:46:55,170 --> 00:46:56,071
SLIDE BEFORE.

1254
00:46:56,071 --> 00:46:57,772
UNFORTUNATELY, WE ARE STILL IN

1255
00:46:57,772 --> 00:47:00,275
THE EXACT SAME SPOT WITH, WE ARE

1256
00:47:00,275 --> 00:47:02,477
HERE BETWEEN STEPS TWO AND 3.

1257
00:47:02,477 --> 00:47:04,179
THE APPROPRIATIONS SUBCOMMITTEES

1258
00:47:04,179 --> 00:47:06,681
ARE STILL WORKING ON TRYING TO

1259
00:47:06,681 --> 00:47:08,383
GET APPROPRIATIONS BILLS READY

1260
00:47:08,383 --> 00:47:10,552
TO GO AND CONFERENCE BETWEEN THE

1261
00:47:10,552 --> 00:47:13,755
HOUSE AND SENATE.

1262
00:47:13,755 --> 00:47:16,992
UNFORTUNATELY, IT'S 131 DAYS

1263
00:47:16,992 --> 00:47:18,693
INTO THE FISCAL YEAR.

1264
00:47:18,693 --> 00:47:20,895
OUR SUBCOMMITTEES GOT THEIR

1265
00:47:20,895 --> 00:47:21,696
ALLOCATIONS.

1266
00:47:21,696 --> 00:47:23,732
12 SUBCOMMITTEES, A TOP LINE

1267
00:47:23,732 --> 00:47:26,001
SPENDING NUMBER, THE 12

1268
00:47:26,001 --> 00:47:28,003
SUBCOMMITTEES GET AN ALLOCATION.

1269
00:47:28,003 --> 00:47:29,604
THEY GOT THEIR ALLOCATION ABOUT

1270
00:47:29,604 --> 00:47:30,605
TWO WEEKS AGO.

1271
00:47:30,605 --> 00:47:32,574
SO WHY IS EVERYTHING SO LATE?

1272
00:47:32,574 --> 00:47:34,776
AS YOU MAY REMEMBER, THERE WAS A

1273
00:47:34,776 --> 00:47:36,778
FISCAL RESPONSIBILITY ACT

1274
00:47:36,778 --> 00:47:37,012
PASSED.

1275
00:47:37,012 --> 00:47:39,381
CAN WE HAVE THE NEXT SLIDE?

1276
00:47:39,381 --> 00:47:41,182
THE FISCAL RESPONSIBILITY ACT,

1277
00:47:41,182 --> 00:47:43,885
THERE WAS A LOT OF DISAGREEMENT

1278
00:47:43,885 --> 00:47:45,286
ABOUT WHETHER IT SUSPENDED THE

1279
00:47:45,286 --> 00:47:47,589
DEBT LIMIT AND SET BUDGET CAPS

1280
00:47:47,589 --> 00:47:48,823
FOR FY24 AND 25.

1281
00:47:48,823 --> 00:47:51,726
THE ISSUE OF DISAGREEMENT WAS

1282
00:47:51,726 --> 00:47:53,294
WHETHER THOSE CAPS WERE THE

1283
00:47:53,294 --> 00:47:57,132
AGREED UPON NUMBERS, WHICH

1284
00:47:57,132 --> 00:47:57,932
THREE-FOURTHS OF THE DECIDING

1285
00:47:57,932 --> 00:47:58,767
AUTHORITY FIGURES IN THE HOUSE

1286
00:47:58,767 --> 00:48:00,602
AND SENATE AGREED THAT THAT WAS

1287
00:48:00,602 --> 00:48:01,336
THE DEAL.

1288
00:48:01,336 --> 00:48:05,607
THE HOUSE GOP DECIDED THOSE WERE

1289
00:48:05,607 --> 00:48:06,441
CEILINGS AND NOT FLOORS.

1290
00:48:06,441 --> 00:48:09,210
SO THEY CHOSE TO MARK THEIRS UP

1291
00:48:09,210 --> 00:48:12,080
TO A LOWER LEVEL, WHICH CREATED

1292
00:48:12,080 --> 00:48:13,815
A LACK OF SYNCHRONIZATION WITH

1293
00:48:13,815 --> 00:48:15,717
THE HOUSE AND SENATE

1294
00:48:15,717 --> 00:48:16,618
APPROPRIATIONS COMMITTEES.

1295
00:48:16,618 --> 00:48:18,920
AND SO EVEN THOUGH THAT HAS BEEN

1296
00:48:18,920 --> 00:48:21,156
RESOLVED NOW, AT LEAST THE TOP

1297
00:48:21,156 --> 00:48:23,958
LINE, THE DIVIDE LINGERED FOR

1298
00:48:23,958 --> 00:48:25,126
6-7 MONTHS AND IT WAS A REAL

1299
00:48:25,126 --> 00:48:25,627
SLOW DOWN.

1300
00:48:25,627 --> 00:48:28,530
WHAT WE ARE SEEING HERE IN TERMS

1301
00:48:28,530 --> 00:48:31,466
OF LEGISLATIVE COMPLICATIONS,

1302
00:48:31,466 --> 00:48:35,103
THERE WERE PROCEDURAL VOTES WITH

1303
00:48:35,103 --> 00:48:36,838
HOUSE SPEAKER MIKE JOHNSON HAD A

1304
00:48:36,838 --> 00:48:38,039
REALLY ROUGH WEEK.

1305
00:48:38,039 --> 00:48:40,942
HE HAS A TWO-VOTE MAJORITY NOW.

1306
00:48:40,942 --> 00:48:42,243
SEVERAL MEMBERS WHO ARE NOT ABLE

1307
00:48:42,243 --> 00:48:44,779
TO BE IN CONGRESS RIGHT NOW.

1308
00:48:44,779 --> 00:48:46,347
STEVE SKA LEASE, THE MAJORITY

1309
00:48:46,347 --> 00:48:48,349
LEADER IS ON MEDICAL LEAVE, AND

1310
00:48:48,349 --> 00:48:51,186
CAUSING A TIGHT SQUEEZE FOR

1311
00:48:51,186 --> 00:48:52,120
HOUSE REPUBLICANS.

1312
00:48:52,120 --> 00:48:54,389
THERE WAS A VOTE FOR AN

1313
00:48:54,389 --> 00:48:56,057
IMPEACHMENT OF HOMELAND

1314
00:48:56,057 --> 00:48:57,659
SECRETARY THIS WEEK THAT WAS

1315
00:48:57,659 --> 00:48:58,827
EXPECTED TO BE A WIN.

1316
00:48:58,827 --> 00:49:00,728
IT WAS NOT.

1317
00:49:00,728 --> 00:49:04,132
AND THEN A STAND ALONE ISRAEL 8

1318
00:49:04,132 --> 00:49:05,567
BILL WAS ALSO DEFEATED.

1319
00:49:05,567 --> 00:49:07,635
THE HOUSE GOS GOING TO HAVE TO

1320
00:49:07,635 --> 00:49:09,938
RELY ON DEMOCRATS TO PASS THE

1321
00:49:09,938 --> 00:49:11,406
FY24 SPENDING BILLS, WHICH IS

1322
00:49:11,406 --> 00:49:13,741
GOING TO CREATE A LOT OF

1323
00:49:13,741 --> 00:49:14,142
CHALLENGES.

1324
00:49:14,142 --> 00:49:15,343
DEMOCRATS ARE NOT GOING TO

1325
00:49:15,343 --> 00:49:22,450
ACCEPT POLICY WRITERS AND NOT

1326
00:49:22,450 --> 00:49:24,052
ACCEPT GUTTING PROGRAMS THAT ARE

1327
00:49:24,052 --> 00:49:24,853
IMPORTANT TO THEM.

1328
00:49:24,853 --> 00:49:26,254
SO THERE WILL BE PUSH AND PULL

1329
00:49:26,254 --> 00:49:27,155
TO GET THOSE DONE.

1330
00:49:27,155 --> 00:49:28,389
WE ARE ALL CONCERNED ABOUT WHERE

1331
00:49:28,389 --> 00:49:30,892
THAT IS GOING TO LAND.

1332
00:49:30,892 --> 00:49:33,461
THE IMMIGRATION FOREIGN AID

1333
00:49:33,461 --> 00:49:34,462
SUPPLEMENTAL BILL FAILED AFTER

1334
00:49:34,462 --> 00:49:37,565
MONTHS OF BIPART SUDDEN

1335
00:49:37,565 --> 00:49:37,966
NEGOTIATION.

1336
00:49:37,966 --> 00:49:39,968
SENATE REPUBLICANS SAID WE WILL

1337
00:49:39,968 --> 00:49:41,202
ONLY VOTE FOR UKRAINE AID IF

1338
00:49:41,202 --> 00:49:42,770
THERE IS BORDER SECURITY

1339
00:49:42,770 --> 00:49:43,037
ATTACHED.

1340
00:49:43,037 --> 00:49:46,508
THEY WORKED ON THAT BILL.

1341
00:49:46,508 --> 00:49:48,643
THE SENATE FROM OKLAHOMA

1342
00:49:48,643 --> 00:49:51,479
REPRESENTED THE REPUBLICANS IN

1343
00:49:51,479 --> 00:49:52,914
THE SENATE.

1344
00:49:52,914 --> 00:49:54,382
ARIZONA WHO IS AN INDEPENDENT

1345
00:49:54,382 --> 00:49:56,985
NOW BUT CAUCASUS WITH THE

1346
00:49:56,985 --> 00:49:59,587
DEMOCRATS NOW, OBVIOUSLY A STATE

1347
00:49:59,587 --> 00:50:01,289
WHERE IMMIGRATION POLICY IS ON

1348
00:50:01,289 --> 00:50:03,892
TOP OF MIND FOR A LOT OF VOTERS.

1349
00:50:03,892 --> 00:50:05,393
AND ALSO SENATOR CHRIS MURPHY

1350
00:50:05,393 --> 00:50:07,495
FROM CONNECTICUT REPRESENTED THE

1351
00:50:07,495 --> 00:50:07,996
DEMOCRATS.

1352
00:50:07,996 --> 00:50:10,131
THEY WORKED FOR MONTHS ON THIS

1353
00:50:10,131 --> 00:50:10,431
LEGISLATION.

1354
00:50:10,431 --> 00:50:12,700
IT WAS -- THEY REVEALED THE DEAL

1355
00:50:12,700 --> 00:50:14,002
ON SUNDAY, SATURDAY OR SUNDAY OF

1356
00:50:14,002 --> 00:50:15,370
THIS PAST WEEKEND AND IT WAS

1357
00:50:15,370 --> 00:50:17,872
DEAD BY MONDAY.

1358
00:50:17,872 --> 00:50:19,407
ESSENTIALLY.

1359
00:50:19,407 --> 00:50:20,975
UNFORTUNATELY, THERE WAS A LOT,

1360
00:50:20,975 --> 00:50:22,443
THEY LOST GOP SUPPORT.

1361
00:50:22,443 --> 00:50:26,214
THERE WERE IMPLICATIONS FOR FY24

1362
00:50:26,214 --> 00:50:27,415
FUNDING BECAUSE THAT BILL WOULD

1363
00:50:27,415 --> 00:50:29,150
HAVE ALSO PROVIDED SUPPLEMENTAL

1364
00:50:29,150 --> 00:50:31,886
AID TO THE HOMELAND SECURITY

1365
00:50:31,886 --> 00:50:32,353
ACCOUNT.

1366
00:50:32,353 --> 00:50:37,425
THAT'S ONE OF THE 12 BILLS THAT

1367
00:50:37,425 --> 00:50:39,460
SHOWED WHICH ONES EXPIRED ON

1368
00:50:39,460 --> 00:50:40,929
MARCH 1 AND MARCH 8.

1369
00:50:40,929 --> 00:50:42,730
THAT IS ONE OF THOSE 12.

1370
00:50:42,730 --> 00:50:44,732
IF HOMELAND HAD GOTTEN SOME

1371
00:50:44,732 --> 00:50:46,834
FUNDING FROM THIS SUPPLEMENTAL

1372
00:50:46,834 --> 00:50:47,635
BILL, THERE WOULD BE A LITTLE

1373
00:50:47,635 --> 00:50:49,604
BIT MORE TO GO AROUND FOR THE

1374
00:50:49,604 --> 00:50:53,441
OTHER 11 BILLS.

1375
00:50:53,441 --> 00:50:55,243
UNFORTUNATELY, THAT BILL IS --

1376
00:50:55,243 --> 00:50:57,445
NO ONE THINKS THAT'S GOING TO BE

1377
00:50:57,445 --> 00:50:57,946
REVIVED AT THIS POINT.

1378
00:50:57,946 --> 00:50:59,781
THERE IS ALSO A TAX BILL THAT

1379
00:50:59,781 --> 00:51:01,849
PASSED THE HOUSE WITH LARGE

1380
00:51:01,849 --> 00:51:02,483
MARGINS.

1381
00:51:02,483 --> 00:51:03,551
WHAT IS IMPORTANT THERE REALLY

1382
00:51:03,551 --> 00:51:06,054
FOR OUR COMMUNITY IS THAT IT

1383
00:51:06,054 --> 00:51:07,555
INCLUDES A IMPORTANT FIX IN THE

1384
00:51:07,555 --> 00:51:10,692
TAX CODE FOR SBIR COMPANIES THAT

1385
00:51:10,692 --> 00:51:14,696
THEY WILL BE ABLE TO WRITE OFF

1386
00:51:14,696 --> 00:51:15,363
R&D COSTS.

1387
00:51:15,363 --> 00:51:17,165
THERE WAS A CHANGE IN A 2017 LAW

1388
00:51:17,165 --> 00:51:18,266
THAT MADE THAT DIFFICULT AND A

1389
00:51:18,266 --> 00:51:20,435
LOT OF SMALL COMPANIES ARE

1390
00:51:20,435 --> 00:51:21,169
FACING LARGE TAX BILLS.

1391
00:51:21,169 --> 00:51:24,138
THAT'S BEEN FIXED.

1392
00:51:24,138 --> 00:51:25,473
NEXT SLIDE.

1393
00:51:25,473 --> 00:51:26,808
FISCAL RESPONSIBILITY ACT.

1394
00:51:26,808 --> 00:51:31,346
SO, AS I SAID, THIS IS THE DEBT

1395
00:51:31,346 --> 00:51:32,046
LIMIT, THAT WAS GREAT.

1396
00:51:32,046 --> 00:51:34,082
BUDGET CUTS FOR 24 AND 25.

1397
00:51:34,082 --> 00:51:37,552
FOR FY24, THE DEAL WAS FOR FLAT

1398
00:51:37,552 --> 00:51:38,886
BUDGETS EXCEPT FOR A 3% INCREASE

1399
00:51:38,886 --> 00:51:40,288
FOR DEFENSE, WHICH IS WHAT

1400
00:51:40,288 --> 00:51:42,156
PRESIDENT BIDEN REQUESTED IN HIS

1401
00:51:42,156 --> 00:51:42,490
BUDGET.

1402
00:51:42,490 --> 00:51:45,193
AND THEN FOR FY25, A 1%

1403
00:51:45,193 --> 00:51:45,627
INCREASE.

1404
00:51:45,627 --> 00:51:48,696
IT ALSO INCLUDED A STICK, A

1405
00:51:48,696 --> 00:51:50,365
PENALTY TO INCENTIVIZE CONGRESS

1406
00:51:50,365 --> 00:51:52,400
TO COMPLETE ALL 12 SPENDING

1407
00:51:52,400 --> 00:51:52,700
BILLS.

1408
00:51:52,700 --> 00:51:54,702
IF ANY OF 12 BILLS ARE NOT

1409
00:51:54,702 --> 00:51:56,471
COMPLETED BY APRIL 30, THERE

1410
00:51:56,471 --> 00:51:58,906
WILL BE A SEQUESTRATION, A

1411
00:51:58,906 --> 00:52:01,776
BUDGET CUT, OF 1% TO ALL DEFENSE

1412
00:52:01,776 --> 00:52:06,180
AND NON-DEFENSE DISCRETIONARY

1413
00:52:06,180 --> 00:52:06,614
FUNDING.

1414
00:52:06,614 --> 00:52:08,483
EXCEPT FOR AGENCIES OR PROGRAMS

1415
00:52:08,483 --> 00:52:10,518
THAT ARE EXEMPT FROM

1416
00:52:10,518 --> 00:52:12,553
SEQUESTRATION, FOR EXAMPLE, THE

1417
00:52:12,553 --> 00:52:13,121
V.A. IS EXEMPT.

1418
00:52:13,121 --> 00:52:14,722
SO THAT IS GOING TO PUT MORE

1419
00:52:14,722 --> 00:52:17,292
PRESSURE ON ALL OF THE OTHER

1420
00:52:17,292 --> 00:52:18,793
DISCRETIONARY PROGRAMS.

1421
00:52:18,793 --> 00:52:21,195
OMB HAS SOLE RESPONSIBILITY FOR

1422
00:52:21,195 --> 00:52:22,797
IMPLEMENTING SEQUESTRATION.

1423
00:52:22,797 --> 00:52:24,832
SO WE HOPE WE DON'T FIND OUT HOW

1424
00:52:24,832 --> 00:52:26,234
THAT WILL BE DONE AND IT DOESN'T

1425
00:52:26,234 --> 00:52:28,903
HAPPEN AND THE BILLS ARE ALL

1426
00:52:28,903 --> 00:52:31,906
DONE BY THIS DATE, BUT IT IS

1427
00:52:31,906 --> 00:52:33,841
COMING PRETTY SOON.

1428
00:52:33,841 --> 00:52:35,243
SO, CONGRESS IS REALLY VERY

1429
00:52:35,243 --> 00:52:37,545
BEHIND IN TERMS OF TIME THEY

1430
00:52:37,545 --> 00:52:40,948
HAVE TO GET THESE DONE.

1431
00:52:40,948 --> 00:52:41,449
NEXT SLIDE, PLEASE.

1432
00:52:41,449 --> 00:52:45,186
I WANTED TO JUST REMIND YOU OF

1433
00:52:45,186 --> 00:52:47,522
THE NUMBERS OF -- AND

1434
00:52:47,522 --> 00:52:49,290
DR. RATHMELL SHOWED YOU THESE

1435
00:52:49,290 --> 00:52:50,925
DATA THAT IN THE SENATE, WE ARE

1436
00:52:50,925 --> 00:52:52,760
LOOKING AT -- IF THE SENATE

1437
00:52:52,760 --> 00:52:55,029
NUMBERS PREVAIL AND WE GET AN

1438
00:52:55,029 --> 00:52:57,231
APPROPRIATION FOR FY24, THAT IS

1439
00:52:57,231 --> 00:53:00,268
CLOSER TO WHAT THE SENATE MARKED

1440
00:53:00,268 --> 00:53:02,570
UP, THAT WOULD CLOSE THE GAP OF

1441
00:53:02,570 --> 00:53:05,740
THE FUNDING CLIFF FOR MOONSHOT

1442
00:53:05,740 --> 00:53:07,275
FUNDING BECAUSE THE MANDATORY

1443
00:53:07,275 --> 00:53:10,144
FUNDING STREAM FOR THE CANCER

1444
00:53:10,144 --> 00:53:11,879
MOONSHOT THAT WAS PROCURED

1445
00:53:11,879 --> 00:53:14,649
BECAUSE OF THE CURES AUTHORIZING

1446
00:53:14,649 --> 00:53:15,850
LAW, THE 21ST CENTURY CURES LAW,

1447
00:53:15,850 --> 00:53:18,653
THAT ENDED IN FY23.

1448
00:53:18,653 --> 00:53:21,556
AND SO WE WILL BE 216 MILLION

1449
00:53:21,556 --> 00:53:24,759
DOLLARS LESS IF WE WERE TO GET A

1450
00:53:24,759 --> 00:53:27,829
FULL YEAR CR OR IF THE

1451
00:53:27,829 --> 00:53:28,663
APPROPRIATORS DO NOT RESCUE US

1452
00:53:28,663 --> 00:53:30,398
FROM THAT CLIFF, THE PHRASE THAT

1453
00:53:30,398 --> 00:53:32,700
IS USED COMMONLY.

1454
00:53:32,700 --> 00:53:34,235
IT WAS NOT PART OF OUR BASE

1455
00:53:34,235 --> 00:53:36,871
BUDGET AND THE HOUSE DID NOT

1456
00:53:36,871 --> 00:53:38,373
INCLUDE ANY OF THE SUPPLEMENTAL

1457
00:53:38,373 --> 00:53:41,442
FUNDS FOR THE INNOVATIONS

1458
00:53:41,442 --> 00:53:41,743
ACCOUNTS.

1459
00:53:41,743 --> 00:53:43,778
NOT JUST US, IT'S ALSO ALL OF

1460
00:53:43,778 --> 00:53:44,212
US.

1461
00:53:44,212 --> 00:53:44,779
THAT PROGRAM.

1462
00:53:44,779 --> 00:53:47,048
IT'S ALSO THE BRAIN INITIATIVE.

1463
00:53:47,048 --> 00:53:48,583
THIEVES WERE ALL IN 21ST CENTURY

1464
00:53:48,583 --> 00:53:49,784
CURES AND THE FUNDING IS NOT IN

1465
00:53:49,784 --> 00:53:51,686
THE BASE BUDGET OF THE

1466
00:53:51,686 --> 00:53:53,254
INSTITUTES ADMINISTERING THOSE

1467
00:53:53,254 --> 00:53:53,888
PROGRAMS.

1468
00:53:53,888 --> 00:53:55,490
SO WE ARE HOPEFUL THAT WE GET A

1469
00:53:55,490 --> 00:53:56,858
NUMBER CLOSER TO THE SENATE.

1470
00:53:56,858 --> 00:53:58,493
BUT WE HAVE TO WAIT AND SEE.

1471
00:53:58,493 --> 00:53:59,594
AND THIS IS JUST SOMETHING THAT

1472
00:53:59,594 --> 00:54:02,864
IS IMPORTANT FOR US TO KEEP

1473
00:54:02,864 --> 00:54:04,632
REMINDING APPROPRIATIONS STAFF

1474
00:54:04,632 --> 00:54:07,368
AND MEMBERS OF CONGRESS WHO ASK

1475
00:54:07,368 --> 00:54:10,271
US SORT OF WHAT THE CONCERNS ARE

1476
00:54:10,271 --> 00:54:11,773
THAT THIS IS SOMETHING THAT

1477
00:54:11,773 --> 00:54:13,207
MIGHT NOT BE TOP OF MIND TO

1478
00:54:13,207 --> 00:54:13,641
THEM.

1479
00:54:13,641 --> 00:54:15,176
IT'S NOT A LARGE AMOUNT OF MONEY

1480
00:54:15,176 --> 00:54:16,611
IN THE CONTEXT OF THE WHOLE

1481
00:54:16,611 --> 00:54:17,879
FEDERAL BUDGET BUT IT IS

1482
00:54:17,879 --> 00:54:19,414
SIGNIFICANT FOR NCI AND THESE

1483
00:54:19,414 --> 00:54:19,680
PROGRAMS.

1484
00:54:19,680 --> 00:54:22,817
NEXT SLIDE, PLEASE.

1485
00:54:22,817 --> 00:54:26,988
I WANTED TO POINT OUT THAT

1486
00:54:26,988 --> 00:54:28,689
DR. RATHMELL IS, SHE WAS 42 DAYS

1487
00:54:28,689 --> 00:54:31,492
INTO THE JOB WHEN SHE HAD

1488
00:54:31,492 --> 00:54:34,862
ALREADY COMPLETED MEETINGS WITH

1489
00:54:34,862 --> 00:54:35,696
SEVERAL SENATORS WHO ARE ON OUR

1490
00:54:35,696 --> 00:54:38,699
APPROPRIATIONS SUBCOMMITTEE WITH

1491
00:54:38,699 --> 00:54:40,902
ALSO AT A RECEPTION SHE WAS ABLE

1492
00:54:40,902 --> 00:54:43,004
TO TALK WITH CONGRESSWOMAN ROSA

1493
00:54:43,004 --> 00:54:44,672
DELOREIO, THE RANKING MEMBER OF

1494
00:54:44,672 --> 00:54:49,444
THE APPROPRIATIONS COMMITTEE.

1495
00:54:49,444 --> 00:54:51,112
THESE MEMBERS, RANKING MEMBER ON

1496
00:54:51,112 --> 00:54:52,213
THE SUBCOMMITTEE IN THE SENATE

1497
00:54:52,213 --> 00:54:55,049
THAT DECIDES THE NIH BUDGET.

1498
00:54:55,049 --> 00:54:59,220
JERRY MORAN, LONG TIME ADVOCATE

1499
00:54:59,220 --> 00:55:00,822
FOR NIH AND NCI.

1500
00:55:00,822 --> 00:55:02,223
VERY PROUD OF THE CANCER CENTER

1501
00:55:02,223 --> 00:55:09,363
AT KU AND ALSO SENATOR BOSMAN

1502
00:55:09,363 --> 00:55:10,031
FROM ARKANSAS AND R DR. ELAINE

1503
00:55:10,031 --> 00:55:13,434
FLORES: D FROM RHODE ISLAND.

1504
00:55:13,434 --> 00:55:15,837
THESE MEETINGS WERE VERY

1505
00:55:15,837 --> 00:55:26,013
POSITIVE.

1506
00:55:31,486 --> 00:55:33,554
IT WOULD BE VERY HARD TO GET

1507
00:55:33,554 --> 00:55:35,256
MEETINGS BUT THESE WERE ALL --

1508
00:55:35,256 --> 00:55:36,858
CONGRESS REALLY CARES ABOUT WHAT

1509
00:55:36,858 --> 00:55:40,027
THE INVESTMENTS THAT THEY ARE

1510
00:55:40,027 --> 00:55:40,862
MAKING IN BIOMEDICAL RESEARCH

1511
00:55:40,862 --> 00:55:41,863
WHAT IT IS YIELDING.

1512
00:55:41,863 --> 00:55:43,464
A LOT OF THESE MEMBERS, IT'S

1513
00:55:43,464 --> 00:55:45,433
PERSONAL TO THEM AND WHAT WE

1514
00:55:45,433 --> 00:55:46,667
FIND IS THAT THEY ARE REALLY

1515
00:55:46,667 --> 00:55:48,736
INTERESTED TO KNOW WHAT WE NEED,

1516
00:55:48,736 --> 00:55:50,338
HOW THEY CAN HELP AND THEN THEY

1517
00:55:50,338 --> 00:55:52,173
OFTEN HAVE QUESTIONS ABOUT

1518
00:55:52,173 --> 00:55:53,574
SPECIFIC AREAS OF RESEARCH,

1519
00:55:53,574 --> 00:55:55,543
SOMETIMES IT'S GEOGRAPHIC,

1520
00:55:55,543 --> 00:55:56,677
SOMETIMES IT'S A PARTICULAR TYPE

1521
00:55:56,677 --> 00:55:57,745
OF DISEASE.

1522
00:55:57,745 --> 00:55:59,747
BUT THESE MEETINGS WERE REALLY

1523
00:55:59,747 --> 00:56:00,781
SUCCESSFUL AND THIS IS SOMETHING

1524
00:56:00,781 --> 00:56:02,483
WE TRIEDED TO DO AS MUCH AS

1525
00:56:02,483 --> 00:56:04,519
POSSIBLE.

1526
00:56:04,519 --> 00:56:11,359
NEXT SLIDE.

1527
00:56:11,359 --> 00:56:12,159
HERE ARE CONGRESSIONAL BRIEF

1528
00:56:12,159 --> 00:56:13,761
ACCIDENT WHERE NCI HAS BEEN

1529
00:56:13,761 --> 00:56:15,563
ASKED TO COME TO AN EVENT

1530
00:56:15,563 --> 00:56:17,098
WHETHER HOSTED BY A DISEASE

1531
00:56:17,098 --> 00:56:18,466
GROUP OR PROFESSIONAL SOCIETY.

1532
00:56:18,466 --> 00:56:20,668
AND THESE WERE JUST VERY RECENT

1533
00:56:20,668 --> 00:56:21,068
EXAMPLES.

1534
00:56:21,068 --> 00:56:23,571
ONE OF OUR INTRAMURAL

1535
00:56:23,571 --> 00:56:27,275
RESEARCHERS SPOKE AT A

1536
00:56:27,275 --> 00:56:28,276
NEUROFIBROMATOSIS BRIEFING, HE

1537
00:56:28,276 --> 00:56:30,978
IS FROM OUR PEDIATRIC ONCOLOGY

1538
00:56:30,978 --> 00:56:32,113
BRANCH AND INTRAMURAL PROGRAM

1539
00:56:32,113 --> 00:56:34,782
AND THEN ANOTHER ONE OF OUR

1540
00:56:34,782 --> 00:56:37,285
EXTRAMURAL PROGRAM STAFF,

1541
00:56:37,285 --> 00:56:37,852
DR. VICK, WHO WORKS IN THE

1542
00:56:37,852 --> 00:56:39,954
DIVISION OF CANCER PREVENTION AT

1543
00:56:39,954 --> 00:56:41,656
NCI, WAS INVITED TO GIVE A TALK

1544
00:56:41,656 --> 00:56:43,257
ABOUT CANCER PREVENTION.

1545
00:56:43,257 --> 00:56:45,293
THIS PICTURE SHOWS HIM WITH

1546
00:56:45,293 --> 00:56:47,361
CONGRESSWOMAN DEBI DINGELL OF

1547
00:56:47,361 --> 00:56:49,463
MICHIGAN WHO IS A SUPPORTER OF

1548
00:56:49,463 --> 00:56:50,464
BIOMEDICAL RESEARCH AND VERY

1549
00:56:50,464 --> 00:56:52,967
INTERESTED IN CANCER RESEARCH IN

1550
00:56:52,967 --> 00:56:53,334
GENERAL.

1551
00:56:53,334 --> 00:56:55,403
THESE TYPES OF OPPORTUNITIES

1552
00:56:55,403 --> 00:56:56,971
REALLY ARE EDUCATIONAL

1553
00:56:56,971 --> 00:56:57,405
OPPORTUNITIES.

1554
00:56:57,405 --> 00:56:59,373
IT IS VERY OFTEN THE CASE THAT

1555
00:56:59,373 --> 00:57:01,075
MEMBERS ARE SURPRISED TO FIND

1556
00:57:01,075 --> 00:57:03,477
OUT THEY MAY TELL US ABOUT

1557
00:57:03,477 --> 00:57:05,613
RESEARCHERS THEY KNOW AT

1558
00:57:05,613 --> 00:57:06,647
INSTITUTIONS IN THEIR STATE OR

1559
00:57:06,647 --> 00:57:06,914
DISTRICT.

1560
00:57:06,914 --> 00:57:07,848
SOMETIMES THEY ARE REALLY

1561
00:57:07,848 --> 00:57:09,083
SURPRISED TO KNOW THAT WE HAVE

1562
00:57:09,083 --> 00:57:10,151
SUPPORTED THAT RESEARCHER FROM

1563
00:57:10,151 --> 00:57:12,053
THE TIME THEY WERE A TRAINEE TO

1564
00:57:12,053 --> 00:57:14,355
THE TIME THEY ARE RUNNING A

1565
00:57:14,355 --> 00:57:15,222
SPORE OR CANCER CENTER DIRECTOR

1566
00:57:15,222 --> 00:57:17,158
AND THOSE ARE REALLY GREAT

1567
00:57:17,158 --> 00:57:18,225
OPPORTUNITIES TO SORT OF BRING

1568
00:57:18,225 --> 00:57:20,861
THIS FULL CIRCLE FOR SOME OF

1569
00:57:20,861 --> 00:57:22,563
THESE MEMBERS.

1570
00:57:22,563 --> 00:57:27,501
NEXT SLIDE, PLEASE.

1571
00:57:27,501 --> 00:57:28,903
WE OF COURSE ALWAYS SAY YES WHEN

1572
00:57:28,903 --> 00:57:32,273
WE ARE INVITED TO VISIT A MEMBER

1573
00:57:32,273 --> 00:57:33,474
OF CONGRESS.

1574
00:57:33,474 --> 00:57:38,379
CERTAINLY ATTEND A HEARING.

1575
00:57:38,379 --> 00:57:39,880
WE HOPE YOU WILL SAY YES WHEN

1576
00:57:39,880 --> 00:57:42,283
YOU'RE INVITED TO BE PART OF

1577
00:57:42,283 --> 00:57:42,883
PROFESSIONAL ASSOCIATION

1578
00:57:42,883 --> 00:57:45,186
MEETINGS AND MANY OF YOU DO THIS

1579
00:57:45,186 --> 00:57:46,120
AS A OF COURSE.

1580
00:57:46,120 --> 00:57:48,089
ONE THING THAT IS HELPFUL FOR,

1581
00:57:48,089 --> 00:57:50,524
IN TERMS OF EDUCATING STAFFERS

1582
00:57:50,524 --> 00:57:52,193
AND HELPING MEMBERS GET

1583
00:57:52,193 --> 00:57:54,562
OPPORTUNITIES TO MEET WITH

1584
00:57:54,562 --> 00:58:04,905
CONSTITUENTS AND MEET WITH

1585
00:58:04,905 --> 00:58:07,608
RESPECT I WAS, THEY GET A SENSE

1586
00:58:07,608 --> 00:58:09,610
OF HOW IMPORTANT CANCER RESEARCH

1587
00:58:09,610 --> 00:58:12,213
IS WITHIN THESE COMMUNITIES AND

1588
00:58:12,213 --> 00:58:12,780
THERE ARE EASTERLY CAREER

1589
00:58:12,780 --> 00:58:14,482
GROUPS, TRAINEES AND WORKFORCE

1590
00:58:14,482 --> 00:58:16,183
DEVELOPMENT IS A VERY -- IT'S A

1591
00:58:16,183 --> 00:58:17,418
PRIORITY FOR A LOT OF CONGRESS

1592
00:58:17,418 --> 00:58:20,688
AND THOSE WHO SUPPORT BIOMEDICAL

1593
00:58:20,688 --> 00:58:20,955
RESEARCH.

1594
00:58:20,955 --> 00:58:22,990
ONE THING I WANTED TO HIGHLIGHT,

1595
00:58:22,990 --> 00:58:26,927
DR. JULIE GRAY LOW OF ASCO WAS

1596
00:58:26,927 --> 00:58:28,729
TESTIFYING -- TESTIFIED AT A

1597
00:58:28,729 --> 00:58:29,563
HOUSE WEIGHS AND MEANS COMMITTEE

1598
00:58:29,563 --> 00:58:30,898
ABOUT DRUG SHORTAGES THIS WEEK.

1599
00:58:30,898 --> 00:58:33,134
THIS SORT OF PRESENCE FROM THIS

1600
00:58:33,134 --> 00:58:34,301
ROBUST CANCER RESEARCH AND

1601
00:58:34,301 --> 00:58:35,703
CANCER CARE COMMUNITY IS

1602
00:58:35,703 --> 00:58:37,371
INCREDIBLY HELPFUL.

1603
00:58:37,371 --> 00:58:39,206
ONE OF THE GROUPS THAT I

1604
00:58:39,206 --> 00:58:41,609
HIGHLIGHTED HERE IS OVAC, ONE

1605
00:58:41,609 --> 00:58:43,511
VOICE AGAINST CANCER GROUP, A

1606
00:58:43,511 --> 00:58:45,012
GROUP OF MANY DIFFERENT TYPES OF

1607
00:58:45,012 --> 00:58:47,014
CANCER ORGANIZATIONS WHO COME

1608
00:58:47,014 --> 00:58:49,016
TOGETHER WITH ONE VOICE TO ASK

1609
00:58:49,016 --> 00:58:53,120
FOR REALLY FUNDING INCREASES.

1610
00:58:53,120 --> 00:58:54,822
AND THAT'S SOMETHING WE CAN'T

1611
00:58:54,822 --> 00:58:55,556
DO.

1612
00:58:55,556 --> 00:58:56,924
WE HAVE SPECIFIC WAYS TO TALK

1613
00:58:56,924 --> 00:59:00,561
ABOUT BUDGET, BYPASS BUDGET AND

1614
00:59:00,561 --> 00:59:01,228
OUR CONGRESSIONAL BUDGET PART OF

1615
00:59:01,228 --> 00:59:02,730
THE PRESIDENT'S BUDGET, BUT

1616
00:59:02,730 --> 00:59:04,632
THESE GROUPS ARE ABLE TO BRING

1617
00:59:04,632 --> 00:59:04,899
PATIENTS.

1618
00:59:04,899 --> 00:59:07,101
THEY ARE ABLE TO HAVE LOCAL

1619
00:59:07,101 --> 00:59:08,035
EMPHASIS WHEN THEY TALK TO

1620
00:59:08,035 --> 00:59:10,071
MEMBERS AND IT HAS A LOT OF

1621
00:59:10,071 --> 00:59:10,304
IMPACT.

1622
00:59:10,304 --> 00:59:11,906
I THINK A LOT OF MEMBERS, THIS

1623
00:59:11,906 --> 00:59:13,741
ONE PICTURE ON THE UPPER LEFT

1624
00:59:13,741 --> 00:59:16,077
CORNER IS DR. JONATHANLICATE

1625
00:59:16,077 --> 00:59:17,211
FROM THE UNIVERSITY OF FLORIDA,

1626
00:59:17,211 --> 00:59:18,746
THE CANCER CENTER DIRECTOR THERE

1627
00:59:18,746 --> 00:59:21,348
MEETING WITH DEBI WASSERMAN

1628
00:59:21,348 --> 00:59:22,416
SHULTZ AND THE EXECUTIVE

1629
00:59:22,416 --> 00:59:24,318
DIRECTOR OF AACI.

1630
00:59:24,318 --> 00:59:25,720
THESE ARE REALLY GREAT

1631
00:59:25,720 --> 00:59:27,021
OPPORTUNITIES FOR MEMBERS TO

1632
00:59:27,021 --> 00:59:28,556
ENGAGE IN WAYS THAT ARE

1633
00:59:28,556 --> 00:59:30,057
MEANINGFUL TO THEM.

1634
00:59:30,057 --> 00:59:31,559
SOMETIMES BECAUSE OF THE CANCER

1635
00:59:31,559 --> 00:59:33,027
HISTORY FOR THEMSELVES OR THEIR

1636
00:59:33,027 --> 00:59:34,428
FAMILY BUT SOMETIMES REALLY JUST

1637
00:59:34,428 --> 00:59:36,363
BECAUSE OF THE REGIONAL LOCAL

1638
00:59:36,363 --> 00:59:38,132
CONNECTION TO THEIR DISTRICT.

1639
00:59:38,132 --> 00:59:39,366
SO WE ALWAYS SAY YES.

1640
00:59:39,366 --> 00:59:40,835
WE HOPE YOU SAY YES WHEN YOU'RE

1641
00:59:40,835 --> 00:59:41,135
ASKED.

1642
00:59:41,135 --> 00:59:43,404
THERE IS NO BETTER MESSENGER

1643
00:59:43,404 --> 00:59:45,539
ABOUT THE IMPORTANCE OF CANCER

1644
00:59:45,539 --> 00:59:47,508
RESEARCH THAN RESEARCHERS FROM

1645
00:59:47,508 --> 00:59:49,577
BASIC TO CLINICIANS WHO ARE

1646
00:59:49,577 --> 00:59:50,478
TAKING CARE OF PATIENTS.

1647
00:59:50,478 --> 00:59:52,246
THOSE HAVE A LOT OF IMPACT AND

1648
00:59:52,246 --> 00:59:54,648
PLEASE TALK ABOUT YOUR NCI

1649
00:59:54,648 --> 00:59:55,750
SUPPORT IF YOU GET THOSE

1650
00:59:55,750 --> 00:59:56,250
OPPORTUNITIES AS WELL.

1651
00:59:56,250 --> 00:59:58,953
I'M GOING TO STOP HERE AND TAKE

1652
00:59:58,953 --> 01:00:00,755
QUESTIONS IF WE HAVE TIME FOR

1653
01:00:00,755 --> 01:00:00,955
THAT.

1654
01:00:00,955 --> 01:00:02,256
COULD WE HAVE THE NEXT SLIDE?

1655
01:00:02,256 --> 01:00:03,858
I WANT TO ENCOURAGE YOU TO

1656
01:00:03,858 --> 01:00:05,860
PLEASE REACH OUT TO ME WITH

1657
01:00:05,860 --> 01:00:07,294
E-MAIL WITH ANY QUESTIONS YOU

1658
01:00:07,294 --> 01:00:07,495
HAVE.

1659
01:00:07,495 --> 01:00:09,263
I'M HAPPY TO TALK TO ANY BOARD

1660
01:00:09,263 --> 01:00:10,664
MEMBERS THAT WOULD LIKE TO HAVE

1661
01:00:10,664 --> 01:00:12,733
ANY QUESTIONS.

1662
01:00:12,733 --> 01:00:13,734
>> THANK YOU.

1663
01:00:13,734 --> 01:00:19,607
WE HAVE TIME FOR A FEW QUESTI

1664
01:00:19,607 --> 01:00:19,874
QUESTIONS.

1665
01:00:19,874 --> 01:00:21,776
ANY QUESTIONS FROM THE BOARD?

1666
01:00:21,776 --> 01:00:22,743
>> I RAISED MY HAND BUT I
DON'T

1667
01:00:22,743 --> 01:00:27,848
KNOW IF YOU CAN SEE ME.

1668
01:00:27,848 --> 01:00:28,149
>> YES.

1669
01:00:28,149 --> 01:00:29,683
>> THE CAMERA IS NOT
WORKING

1670
01:00:29,683 --> 01:00:33,154
TODAY SO I APOLOGIZE FOR THAT.

1671
01:00:33,154 --> 01:00:34,822
ONE THING THAT IS A LITTLE --

1672
01:00:34,822 --> 01:00:35,656
THANK YOU VERY MUCH FOR THE

1673
01:00:35,656 --> 01:00:40,461
GREAT PRESENTATION.

1674
01:00:40,461 --> 01:00:42,463
THERE ARE TIMES WHERE WE ARE

1675
01:00:42,463 --> 01:00:44,265
ASKED TO GO AND DO ADVOCACY BUT

1676
01:00:44,265 --> 01:00:45,866
IN OUR ROLE, AND MAYBE THIS IS

1677
01:00:45,866 --> 01:00:47,601
MORE A QUESTION FOR PAULETTE,

1678
01:00:47,601 --> 01:00:50,137
BUT IN OUR ROLE AS NCAB MEMBERS,

1679
01:00:50,137 --> 01:00:52,139
I KNOW THERE ARE A LOT OF

1680
01:00:52,139 --> 01:00:53,407
RESTRICTIONS AROUND WHAT WE CAN

1681
01:00:53,407 --> 01:00:54,775
AND CAN'T DO, ESPECIALLY IN

1682
01:00:54,775 --> 01:00:56,443
TERMS OF LIKE ONE AGENCY

1683
01:00:56,443 --> 01:00:57,111
LOBBYING ANOTHER.

1684
01:00:57,111 --> 01:01:01,382
SO I HAD A RECENT REQUEST TO

1685
01:01:01,382 --> 01:01:03,684
JOIN THE MYELOMA RESEARCH

1686
01:01:03,684 --> 01:01:04,852
FOUNDATION ON THE HILL FOR

1687
01:01:04,852 --> 01:01:05,786
ADVOCACY DAY.

1688
01:01:05,786 --> 01:01:07,888
I RAN THE REQUEST THROUGH JOY

1689
01:01:07,888 --> 01:01:09,757
AND SHALA AND THEY SAID,

1690
01:01:09,757 --> 01:01:10,691
PROBABLY NOT SOMETHING YOU

1691
01:01:10,691 --> 01:01:11,992
SHOULD BE INVOLVED IN.

1692
01:01:11,992 --> 01:01:15,062
SO HOW DO WE KNOW WHAT WE CAN

1693
01:01:15,062 --> 01:01:16,197
AND CAN'T BE INVOLVED IN?

1694
01:01:16,197 --> 01:01:17,798
BECAUSE YOU JUST ENCOURAGED US

1695
01:01:17,798 --> 01:01:19,900
ALL TO DO THIS KIND OF THING BUT

1696
01:01:19,900 --> 01:01:21,969
I'M ALWAYS VERY WARY THAT I'M

1697
01:01:21,969 --> 01:01:23,771
GOING TO BE IN SOME FORM OF

1698
01:01:23,771 --> 01:01:28,576
CONFLICT IF I DO DO SOMETHING.

1699
01:01:28,576 --> 01:01:29,977
>> I WILL SIMPLY SAY, AS
LONG AS

1700
01:01:29,977 --> 01:01:33,614
YOU DO IT AS A PRIVATE CITIZEN,

1701
01:01:33,614 --> 01:01:34,715
THERE ARE NO ISSUES.

1702
01:01:34,715 --> 01:01:37,952
BUT YOU CAN NOT DO IT ON THE

1703
01:01:37,952 --> 01:01:41,889
PART OF THE GOVERNMENT OR AS A

1704
01:01:41,889 --> 01:01:43,157
REPRESENTATIVE OR A MEMBER OF

1705
01:01:43,157 --> 01:01:44,925
THE NATIONAL CANCER ADVISORY

1706
01:01:44,925 --> 01:01:45,125
BOARD.

1707
01:01:45,125 --> 01:01:47,494
AND YOU DID THE RIGHT THING IN

1708
01:01:47,494 --> 01:01:53,667
REACHING OUT TO JOY AND TO

1709
01:01:53,667 --> 01:01:54,835
OTHERS.

1710
01:01:54,835 --> 01:01:55,669
>> OKAY, THANK YOU.

1711
01:01:55,669 --> 01:02:00,374
>> -- AUTHORITY ON THAT
ISSUE, I

1712
01:02:00,374 --> 01:02:03,477
WOULD SAY IF YOU ARE ASKED TO

1713
01:02:03,477 --> 01:02:05,779
TALK, TO GIVE A TALK WITH A

1714
01:02:05,779 --> 01:02:08,115
DISEASE GROUP OR A PROFESSIONAL

1715
01:02:08,115 --> 01:02:08,983
ASSOCIATION THAT RELATES TOTS

1716
01:02:08,983 --> 01:02:10,784
YOUR PROFESSIONAL EXPERTISE AND

1717
01:02:10,784 --> 01:02:12,286
YOUR RESEARCH EXPERTISE,

1718
01:02:12,286 --> 01:02:15,189
CERTAINLY YOU CAN ALWAYS RUN IT

1719
01:02:15,189 --> 01:02:16,790
THROUGH OUR COMMITTEE MANAGEMENT

1720
01:02:16,790 --> 01:02:18,392
TEAM, BUT I THINK THAT'S REALLY

1721
01:02:18,392 --> 01:02:19,593
DIFFERENT THAN BEING ASKED TO

1722
01:02:19,593 --> 01:02:22,696
COME IN AS A NATIONAL CANCER

1723
01:02:22,696 --> 01:02:24,298
ADVISORY CHAIR.

1724
01:02:24,298 --> 01:02:25,900
AND IT'S THE SCIENTIFIC

1725
01:02:25,900 --> 01:02:29,270
EXPERTISE THAT IS SO -- FOR

1726
01:02:29,270 --> 01:02:32,406
EXAMPLE, I'VE BEEN IN HEARINGS

1727
01:02:32,406 --> 01:02:34,441
WITH JAFFEE WHEN SHE WAS THE

1728
01:02:34,441 --> 01:02:35,809
NCAB CHAIR AND SHE BROUGHT A

1729
01:02:35,809 --> 01:02:38,545
PATIENT AND TALKED ABOUT

1730
01:02:38,545 --> 01:02:40,147
RESEARCH AND TALKED ABOUT THIS

1731
01:02:40,147 --> 01:02:42,316
PATIENT WHO HAD BENEFITED FROM A

1732
01:02:42,316 --> 01:02:43,350
TARGETED THERAPY.

1733
01:02:43,350 --> 01:02:48,255
AND SO THAT WAS A VERY POWERFUL

1734
01:02:48,255 --> 01:02:49,623
DISCUSSION OF BENCH TO BEDSIDE

1735
01:02:49,623 --> 01:02:50,858
RESEARCH AND THE MEANING OF IT.

1736
01:02:50,858 --> 01:02:52,826
I THINK IT REALLY DOES DEPEND

1737
01:02:52,826 --> 01:02:55,796
WHY THE ORGANIZATION IS ASKING

1738
01:02:55,796 --> 01:02:55,963
YOU.

1739
01:02:55,963 --> 01:02:57,531
AND I THINK THAT IS SOMETHING

1740
01:02:57,531 --> 01:02:59,700
DR. GRAY WOULD PROBABLY WANT TO

1741
01:02:59,700 --> 01:03:03,103
UNDERSTAND BEFORE -- SO SHE CAN

1742
01:03:03,103 --> 01:03:04,505
HAVE ALL THE INFORMATION.

1743
01:03:04,505 --> 01:03:05,940
>> YES, WE DO NEED
INFORMATION

1744
01:03:05,940 --> 01:03:08,142
AHEAD OF TIME AND WE CAN

1745
01:03:08,142 --> 01:03:09,710
INDICATE TO YOU WHETHER YOU CAN

1746
01:03:09,710 --> 01:03:14,348
DO IT AS A PRIVATE CITIZEN,

1747
01:03:14,348 --> 01:03:15,816
REPRESENTING YOUR INSTITUTION

1748
01:03:15,816 --> 01:03:17,818
AND WHETHER IT SHOULD OR SHOULD

1749
01:03:17,818 --> 01:03:21,522
NOT BE AS AN NCAB MEMBER

1750
01:03:21,522 --> 01:03:21,922
REPRESENTATIVE.

1751
01:03:21,922 --> 01:03:27,928
SO YOU DID THE RIGHT THING.

1752
01:03:27,928 --> 01:03:29,430
SO KEEPING WITH TIME, I'M GOING

1753
01:03:29,430 --> 01:03:35,035
TO MOVE ON.

1754
01:03:35,035 --> 01:03:38,005
AND I WILL FLY THROUGH THIS AS I

1755
01:03:38,005 --> 01:03:39,540
NORMALLY DO.

1756
01:03:39,540 --> 01:03:42,810
AND I DON'T HAVE SLIDES, BUT WE

1757
01:03:42,810 --> 01:03:46,413
HAVE TO DO THE ANNUAL

1758
01:03:46,413 --> 01:03:47,748
DELEGATIONS OF AUTHORITY.

1759
01:03:47,748 --> 01:03:51,118
SO ANNUALLY AT THE FIRST NCAB

1760
01:03:51,118 --> 01:03:53,120
MEETING, THE BOARD MUST APPROVE

1761
01:03:53,120 --> 01:03:54,722
SPECIFIC DELEGATIONS OF

1762
01:03:54,722 --> 01:03:56,156
AUTHORITIES SO THAT THE DIRECTOR

1763
01:03:56,156 --> 01:03:58,759
AND NCI STAFF CAN FUNCTION

1764
01:03:58,759 --> 01:04:03,163
WITHOUT HAVING TO COME TO AN --

1765
01:04:03,163 --> 01:04:05,833
FOR CERTAIN ACTION AS,

1766
01:04:05,833 --> 01:04:06,867
SPECIFICALLY DELEGATION A STATES

1767
01:04:06,867 --> 01:04:10,604
THE NCAB DELEGATES TO THE

1768
01:04:10,604 --> 01:04:13,841
DIRECTOR OF THE NATIONAL CANCER

1769
01:04:13,841 --> 01:04:16,043
INSTITUTE PERMISSION TO OBTAIN

1770
01:04:16,043 --> 01:04:21,815
AS STATED IN SECTION 413B5 OF

1771
01:04:21,815 --> 01:04:23,450
THE PUBLIC HEALTH -- AND IN

1772
01:04:23,450 --> 01:04:27,921
ACCORDANCE WITH SECTION 3109

1773
01:04:27,921 --> 01:04:28,856
TITLE V IN THE UNITED STATES

1774
01:04:28,856 --> 01:04:30,958
CODE, THE OPPORTUNITY TO REQUEST

1775
01:04:30,958 --> 01:04:34,962
THE SERVICES OF NOT MORE THAN

1776
01:04:34,962 --> 01:04:38,165
151 SPECIAL EXPERTS OR

1777
01:04:38,165 --> 01:04:39,266
CONSULTANTS WHO HAVE SCIENTIFIC

1778
01:04:39,266 --> 01:04:42,836
OR PROFESSIONAL QUALIFICATIONS

1779
01:04:42,836 --> 01:04:45,039
TO ASSESS AND ACCOMPLISH THE

1780
01:04:45,039 --> 01:04:47,741
MISSION OF THE INSTITUTE.

1781
01:04:47,741 --> 01:04:50,878
DELEGATION B, THE NCAB DELEGATES

1782
01:04:50,878 --> 01:04:53,580
TO THE DIRECTOR, NCI, PER

1783
01:04:53,580 --> 01:04:56,150
MISSION TO EXERCISE AUTHORITY AS

1784
01:04:56,150 --> 01:05:00,621
STATED IN SECTION 413B7 OF THE

1785
01:05:00,621 --> 01:05:02,890
PUBLIC HEALTH SERVICE ACT, THE

1786
01:05:02,890 --> 01:05:04,558
OPPORTUNITY TO ESTABLISH ONE OR

1787
01:05:04,558 --> 01:05:06,226
MORE ADVISORY COMMITTEES

1788
01:05:06,226 --> 01:05:08,896
COMPOSED OF PRIVATE CITIZENS AND

1789
01:05:08,896 --> 01:05:11,865
OFFICIALS OF FEDERAL, STATE AND

1790
01:05:11,865 --> 01:05:15,135
LOCAL GOVERNMENTS TO ADVISE

1791
01:05:15,135 --> 01:05:18,072
HIM/HER WITH RESPECT TO HIS/HER

1792
01:05:18,072 --> 01:05:18,338
FUNCTIONS.

1793
01:05:18,338 --> 01:05:20,507
NEXT IS THE STATEMENT OF

1794
01:05:20,507 --> 01:05:24,178
UNDERSTANDING WHAT NCI STAFF ON

1795
01:05:24,178 --> 01:05:26,547
OPERATING PRINCIPLES AND MAKING

1796
01:05:26,547 --> 01:05:29,116
EXTRAMURAL AWARDS WITHIN

1797
01:05:29,116 --> 01:05:30,751
ACCORDANCE WITH MANAGEMENT AND

1798
01:05:30,751 --> 01:05:32,753
REVIEW PROCEDURES SET FORTH IN

1799
01:05:32,753 --> 01:05:36,657
THE NIH MANUAL ISSUANCE 4513.

1800
01:05:36,657 --> 01:05:40,861
THAT IS, NCAB COMPARES WITH

1801
01:05:40,861 --> 01:05:41,762
RECOMMENDATIONS OF INITIAL

1802
01:05:41,762 --> 01:05:44,064
REVIEW GROUPS WILL BE REQUIRED

1803
01:05:44,064 --> 01:05:46,066
TO ALL GRANTS, THAT IS EXCEPT

1804
01:05:46,066 --> 01:05:48,602
FOR TRAINING GRANTS, FELLOWSHIPS

1805
01:05:48,602 --> 01:05:51,472
AND OTHER NON-RESEARCH GRANT

1806
01:05:51,472 --> 01:05:51,805
APPLICATIONS.

1807
01:05:51,805 --> 01:05:54,308
THESE GRANTS MAY BE AWARDED

1808
01:05:54,308 --> 01:05:56,877
WITHOUT PRESENTATION TO THE

1809
01:05:56,877 --> 01:05:57,444
NCAB.

1810
01:05:57,444 --> 01:06:01,648
THAT IS WITH THE EXCEPTION OF

1811
01:06:01,648 --> 01:06:03,884
THE RUTH L KIRSTEN NATIONAL

1812
01:06:03,884 --> 01:06:06,086
RESEARCH SERVICE AWARD.

1813
01:06:06,086 --> 01:06:08,422
APPLICATIONS OF THE 20 ERSENTILE

1814
01:06:08,422 --> 01:06:10,624
WILL NOT HAVE THE SUMMARY

1815
01:06:10,624 --> 01:06:12,759
STATEMENTS PRESENTED TO THE NCAB

1816
01:06:12,759 --> 01:06:14,094
UNLESS THE INSTITUTE IS THE

1817
01:06:14,094 --> 01:06:17,431
CONSIDERING THEIR AWARD OF SUCH

1818
01:06:17,431 --> 01:06:21,368
AN APPLICATION FOR SPECIAL

1819
01:06:21,368 --> 01:06:23,070
CONSIDERATION BY AN APPOINTED

1820
01:06:23,070 --> 01:06:26,940
MEMBER OF THE BOARD.

1821
01:06:26,940 --> 01:06:30,277
APPLICATIONS ASSIGNED NOT -- THE

1822
01:06:30,277 --> 01:06:31,979
CUT OFF WILL BE AN IMPACT SCORE

1823
01:06:31,979 --> 01:06:37,084
OF 45 FOR ALL MECHANISMS, EXCEPT

1824
01:06:37,084 --> 01:06:40,654
R41, 42, 43 AND 44 AWARDS.

1825
01:06:40,654 --> 01:06:43,590
THE LATTER AWARDS ALL SCORED

1826
01:06:43,590 --> 01:06:49,196
APPLICATIONS WILL BE INCLUDED.

1827
01:06:49,196 --> 01:06:53,267
EXPEDITED -- WILL BE USED FOR

1828
01:06:53,267 --> 01:06:55,068
L21 APPLICATIONS.

1829
01:06:55,068 --> 01:06:58,672
EXCLUDING THOSE FROM FOREIGN

1830
01:06:58,672 --> 01:06:59,606
ORGANIZATIONS.

1831
01:06:59,606 --> 01:07:00,474
PERCENTILE SCORES THAT FALL

1832
01:07:00,474 --> 01:07:04,011
WITHIN THE NCI PAY LINES, AND

1833
01:07:04,011 --> 01:07:05,979
THAT HAVE NO CONCERNS NOTED THAT

1834
01:07:05,979 --> 01:07:08,081
WOULD REPRESENT AN

1835
01:07:08,081 --> 01:07:10,217
ADMINISTRATIVE AWARD, FOR

1836
01:07:10,217 --> 01:07:13,320
EXAMPLE, HUMAN SUBJECTS, ANIMAL

1837
01:07:13,320 --> 01:07:14,821
WELFARE, BIOHAZARDS FOR

1838
01:07:14,821 --> 01:07:16,990
INCLUSION OF WOMEN, CHILDREN AND

1839
01:07:16,990 --> 01:07:19,493
APPROPRIATE MINORITY

1840
01:07:19,493 --> 01:07:21,528
DISTRIBUTION.

1841
01:07:21,528 --> 01:07:22,396
EXPEDITED -- WILL BE DELEGATED

1842
01:07:22,396 --> 01:07:26,500
BY THE CHAIR TO SPECIFICALLY

1843
01:07:26,500 --> 01:07:28,602
DESIGNATE MEMBERS OF THE BOARD

1844
01:07:28,602 --> 01:07:30,504
AND ON BEHALF OF THE BOARD AS A

1845
01:07:30,504 --> 01:07:32,306
WHOLE.

1846
01:07:32,306 --> 01:07:34,241
THE REVIEWERS WILL CONSIST OF

1847
01:07:34,241 --> 01:07:36,310
THE CHAIR OF THE SUBCOMMITTEE ON

1848
01:07:36,310 --> 01:07:37,811
SPECIAL ACTIONS AND THREE,

1849
01:07:37,811 --> 01:07:41,081
ADDITIONAL NCAB MEMBERS

1850
01:07:41,081 --> 01:07:43,016
APPOINTED BY THE CHAIR OF THE

1851
01:07:43,016 --> 01:07:43,217
NCAB.

1852
01:07:43,217 --> 01:07:45,686
IN CASES OF EMERGENT NEED AS

1853
01:07:45,686 --> 01:07:48,388
DETERMINED BY THE DIRECTOR OF

1854
01:07:48,388 --> 01:07:51,525
NCI, WITH THE CONCURRENCE OF

1855
01:07:51,525 --> 01:07:53,627
NCAB CHAIR, EXPEDITED

1856
01:07:53,627 --> 01:07:56,029
CONCURRENCE MAY BE UTILIZED FOR

1857
01:07:56,029 --> 01:07:59,132
SINGLE-CASE DEVIATIONS.

1858
01:07:59,132 --> 01:08:02,603
EXPEDITED -- ENOUGH VOTES FOR

1859
01:08:02,603 --> 01:08:04,271
FINAL ACTION WILL BE PRESENTED

1860
01:08:04,271 --> 01:08:09,009
TO THE FULL NCAB AT ITS REGULAR

1861
01:08:09,009 --> 01:08:10,410
MEETING.

1862
01:08:10,410 --> 01:08:11,311
ADMINISTRATIVE ADJUSTMENTS.

1863
01:08:11,311 --> 01:08:13,914
THE NCAB DELEGATES TO THE

1864
01:08:13,914 --> 01:08:18,819
DIRECTOR OF NCI PERMISSION TO

1865
01:08:18,819 --> 01:08:20,153
ALLOW STAFF TO NEGOTIATE THE

1866
01:08:20,153 --> 01:08:21,922
APPROPRIATE ADJUSTMENTS IN

1867
01:08:21,922 --> 01:08:24,424
DOLLARS AND OTHER TERMS AND

1868
01:08:24,424 --> 01:08:25,459
CONDITIONS OF GRANTS AND

1869
01:08:25,459 --> 01:08:27,094
COOPERATIVE AGREEMENT AWARDS

1870
01:08:27,094 --> 01:08:28,629
RECOMMENDED BY THE BOARD.

1871
01:08:28,629 --> 01:08:32,032
IN DOING SO, ALLOWS THE

1872
01:08:32,032 --> 01:08:33,867
INSTITUTE TO MAINTAIN A SMOOTH

1873
01:08:33,867 --> 01:08:35,936
AND EFFECTIVE OPERATION OF THE

1874
01:08:35,936 --> 01:08:39,439
ADMINISTRATION OF GRANTS BY THE

1875
01:08:39,439 --> 01:08:39,806
INSTITUTER.

1876
01:08:39,806 --> 01:08:42,109
STAFF WILL NEGOTIATE APPROPRIATE

1877
01:08:42,109 --> 01:08:44,544
ADJUSTMENTS AND WHEN APPLICABLE,

1878
01:08:44,544 --> 01:08:48,615
WILL MAKE ADJUSTMENTS TO

1879
01:08:48,615 --> 01:08:49,149
RECONCILE INCONSISTENCIES

1880
01:08:49,149 --> 01:08:51,852
BETWEEN RECK HENDED BUDGET AND

1881
01:08:51,852 --> 01:08:54,354
RECOMMENDED ACTIVITIES --

1882
01:08:54,354 --> 01:08:54,955
RECOMMENDED -- ADMINISTRATIVE

1883
01:08:54,955 --> 01:08:57,291
REQUESTS FOR INCREASE IN DIRECT

1884
01:08:57,291 --> 01:09:00,627
COSTS, WHICH ARE THE RESULT

1885
01:09:00,627 --> 01:09:02,829
OF -- FOR SIGNIFICANT CHANGE IN

1886
01:09:02,829 --> 01:09:05,399
SCIENTIFIC CONTENT OF A PROGRAM

1887
01:09:05,399 --> 01:09:07,234
AFTER FORMAL PEER REVIEW, WILL

1888
01:09:07,234 --> 01:09:10,037
BE REFERRED TO THE BOARD FOR

1889
01:09:10,037 --> 01:09:11,238
ADVICE AND RECOMMENDATION.

1890
01:09:11,238 --> 01:09:13,807
IF THERE IS AN ISSUE, THAT IS IN

1891
01:09:13,807 --> 01:09:16,877
TERMS OF SCOPE ANDUREIGENCEY,

1892
01:09:16,877 --> 01:09:19,746
THE DIRECTOR OF NCI WILL CONSULT

1893
01:09:19,746 --> 01:09:24,017
WITH THE NCAB CHAIR PRIOR TO A

1894
01:09:24,017 --> 01:09:26,219
FINAL DETERMINATION THAT NCAB

1895
01:09:26,219 --> 01:09:29,556
CHAIR WILL ACT ON BEHALF OF THE

1896
01:09:29,556 --> 01:09:31,058
BOARD AS A WHOLE.

1897
01:09:31,058 --> 01:09:32,859
IN TERMS OF ACTIONS NOT

1898
01:09:32,859 --> 01:09:35,929
REQUIRED, THE BOARD REVIEW OR

1899
01:09:35,929 --> 01:09:37,931
ADVICE, THOSE INCLUDE ACTIONS

1900
01:09:37,931 --> 01:09:40,334
SUCH AS CHANGE OF INSTITUTION,

1901
01:09:40,334 --> 01:09:42,769
CHANGE OF PRINCIPAL

1902
01:09:42,769 --> 01:09:44,538
INVESTIGATOR, PHASE OUT OR

1903
01:09:44,538 --> 01:09:46,239
INTERIM SUPPORT OR ADDITIONAL

1904
01:09:46,239 --> 01:09:47,941
SUPPORT EITHER TO MEET THE

1905
01:09:47,941 --> 01:09:51,845
INCREASED COST OF MAINTAINING

1906
01:09:51,845 --> 01:09:53,447
THE LEVEL OR RESEARCH

1907
01:09:53,447 --> 01:09:58,118
RECOMMENDED OR TO ACCOMMODATE

1908
01:09:58,118 --> 01:09:58,952
ACTIVITIES JUDGED BY STAFF TO BE

1909
01:09:58,952 --> 01:10:00,821
WITHIN THE SCOPE OF THE

1910
01:10:00,821 --> 01:10:02,756
PREVIOUSLY PEER-REVIEWED

1911
01:10:02,756 --> 01:10:03,023
RESEARCH.

1912
01:10:03,023 --> 01:10:06,226
THESE ACTIONS WILL NOT BE

1913
01:10:06,226 --> 01:10:07,260
REPORTED TO THE BOARD.

1914
01:10:07,260 --> 01:10:11,965
IN ADDITION, NCI STAFF MAY

1915
01:10:11,965 --> 01:10:12,666
RESTORY QUESTS IN TIMES TO

1916
01:10:12,666 --> 01:10:14,067
SUPPORT WHICH WERE DELETED BY

1917
01:10:14,067 --> 01:10:16,436
THE INITIAL REVIEW GROUP WHEN

1918
01:10:16,436 --> 01:10:18,238
THE PRINCIPAL INVESTIGATOR HAS

1919
01:10:18,238 --> 01:10:20,640
PROVIDED JUSTIFICATION IN AN

1920
01:10:20,640 --> 01:10:21,241
APPEAL LETTER.

1921
01:10:21,241 --> 01:10:23,243
THE RESTORATION IS IN THE BEST

1922
01:10:23,243 --> 01:10:25,545
INTEREST OF THE NCI AND THE

1923
01:10:25,545 --> 01:10:30,450
PROJECT IS OF HIGH PROGRAMMATIC

1924
01:10:30,450 --> 01:10:40,627
RELEVANCE.

1925
01:10:44,131 --> 01:10:46,166
THERE IS SPECIAL COUNSEL REVIEW

1926
01:10:46,166 --> 01:10:47,367
OF PRINCIPAL INVESTIGATORS WITH

1927
01:10:47,367 --> 01:10:50,103
TWO MILLION TOTAL COST OR MORE

1928
01:10:50,103 --> 01:10:52,372
IN RPG AWARDS.

1929
01:10:52,372 --> 01:10:54,174
IN AN EFFORT TO CONTINUE

1930
01:10:54,174 --> 01:10:55,175
RESPONSIBLE STEWARDSHIP OF

1931
01:10:55,175 --> 01:10:57,677
PUBLIC FUNDS AND TO SUPPORT

1932
01:10:57,677 --> 01:11:01,481
MERITORIOUS AND INNOVATIVE

1933
01:11:01,481 --> 01:11:04,484
RESEARCH, NIH HAS INSTITUTED A

1934
01:11:04,484 --> 01:11:06,787
POLICY OF SPECIAL CANCER REVIEW

1935
01:11:06,787 --> 01:11:10,791
FROM WELL-FUNDED INVESTIGATORS.

1936
01:11:10,791 --> 01:11:13,660
PENDING GRANTS GOING TO THE

1937
01:11:13,660 --> 01:11:14,895
BOARD FROM PRINCIPAL

1938
01:11:14,895 --> 01:11:15,562
INVESTIGATORS THAT HAVE MORE

1939
01:11:15,562 --> 01:11:17,197
THAN TWO MILLION OR MORE DIRECT

1940
01:11:17,197 --> 01:11:20,734
COSTS FROM ACTIVE NIH RESEARCH

1941
01:11:20,734 --> 01:11:24,404
GRANTS THAT IS RPGs, MUST BE

1942
01:11:24,404 --> 01:11:25,605
GIVEN ADDITIONAL CONSIDERATION T

1943
01:11:25,605 --> 01:11:27,674
IS IMPORTANT TO RECOGNIZE THAT

1944
01:11:27,674 --> 01:11:30,610
THIS IS A THRESHOLD ONLY.

1945
01:11:30,610 --> 01:11:32,579
INVESTIGATORS WHO HAVE MORE

1946
01:11:32,579 --> 01:11:33,914
RESEARCH SUPPORT MAY STILL

1947
01:11:33,914 --> 01:11:37,417
RECEIVE ADDITIONAL AWARDS AS

1948
01:11:37,417 --> 01:11:37,784
WARRANTED.

1949
01:11:37,784 --> 01:11:41,221
SO, ARE THERE QUESTIONS?

1950
01:11:41,221 --> 01:11:43,089
OR IS FURTHER CLARIFICATION

1951
01:11:43,089 --> 01:11:43,423
NEEDED?

1952
01:11:43,423 --> 01:11:45,692
IF NOT, THEN JOHN WILL CALL FOR

1953
01:11:45,692 --> 01:11:49,095
A VOTE OF APPROVAL, DISAPPROVAL

1954
01:11:49,095 --> 01:11:49,629
OR EXTENSION.

1955
01:11:49,629 --> 01:11:53,767
THAT IS, HE CAN INDICATION OF

1956
01:11:53,767 --> 01:11:58,104
THE DELEGATIONS OF AUTHORITY.

1957
01:11:58,104 --> 01:11:59,706
-- HE CAN EXTEND THE DELEGATIONS

1958
01:11:59,706 --> 01:12:00,407
OF AUTHORITY.

1959
01:12:00,407 --> 01:12:01,608
>> THANK YOU, PAULETTE.

1960
01:12:01,608 --> 01:12:06,179
AS PAULETTE SAID, WE NEED TO

1961
01:12:06,179 --> 01:12:09,115
CALL FOR A MOTION TO EITHER

1962
01:12:09,115 --> 01:12:11,218
APPROVE, DISPROVE OR FOR

1963
01:12:11,218 --> 01:12:11,485
EXTENSION.

1964
01:12:11,485 --> 01:12:14,988
IS THERE A MOTION?

1965
01:12:14,988 --> 01:12:16,556
>> MOVE TO AAPPROVE.

1966
01:12:16,556 --> 01:12:19,025
>> IS THERE A SECOND?

1967
01:12:19,025 --> 01:12:19,726
>> SECOND.

1968
01:12:19,726 --> 01:12:20,760
>> PROPERLY MOVED AND
SECONDED.

1969
01:12:20,760 --> 01:12:22,796
IS THERE ANY FURTHER DISCUSSION

1970
01:12:22,796 --> 01:12:25,966
OR QUESTIONS?

1971
01:12:25,966 --> 01:12:27,934
IF NOT, WE'LL GO AHEAD AND VOTE.

1972
01:12:27,934 --> 01:12:32,239
I'M GOING TO ASK IF THERE ARE

1973
01:12:32,239 --> 01:12:32,839
ANY NEIGHS.

1974
01:12:32,839 --> 01:12:38,745
ANY ABSTENTIONS?

1975
01:12:38,745 --> 01:12:40,514
PAULETTE?

1976
01:12:40,514 --> 01:12:41,448
>> IT'S UNANIMOUS.

1977
01:12:41,448 --> 01:12:48,021
AND I GAVE YOU BACK TWO MINUTES.

1978
01:12:48,021 --> 01:12:51,224
>> SO FOR OUR PRESENTERS,
NEXT

1979
01:12:51,224 --> 01:12:54,127
UP WE HAVE TWO SCIENTIFIC

1980
01:12:54,127 --> 01:12:55,428
PRESENTATIONS AND THESE ARE BY

1981
01:12:55,428 --> 01:12:58,632
MID CAREERS AND SELECTED IN

1982
01:12:58,632 --> 01:13:01,034
INTRAMURAL AND EXTRAMURAL.

1983
01:13:01,034 --> 01:13:06,640
SO THE FIRST WILL BE BROUGHT TO

1984
01:13:06,640 --> 01:13:10,043
US BY DR. MACHIELA, AN

1985
01:13:10,043 --> 01:13:12,913
INVESTIGATOR INTEGRATIVE TUMOR

1986
01:13:12,913 --> 01:13:13,547
EPIDEMIOLOGY BRANCH IN THE

1987
01:13:13,547 --> 01:13:14,915
BRANCH OF CANCER EPIDEMIOLOGY

1988
01:13:14,915 --> 01:13:17,150
AND GENETICS, WHO WILL BE

1989
01:13:17,150 --> 01:13:20,120
PRESENTING A TALK ENTITLED,

1990
01:13:20,120 --> 01:13:21,221
INTEGRATIVE POPULATION BASED

1991
01:13:21,221 --> 01:13:24,824
CHARACTERIZATION OF MOSAIC

1992
01:13:24,824 --> 01:13:27,928
CHROMOSOMAL ALTERATIONS UNCOVERS

1993
01:13:27,928 --> 01:13:30,664
ETIOLOGIC INSIGHTS FOR

1994
01:13:30,664 --> 01:13:33,833
HEMATOLOGIC MALIGNANCIES.

1995
01:13:33,833 --> 01:13:35,735
>> LET ME PULL UP THE
SLIDES

1996
01:13:35,735 --> 01:13:45,178
HERE REAL QUICK.

1997
01:13:45,178 --> 01:13:46,746
THANK YOU FOR THE OPPORTUNITY TO

1998
01:13:46,746 --> 01:13:48,014
PRESENT MY WORK HERE IN FRONT OF

1999
01:13:48,014 --> 01:13:50,116
THE NCAB.

2000
01:13:50,116 --> 01:13:52,552
I'M DELIGHTED TO PRESENT

2001
01:13:52,552 --> 01:13:55,255
FINDINGS FROM INTEGRATIVE

2002
01:13:55,255 --> 01:13:55,822
POPULATION BASED ANALYSIS

2003
01:13:55,822 --> 01:13:58,124
UNDERSTANDING SOMATIC

2004
01:13:58,124 --> 01:13:59,659
ALTERATIONS AND HOW THE

2005
01:13:59,659 --> 01:14:01,261
ENVIRONMENTAL EXPOSURES INTERACT

2006
01:14:01,261 --> 01:14:03,730
AND INFLUENCE CANCER RISK.

2007
01:14:03,730 --> 01:14:05,632
GENETIC ETIOLOGY OF CANCER, I

2008
01:14:05,632 --> 01:14:06,967
STUDY NORMAL TISSUES BEFORE

2009
01:14:06,967 --> 01:14:08,735
TUMOR FORMATION.

2010
01:14:08,735 --> 01:14:12,806
CHARACTERIZED CHANGES THAT COULD

2011
01:14:12,806 --> 01:14:13,540
PROMOTE CLONAL EXPANSION TO

2012
01:14:13,540 --> 01:14:14,474
MUTATED CELLS.

2013
01:14:14,474 --> 01:14:15,575
BIOBANKS HAVE EXISTING

2014
01:14:15,575 --> 01:14:16,643
COLLECTIONS OF BLOOD SAMPLES.

2015
01:14:16,643 --> 01:14:18,445
BLOOD IS AN IDEAL TISSUE TO

2016
01:14:18,445 --> 01:14:18,645
STUDY.

2017
01:14:18,645 --> 01:14:20,580
MY RESEARCH CAPITALIZES ON

2018
01:14:20,580 --> 01:14:22,949
DECADES OF INTRAMURAL AND DCCPS

2019
01:14:22,949 --> 01:14:24,951
EXTRAMURAL INVESTMENTS TO

2020
01:14:24,951 --> 01:14:25,986
CHARACTERIZE AGE RELATED

2021
01:14:25,986 --> 01:14:28,655
MUTATIONS AND EXISTING SAMPLES

2022
01:14:28,655 --> 01:14:31,057
WITHIN SHEDDING LIGHT ON

2023
01:14:31,057 --> 01:14:32,359
FREQUENCY AS WELL AS BIOLOGIC

2024
01:14:32,359 --> 01:14:35,662
IMPORTANCE OF THESE OBSERVAT 

2025
01:14:35,662 --> 01:14:35,996
OBSERVATIONS.

2026
01:14:35,996 --> 01:14:37,263
THE MUTATIONS IN THE LEUKOCYTES

2027
01:14:37,263 --> 01:14:41,768
OF CANCER-FREE INDIVIDUALS IS

2028
01:14:41,768 --> 01:14:41,935
CH.

2029
01:14:41,935 --> 01:14:43,737
CH IS ACQUIRED WHEN NORMAL CELLS

2030
01:14:43,737 --> 01:14:47,240
ARE MUTATED AND THE MUTATION

2031
01:14:47,240 --> 01:14:48,942
CONFERS A SURVIVAL ADVANTAGE OF

2032
01:14:48,942 --> 01:14:51,344
MUTATED CELLS TO EXPAND.

2033
01:14:51,344 --> 01:14:53,546
ANY SUCH EXPANDING MUTATION

2034
01:14:53,546 --> 01:14:55,448
COULD HAVE RELEVANCE FOR FUTURE

2035
01:14:55,448 --> 01:14:56,149
CANCER RISK.

2036
01:14:56,149 --> 01:14:57,951
AS SUCH, CH COULD PROVIDE

2037
01:14:57,951 --> 01:14:59,686
INSIGHT INTO THE GENETIC

2038
01:14:59,686 --> 01:15:02,255
ETIOLOGY OF HEMATOLOGIC

2039
01:15:02,255 --> 01:15:02,622
MALIGNANCIES.

2040
01:15:02,622 --> 01:15:06,660
MOST INDIVIDUALS CH DO NOT

2041
01:15:06,660 --> 01:15:08,461
DEVELOP MALIGNANCY HIGHLIGHTING

2042
01:15:08,461 --> 01:15:12,699
THE NEEDS TO IDENTIFY HIGH-RISK

2043
01:15:12,699 --> 01:15:12,966
SUBTYPES.

2044
01:15:12,966 --> 01:15:17,303
THERE A BROAD SPECTRUM OF CH.

2045
01:15:17,303 --> 01:15:19,472
MY RESEARCH FOCUSES ON

2046
01:15:19,472 --> 01:15:20,974
CHROMOSOMAL ALTERATIONS WHICH

2047
01:15:20,974 --> 01:15:23,376
ARE LARGE STRUCTURAL CHROMOSOMAL

2048
01:15:23,376 --> 01:15:23,677
ALTERATIONS.

2049
01:15:23,677 --> 01:15:26,379
THEY ARE USUALLY DETECTED WITH

2050
01:15:26,379 --> 01:15:27,580
PHENOTYPE ARRAY DATA.

2051
01:15:27,580 --> 01:15:29,683
AS DESCRIBED IN EARLY POPULATION

2052
01:15:29,683 --> 01:15:32,485
BASED STUDIES BY MY MENTOR.

2053
01:15:32,485 --> 01:15:37,090
THE OTHER END OF THE SPECTRUM,

2054
01:15:37,090 --> 01:15:38,591
CHIP WAS CARTED RIDES LATER AS

2055
01:15:38,591 --> 01:15:40,293
POPULATION BASED SEQUENCING

2056
01:15:40,293 --> 01:15:44,397
STUDIES BECAME AVAILABLE.

2057
01:15:44,397 --> 01:15:46,533
CHIP IS CHARACTERIZED BY

2058
01:15:46,533 --> 01:15:51,404
VARIANCE WHICH IMPACT ON THE

2059
01:15:51,404 --> 01:15:51,604
GENES.

2060
01:15:51,604 --> 01:15:53,273
SIMILAR TO CYTOLOGY BASED

2061
01:15:53,273 --> 01:15:54,908
METHODS, MORE.

2062
01:15:54,908 --> 01:15:59,079
CAs ATTACK USING VIRTUAL

2063
01:15:59,079 --> 01:15:59,713
KARYOTYPES.

2064
01:15:59,713 --> 01:16:01,181
SPECIALIZED ALGORITHMS CAN SCAN

2065
01:16:01,181 --> 01:16:04,584
THE GENOME FOR IMBALANCES

2066
01:16:04,584 --> 01:16:06,286
MEASURED BY ALLELE FREQUENCY.

2067
01:16:06,286 --> 01:16:10,423
AND DEVIATIONS MEASURED BY LOG 2

2068
01:16:10,423 --> 01:16:11,758
RATIOS ARE HALLMARK SIGNATURES

2069
01:16:11,758 --> 01:16:13,493
OF MCAs.

2070
01:16:13,493 --> 01:16:15,095
CONTINUOUS CHROMOSOMAL STRETCHES

2071
01:16:15,095 --> 01:16:17,530
AND DEVIATIONS SEEN HERE ARE

2072
01:16:17,530 --> 01:16:21,067
EVIDENCE OF CHROMOSOMAL

2073
01:16:21,067 --> 01:16:21,401
ALLERRATIONS.

2074
01:16:21,401 --> 01:16:22,702
DETECTED EVENTS ARE

2075
01:16:22,702 --> 01:16:28,708
CHARACTERIZED INTO COPY NEUTRAL

2076
01:16:28,708 --> 01:16:30,110
HETEROZYGOSITY.

2077
01:16:30,110 --> 01:16:32,412
ENSURING BALANCES MEASURED BY

2078
01:16:32,412 --> 01:16:33,580
THE B LEGAL FREQUENCY ARE

2079
01:16:33,580 --> 01:16:34,414
PROPORTIONAL TO EXPECTED

2080
01:16:34,414 --> 01:16:37,050
DEVIATIONS AND SIGNAL INTENSITY

2081
01:16:37,050 --> 01:16:37,817
MEASURED BY LRR.

2082
01:16:37,817 --> 01:16:40,653
THIS HAS BEEN VALIDATED BY BOTH

2083
01:16:40,653 --> 01:16:41,788
CYTOGENETIC AS WELL AS MONTH

2084
01:16:41,788 --> 01:16:43,590
ELECTULAR TECHNIQUES.

2085
01:16:43,590 --> 01:16:45,091
AS A LOT OF SAMPLE SIZES ARE

2086
01:16:45,091 --> 01:16:48,094
NEEDED TO STUDY MCAs, WE HAVE

2087
01:16:48,094 --> 01:16:49,429
CHARACTERIZED OVER ONE MILLION

2088
01:16:49,429 --> 01:16:51,331
STUDY PARTICIPANTS TO GAIN

2089
01:16:51,331 --> 01:16:52,732
IMPORTANT INSIGHTS ON THE

2090
01:16:52,732 --> 01:16:57,704
FREQUENCY AND DISTRIBUTION.

2091
01:16:57,704 --> 01:16:58,838
INITIAL STUDIES IDENTIFIED

2092
01:16:58,838 --> 01:16:59,806
HIGHER THAN ANTICIPATED

2093
01:16:59,806 --> 01:17:02,442
FREQUENCIES OF MORE.

2094
01:17:02,442 --> 01:17:03,510
CAs.

2095
01:17:03,510 --> 01:17:05,845
STUDIES DETECTED FREQUENCY OF

2096
01:17:05,845 --> 01:17:09,415
3-5% WITH INCREASES WITH

2097
01:17:09,415 --> 01:17:11,317
INCREASING AGE, NOTABLE

2098
01:17:11,317 --> 01:17:12,952
ENRICHMENT IN REGIONS KNOWN TO

2099
01:17:12,952 --> 01:17:18,858
BE ALTERED IN MALIGNANCIES.

2100
01:17:18,858 --> 01:17:21,795
-- MOSAIC Y LOSS AS MOST

2101
01:17:21,795 --> 01:17:24,230
FREQUENTLY OCCURRING AGE RELATED

2102
01:17:24,230 --> 01:17:25,131
MCA WITH FREQUENCIES IN ACCESS

2103
01:17:25,131 --> 01:17:30,303
OF 20% IN ELDERLY POPULATIONS.

2104
01:17:30,303 --> 01:17:31,738
LIKEWISE X LOSS IS THE MOST

2105
01:17:31,738 --> 01:17:33,406
COMMONLY OCCURRING IN FEMALES

2106
01:17:33,406 --> 01:17:35,508
WITH X CHROMOSOME BEING PRESENT

2107
01:17:35,508 --> 01:17:38,545
AND 10-12% OF WOMEN.

2108
01:17:38,545 --> 01:17:41,414
OUR INVESTIGATIONS OBSERVED

2109
01:17:41,414 --> 01:17:43,116
HIGHER FREQUENCIES AMONG

2110
01:17:43,116 --> 01:17:44,217
INACTIVATED X CHROMOSOME IN

2111
01:17:44,217 --> 01:17:45,819
AGREEMENT WITH HIGH MUTATION

2112
01:17:45,819 --> 01:17:50,023
FREQUENCIES IN CANCER GENOMES AS

2113
01:17:50,023 --> 01:17:52,425
INACTIVE X CHROMOSOME IS

2114
01:17:52,425 --> 01:17:54,527
REPLICATING AND SUSCEPTIBLE TO

2115
01:17:54,527 --> 01:17:55,228
REPLICATION ERRORS.

2116
01:17:55,228 --> 01:17:58,331
FINALLY OUR STUDY OF X MOSAICS

2117
01:17:58,331 --> 01:18:00,133
IN MEN IDENTIFIED LOW

2118
01:18:00,133 --> 01:18:02,936
FREQUENCIES OF .006% WITH NO

2119
01:18:02,936 --> 01:18:04,537
OBSERVATIONS OF MALE X

2120
01:18:04,537 --> 01:18:06,139
CHROMOSOMAL LOSS DEMONSTRATING

2121
01:18:06,139 --> 01:18:07,941
IMPORTANCE OF ONE COPY OF X

2122
01:18:07,941 --> 01:18:11,010
CHROMOSOME FOR LEUCOCYTE

2123
01:18:11,010 --> 01:18:11,477
FUNCTION.

2124
01:18:11,477 --> 01:18:13,546
THESE INDICATE MCAs ARE COMMON

2125
01:18:13,546 --> 01:18:18,251
IN THE ADULT POPULATIONS BUT

2126
01:18:18,251 --> 01:18:19,719
VERY INFREQUENT BY THE

2127
01:18:19,719 --> 01:18:22,222
CHROMOSOME EFFECTED.

2128
01:18:22,222 --> 01:18:24,557
-- POPULATION BASED STUDIES

2129
01:18:24,557 --> 01:18:25,959
UTILIZING EXPOSURE POPULATIONS

2130
01:18:25,959 --> 01:18:29,229
WITHIN DCG AND EXTRAMURAL

2131
01:18:29,229 --> 01:18:31,397
IDENTIFIED RISK FACTORS.

2132
01:18:31,397 --> 01:18:35,134
ACROSS ALL TYPES OF MCAs,

2133
01:18:35,134 --> 01:18:37,737
AGING IS THE STRONGEST RISK

2134
01:18:37,737 --> 01:18:39,239
FACTORS WITH FREQUENCY

2135
01:18:39,239 --> 01:18:40,139
INCREASING WITH AGE.

2136
01:18:40,139 --> 01:18:41,674
GENERALLY POPULATIONS UNDER 40

2137
01:18:41,674 --> 01:18:43,209
YEARS OF AGE HAVE LOW

2138
01:18:43,209 --> 01:18:45,245
FREQUENCIES OF MCAs,

2139
01:18:45,245 --> 01:18:47,213
EXPONENTIAL INCREASES OBSERVED

2140
01:18:47,213 --> 01:18:50,550
IN THE 50s.

2141
01:18:50,550 --> 01:18:52,752
SEX IS OTHER WELL-CHARACTERIZED

2142
01:18:52,752 --> 01:18:54,988
RISK FACTOR WITH MALES HAVING

2143
01:18:54,988 --> 01:18:56,856
HIGHER FREQUENCIES OF AUTOSOMAL

2144
01:18:56,856 --> 01:18:59,092
MCAs RELATIVE TO FEMALES.

2145
01:18:59,092 --> 01:19:01,761
WHEN FACTORING IN SEX, MALES

2146
01:19:01,761 --> 01:19:04,631
HAVE FURTHER ELEVATED

2147
01:19:04,631 --> 01:19:05,064
FREQUENCIES.

2148
01:19:05,064 --> 01:19:06,733
ANCESTRY IS ASSOCIATED WITH MCA

2149
01:19:06,733 --> 01:19:08,568
RISK WITH INDIVIDUALS OF AFRICAN

2150
01:19:08,568 --> 01:19:10,536
ANCESTRY HAVING LOWER

2151
01:19:10,536 --> 01:19:11,938
FREQUENCIES OF MCAs THAN

2152
01:19:11,938 --> 01:19:13,873
INDIVIDUALS WITH THE EUROPEAN OR

2153
01:19:13,873 --> 01:19:15,408
ASIAN ANCESTRY.

2154
01:19:15,408 --> 01:19:18,144
THERE ARE ALSO DIFFERENCES MCA

2155
01:19:18,144 --> 01:19:19,445
FREQUENCY BY GEOGRAPHY.

2156
01:19:19,445 --> 01:19:21,214
IN SUB-SAHARAN AFRICA WE

2157
01:19:21,214 --> 01:19:23,182
IDENTIFIED CHILDREN WITH RATES

2158
01:19:23,182 --> 01:19:24,384
COMPARABLE TO MIDDLE AGED

2159
01:19:24,384 --> 01:19:26,753
POPULATION IN DEVELOPED NATIONS.

2160
01:19:26,753 --> 01:19:27,954
SUGGESTING ENVIRONMENTAL FACTORS

2161
01:19:27,954 --> 01:19:31,758
SUCHA MALARIA INFECTION MAKE MCA

2162
01:19:31,758 --> 01:19:32,458
RISK.

2163
01:19:32,458 --> 01:19:34,193
MODIFIABLE RISK FACTORS, SUCH AS

2164
01:19:34,193 --> 01:19:36,062
SMOKING ARE ASSOCIATED WITH

2165
01:19:36,062 --> 01:19:37,397
MCAs WITH STRONGEST

2166
01:19:37,397 --> 01:19:39,065
ASSOCIATIONS FOR LOSS OF Y

2167
01:19:39,065 --> 01:19:42,702
CHROMOSOME IN MEN.

2168
01:19:42,702 --> 01:19:44,570
SMOKERS SUGGESTS THAT Y LOSS

2169
01:19:44,570 --> 01:19:47,974
DECREASE AS YEARS OF CESSATION

2170
01:19:47,974 --> 01:19:49,008
INCREASE.

2171
01:19:49,008 --> 01:19:49,876
STUDIES ALSO IDENTIFIED

2172
01:19:49,876 --> 01:19:52,078
RELATIONSHIP WITH INHERITY TEAL

2173
01:19:52,078 --> 01:19:52,345
MERLENGTH.

2174
01:19:52,345 --> 01:19:54,380
INDIVIDUALS WITH LONGER INHERITY

2175
01:19:54,380 --> 01:19:58,685
TELOMERE LENGTH HAVE INCREASE

2176
01:19:58,685 --> 01:19:59,052
SUSCEPTIBILITY.

2177
01:19:59,052 --> 01:20:04,257
AS MCAs -- ALL DATA NECESSARY

2178
01:20:04,257 --> 01:20:07,994
TO PERFORM GWAS TO IDENTIFY

2179
01:20:07,994 --> 01:20:09,762
GERMLINE SUSCEPTIBILITY IS

2180
01:20:09,762 --> 01:20:10,663
AVAILABLE.

2181
01:20:10,663 --> 01:20:13,199
IDENTIFIED 156 AUTOSOMAL LOCI

2182
01:20:13,199 --> 01:20:16,803
ASSOCIATED WITH MOSAIC Y LOSS.

2183
01:20:16,803 --> 01:20:19,072
I HAVE RECENTY CALLED A GWAS OF

2184
01:20:19,072 --> 01:20:21,107
LOSS OF X CHROMOSOME IN FEMALES

2185
01:20:21,107 --> 01:20:23,509
THAT IDENTIFIED AN ADDITIONAL 56

2186
01:20:23,509 --> 01:20:28,881
LOCI AND RARE VARIANT

2187
01:20:28,881 --> 01:20:29,182
ASSOCIATION.

2188
01:20:29,182 --> 01:20:31,718
X LOSS LOCI ARE SHARED WITH LOSS

2189
01:20:31,718 --> 01:20:34,287
OF Y MANY OF GENES ASSOCIATED

2190
01:20:34,287 --> 01:20:36,189
WITH BLOOD CELL COUNTS AND

2191
01:20:36,189 --> 01:20:39,892
IMMUNE FUNCTION AND CANCER PRE

2192
01:20:39,892 --> 01:20:40,626
DISPOSITION.

2193
01:20:40,626 --> 01:20:41,794
INTERESTINGLY, LOOKING AT ONLY

2194
01:20:41,794 --> 01:20:45,098
THE X CHROMOSOME, WE IDENTIFIED

2195
01:20:45,098 --> 01:20:47,467
44 LOCI RETAINED ON THE

2196
01:20:47,467 --> 01:20:49,402
REMAINING X CHROMOSOME USING

2197
01:20:49,402 --> 01:20:51,637
DIFFERENTIAL SCORES OF LOCI FOR

2198
01:20:51,637 --> 01:20:54,474
EACH COPY OF X, WE CAN INFER

2199
01:20:54,474 --> 01:20:58,011
THAT RETAINED X CHROMOSOME UP TO

2200
01:20:58,011 --> 01:21:00,413
8% OF LOSS OF X CASES.

2201
01:21:00,413 --> 01:21:01,714
TO INVESTIGATE DOWNSTREAM

2202
01:21:01,714 --> 01:21:04,617
CONSEQUENCES OF MCAs, STUDIES

2203
01:21:04,617 --> 01:21:06,619
OF DIVERSE OUTCOMES RELEVANT FOR

2204
01:21:06,619 --> 01:21:10,390
DISEASE AND CANCER RISK.

2205
01:21:10,390 --> 01:21:11,724
MCAs ARE STRONGLY ASSOCIATED

2206
01:21:11,724 --> 01:21:13,126
WITH INCREASED LEUKEMIA RISK

2207
01:21:13,126 --> 01:21:16,729
WITH ESTIMATED HAZARD RATIOS IN

2208
01:21:16,729 --> 01:21:19,432
EXCESS OF 15.

2209
01:21:19,432 --> 01:21:21,534
ASSOCIATIONS ARE STRONGEST FOR

2210
01:21:21,534 --> 01:21:23,803
LYMPHOID LEUKEMIA AND ALSO

2211
01:21:23,803 --> 01:21:24,337
MYELOID.

2212
01:21:24,337 --> 01:21:26,406
SPECIFIC EVENTS SUCH AS

2213
01:21:26,406 --> 01:21:28,908
DELETIONS ARE ASSOCIATED WITH

2214
01:21:28,908 --> 01:21:31,744
HAZARD RATIOS WITH OVER 100 FOR

2215
01:21:31,744 --> 01:21:33,413
CLL RISK.

2216
01:21:33,413 --> 01:21:34,747
MCAs ARE ASSOCIATED WITH

2217
01:21:34,747 --> 01:21:36,816
SELECT SOLID TUMOR RISK

2218
01:21:36,816 --> 01:21:38,918
INCLUDING LONG, SKIN AND

2219
01:21:38,918 --> 01:21:41,120
PROSTATE CANCER, TOGETHERRING

2220
01:21:41,120 --> 01:21:43,389
THOSE IN BLOOD COULD SERVE AS

2221
01:21:43,389 --> 01:21:44,323
ABA ROM TORE FOR MUTATIONAL

2222
01:21:44,323 --> 01:21:45,625
PROCESS AND OTHER TISSUES.

2223
01:21:45,625 --> 01:21:51,731
RISK ESTIMATES ARE MUCH LOWER.

2224
01:21:51,731 --> 01:21:55,401
LONGER TELOMERE LENGTH IS

2225
01:21:55,401 --> 01:21:58,137
INCREASED MCAs.

2226
01:21:58,137 --> 01:22:00,740
THIS SUGGESTS THAT DYNAMIC

2227
01:22:00,740 --> 01:22:01,707
RELATIONSHIPS SUCH CELLS

2228
01:22:01,707 --> 01:22:05,044
HARBORING MCAs MEET MECHANISMS

2229
01:22:05,044 --> 01:22:07,313
THAT MAINTAIN LONGER TELOMERES.

2230
01:22:07,313 --> 01:22:09,849
THE CLONE EXPANSION RESULTS IN

2231
01:22:09,849 --> 01:22:12,919
TELOMERE LENGTH ATTRITION.

2232
01:22:12,919 --> 01:22:14,320
MCAs ARE ASSOCIATED WITH

2233
01:22:14,320 --> 01:22:15,822
ALTERATIONS IN BLOOD CELL COUNTS

2234
01:22:15,822 --> 01:22:20,626
SPECIFICALLY ELEVATED LEUCOCYTE

2235
01:22:20,626 --> 01:22:20,960
COUNTS.

2236
01:22:20,960 --> 01:22:23,963
THE COVID-19 PANDEMIC MOTIVATED

2237
01:22:23,963 --> 01:22:24,831
ME TO INVESTIGATION

2238
01:22:24,831 --> 01:22:27,333
RELATIONSHIPS BETWEEN MCAs AND

2239
01:22:27,333 --> 01:22:29,035
INFECTIOUS DISEASE RISK.

2240
01:22:29,035 --> 01:22:30,136
WE IDENTIFIED RELATIONSHIPS WITH

2241
01:22:30,136 --> 01:22:33,005
EXPANDED MCAs AND RISK OF

2242
01:22:33,005 --> 01:22:34,841
SEPSIS AND PNEUMONIA WITH

2243
01:22:34,841 --> 01:22:36,142
STRONGER EFFECTS OBSERVED IN

2244
01:22:36,142 --> 01:22:37,176
CANCER PATIENTS.

2245
01:22:37,176 --> 01:22:39,245
WE ALSO NOTED EVIDENCE DURING

2246
01:22:39,245 --> 01:22:43,249
PRE SUSCEPTIBILITY TO SEVERE

2247
01:22:43,249 --> 01:22:45,251
COVID-19.

2248
01:22:45,251 --> 01:22:46,853
MY RESEARCH PROGRAMS ALSO

2249
01:22:46,853 --> 01:22:48,454
DEVELOPING MODELS TO IMPROVE

2250
01:22:48,454 --> 01:22:50,556
CANCER RISK STRATIFICATION USING

2251
01:22:50,556 --> 01:22:52,558
CLL AS AN EXAMPLE, WE AIM TO SEE

2252
01:22:52,558 --> 01:22:54,894
HOW THE INCORPORATION OF GENETIC

2253
01:22:54,894 --> 01:22:57,263
KNOWLEDGE CAN IMPROVE RISK

2254
01:22:57,263 --> 01:22:58,531
STRATIFICATION OVER CLINICAL

2255
01:22:58,531 --> 01:22:59,966
RISK FACTOR INFORMATION.

2256
01:22:59,966 --> 01:23:03,136
USING UK BIOBANK DAY DATA AND A

2257
01:23:03,136 --> 01:23:06,639
MODEL ONE CONTAIN CLASSICAL RISK

2258
01:23:06,639 --> 01:23:09,942
FACTORS, WE OBSERVED 0.84, HIGH

2259
01:23:09,942 --> 01:23:13,579
VALUE TO START WITH ATTRIBUTABLE

2260
01:23:13,579 --> 01:23:15,748
TO THE UTILITY OF BLOOD CELL

2261
01:23:15,748 --> 01:23:16,949
COUNTS.

2262
01:23:16,949 --> 01:23:20,653
INCREASES IN A1C ADDING DATA

2263
01:23:20,653 --> 01:23:22,155
DERIVED FROM GENOME-WIDE

2264
01:23:22,155 --> 01:23:23,556
ASSOCIATION STUDIES.

2265
01:23:23,556 --> 01:23:25,591
FINALLY MODEL 3 SHOWS PREDICTED

2266
01:23:25,591 --> 01:23:28,494
UTILITY OF A FINAL COMBINED

2267
01:23:28,494 --> 01:23:29,662
MODEL THAT INCLUDES INFORMATION

2268
01:23:29,662 --> 01:23:32,098
ON MCAs AND CHIP.

2269
01:23:32,098 --> 01:23:33,766
THIS EXAMPLE DEMONSTRATES THAT

2270
01:23:33,766 --> 01:23:35,902
EVEN FOR HEMATOLOGIC

2271
01:23:35,902 --> 01:23:37,570
MALIGNANCIES FOR WHICH CLINICAL

2272
01:23:37,570 --> 01:23:40,072
RISK FACTORS PERFORM WELL,

2273
01:23:40,072 --> 01:23:43,609
ADDITION OF GERMLINE AND SOMATIC

2274
01:23:43,609 --> 01:23:44,177
INFORMATION NUTS NOTICEABLE

2275
01:23:44,177 --> 01:23:46,679
IMPROVEMENTS IN RISK.

2276
01:23:46,679 --> 01:23:49,282
MCAs ARE UNDER SELECTIVE

2277
01:23:49,282 --> 01:23:49,882
PRESSURE, THEIR CLONAL

2278
01:23:49,882 --> 01:23:52,685
TRAJECTORIES ARE DYNAMIC AND

2279
01:23:52,685 --> 01:23:54,787
PERIOD OF RAPID CLONAL EXPANSION

2280
01:23:54,787 --> 01:23:57,223
OR REVERTING BACK TO NORMAL

2281
01:23:57,223 --> 01:23:57,657
STATES.

2282
01:23:57,657 --> 01:23:59,659
WHILE THE DELETIONS ARE PRESENT

2283
01:23:59,659 --> 01:24:02,094
IN CIRCULATING BLOOD UP TO 15

2284
01:24:02,094 --> 01:24:04,564
YEARS PRIOR TO CLL DIAGNOSIS,

2285
01:24:04,564 --> 01:24:07,200
OUR ANALYSIS SUGGESTS CLL IS

2286
01:24:07,200 --> 01:24:08,901
BEST PREDICTED WITHIN 5-10 YEARS

2287
01:24:08,901 --> 01:24:12,405
OF SAMPLE COLLECTION AND

2288
01:24:12,405 --> 01:24:13,039
ADDITIONAL ASSESSMENTS MIGHT BE

2289
01:24:13,039 --> 01:24:14,273
NECESSARY WHEN PREDICTING FOR

2290
01:24:14,273 --> 01:24:18,211
LONGER TIME INTERVALS.

2291
01:24:18,211 --> 01:24:19,679
SO A QUICK SUMMARY OF KEY

2292
01:24:19,679 --> 01:24:21,314
FINDINGS FROM MY INVESTIGATIONS

2293
01:24:21,314 --> 01:24:22,548
OF MCAs.

2294
01:24:22,548 --> 01:24:25,251
FIRST MCAs IS DETECTABLE IN

2295
01:24:25,251 --> 01:24:29,789
THE BLOOD OF CANCER FREE

2296
01:24:29,789 --> 01:24:30,389
INDIVIDUALS INDICATING

2297
01:24:30,389 --> 01:24:31,290
EORGANIZATION WITH AGE AND

2298
01:24:31,290 --> 01:24:33,392
HEMATOPOIETIC COMPARTMENT TO

2299
01:24:33,392 --> 01:24:35,695
TOLERATE MUTATED CLONES.

2300
01:24:35,695 --> 01:24:39,298
THE DISTRIBUTION OF MCAs

2301
01:24:39,298 --> 01:24:40,433
DIFFERS BY CHROMOSOME WITH

2302
01:24:40,433 --> 01:24:42,768
REEGENCE MUTAT MUTATED IN LEUKES

2303
01:24:42,768 --> 01:24:45,738
ALTHOUGH MOST INDIVIDUALS OF MCA

2304
01:24:45,738 --> 01:24:47,006
CLONES DO NOT EQUIP PEOPLE TA

2305
01:24:47,006 --> 01:24:49,075
LOGIC CANCERS.

2306
01:24:49,075 --> 01:24:52,144
RISK FACTORS HAVE A HIGH DEGREE

2307
01:24:52,144 --> 01:24:54,981
OF SIMILARITY WITH HEMATOLOGIC

2308
01:24:54,981 --> 01:24:56,983
CANCER RISK FACTORS.

2309
01:24:56,983 --> 01:24:59,118
ON AGE AS WELL AS SMOKING.

2310
01:24:59,118 --> 01:25:02,288
INDICATING THE POTENTIAL TIME TO

2311
01:25:02,288 --> 01:25:03,889
UNCOVER NOVEL ETIOLOGIC

2312
01:25:03,889 --> 01:25:04,290
INSIGHTS.

2313
01:25:04,290 --> 01:25:05,791
FINALLY MCAs ARE ASSOCIATED

2314
01:25:05,791 --> 01:25:07,793
WITH MULTIPLE OUTCOMES AND CAN

2315
01:25:07,793 --> 01:25:10,496
BE IMPORTANT FOR HEMATOLOGIC

2316
01:25:10,496 --> 01:25:11,697
CANCERS SUGGESTING POSSIBLY

2317
01:25:11,697 --> 01:25:14,600
UTILITY FOR A MARKER FOR DISEASE

2318
01:25:14,600 --> 01:25:14,800
RISK.

2319
01:25:14,800 --> 01:25:17,103
WITH THAT, I WANT TO THANK MY

2320
01:25:17,103 --> 01:25:17,903
AMAZING RESEARCH GROUP AS WELL

2321
01:25:17,903 --> 01:25:19,005
AS MANY EXCEPTIONAL

2322
01:25:19,005 --> 01:25:20,406
COLLABORATORS AND RESOURCES

2323
01:25:20,406 --> 01:25:24,610
WITHIN NCI AND EXTRAMURALLY.

2324
01:25:24,610 --> 01:25:27,413
AND IF YOU ARE LOOKING FOR A

2325
01:25:27,413 --> 01:25:28,914
FELLOWSHIP, WE HAVE TERRIFIC

2326
01:25:28,914 --> 01:25:29,248
OPPORTUNITIES.

2327
01:25:29,248 --> 01:25:30,483
THANK YOU FOR YOUR ATTENTION AND

2328
01:25:30,483 --> 01:25:33,886
I WOULD WELCOME ANY QUESTIONS.

2329
01:25:33,886 --> 01:25:36,789
>> THANK YOU.

2330
01:25:36,789 --> 01:25:38,858
EXCEPTIONAL WORK.

2331
01:25:38,858 --> 01:25:42,395
ANY QUESTIONS FROM THE BOARD

2332
01:25:42,395 --> 01:25:46,932
MEMBERS I CAN START WITH ONE

2333
01:25:46,932 --> 01:25:48,200
WHILE WAITING FOR HANDS.

2334
01:25:48,200 --> 01:25:50,670
SO YOU MENTIONED ONE POTENTIAL

2335
01:25:50,670 --> 01:25:53,639
RISK FACTOR BEING AGING.

2336
01:25:53,639 --> 01:25:55,241
HAVE YOU LOOKED AT ASPECTS

2337
01:25:55,241 --> 01:25:59,312
RELATED TO EPIGENETIC AGING OR

2338
01:25:59,312 --> 01:26:01,013
FASTER AGING?

2339
01:26:01,013 --> 01:26:04,116
AND EARLIER ONSET OF THESE

2340
01:26:04,116 --> 01:26:05,318
ALTERATIONS AND INCREASED RISK

2341
01:26:05,318 --> 01:26:07,720
OF THESE TYPES OF CANCERS?

2342
01:26:07,720 --> 01:26:09,555
>> YES, THAT'S A TERRIFIC

2343
01:26:09,555 --> 01:26:09,822
QUESTION.

2344
01:26:09,822 --> 01:26:11,524
TO DATE, WE HAVE NOT.

2345
01:26:11,524 --> 01:26:13,526
BUT WE HAVE A STUDY UNDERWAY

2346
01:26:13,526 --> 01:26:15,027
LOOKING AT METHYLATION AGE AND A

2347
01:26:15,027 --> 01:26:17,697
LOT OF THESE OTHER METHYLATION

2348
01:26:17,697 --> 01:26:20,800
CLOCKS AND SEEING HOW THAT

2349
01:26:20,800 --> 01:26:21,801
BIOLOGIC AGE DIFFERS FROM THE

2350
01:26:21,801 --> 01:26:23,569
CHRONOLOGIC AGE AND SEEING IF

2351
01:26:23,569 --> 01:26:24,637
THERE ARE CERTAIN MECHANISMS

2352
01:26:24,637 --> 01:26:26,539
THAT MIGHT BE MORE CLOSELY

2353
01:26:26,539 --> 01:26:29,675
RELATED TO MCA RISK RELATIVE TO

2354
01:26:29,675 --> 01:26:31,043
THE CHRONOLOGIC AGE.

2355
01:26:31,043 --> 01:26:31,844
SO STAY TUNED.

2356
01:26:31,844 --> 01:26:34,213
THE ASSAYS ARE UNDER WAYITE NOW

2357
01:26:34,213 --> 01:26:35,948
AND HOPEFULLY IN THE NEXT FEW

2358
01:26:35,948 --> 01:26:38,417
MONTHS WE HAVE THE BEGINNINGS

2359
01:26:38,417 --> 01:26:40,419
OF --

2360
01:26:40,419 --> 01:26:41,721
>> INCREDIBLE EPIDEMIOLOGY
YOU

2361
01:26:41,721 --> 01:26:44,056
GUYS HAVE TO SORT OF ASSOCIATE

2362
01:26:44,056 --> 01:26:46,959
THAT WITH THE EPIGENETIC AGING

2363
01:26:46,959 --> 01:26:49,962
WITH EXPOSURES OR OTHER

2364
01:26:49,962 --> 01:26:50,830
EPIDEMIOLOGICAL RISK FACTORS.

2365
01:26:50,830 --> 01:26:52,631
SO THIS IS GREAT.

2366
01:26:52,631 --> 01:26:56,168
SO I SEE ANN AND KIM'S HANDS.

2367
01:26:56,168 --> 01:26:57,236
>> THANK YOU.

2368
01:26:57,236 --> 01:27:00,439
THAT WAS REALLY INTERESTING AND

2369
01:27:00,439 --> 01:27:00,840
EXCITING.

2370
01:27:00,840 --> 01:27:03,042
THE THING ABOUT MCAs THEY SEEM

2371
01:27:03,042 --> 01:27:04,744
TO BE INCREASINGLY BE ASSOCIATED

2372
01:27:04,744 --> 01:27:06,545
WITH ALMOST EVERYTHING,

2373
01:27:06,545 --> 01:27:08,647
CARDIOVASCULAR DISEASE AND

2374
01:27:08,647 --> 01:27:08,914
ET CETERA.

2375
01:27:08,914 --> 01:27:10,449
AND JOHN JUST TOUCHED ON A POINT

2376
01:27:10,449 --> 01:27:12,785
THAT IS CRITICAL AND THAT IS,

2377
01:27:12,785 --> 01:27:15,388
THE AGE FACTOR, I THINK, IS

2378
01:27:15,388 --> 01:27:16,889
GOING TO BE INCREDIBLY IMPORTANT

2379
01:27:16,889 --> 01:27:17,490
IN TERMS OF UNDERSTANDING THE

2380
01:27:17,490 --> 01:27:18,457
ROLE IN CANCER.

2381
01:27:18,457 --> 01:27:20,426
SO I'M WONDERING HOW PREDICTIVE

2382
01:27:20,426 --> 01:27:24,964
DO YOU THINK MCAs WILL BE?

2383
01:27:24,964 --> 01:27:26,632
YOU'RE LOOKING AT LEUKEMIAS BUT

2384
01:27:26,632 --> 01:27:28,934
BEYOND LEUKEMIAS, IS THIS A

2385
01:27:28,934 --> 01:27:30,202
BETTER PREDICTIVE TOOL THAN SOME

2386
01:27:30,202 --> 01:27:32,371
OF THE OTHER THINGS WE ARE

2387
01:27:32,371 --> 01:27:34,740
SEEING, IN MULTIPLE CANCER EARLY

2388
01:27:34,740 --> 01:27:35,841
DETECTION ASSAYS?

2389
01:27:35,841 --> 01:27:38,244
>> THAT'S A REALLY GOOD

2390
01:27:38,244 --> 01:27:38,511
QUESTION.

2391
01:27:38,511 --> 01:27:39,445
I THINK PART OF THE REASON THAT

2392
01:27:39,445 --> 01:27:41,247
WE'RE DOING A LOT OF THESE

2393
01:27:41,247 --> 01:27:43,449
REALLY INTEGRATIVE MODELS, IS WE

2394
01:27:43,449 --> 01:27:45,050
THINK IT HAS VALUABLE

2395
01:27:45,050 --> 01:27:46,652
INFORMATION TO ADD ALONG WITH

2396
01:27:46,652 --> 01:27:48,754
OTHER CLINICAL RISK FACTOR

2397
01:27:48,754 --> 01:27:51,090
INFORMATION ALONG THE OTHER GERM

2398
01:27:51,090 --> 01:27:52,158
LINES AND SUSCEPTIBILITY

2399
01:27:52,158 --> 01:27:52,458
INFORMATION.

2400
01:27:52,458 --> 01:27:55,361
I DON'T THINK MCAs IN AND OF

2401
01:27:55,361 --> 01:27:56,862
THEMSELVES WILL BE INCREDIBLY

2402
01:27:56,862 --> 01:27:58,898
PREDICTIVE, BUT I THINK IT DOES

2403
01:27:58,898 --> 01:28:00,599
ADD ADDITIONAL INFORMATION TO

2404
01:28:00,599 --> 01:28:03,002
THESE MODELS.

2405
01:28:03,002 --> 01:28:03,702
TING JUST IMPROVES OUR KNOWLEDGE

2406
01:28:03,702 --> 01:28:05,504
OF HOW THE GENOME WITH AGE

2407
01:28:05,504 --> 01:28:09,208
BEGINS TO DETERIORATE.

2408
01:28:09,208 --> 01:28:10,609
I ALSO LIKE AT THE BEGINNING OF

2409
01:28:10,609 --> 01:28:11,977
YOUR QUESTION, MENTION THE FACT

2410
01:28:11,977 --> 01:28:14,079
THAT WE SEE A LOT OF THESE

2411
01:28:14,079 --> 01:28:16,315
ASSOCIATIONS OUT THERE WITH

2412
01:28:16,315 --> 01:28:18,117
MCAs AND A LOT OF CHRONIC

2413
01:28:18,117 --> 01:28:19,018
DISEASES.

2414
01:28:19,018 --> 01:28:20,920
AND I THINK A LOT OF STUDIES

2415
01:28:20,920 --> 01:28:22,788
NEED TO BE CAREFUL IN THIS AREA.

2416
01:28:22,788 --> 01:28:24,190
MCAs ARE RELATED TO AGING AND

2417
01:28:24,190 --> 01:28:25,991
SMOKING AND THESE ARE LIKE TWO

2418
01:28:25,991 --> 01:28:27,993
REALLY STRONG RISK FACTORS FOR A

2419
01:28:27,993 --> 01:28:29,795
LOT OF OTHER DISEASES.

2420
01:28:29,795 --> 01:28:31,797
WE REALLY TRIED TO, AS CAREFULLY

2421
01:28:31,797 --> 01:28:33,199
AS WE CAN, MODEL THAT

2422
01:28:33,199 --> 01:28:34,834
RELATIONSHIP WITH AGE WHERE IT'S

2423
01:28:34,834 --> 01:28:37,536
NOT THIS LIN AREA RELATIONSHIP,

2424
01:28:37,536 --> 01:28:39,038
BUT EXPONENTIAL INCREASE WITH

2425
01:28:39,038 --> 01:28:39,205
AGE.

2426
01:28:39,205 --> 01:28:41,207
IF YOU INCORRECTLY SPECIFY THAT,

2427
01:28:41,207 --> 01:28:43,809
YOU DO HAVE POTENTIAL BIAS

2428
01:28:43,809 --> 01:28:44,810
CREEPING IN THERE AS WELL AS

2429
01:28:44,810 --> 01:28:46,111
THINGS LIKE SMOKING.

2430
01:28:46,111 --> 01:28:48,414
SMOKING IS DIFFICULT TO MEASURE

2431
01:28:48,414 --> 01:28:51,484
AND IF YOU HAVE POOR ADJUSTMENT

2432
01:28:51,484 --> 01:28:53,486
FOR THAT, OTHER ASSERTIONS ARE

2433
01:28:53,486 --> 01:28:56,288
IN THERE AS WELL.

2434
01:28:56,288 --> 01:28:58,624
>> IS THERE ANY DATA ON
THE

2435
01:28:58,624 --> 01:29:03,729
SUPER AGERS, THOSE LIVING OVER

2436
01:29:03,729 --> 01:29:04,029
100?

2437
01:29:04,029 --> 01:29:06,198
DO THEY HAVE FEWER OF THESE

2438
01:29:06,198 --> 01:29:09,401
KINDS OF STRUCTURAL CHANGES?

2439
01:29:09,401 --> 01:29:12,338
>> THAT'S A TERRIFIC
QUESTION.

2440
01:29:12,338 --> 01:29:15,441
WE HAVE LIMITED EVIDENCE FOR

2441
01:29:15,441 --> 01:29:17,009
OLDER AGE GROUPS AND THE CURRENT

2442
01:29:17,009 --> 01:29:18,344
STUDIES WE ARE ASSESSING.

2443
01:29:18,344 --> 01:29:20,913
IT'S POSSIBLE THAT THERE IS AT

2444
01:29:20,913 --> 01:29:23,215
THE HIGHEST AGE RANGE, A SLIGHT

2445
01:29:23,215 --> 01:29:26,919
DIP IN FREQUENCY OF MCAs.

2446
01:29:26,919 --> 01:29:28,053
SO IT'S MAYBE SOMETHING THESE

2447
01:29:28,053 --> 01:29:29,421
INDIVIDUALS THAT DO HAVE THESE

2448
01:29:29,421 --> 01:29:31,056
REALLY LONG LIFESPANS HAVE SOME

2449
01:29:31,056 --> 01:29:32,591
TYPE OF MECHANISMS THAT HELP

2450
01:29:32,591 --> 01:29:33,359
PROTECT AGAINST THAT.

2451
01:29:33,359 --> 01:29:35,327
WE JUST DON'T HAVE SUFFICIENT

2452
01:29:35,327 --> 01:29:36,929
DATA AT THIS MOMENT IN OUR

2453
01:29:36,929 --> 01:29:42,635
SAMPLE SIZE TO CONFIRM THAT AT

2454
01:29:42,635 --> 01:29:43,836
THIS POINT.

2455
01:29:43,836 --> 01:29:45,337
>> JUST WANT TO JUMP IN.

2456
01:29:45,337 --> 01:29:47,039
NICE TALK AND GOOD TO SEE YOUR

2457
01:29:47,039 --> 01:29:49,108
WORK CONTINUING TO PROGRESS.

2458
01:29:49,108 --> 01:29:50,442
I WONDER IF YOU CAN SPEAK,

2459
01:29:50,442 --> 01:29:52,411
BEFORE I ASK THE QUESTION, I

2460
01:29:52,411 --> 01:29:53,979
THINK IT'S A GREAT EXAMPLE OF

2461
01:29:53,979 --> 01:29:56,348
WHERE WE CAN LEARN SO MUCH FROM

2462
01:29:56,348 --> 01:29:58,884
DATA THAT IS THERE.

2463
01:29:58,884 --> 01:30:02,621
LIKE THESE MUTATIONS ARE SORT OF

2464
01:30:02,621 --> 01:30:04,857
HIDING UNDER OUR IF I WANTS AND

2465
01:30:04,857 --> 01:30:06,325
WE DIDN'T NOTICE THEM UNTIL WE

2466
01:30:06,325 --> 01:30:08,561
START LOOKING -- FINGERTIPS.

2467
01:30:08,561 --> 01:30:10,829
CAN YOU SPEAK TO WHY YOU CHOSEN

2468
01:30:10,829 --> 01:30:13,132
TO KEEP YOUR CAREER AT NCI?

2469
01:30:13,132 --> 01:30:14,667
LIKE WHAT RESOURCES ARE UNIQUE

2470
01:30:14,667 --> 01:30:16,835
HERE IN THE KIND OF WORK THAT

2471
01:30:16,835 --> 01:30:18,637
YOU DO?

2472
01:30:18,637 --> 01:30:19,772
>> YES, GREAT QUESTION.

2473
01:30:19,772 --> 01:30:22,341
THANKS FOR ASKING.

2474
01:30:22,341 --> 01:30:24,443
MOST OF MY WORK ACTUALLY BEGAN

2475
01:30:24,443 --> 01:30:27,680
IN DOING GENOME-WIDE ASSOCIATION

2476
01:30:27,680 --> 01:30:30,549
STUDIES LOOKING AT GERMLINE

2477
01:30:30,549 --> 01:30:31,750
SUSCEPTIBILITY TO DISEASE RISK.

2478
01:30:31,750 --> 01:30:33,652
IT'S A TERRIFIC COLLECTION OF

2479
01:30:33,652 --> 01:30:36,188
GENOME-WIDE ASSOCIATION STUDY

2480
01:30:36,188 --> 01:30:36,855
DATA.

2481
01:30:36,855 --> 01:30:38,591
AND DOING THESE GENOTYPING

2482
01:30:38,591 --> 01:30:41,594
EFFORTS WE NOTICED THAT KEY

2483
01:30:41,594 --> 01:30:43,562
FAILING QC OVER AND OVER AGAIN

2484
01:30:43,562 --> 01:30:46,732
WITH DIFFERENT HETEROZYGOSITY

2485
01:30:46,732 --> 01:30:48,267
RATES AND THAT'S HOW WE BEGAN

2486
01:30:48,267 --> 01:30:49,568
USING THESE MEASUREMENTS TO

2487
01:30:49,568 --> 01:30:52,871
DETECT THESE EVENTS USING THE

2488
01:30:52,871 --> 01:30:54,607
VIRTUAL KARYOTYPING.

2489
01:30:54,607 --> 01:30:55,441
THAT REALLY OPENED UP A WHOLE

2490
01:30:55,441 --> 01:30:56,976
NEW WINDOW OF NOT ONLY BEING

2491
01:30:56,976 --> 01:30:58,877
ABLE TO USE THAT INFORMATION TO

2492
01:30:58,877 --> 01:31:00,980
STUDY GERMLINE VARIATION IN

2493
01:31:00,980 --> 01:31:02,781
INDIVIDUALS, BUT WE ALSO GET A

2494
01:31:02,781 --> 01:31:04,683
GLIMPSE OF THE SOMATIC VARIATION

2495
01:31:04,683 --> 01:31:05,884
BEGINNING TO HAPPEN IN THE FORM

2496
01:31:05,884 --> 01:31:08,087
OF REALLY LARGE STRUCTURAL COPY

2497
01:31:08,087 --> 01:31:08,954
NUMBER EVENTS.

2498
01:31:08,954 --> 01:31:11,357
TO BE HONEST, I WAS REALLY

2499
01:31:11,357 --> 01:31:12,758
SURPRISED HOW FREQUENT THESE

2500
01:31:12,758 --> 01:31:14,760
WERE IN THE POPULATION AND AS WE

2501
01:31:14,760 --> 01:31:16,495
HAVE BEGUN TO CHARACTERIZE THESE

2502
01:31:16,495 --> 01:31:18,263
OVER THE YEARS, REALLY TRYING TO

2503
01:31:18,263 --> 01:31:20,566
FIND OUT THE UTILITY OF THESE

2504
01:31:20,566 --> 01:31:22,101
EVENTS WHERE WE CAN LEARN FROM

2505
01:31:22,101 --> 01:31:24,236
THEM ABOUT THE DISEASE PROCESS

2506
01:31:24,236 --> 01:31:27,272
AS WELL AS HOW THEY CAN BE USED

2507
01:31:27,272 --> 01:31:31,010
TO PREDICT DISEASE.

2508
01:31:31,010 --> 01:31:32,611
>> I'LL ASK ONE MORE
QUESTION.

2509
01:31:32,611 --> 01:31:37,216
I'LL GO AHEAD AND LET KARIN ASK.

2510
01:31:37,216 --> 01:31:38,150
>> GREAT TALK, THANK YOU
VERY

2511
01:31:38,150 --> 01:31:39,385
MUCH, JOHN FOR ALLOWING ME TO

2512
01:31:39,385 --> 01:31:40,185
ASK THIS QUESTION.

2513
01:31:40,185 --> 01:31:41,587
IT'S RELATEDDED TO WHAT YOU HAD

2514
01:31:41,587 --> 01:31:42,788
JUST MENTIONED AS WELL.

2515
01:31:42,788 --> 01:31:44,390
AND I DO WONDER IF YOU HAVE

2516
01:31:44,390 --> 01:31:45,491
THOUGHT A LITTLE BIT ABOUT THE

2517
01:31:45,491 --> 01:31:47,926
IMPACT OF CHRONIC INFLAMMATION

2518
01:31:47,926 --> 01:31:49,662
ON THE MCA DEVELOPMENT.

2519
01:31:49,662 --> 01:31:50,796
BECAUSE THAT'S ONE OF THE THINGS

2520
01:31:50,796 --> 01:31:52,998
FOR COMMUNITIES OF COLOR, THOSE

2521
01:31:52,998 --> 01:31:56,335
WITH OTHER DISENFRANCHISED

2522
01:31:56,335 --> 01:31:57,403
COMMUNITIES, IT'S A CONSTANT

2523
01:31:57,403 --> 01:31:57,836
STRESSOR.

2524
01:31:57,836 --> 01:31:59,338
IT MAY BE HARDER TO LOOK AT

2525
01:31:59,338 --> 01:32:01,240
SINCE YOU HAVE PRO INFLAMMATORY

2526
01:32:01,240 --> 01:32:02,908
CYTOKINE RESPONSE, BUT I DON'T

2527
01:32:02,908 --> 01:32:04,009
KNOW IF THAT'S SOMETHING YOU

2528
01:32:04,009 --> 01:32:06,311
THOUGHT ABOUT LOOKING AT, IS

2529
01:32:06,311 --> 01:32:09,915
THIS CHRONIC RESPONSE TO

2530
01:32:09,915 --> 01:32:12,818
INFLAMMATORY INFLAMMATION.

2531
01:32:12,818 --> 01:32:13,419
>> TERRIFIC QUESTION.

2532
01:32:13,419 --> 01:32:15,287
AS I PRESENTED EARLIER IN THE

2533
01:32:15,287 --> 01:32:17,956
TALK, THERE IS A BIT OF A

2534
01:32:17,956 --> 01:32:19,358
SPECTRUM TO HEMATOPOIESIS.

2535
01:32:19,358 --> 01:32:21,427
I'M STUDYING LARGER EVENTS IN

2536
01:32:21,427 --> 01:32:23,195
THE SPECTRUM AND THERE ARE

2537
01:32:23,195 --> 01:32:24,697
SMALLER POINT MUTATIONS AT THE

2538
01:32:24,697 --> 01:32:25,798
OTHER END.

2539
01:32:25,798 --> 01:32:27,299
FOR THE POINT MUTATIONS, I THINK

2540
01:32:27,299 --> 01:32:30,002
THERE IS SOME INITIAL EVIDENCE

2541
01:32:30,002 --> 01:32:31,437
OF INFLAMMATION BEING A ROLE IN

2542
01:32:31,437 --> 01:32:32,438
DEVELOPMENT AND PROGRESSION

2543
01:32:32,438 --> 01:32:32,638
THERE.

2544
01:32:32,638 --> 01:32:35,107
FOR THE LARGER EVENTS, STUDIES

2545
01:32:35,107 --> 01:32:38,210
WE LOOKED AT SO FAR IN THE U.K.

2546
01:32:38,210 --> 01:32:40,746
BIOBANK THAT HAS SOME MEASURE OF

2547
01:32:40,746 --> 01:32:42,614
C RAV PROTEIN, WHICH AGAIN MIGHT

2548
01:32:42,614 --> 01:32:44,616
NOT BE THE BEST MEASURE OF

2549
01:32:44,616 --> 01:32:47,252
INFLAMMATION, WE DO NOT SEE ANY

2550
01:32:47,252 --> 01:32:48,821
ASSOCIATIONS BETWEEN THOSE

2551
01:32:48,821 --> 01:32:50,422
MEASUREMENTS AND MCAs.

2552
01:32:50,422 --> 01:32:54,460
MAYBE THERE IS OTHER BETTER

2553
01:32:54,460 --> 01:32:55,027
INFLAMMATION MEASUREMENTS WE

2554
01:32:55,027 --> 01:32:55,961
COULD LOOK AT BUT AT LEAST WE

2555
01:32:55,961 --> 01:32:57,229
DON'T HAVE INFORMATION RIGHT NOW

2556
01:32:57,229 --> 01:32:58,530
FROM LARGE ENOUGH SAMPLE SIZES

2557
01:32:58,530 --> 01:33:07,706
TO REALLY THROUGHLY ASSESS THAT.

2558
01:33:07,706 --> 01:33:11,510
>> THAT WAS A GREAT
QUESTION.

2559
01:33:11,510 --> 01:33:16,048
WE KNOW THAT SOME HEME TA LODGE

2560
01:33:16,048 --> 01:33:18,016
CACK MALIGNANCIES SHOWS

2561
01:33:18,016 --> 01:33:19,952
DISPARITIES, MYELOMA, ALL, AND

2562
01:33:19,952 --> 01:33:22,221
SO I GUESS THE QUESTION IS, HOW

2563
01:33:22,221 --> 01:33:25,290
DIVERSE IS THE DATASET THAT YOU

2564
01:33:25,290 --> 01:33:27,126
HAVE BEEN MINING AND DO YOU

2565
01:33:27,126 --> 01:33:30,763
THINK THAT THERE COULD BE ANY

2566
01:33:30,763 --> 01:33:34,933
INSIGHTS THAT COULD BE GLEANED

2567
01:33:34,933 --> 01:33:35,534
ABOUT THE DIFFERENCES AND

2568
01:33:35,534 --> 01:33:38,237
PREVALENCE OR RISKS FOR THESE

2569
01:33:38,237 --> 01:33:40,172
DISEASES IN CERTAIN GROUPS?

2570
01:33:40,172 --> 01:33:40,572
>> THANK YOU.

2571
01:33:40,572 --> 01:33:43,742
THAT'S A REALLY TERRIFIC

2572
01:33:43,742 --> 01:33:44,042
QUESTION.

2573
01:33:44,042 --> 01:33:45,144
MOST OF THE RESEARCH I'M WORKING

2574
01:33:45,144 --> 01:33:47,746
ON RIGHT NOW IS USING EXISTING

2575
01:33:47,746 --> 01:33:49,148
GENOME-WIDE ASSOCIATION STUDY

2576
01:33:49,148 --> 01:33:49,414
DATA.

2577
01:33:49,414 --> 01:33:52,951
SO WE ARE REALLY LIMITED TO THE

2578
01:33:52,951 --> 01:33:54,453
GEE NO TYPING SETS THAT EXIST

2579
01:33:54,453 --> 01:33:57,122
AND UNFORTUNATELY, MOST OF THEM

2580
01:33:57,122 --> 01:34:00,526
TEND TO BE ON EUROPEAN

2581
01:34:00,526 --> 01:34:00,859
POPULATIONS.

2582
01:34:00,859 --> 01:34:02,060
REALLY LIMITING WHAT WE CAN DO

2583
01:34:02,060 --> 01:34:04,429
AS FAR AS LOOKING AT SAMPLE SIZE

2584
01:34:04,429 --> 01:34:06,465
WISE IN OTHER POPULATIONS.

2585
01:34:06,465 --> 01:34:08,367
LIKE I MENTIONED IN MY TALK, WE

2586
01:34:08,367 --> 01:34:10,068
DO HAVE EVIDENCE THAT

2587
01:34:10,068 --> 01:34:12,037
INDIVIDUALS WITH AFRICAN

2588
01:34:12,037 --> 01:34:14,840
ANCESTRY HAVE REDUCED RATES OF

2589
01:34:14,840 --> 01:34:20,846
MCAs WHICH WE FOUND

2590
01:34:20,846 --> 01:34:23,048
INTERESTING I'M WORKING IN

2591
01:34:23,048 --> 01:34:24,650
SUB-SAHARAN AFRICA FROM UGANDA

2592
01:34:24,650 --> 01:34:26,385
LOOKING AT POPULATIONS THERE AND

2593
01:34:26,385 --> 01:34:29,755
THIS IS A CONTINUATION ON WHAT

2594
01:34:29,755 --> 01:34:32,457
WE FOUND WITH THIS MALARIAL RISK

2595
01:34:32,457 --> 01:34:34,159
FACTOR FOR MCA RISK.

2596
01:34:34,159 --> 01:34:36,361
THIS IS A LARGER POPULATION OUT

2597
01:34:36,361 --> 01:34:36,562
THERE.

2598
01:34:36,562 --> 01:34:38,964
SO THAT IS ONE OPPORTUNITY TO

2599
01:34:38,964 --> 01:34:42,000
LOOK AT A DIFFERENT POPULATION

2600
01:34:42,000 --> 01:34:43,268
BEYOND EUROPEANS THAT WILL BE

2601
01:34:43,268 --> 01:34:45,470
SIZEABLE TO INVESTIGATE.

2602
01:34:45,470 --> 01:34:49,274
AND AS GWAS ARE BECOMING MORE

2603
01:34:49,274 --> 01:34:50,375
MULTI-ANCESTRY FOCUSED, WE WILL

2604
01:34:50,375 --> 01:34:51,877
HAVE MORE AND MORE DATA COMING

2605
01:34:51,877 --> 01:34:54,279
IN TO ASSESS THIS.

2606
01:34:54,279 --> 01:34:55,747
BUT MY PROGRAM IN AND OF ITSELF

2607
01:34:55,747 --> 01:34:57,149
JUST DOESN'T HAVE THE BANDWIDTH

2608
01:34:57,149 --> 01:35:00,052
OR RESOURCES TO REALLY ACQUIRE

2609
01:35:00,052 --> 01:35:02,454
THESE VERY LARGE SAMPLE SIZES

2610
01:35:02,454 --> 01:35:06,692
NEEDED TO INVESTIGATE THOSE

2611
01:35:06,692 --> 01:35:08,060
POPULATIONS.

2612
01:35:08,060 --> 01:35:08,360
>> THANKS.

2613
01:35:08,360 --> 01:35:09,194
GREAT ANSWER.

2614
01:35:09,194 --> 01:35:12,664
AND WE'LL KEEP WORKING TOWARDS

2615
01:35:12,664 --> 01:35:14,499
THAT.

2616
01:35:14,499 --> 01:35:14,867
FANTASTIC WORK.

2617
01:35:14,867 --> 01:35:17,669
THANK YOU VERY MUCH FOR THAT

2618
01:35:17,669 --> 01:35:18,003
PRESENTATION.

2619
01:35:18,003 --> 01:35:21,707
NEXT ON OUR AGENDA IS OUR BREAK.

2620
01:35:21,707 --> 01:35:25,077
AND IT WAS ORIGINALLY SET FOR

2621
01:35:25,077 --> 01:35:25,377
2:55-3:10.

2622
01:35:25,377 --> 01:35:28,780
LOOKS LIKE WE MAY GAIN ANOTHER 5

2623
01:35:28,780 --> 01:35:29,948
MINUTES HERE.

2624
01:35:29,948 --> 01:35:33,785
SO CAN EVERYONE PLEASE RETURN

2625
01:35:33,785 --> 01:35:34,987
ROUGHLY EIGHT MINUTES AFTER THE

2626
01:35:34,987 --> 01:35:37,689
HOUR SO WE CAN BEGIN PROMPTLY AT

2627
01:35:37,689 --> 01:35:39,091
10 MINUTES AFTER THE HOUR.

2628
01:35:39,091 --> 01:35:42,594
SO IT WOULD BE 3:10 EASTERN FOR

2629
01:35:42,594 --> 01:35:44,930
OUR NEXT PRESENTATION.

2630
01:35:44,930 --> 01:35:46,465
SO JUST MUTE AND TURN YOUR

2631
01:35:46,465 --> 01:35:50,928
CAMERAS OFF AND LOG BACK IN
AROUND EIGHT AFTER.

2632
01:35:50,928 --> 01:35:51,428
>> THANK YOU ALL.

2633
01:35:51,428 --> 01:35:55,599
SO WE HAVE OUR FINAL

2634
01:35:55,599 --> 01:35:56,400
PRESENTATION FOR TODAY.

2635
01:35:56,400 --> 01:35:58,402
AND THE TITLE IS DECIPHERING THE

2636
01:35:58,402 --> 01:36:00,571
COMPLEXITY OF GENOMIC

2637
01:36:00,571 --> 01:36:02,306
ALTERATIONS IN HUMAN BREAST

2638
01:36:02,306 --> 01:36:08,645
CANCER FOR PRECISION ONCOLOGY BY

2639
01:36:08,645 --> 01:36:16,520
DR. A GUTTE GUTTE, AN ASSOCIATE,

2640
01:36:16,520 --> 01:36:18,655
UNIVERSITY OF NORTH CAROLINA,

2641
01:36:18,655 --> 01:36:21,158
CHAPEL HILL.

2642
01:36:21,158 --> 01:36:22,292
>> THANK YOU VERY MUCH FOR
THE

2643
01:36:22,292 --> 01:36:24,695
INTRODUCTION AND IT'S A REAL

2644
01:36:24,695 --> 01:36:27,197
PLEASURE TO BE INVITED TO SPEAK

2645
01:36:27,197 --> 01:36:28,799
TODAY BY DR. RATHMELL AND A

2646
01:36:28,799 --> 01:36:31,702
PLEASURE TO BE HERE AND SHARE

2647
01:36:31,702 --> 01:36:33,103
SOME, UPDATES AND OPPORTUNITIES

2648
01:36:33,103 --> 01:36:36,607
IN THIS REALM OF DECIPHERING THE

2649
01:36:36,607 --> 01:36:37,841
COMPLEX CANCER GENOMES.

2650
01:36:37,841 --> 01:36:40,243
SO GENOME REARRANGEMENTS ARE A

2651
01:36:40,243 --> 01:36:41,311
HALLMARK OF CANCER AS MANY OF

2652
01:36:41,311 --> 01:36:45,148
YOU KNOW, BUT THEY ARE DISTINCT

2653
01:36:45,148 --> 01:36:47,050
FROM SINGLE NUCLEOTIDE

2654
01:36:47,050 --> 01:36:48,318
VARIATIONS THAT ARISE FROM

2655
01:36:48,318 --> 01:36:50,821
DAMAGE TO A SINGLE STRAND OF THE

2656
01:36:50,821 --> 01:36:53,624
DOUBLE-STRANDED DNA, SUCH AS

2657
01:36:53,624 --> 01:36:54,324
SHOWN HERE.

2658
01:36:54,324 --> 01:36:57,127
IN CONTRAST, GENOME

2659
01:36:57,127 --> 01:36:58,428
REARRANGEMENTS ARISE FROM A

2660
01:36:58,428 --> 01:37:00,030
BREAK TO BOTH STRANDS OF THE DNA

2661
01:37:00,030 --> 01:37:01,632
THAT WE CALL A DOUBLE STRAND

2662
01:37:01,632 --> 01:37:02,399
BREAK.

2663
01:37:02,399 --> 01:37:04,234
AND DURING THE POTENTIAL MISERY

2664
01:37:04,234 --> 01:37:05,602
PAIR OF THESE LESIONS THAT CAN

2665
01:37:05,602 --> 01:37:08,405
LEAD TO GENOME REARRANGEMENT.

2666
01:37:08,405 --> 01:37:09,439
ANOTHER INTERESTING DIFFERENCE

2667
01:37:09,439 --> 01:37:13,143
BETWEEN THESE TWO IS THAT WHILE

2668
01:37:13,143 --> 01:37:14,511
SINGLE NUCLEOTIDE VARIATIONS

2669
01:37:14,511 --> 01:37:16,613
SEEM TO INCREASE SOMEWHAT

2670
01:37:16,613 --> 01:37:19,149
LINEARLY ACROSS THE LIFETIME OF

2671
01:37:19,149 --> 01:37:20,717
A NORMAL TISSUE THAT PROGRESSES

2672
01:37:20,717 --> 01:37:23,220
TO PRE CANCER AND EVENTUALLY TO

2673
01:37:23,220 --> 01:37:27,190
INVASIVE CANCER, GENOME

2674
01:37:27,190 --> 01:37:28,759
REARRANGEMENTS ARE QUITE

2675
01:37:28,759 --> 01:37:30,627
INFREQUENT IN PRE CANCERS BUT

2676
01:37:30,627 --> 01:37:33,263
ARISE AT A MUCH HIGHER RATE IN

2677
01:37:33,263 --> 01:37:34,398
OVERT CANCER.

2678
01:37:34,398 --> 01:37:37,334
AND SO, THE PROCESSES THAT GIVE

2679
01:37:37,334 --> 01:37:39,703
RISE TO THESE GENOME REARRANGEMS

2680
01:37:39,703 --> 01:37:41,805
SUCH AS WHOLE GENOME

2681
01:37:41,805 --> 01:37:43,540
DUPLICATIONS AND p53

2682
01:37:43,540 --> 01:37:45,342
IMPAIRMENT, MAY BE PARTICULARLY

2683
01:37:45,342 --> 01:37:47,144
RELEVANT TO THIS PROCESS OF PRE

2684
01:37:47,144 --> 01:37:49,012
CANCER TO CANCER TRANSITION THAT

2685
01:37:49,012 --> 01:37:53,116
WE KNOW IS IMPORTANT FOR CANCER

2686
01:37:53,116 --> 01:37:54,651
ETIOLOGY.

2687
01:37:54,651 --> 01:37:56,520
ADDITIONALLY, DIFFERENT CANCERS

2688
01:37:56,520 --> 01:37:59,356
EVEN FROM THE SAME HISTOLOGICAL

2689
01:37:59,356 --> 01:38:01,324
SITE SUCH AS BREAST CANCER, CAN

2690
01:38:01,324 --> 01:38:03,460
SHOW VASTLY DIFFERENT AMOUNTS

2691
01:38:03,460 --> 01:38:05,662
AND PATTERNS OF GENOME

2692
01:38:05,662 --> 01:38:06,029
REARRANGEMENTS.

2693
01:38:06,029 --> 01:38:08,031
AND THE CAUSES AND THE CLINICAL

2694
01:38:08,031 --> 01:38:10,434
IMPLICATIONS OF THESE DIFFERENT

2695
01:38:10,434 --> 01:38:13,236
PATTERNS REMAINS TO BE

2696
01:38:13,236 --> 01:38:14,938
UNDERSTOOD IN MUCH GREATER

2697
01:38:14,938 --> 01:38:15,272
DETAIL.

2698
01:38:15,272 --> 01:38:17,240
NOW WHOLE GENOME SEQUENCING

2699
01:38:17,240 --> 01:38:18,909
PROVIDES A MUCH MORE COMPLETE

2700
01:38:18,909 --> 01:38:22,345
PICTURE OF CANCER GENOME

2701
01:38:22,345 --> 01:38:30,454
REARRANGEMENTS BUT IS MORE

2702
01:38:30,454 --> 01:38:30,687
COMPLEX.

2703
01:38:30,687 --> 01:38:34,024
NOW THANKFULLY, THERE IS 100,000

2704
01:38:34,024 --> 01:38:39,296
GENOMES PROJECT THAT IS ACTIVE

2705
01:38:39,296 --> 01:38:41,832
LEON GOING IN THE U.K. AND THEY

2706
01:38:41,832 --> 01:38:44,868
RECENTLY PUBLISHED THEIR INITIAL

2707
01:38:44,868 --> 01:38:46,369
EXPERIENCE BEFORE PERFORMING

2708
01:38:46,369 --> 01:38:49,139
WHOLE GENOME SEQUENCING IN

2709
01:38:49,139 --> 01:38:56,146
13,000 CANCERS THAT ARE BEING

2710
01:38:56,146 --> 01:39:06,056
DIAGNOSED.

2711
01:39:06,056 --> 01:39:09,059
POTENTIALLY CREATING A PATHWAY

2712
01:39:09,059 --> 01:39:12,996
TO EVALUATING ITS USE MORE

2713
01:39:12,996 --> 01:39:15,766
BROADLY IN CLINICAL SCENARIOS.

2714
01:39:15,766 --> 01:39:16,767
IN TERMS OF DECIPHERING THE

2715
01:39:16,767 --> 01:39:18,869
COMPLEXITY OF GENOMES, WE MADE A

2716
01:39:18,869 --> 01:39:22,472
LOT OF PROGRESS AND HERE I'M

2717
01:39:22,472 --> 01:39:24,574
REFERRING TO THE PAN CANCER

2718
01:39:24,574 --> 01:39:26,076
ANALYSIS OF WHOLE GENOMES

2719
01:39:26,076 --> 01:39:28,979
EFFORT, REALLY AN INTERNATIONAL

2720
01:39:28,979 --> 01:39:31,481
COLLABORATION BETWEEN THE TCAGA

2721
01:39:31,481 --> 01:39:35,051
GROUP IN THE U.S. AND

2722
01:39:35,051 --> 01:39:36,586
INTERNATIONAL COLLABORATORS THAT

2723
01:39:36,586 --> 01:39:38,955
HAVE BEGUN TO DISSECT THIS

2724
01:39:38,955 --> 01:39:40,991
COMPLEX PATTERN AND FOUND

2725
01:39:40,991 --> 01:39:44,294
RECURRENT SIGNATURES OF

2726
01:39:44,294 --> 01:39:47,364
CHROMOSOMAL INSTABILITY THAT ARE

2727
01:39:47,364 --> 01:39:49,399
BEING SEEN ACROSS DIFFERENT

2728
01:39:49,399 --> 01:39:53,804
TYPES OF CANCERS AND REALLY

2729
01:39:53,804 --> 01:39:55,005
INCORPORATING VAST AMOUNTS OF

2730
01:39:55,005 --> 01:39:57,374
DATA COMING NOT JUST FROM DNA

2731
01:39:57,374 --> 01:39:59,376
SEQUENCING BUT ALSO RNA

2732
01:39:59,376 --> 01:40:00,877
SEQUENCING AND FUNCTIONAL

2733
01:40:00,877 --> 01:40:01,144
GENOMICS.

2734
01:40:01,144 --> 01:40:03,880
AND WHILE WE HAVE MADE THIS

2735
01:40:03,880 --> 01:40:05,182
SIGNIFICANT PROGRESS, I THINK

2736
01:40:05,182 --> 01:40:06,616
THERE IS STILL IMPORTANT GAPS IN

2737
01:40:06,616 --> 01:40:08,718
OUR KNOWLEDGE THAT I WANT TO GO

2738
01:40:08,718 --> 01:40:13,557
OVER IN THE NEXT FEW SLIDES.

2739
01:40:13,557 --> 01:40:15,992
THE FIRST GAP IS HOW WE CAN

2740
01:40:15,992 --> 01:40:18,094
OPTIMALLY CAPTURE THE COMPLEXITY

2741
01:40:18,094 --> 01:40:19,296
OF CANCER GENOMES.

2742
01:40:19,296 --> 01:40:24,267
AND IN THIS STUDY PUBLISHED BY

2743
01:40:24,267 --> 01:40:28,405
THE LABS JUST LAST YEAR, IT

2744
01:40:28,405 --> 01:40:32,876
DEMONSTRATED USING LINKED READ

2745
01:40:32,876 --> 01:40:35,712
TECHNOLOGY OF NEXT GENERATION

2746
01:40:35,712 --> 01:40:36,012
SEQUENCING.

2747
01:40:36,012 --> 01:40:38,215
THEY FOUND THAT THE SAME PATTERN

2748
01:40:38,215 --> 01:40:41,518
OF COPY NUMBER ABERRATION AND

2749
01:40:41,518 --> 01:40:45,589
REARRANGEMENTS THAT WAS OBSERVED

2750
01:40:45,589 --> 01:40:48,525
COULD ACTUALLY ARISE FROM THREE

2751
01:40:48,525 --> 01:40:50,393
VERY DIFFERENT STRUCTURAL

2752
01:40:50,393 --> 01:40:51,862
REARRANGEMENTS IN THE GENOME

2753
01:40:51,862 --> 01:40:53,797
THAT COULD ONLY BE OBSERVED WHEN

2754
01:40:53,797 --> 01:40:55,665
THEY USED LINK READ SEQUENCING

2755
01:40:55,665 --> 01:40:55,999
METHOD.

2756
01:40:55,999 --> 01:40:57,200
WHY DOES THIS MATTER?

2757
01:40:57,200 --> 01:40:58,768
THEY FOUND THAT A SPECIFIC

2758
01:40:58,768 --> 01:41:00,704
PATTERN OF REARRANGEMENT THEY

2759
01:41:00,704 --> 01:41:03,273
CALLED RECIPROCAL PAIR

2760
01:41:03,273 --> 01:41:04,908
REARRANGEMENT, IS PARTICULARLY

2761
01:41:04,908 --> 01:41:06,810
PREVALENT IN BRCA DEFICIENT

2762
01:41:06,810 --> 01:41:07,043
CANCERS.

2763
01:41:07,043 --> 01:41:10,180
AND IT WAS ONLY REALLY BEING

2764
01:41:10,180 --> 01:41:13,917
IDENTIFIED USING THIS LINKED

2765
01:41:13,917 --> 01:41:14,217
READ METHOD.

2766
01:41:14,217 --> 01:41:16,186
BUT THERE IS GOOD NEWS HERE AS

2767
01:41:16,186 --> 01:41:17,921
IF YOU KNOW WHAT PATTERN YOU'RE

2768
01:41:17,921 --> 01:41:19,890
LOOKING FOR, YOU CAN SOMETIMES

2769
01:41:19,890 --> 01:41:23,894
FILL IN THE GAPS WITH SHORT READ

2770
01:41:23,894 --> 01:41:26,429
SEQUENCING AND THEY SHOWED THAT

2771
01:41:26,429 --> 01:41:27,998
HAVING THIS KNOWLEDGE OF THIS

2772
01:41:27,998 --> 01:41:31,134
UNDERLYING STRUCTURE, THEY COULD

2773
01:41:31,134 --> 01:41:33,336
PROX MADE THESE SIGNALS FROM THE

2774
01:41:33,336 --> 01:41:34,638
LUMINA SEQUENCING AND IMPROVE

2775
01:41:34,638 --> 01:41:36,907
THEIR ABILITY TO IDENTIFY HR

2776
01:41:36,907 --> 01:41:38,808
DEFICIENT CANCERS, WHICH MAY

2777
01:41:38,808 --> 01:41:43,613
ALLOW US TO BETTER TARGET

2778
01:41:43,613 --> 01:41:45,982
TREATMENT SUCH AS PARP

2779
01:41:45,982 --> 01:41:55,625
INHIBITORS AND OTHER THERAPIES.

2780
01:41:55,625 --> 01:41:58,795
WHAT DNA PROCESSES DRIVE THESE

2781
01:41:58,795 --> 01:42:01,131
THAT ARE BEING OBSERVED?

2782
01:42:01,131 --> 01:42:03,700
HERE, THERE IS A SPECIFIC

2783
01:42:03,700 --> 01:42:07,037
PATTERN OF EXTRACHROMOSOMAL

2784
01:42:07,037 --> 01:42:09,372
CIRCULAR DNA WHERE ONCOGENES

2785
01:42:09,372 --> 01:42:12,008
THAT ARE HIGHLY AMPLIFIED CAN

2786
01:42:12,008 --> 01:42:15,712
EXIST IN THESE CIRCLES THAT ARE

2787
01:42:15,712 --> 01:42:18,114
FLOATING AROUND IN THE NUCLEI OF

2788
01:42:18,114 --> 01:42:21,217
SOME AGGRESSIVE CANCERS, SUCH AS

2789
01:42:21,217 --> 01:42:22,118
GLIOBLASTOMA.

2790
01:42:22,118 --> 01:42:27,090
RECENTLY, A STUDY BY THE ZHANG

2791
01:42:27,090 --> 01:42:29,092
LAB AT DUKE FOUND A SPECIFIC DNA

2792
01:42:29,092 --> 01:42:32,929
REPEER PATHWAY MEDIATED BY DNA

2793
01:42:32,929 --> 01:42:34,431
POLYMERASE THETA THAT IS

2794
01:42:34,431 --> 01:42:37,434
REQUIRED FOR THE GENERATION OF

2795
01:42:37,434 --> 01:42:38,234
EXTRACHROMOSOMAL CIRCLES.

2796
01:42:38,234 --> 01:42:39,602
WHAT IS STRIKING IS THEY FOUND

2797
01:42:39,602 --> 01:42:42,472
THIS INITIALLY BY STUDYING

2798
01:42:42,472 --> 01:42:44,140
DROSOPHILA CELL SYSTEMS AND

2799
01:42:44,140 --> 01:42:45,342
VALIDATED IN MAMMALIAN SYSTEMS

2800
01:42:45,342 --> 01:42:47,911
AND IT REALLY HIGHLIGHTS THAT

2801
01:42:47,911 --> 01:42:51,748
THIS PATHWAY MAY BE -- WE KNOW

2802
01:42:51,748 --> 01:42:53,049
IT'S DRUGABLE BECAUSE THERE ARE

2803
01:42:53,049 --> 01:42:54,718
INHIBITORS TO THIS ENZYME THAT

2804
01:42:54,718 --> 01:42:56,286
ARE IN EARLY-STAGE CLINICAL

2805
01:42:56,286 --> 01:42:57,787
TRIALS BUT IT MAY ACTUALLY HELP

2806
01:42:57,787 --> 01:42:59,422
IN THE TREATMENT OF CANCERS THAT

2807
01:42:59,422 --> 01:43:03,793
HAVE THESE EXTRACHROMOSOMAL DNA

2808
01:43:03,793 --> 01:43:04,127
CIRCLES.

2809
01:43:04,127 --> 01:43:07,230
A THIRD IMPORTANT KNOWLEDGE GAP

2810
01:43:07,230 --> 01:43:10,533
IS HOW CELLS EVADE MITOTIC

2811
01:43:10,533 --> 01:43:12,068
CATASTROPHE AND WHAT ARE THE

2812
01:43:12,068 --> 01:43:14,571
PATHWAY THAT IS DICTATE THESE

2813
01:43:14,571 --> 01:43:14,871
MECHANISMS?

2814
01:43:14,871 --> 01:43:17,273
AND THESE TWO STUDIES ALSO

2815
01:43:17,273 --> 01:43:19,743
RECENTLY PUBLISHED BY THE

2816
01:43:19,743 --> 01:43:21,978
CLEVELAND AND PETER LIE LABS,

2817
01:43:21,978 --> 01:43:24,714
IDENTIFIED A NOVEL PATHWAY

2818
01:43:24,714 --> 01:43:29,953
INVOLVING TOP BP ONE AND CIP2A.

2819
01:43:29,953 --> 01:43:32,956
THAT CLUSTERS BROKEN FRAGMENTS

2820
01:43:32,956 --> 01:43:35,258
OF DNA AND THIS CLUSTERING OF

2821
01:43:35,258 --> 01:43:37,360
THESE FRAGMENTS ALLOWS THESE

2822
01:43:37,360 --> 01:43:40,797
CELLS TO SURVIVE THIS MY TO

2823
01:43:40,797 --> 01:43:43,166
THETIC CATASTROPHE MORE

2824
01:43:43,166 --> 01:43:44,034
EFFECTIVELY.

2825
01:43:44,034 --> 01:43:45,735
CANCER THAT OVEREXPRESS THIS

2826
01:43:45,735 --> 01:43:49,672
PROGRAM HAVE A SPECIFIC AND

2827
01:43:49,672 --> 01:43:50,974
IDENTIFY PANEL THAT IS OBSERVED

2828
01:43:50,974 --> 01:43:54,244
IN A SUBSET OF CANCERS AND THEIR

2829
01:43:54,244 --> 01:43:56,679
FUTURE WORK, I'M SURE, WILL

2830
01:43:56,679 --> 01:43:57,947
EXPLORE WHETHER THESE PATHWAYS

2831
01:43:57,947 --> 01:44:01,151
CAN POTENTIALLY BE TARGETED

2832
01:44:01,151 --> 01:44:02,052
THERAPEUTICALLY.

2833
01:44:02,052 --> 01:44:03,186
NOW LAST BUT NOT LEAST, I THINK

2834
01:44:03,186 --> 01:44:05,355
WE ARE REALIZING MUCH BETTER

2835
01:44:05,355 --> 01:44:07,857
THAT THERE IS AN INTERPLAY

2836
01:44:07,857 --> 01:44:09,926
BETWEEN GENOME REARRANGEMENT

2837
01:44:09,926 --> 01:44:12,662
PROFILES AND IMMUNE SURVEILLANCE

2838
01:44:12,662 --> 01:44:12,962
PATHWAYS.

2839
01:44:12,962 --> 01:44:15,198
AND IN WORK THAT WAS RECENTLY

2840
01:44:15,198 --> 01:44:17,033
PUBLISHED FROM OUR OWN GROUP, WE

2841
01:44:17,033 --> 01:44:21,071
WERE ABLE TO DEVELOP AN IN-VIVO

2842
01:44:21,071 --> 01:44:22,906
TRIPLE NEGATIVE BREAST CANCER

2843
01:44:22,906 --> 01:44:28,578
MOUSE MODEL THAT ALLOWS US TO

2844
01:44:28,578 --> 01:44:29,712
REALLY EVALUATE MODULATORS OF

2845
01:44:29,712 --> 01:44:31,848
THIS PRE CANCER TO CANCER

2846
01:44:31,848 --> 01:44:33,750
TRANSITION USING AN IN-VIVO

2847
01:44:33,750 --> 01:44:35,985
CHRIS PER SCREEN.

2848
01:44:35,985 --> 01:44:39,389
WHEN WE CHASED THE MECHANISMS,

2849
01:44:39,389 --> 01:44:41,658
WE FOUND A SHARED MECHANISM THAT

2850
01:44:41,658 --> 01:44:43,960
WAS CENTERED AROUND THE INNATE

2851
01:44:43,960 --> 01:44:46,863
IMMUNE SENSING OF DNA DAMAGE IN

2852
01:44:46,863 --> 01:44:48,031
THESE PRE CANCERS.

2853
01:44:48,031 --> 01:44:50,300
AND THE LOSS OF THAT ABILITY TO

2854
01:44:50,300 --> 01:44:52,902
ENGAGE THE INNATE IMMUNE SYSTEM

2855
01:44:52,902 --> 01:44:54,370
WAS ABSOLUTELY CRITICAL TO ALLOW

2856
01:44:54,370 --> 01:44:56,940
THESE PRE CANCERS TO PROGRESS

2857
01:44:56,940 --> 01:44:58,675
INTO OVERT CANCERS WITH HIGH

2858
01:44:58,675 --> 01:45:01,311
DEGREES OF GENOME INSTABILITY.

2859
01:45:01,311 --> 01:45:03,480
WE BELIEVE THAT THIS IS AN

2860
01:45:03,480 --> 01:45:05,682
IMPORTANT FACET OF HOW CANCERS

2861
01:45:05,682 --> 01:45:07,917
WITH HIGH DEGREES OF GENOME

2862
01:45:07,917 --> 01:45:10,720
ABERRATIONS ARE ABLE TO THRIVE

2863
01:45:10,720 --> 01:45:13,089
AND HOW THEY MAY SIMULTANEOUSLY

2864
01:45:13,089 --> 01:45:13,690
EVADE IMMUNE DETECTION, WHICH

2865
01:45:13,690 --> 01:45:16,259
MAY HAVE IMPLICATIONS FOR BOTH

2866
01:45:16,259 --> 01:45:18,394
CANCER PREVENTION AS WELL AS

2867
01:45:18,394 --> 01:45:19,562
IMMUNOTHERAPY RESPONSE.

2868
01:45:19,562 --> 01:45:21,197
SO JUST IN SUMMARY, I THINK WE

2869
01:45:21,197 --> 01:45:23,900
ARE CERTAINLY MAKING PROGRESS IN

2870
01:45:23,900 --> 01:45:26,769
SEEING THE PROMISE OF GENOME

2871
01:45:26,769 --> 01:45:28,371
REARRANGEMENT ANALYSIS TO HELP

2872
01:45:28,371 --> 01:45:29,873
GUIDE PRECISION ONCOLOGY.

2873
01:45:29,873 --> 01:45:31,074
BUT THERE IS STILL MORE WORK

2874
01:45:31,074 --> 01:45:31,975
THAT NEEDS TO BE DONE.

2875
01:45:31,975 --> 01:45:33,910
I THINK WE NEED TO FURTHER

2876
01:45:33,910 --> 01:45:36,212
DEVELOP OPTIMIZED METHODS FOR

2877
01:45:36,212 --> 01:45:38,281
GENOME CHARACTERIZATION AND

2878
01:45:38,281 --> 01:45:39,482
EVALUATE STRATEGIES AND THE

2879
01:45:39,482 --> 01:45:40,884
FEASIBILITY OF BRINGING SOME OF

2880
01:45:40,884 --> 01:45:43,786
THESE TECHNOLOGIES INTO CLINICAL

2881
01:45:43,786 --> 01:45:44,087
APPLICATION.

2882
01:45:44,087 --> 01:45:46,890
WE NEED TO CONDUCT MECHANISTIC

2883
01:45:46,890 --> 01:45:48,791
STUDIES TO LINK ETIOLOGY TO

2884
01:45:48,791 --> 01:45:50,326
THESE DIFFERENT PATTERNS OF

2885
01:45:50,326 --> 01:45:51,995
GENOME REARRANGEMENT SIGNATURES

2886
01:45:51,995 --> 01:45:53,229
AND EVALUATE THEIR IMPLICATIONS

2887
01:45:53,229 --> 01:45:56,099
FOR CANCER PREVENTION AND

2888
01:45:56,099 --> 01:45:56,900
POTENTIALLY TREATMENT.

2889
01:45:56,900 --> 01:45:59,002
WE NEED TO FURTHER GET INTO THIS

2890
01:45:59,002 --> 01:46:01,237
RELATIONSHIP BETWEEN GENOME

2891
01:46:01,237 --> 01:46:03,239
REARRANGEMENT MECHANISMS AND

2892
01:46:03,239 --> 01:46:04,607
IMMUNE EVASION BECAUSE THIS MAY

2893
01:46:04,607 --> 01:46:08,811
HAVE MAJOR IMPLICATIONS FOR HOW

2894
01:46:08,811 --> 01:46:10,213
WE CAN LEVERAGE THE IMMUNE SAYS

2895
01:46:10,213 --> 01:46:12,015
FOR CANCER PREVENTION AND

2896
01:46:12,015 --> 01:46:13,883
POSSIBLY TO IMPROVE OUR ABILITY

2897
01:46:13,883 --> 01:46:16,486
TO ENGAGE IN IMMUNE SYSTEM

2898
01:46:16,486 --> 01:46:18,388
THERAPEUTIC RESPONSES AND

2899
01:46:18,388 --> 01:46:19,956
FINALLY, WHILE WE CAN IDENTIFY

2900
01:46:19,956 --> 01:46:21,891
SOME OF THESE REARRANGEMENT

2901
01:46:21,891 --> 01:46:23,593
SIGNATURES, WE REALLY NEED TO

2902
01:46:23,593 --> 01:46:25,962
LINK THEM TO TARGETABLE

2903
01:46:25,962 --> 01:46:26,396
VULNERABILITIES.

2904
01:46:26,396 --> 01:46:28,298
AND WHILE I DESCRIBED SOME OF

2905
01:46:28,298 --> 01:46:30,500
PROGRESS IN THIS AREA, THERE IS

2906
01:46:30,500 --> 01:46:31,801
STILL MUCH WORK TO BE DONE,

2907
01:46:31,801 --> 01:46:33,803
PARTICULARLY IN DEVELOPING MODEL

2908
01:46:33,803 --> 01:46:36,806
SYSTEMS THAT CAN RECAPITULATE

2909
01:46:36,806 --> 01:46:39,809
THESE MECHANISMS AND EVALUATE

2910
01:46:39,809 --> 01:46:41,211
FOR POTENTIAL VULNERABILITIES.

2911
01:46:41,211 --> 01:46:43,613
SO I'LL STOP THERE.

2912
01:46:43,613 --> 01:46:46,216
I HOPE I REMAINED ON TIME AND

2913
01:46:46,216 --> 01:46:50,820
I'D BE HAPPY TO TAKE ANY

2914
01:46:50,820 --> 01:46:51,821
QUESTIONS.

2915
01:46:51,821 --> 01:46:54,724
>> THERE IS PLENTY OF TIME
FOR

2916
01:46:54,724 --> 01:46:55,024
QUESTIONS.

2917
01:46:55,024 --> 01:47:00,330
WE CAN PULL DOWN THE

2918
01:47:00,330 --> 01:47:01,998
PRESENTATION AND GO TO

2919
01:47:01,998 --> 01:47:02,732
INDIVIDUAL MODE.

2920
01:47:02,732 --> 01:47:05,735
ANY QUESTIONS FOR DR. GUPTA?

2921
01:47:05,735 --> 01:47:07,604
>> I'LL START WITH A
QUESTION.

2922
01:47:07,604 --> 01:47:10,607
I SEE SOME HANDS STARTING TO POP

2923
01:47:10,607 --> 01:47:11,040
UP.

2924
01:47:11,040 --> 01:47:12,609
IT'S NOT GOING TO BE ABOUT YOUR

2925
01:47:12,609 --> 01:47:16,613
SCIENCE BUT, I WAS -- SO I KNOW

2926
01:47:16,613 --> 01:47:18,848
BRITT BUT I WAS LOOKING AT YOUR

2927
01:47:18,848 --> 01:47:21,017
BIOEARLIER TODAY AND DISCOVERED

2928
01:47:21,017 --> 01:47:23,820
THAT YOUR ASSOCIATE DIRECTOR FOR

2929
01:47:23,820 --> 01:47:25,655
THE M.D., PH.D. PROGRAM FOR MY

2930
01:47:25,655 --> 01:47:27,757
OLD JOB, YOU'RE A RADIATION

2931
01:47:27,757 --> 01:47:30,226
ONCOLOGY AND CLEARLY DOING

2932
01:47:30,226 --> 01:47:32,028
DISCOVERY BASIC SCIENCE.

2933
01:47:32,028 --> 01:47:34,163
SO, I WONDER IF YOU CAN COMMENT

2934
01:47:34,163 --> 01:47:36,332
ON THE -- YOUR EXPERIENCE AS A

2935
01:47:36,332 --> 01:47:37,600
PHYSICIAN SCIENTIST AND YOUR

2936
01:47:37,600 --> 01:47:39,335
THOUGHTS ON THE ROLE OF

2937
01:47:39,335 --> 01:47:42,338
PHYSICIAN-SCIENTISTS IN THIS

2938
01:47:42,338 --> 01:47:42,538
SPACE.

2939
01:47:42,538 --> 01:47:43,640
>> THANK YOU FOR THAT
QUESTION.

2940
01:47:43,640 --> 01:47:45,041
IT'S SOMETHING THAT IS NEAR AND

2941
01:47:45,041 --> 01:47:47,744
DEAR TO MY HEART AND IT'S A LONG

2942
01:47:47,744 --> 01:47:50,346
PATHWAY TO TRAIN AS A PHYSICIAN

2943
01:47:50,346 --> 01:47:50,647
SCIENTIST.

2944
01:47:50,647 --> 01:47:51,948
AND SOMETIMES YOU FEEL LIKE

2945
01:47:51,948 --> 01:47:54,050
THERE IS TWO PARTS OF YOU THAT

2946
01:47:54,050 --> 01:47:55,585
YOU'RE DEVELOPING AND

2947
01:47:55,585 --> 01:47:55,885
CULTIVATING.

2948
01:47:55,885 --> 01:47:57,253
AND IT TAKES SO LONG TO REALLY

2949
01:47:57,253 --> 01:47:59,088
SEE THEM COME TOGETHER.

2950
01:47:59,088 --> 01:48:01,958
BUT, I OPEN THE DOORS TO MY LAB

2951
01:48:01,958 --> 01:48:04,861
AND I WAS STUDYING FUNDAMENTAL

2952
01:48:04,861 --> 01:48:06,229
MECHANISMS WHILE I ALSO STARTING

2953
01:48:06,229 --> 01:48:09,632
TO TREAT PATIENTS IN THE CLINIC.

2954
01:48:09,632 --> 01:48:13,036
BUT YOU KNOW, DUE TO MY ROLE AS

2955
01:48:13,036 --> 01:48:16,739
A PHYSICIAN AND A SCIENTIST, I

2956
01:48:16,739 --> 01:48:18,441
WAS ALSO ABLE TO BE INVOLVED IN

2957
01:48:18,441 --> 01:48:19,108
CLINICAL TRIAL DEVELOPMENT AND

2958
01:48:19,108 --> 01:48:20,743
THE GUIDANCE OF THOSE TRIALS TO

2959
01:48:20,743 --> 01:48:23,546
MAKE SURE THAT WE COULD ACCESS

2960
01:48:23,546 --> 01:48:24,480
BIOSPECIMENS THAT WOULD ALLOW US

2961
01:48:24,480 --> 01:48:26,349
TO LEARN FROM THOSE STUDIES.

2962
01:48:26,349 --> 01:48:28,051
SO ONE OF THOSE TRIALS IS A

2963
01:48:28,051 --> 01:48:30,353
STUDY OF COMBINING IMMUNE

2964
01:48:30,353 --> 01:48:32,555
CHECKPOINT BLOCKADE WITH

2965
01:48:32,555 --> 01:48:33,856
RADIATION IN BREAST CANCER

2966
01:48:33,856 --> 01:48:34,357
PATIENTS.

2967
01:48:34,357 --> 01:48:36,459
AND WHAT IS QUITE REMARKABLE IS

2968
01:48:36,459 --> 01:48:38,361
THAT NOW THIS TRIAL IS NEARLY

2969
01:48:38,361 --> 01:48:40,163
COMPLETE AND WE HAVE THE

2970
01:48:40,163 --> 01:48:42,765
SPECIMENS AND WE ARE SEEING

2971
01:48:42,765 --> 01:48:44,967
INCREDIBLE AND UNEXPECTED

2972
01:48:44,967 --> 01:48:46,469
RESPONSES TO THE COMBINATION AND

2973
01:48:46,469 --> 01:48:48,438
WE SEE IT IN SOME PATIENTS AND

2974
01:48:48,438 --> 01:48:49,539
NOT IN OTHERS.

2975
01:48:49,539 --> 01:48:50,873
AND SO WHILE WE WERE DOING THIS

2976
01:48:50,873 --> 01:48:52,975
WORK IN THE PRE-CLINICAL MODELS,

2977
01:48:52,975 --> 01:48:55,244
AND WE MAKE THIS DISCOVERY,

2978
01:48:55,244 --> 01:48:56,479
ACTUALLY ALREADY IN OUR LAB, WE

2979
01:48:56,479 --> 01:48:58,047
ARE LOOKING AT WHETHER THESE

2980
01:48:58,047 --> 01:49:00,049
MECHANISMS ARE AT PLAY IN THIS

2981
01:49:00,049 --> 01:49:01,050
CLINICAL TRIAL WHERE WE ARE

2982
01:49:01,050 --> 01:49:03,886
SEEING THESE NICE RESPONSES.

2983
01:49:03,886 --> 01:49:06,756
SO, I THINK IT'S JUST A

2984
01:49:06,756 --> 01:49:09,058
TESTAMENT TO OBVIOUSLY THERE IS

2985
01:49:09,058 --> 01:49:09,992
SERENDIPITY INVOLVED, BUT I

2986
01:49:09,992 --> 01:49:11,861
THINK IT REALLY TOOK THE TWO

2987
01:49:11,861 --> 01:49:13,963
SIDES OF MY TRAINING THAT

2988
01:49:13,963 --> 01:49:16,165
ALLOWED ME TO HAVE THIS

2989
01:49:16,165 --> 01:49:17,500
CULMINATION OF OPPORTUNITY.

2990
01:49:17,500 --> 01:49:20,603
AND SO I FEEL VERY FORTUNATE AND

2991
01:49:20,603 --> 01:49:21,471
I'M SO HAPPY TO BE ABLE TO BE IN

2992
01:49:21,471 --> 01:49:23,272
A ROLE WHERE I CAN CULTIVATE

2993
01:49:23,272 --> 01:49:24,807
THIS FOR THE NEXT GENERATION

2994
01:49:24,807 --> 01:49:26,275
BECAUSE I THINK IT'S A LONG ROAD

2995
01:49:26,275 --> 01:49:30,880
BUT I THINK IT HAS SOME UNIQUE

2996
01:49:30,880 --> 01:49:31,547
OPPORTUNITIES.

2997
01:49:31,547 --> 01:49:32,782
>> AWESOME, THANK YOU.

2998
01:49:32,782 --> 01:49:33,616
AND PATIENTS BENEFIT AS WELL.

2999
01:49:33,616 --> 01:49:35,418
I LOVE THAT FULL CIRCLE STORY.

3000
01:49:35,418 --> 01:49:40,523
THAT IS GREAT.

3001
01:49:40,523 --> 01:49:40,790
>> ANN?

3002
01:49:40,790 --> 01:49:42,992
>> SO FIRST OF ALL,
OUTSTANDING

3003
01:49:42,992 --> 01:49:43,326
PRESENTATION.

3004
01:49:43,326 --> 01:49:48,398
SO MUCH TO DO HERE.

3005
01:49:48,398 --> 01:49:51,000
SO EARLY ON IN THE CANCER GENOME

3006
01:49:51,000 --> 01:49:53,703
ATLAS, ACTUALLY ABOUT A YEAR

3007
01:49:53,703 --> 01:49:56,372
INTO IT, WE DID A SIMPLE THING.

3008
01:49:56,372 --> 01:49:57,840
WE JUST STACKED UP ALL THE

3009
01:49:57,840 --> 01:49:59,509
CHANGES SEEN IN THE TUMORS WE

3010
01:49:59,509 --> 01:50:00,910
HAD DONE TO THAT POINT.

3011
01:50:00,910 --> 01:50:02,245
AND WHAT FELL OUT OF THAT WAS

3012
01:50:02,245 --> 01:50:04,213
THAT THERE ARE THESE TUMORS THAT

3013
01:50:04,213 --> 01:50:07,016
ARE VERY, VERY CLEARLY RELATED

3014
01:50:07,016 --> 01:50:09,619
TO THESE LARGE STRUCTURAL

3015
01:50:09,619 --> 01:50:09,852
CHANGES.

3016
01:50:09,852 --> 01:50:12,422
THERE WERE COPY NUMBER, COPY

3017
01:50:12,422 --> 01:50:14,824
NUMBER SIGNATURE KIND OF TUMORS,

3018
01:50:14,824 --> 01:50:15,625
NO QUESTION.

3019
01:50:15,625 --> 01:50:19,128
OVARIAN CANCER IS PROBABLY THE

3020
01:50:19,128 --> 01:50:20,630
BEST EXAMPLE.

3021
01:50:20,630 --> 01:50:21,931
BUT, AND THE PATTERNS ARE

3022
01:50:21,931 --> 01:50:24,734
STARTING TO EMERGE BUT WHAT IS

3023
01:50:24,734 --> 01:50:27,336
IT IN THAT ACTUALLY YOU THINK IS

3024
01:50:27,336 --> 01:50:29,739
BEHIND OR CAUSED OR

3025
01:50:29,739 --> 01:50:31,040
MECHANISTICALLY PRODUCING THIS

3026
01:50:31,040 --> 01:50:32,642
KIND OF CHANGE?

3027
01:50:32,642 --> 01:50:34,444
AND ARE THESE CANCERS

3028
01:50:34,444 --> 01:50:35,211
SUFFICIENTLY DIFFERENT THAT

3029
01:50:35,211 --> 01:50:36,245
WE'RE JUST NOT THINKING ABOUT

3030
01:50:36,245 --> 01:50:37,313
THEM THE WAY WE SHOULD BE

3031
01:50:37,313 --> 01:50:38,548
THINKING ABOUT THEM?

3032
01:50:38,548 --> 01:50:40,082
I MEAN I WOULD HAVE PREDICTED

3033
01:50:40,082 --> 01:50:42,819
THAT WE WOULD HAVE HAD A MUCH,

3034
01:50:42,819 --> 01:50:44,253
MUCH BETTER TRACK RECORD ON

3035
01:50:44,253 --> 01:50:46,355
TREATING OVARIAN CANCER BY NOW

3036
01:50:46,355 --> 01:50:47,824
THAN WE HAVE.

3037
01:50:47,824 --> 01:50:49,025
WHAT DO YOU THINK YOU'RE LOOKING

3038
01:50:49,025 --> 01:50:50,426
AT THIS CAREFULLY?

3039
01:50:50,426 --> 01:50:52,395
>> SO, I HAVE A BIT OF A
SOAPBOX

3040
01:50:52,395 --> 01:50:54,464
ON THIS BUT I'LL GIVE YOU THE

3041
01:50:54,464 --> 01:50:55,364
SHORT VERSION.

3042
01:50:55,364 --> 01:50:57,033
WE HAVE TO BE CAREFUL ABOUT WHAT

3043
01:50:57,033 --> 01:50:58,835
SIGNALS WE MAY BE MISSING.

3044
01:50:58,835 --> 01:51:00,903
SO, WE ARE LOOKING AT DNA.

3045
01:51:00,903 --> 01:51:02,705
WE ARE LOOKING AT RNA AND THE WE

3046
01:51:02,705 --> 01:51:04,340
HAVE BEEN REALLY GOOD AT THAT

3047
01:51:04,340 --> 01:51:06,142
AND I'M SO GLAD WE MOVED TOWARDS

3048
01:51:06,142 --> 01:51:07,743
PROTEIN AND OTHER SIGNALS

3049
01:51:07,743 --> 01:51:09,846
BECAUSE WE KNOW THAT THE DNA

3050
01:51:09,846 --> 01:51:11,948
DAMAGE RESPONSE IS NOT WELL

3051
01:51:11,948 --> 01:51:15,051
CAPTURED BY DNA AND RNA.

3052
01:51:15,051 --> 01:51:16,652
p53 IS LOST IN THE MAJORITY OF

3053
01:51:16,652 --> 01:51:20,456
THESE HIGHLY-COMPLEX GENOMES.

3054
01:51:20,456 --> 01:51:20,690
CANCERS.

3055
01:51:20,690 --> 01:51:22,358
BUT p53 IS LOST IN OTHER

3056
01:51:22,358 --> 01:51:24,460
CANCERS THAT DON'T HAVE THAT

3057
01:51:24,460 --> 01:51:24,727
PHENOTYPE.

3058
01:51:24,727 --> 01:51:26,162
WHILE IT MAY BE REQUIRED, WE

3059
01:51:26,162 --> 01:51:28,764
KNOW IT'S NOT SUFFICIENT AND I

3060
01:51:28,764 --> 01:51:30,366
THINK THIS INTERPLAY WITH THE

3061
01:51:30,366 --> 01:51:34,237
IMMUNE SYSTEM MAY BE A CRITICAL

3062
01:51:34,237 --> 01:51:36,038
ASPECT OF WHAT MAY BE MISSING

3063
01:51:36,038 --> 01:51:36,239
HERE.

3064
01:51:36,239 --> 01:51:38,741
AND I SAY THAT BECAUSE WHEN WE

3065
01:51:38,741 --> 01:51:40,843
LOOK AT, FOR EXAMPLE, TRIPLE

3066
01:51:40,843 --> 01:51:42,044
NEGATIVE BREAST CANCER WHERE WE

3067
01:51:42,044 --> 01:51:43,346
GIVE CHEMOTHERAPY BEFORE SURGERY

3068
01:51:43,346 --> 01:51:47,049
AND WE KNOW THAT RESPONSE TO

3069
01:51:47,049 --> 01:51:49,051
CHEMO IS CRITICALLY LINKED TO

3070
01:51:49,051 --> 01:51:50,253
OUTCOME, WE CAN'T PREDICT THAT

3071
01:51:50,253 --> 01:51:54,657
RESPONSE BY RNA-SEQ AND DNA SEQ.

3072
01:51:54,657 --> 01:51:56,659
BUT, WHEN WE START LOOKING

3073
01:51:56,659 --> 01:51:58,394
CAREFULLY, THE SIGNALS THAT

3074
01:51:58,394 --> 01:51:59,862
EMERGE THAT ARE MOST PREDICTIVE

3075
01:51:59,862 --> 01:52:02,565
OF CHEMOTHERAPY RESPONSE IS

3076
01:52:02,565 --> 01:52:03,566
IMMUNE INFILTRATION.

3077
01:52:03,566 --> 01:52:05,268
AND THERE IS NO IMMUNE

3078
01:52:05,268 --> 01:52:06,869
CHECKPOINT BLOCKADE THERE.

3079
01:52:06,869 --> 01:52:08,971
SO THIS CONNECTION BETWEEN DNA

3080
01:52:08,971 --> 01:52:12,441
DAMAGE RESPONSE AND IMMUNE

3081
01:52:12,441 --> 01:52:13,543
INTERPLAY SEEMS TO BE CRITICAL

3082
01:52:13,543 --> 01:52:14,944
AND WE MAY HAVE MISSED THAT

3083
01:52:14,944 --> 01:52:16,045
EARLY ON.

3084
01:52:16,045 --> 01:52:18,481
AND SO, I THINK WE'RE ON THE

3085
01:52:18,481 --> 01:52:20,883
RIGHT PATH BUT WE NEED TO

3086
01:52:20,883 --> 01:52:21,817
UNDERSTAND THIS BETTER.

3087
01:52:21,817 --> 01:52:24,020
THANK YOU FOR YOUR QUESTION.

3088
01:52:24,020 --> 01:52:25,321
>> I ALSO THINK -- ONE
OTHER

3089
01:52:25,321 --> 01:52:26,889
THING WE ARE MISSING, AND WE ARE

3090
01:52:26,889 --> 01:52:29,458
STARTING TO GET ON TOP OF THIS,

3091
01:52:29,458 --> 01:52:34,263
SOME OF THE WORK IN THE LAST

3092
01:52:34,263 --> 01:52:35,798
MOONSHOT AND NOW THE

3093
01:52:35,798 --> 01:52:36,198
MICROENVIRONMENT.

3094
01:52:36,198 --> 01:52:37,867
I MEAN IF YOU LOOK AT SOME OF

3095
01:52:37,867 --> 01:52:39,602
THESE TUMORS, AND GETTING BACK

3096
01:52:39,602 --> 01:52:41,604
TO MY PHYSICS TRAINING, A LOT OF

3097
01:52:41,604 --> 01:52:44,707
THESE TUMORS ARE SO DIFFERENT IN

3098
01:52:44,707 --> 01:52:45,508
TERMS OF THEIR ENVIRONMENT

3099
01:52:45,508 --> 01:52:47,910
COMING BACK TO OVARIAN CANCER.

3100
01:52:47,910 --> 01:52:49,378
AND I THINK THAT'S ANOTHER BIG

3101
01:52:49,378 --> 01:52:52,915
PART OF THE MISSING PIECES HERE.

3102
01:52:52,915 --> 01:52:57,219
>> ABSOLUTELY.

3103
01:52:57,219 --> 01:52:59,488
>> SO ONE QUESTION I HAVE
FOR

3104
01:52:59,488 --> 01:53:02,592
YOU IS, BECAUSE THE WORD

3105
01:53:02,592 --> 01:53:04,260
PRECISION ONCOLOGY WAS IN THE

3106
01:53:04,260 --> 01:53:04,627
TITLE.

3107
01:53:04,627 --> 01:53:07,797
WHAT DOES THIS MEAN AS WE

3108
01:53:07,797 --> 01:53:10,066
CONSIDER SORT OF TREATMENT,

3109
01:53:10,066 --> 01:53:11,534
INFORMED THERAPEUTICS?

3110
01:53:11,534 --> 01:53:12,768
SO I GUESS THE QUESTION IS, DO

3111
01:53:12,768 --> 01:53:14,670
YOU THINK WE NEED TO GET WHOLE

3112
01:53:14,670 --> 01:53:17,807
GENOME INTO THE CLINIC?

3113
01:53:17,807 --> 01:53:20,810
>> I THINK WE DON'T KNOW
YET.

3114
01:53:20,810 --> 01:53:22,712
YOU KNOW, WE'RE DEVELOPING A LOT

3115
01:53:22,712 --> 01:53:25,715
OF THESE VERY COMPLEX TOOLS SUCH

3116
01:53:25,715 --> 01:53:29,085
AS SPACIAL TRANSCRIPTOMICS,

3117
01:53:29,085 --> 01:53:29,685
SINGLE-CELL ANALYSIS, I DON'T

3118
01:53:29,685 --> 01:53:32,088
SEE THAT WE WILL BE ABLE TO

3119
01:53:32,088 --> 01:53:34,724
SCALE THAT FOR REALTIME CLINICAL

3120
01:53:34,724 --> 01:53:35,191
USE.

3121
01:53:35,191 --> 01:53:37,026
BUT, I SHOWED ONE EXAMPLE WHERE

3122
01:53:37,026 --> 01:53:39,295
IF YOU APPLY IT IN CERTAIN

3123
01:53:39,295 --> 01:53:41,497
SETTINGS, YOU MAY LEARN CERTAIN

3124
01:53:41,497 --> 01:53:42,832
INSIGHTS THAT YOU THOUGHT --

3125
01:53:42,832 --> 01:53:44,100
THAT YOU DIDN'T REALIZE YOU WERE

3126
01:53:44,100 --> 01:53:48,304
MISSING AND THEN YOU CAN COLLECT

3127
01:53:48,304 --> 01:53:50,606
A MORE PRAGMATIC ASSAY TO GATHER

3128
01:53:50,606 --> 01:53:51,173
THAT INFORMATION.

3129
01:53:51,173 --> 01:53:52,508
THAT'S MORE WHAT I'M THINKING

3130
01:53:52,508 --> 01:53:54,210
ABOUT, IS THAT THE CANCER

3131
01:53:54,210 --> 01:53:56,112
GENOME, THE WHOLE GENOME IS IT A

3132
01:53:56,112 --> 01:53:58,114
REFLECTION OF THE UNDERLYING

3133
01:53:58,114 --> 01:53:58,748
BIOLOGICAL STATE.

3134
01:53:58,748 --> 01:54:01,584
AND WE NEED TO UNDERSTAND THE

3135
01:54:01,584 --> 01:54:03,185
BIOLOGICAL UNDERPINNINGS IN A

3136
01:54:03,185 --> 01:54:05,021
MORE CONTROLLED SETTING BUT THEN

3137
01:54:05,021 --> 01:54:07,089
PERHAPS WE CAN SIMPLIFY THAT AND

3138
01:54:07,089 --> 01:54:10,292
CREATE A MORE PRAGMATIC ASSAY TO

3139
01:54:10,292 --> 01:54:11,494
CAPTURE THAT AND THEN APPLY THAT

3140
01:54:11,494 --> 01:54:13,429
IN THE CLINIC.

3141
01:54:13,429 --> 01:54:15,698
SO, IF I WERE TO SUMMARIZE,

3142
01:54:15,698 --> 01:54:17,500
THAT'S KIND OF THE WAY I SEE IT

3143
01:54:17,500 --> 01:54:21,103
IS THAT THIS IS THE REMBRANDT OF

3144
01:54:21,103 --> 01:54:23,539
THE CANCER GENOME AND IT'S

3145
01:54:23,539 --> 01:54:25,608
COMPOSED OF MANY COMPONENT PARTS

3146
01:54:25,608 --> 01:54:27,910
AND IT'S OUR JOB TO DECIPHER

3147
01:54:27,910 --> 01:54:28,110
THAT.

3148
01:54:28,110 --> 01:54:30,146
BUT THEN THE APPLICATION DOESN'T

3149
01:54:30,146 --> 01:54:31,213
NECESSARILY MEAN WE HAVE TO

3150
01:54:31,213 --> 01:54:33,916
APPLY THE MOST COMPLEX ASSAYS TO

3151
01:54:33,916 --> 01:54:37,219
EXTRACT THE MEANINGFUL

3152
01:54:37,219 --> 01:54:37,520
INFORMATION.

3153
01:54:37,520 --> 01:54:38,187
>> I AGREE.

3154
01:54:38,187 --> 01:54:42,792
I GUESS WE TALK ABOUT MOLECULAR,

3155
01:54:42,792 --> 01:54:43,993
CELLULAR, BIOLOGICAL STATES.

3156
01:54:43,993 --> 01:54:45,728
THINK A FOURTH ONE THAT WE MAY

3157
01:54:45,728 --> 01:54:47,830
NOT LOOK AT AS MUCH THAT COULD

3158
01:54:47,830 --> 01:54:49,732
ALSO BE IMPORTANT IS

3159
01:54:49,732 --> 01:54:50,833
PHYSIOLOGICAL STATE.

3160
01:54:50,833 --> 01:54:53,536
I THINK IT TIES INTO ANNA'S

3161
01:54:53,536 --> 01:54:55,004
COMMENTS ABOUT THE

3162
01:54:55,004 --> 01:54:55,404
MICROENVIRONMENT.

3163
01:54:55,404 --> 01:54:58,007
THINGS LIKE HYPOXIA.

3164
01:54:58,007 --> 01:55:00,109
WE HAVE OXYGEN SPECIES, THE PH

3165
01:55:00,109 --> 01:55:01,310
IN CERTAIN REGIONS OF THE CANCER

3166
01:55:01,310 --> 01:55:04,513
AND HOW THAT CAN IMPACT THE

3167
01:55:04,513 --> 01:55:06,215
TUMOR GROWTH AND ITS EVASION

3168
01:55:06,215 --> 01:55:08,017
FROM THE IMMUNE SYSTEM.

3169
01:55:08,017 --> 01:55:10,920
SO IT IS REALLY EXCITING WORK.

3170
01:55:10,920 --> 01:55:12,621
>> SO CAN I MAKE ONE
COMMENT.

3171
01:55:12,621 --> 01:55:15,825
I'M IN FAVOR OF WHOLE GENOME

3172
01:55:15,825 --> 01:55:16,726
SEQUENCING OF EVERYONE OUT

3173
01:55:16,726 --> 01:55:17,026
THERE.

3174
01:55:17,026 --> 01:55:18,828
KNOW I FEEL LIKE THAT.

3175
01:55:18,828 --> 01:55:21,630
BUT THE 100 DOLLAR GENOME IS OUT

3176
01:55:21,630 --> 01:55:22,431
THERE TODAY.

3177
01:55:22,431 --> 01:55:24,233
I MEAN WE HAD AN ANNOUNCEMENT

3178
01:55:24,233 --> 01:55:25,735
TODAY AND I THINK PEOPLE WHO

3179
01:55:25,735 --> 01:55:29,004
LOOKED AT THIS PARTICULAR

3180
01:55:29,004 --> 01:55:29,839
INSTRUMENT ARE SAYING GOOD

3181
01:55:29,839 --> 01:55:30,673
THINGS ABOUT IT.

3182
01:55:30,673 --> 01:55:32,742
SO I THINK THE 100 DOLLAR GENOME

3183
01:55:32,742 --> 01:55:34,343
PUTS IT IN THE HANDS OF EVERY

3184
01:55:34,343 --> 01:55:35,444
PHYSICIAN VERY SOON.

3185
01:55:35,444 --> 01:55:38,748
AND WE TALK ABOUT INEQUITIES IN

3186
01:55:38,748 --> 01:55:39,715
CARE, THAT'S WHERE THE

3187
01:55:39,715 --> 01:55:40,249
INEQUITIES ARE.

3188
01:55:40,249 --> 01:55:42,952
AND WE ARE GOING TO FIX THAT BY

3189
01:55:42,952 --> 01:55:44,153
GETTING THESE COSTS DOWN, I

3190
01:55:44,153 --> 01:55:45,054
THINK.

3191
01:55:45,054 --> 01:55:47,556
I HOPE.

3192
01:55:47,556 --> 01:55:48,924
SO LET'S DON'T RULE OUT -- IF

3193
01:55:48,924 --> 01:55:51,160
YOU HAVE ALL THAT DIGITAL

3194
01:55:51,160 --> 01:55:52,061
INFORMATION, YOU HAVE A LOT OF

3195
01:55:52,061 --> 01:55:52,928
INFORMATION AND YOU'RE GOING TO

3196
01:55:52,928 --> 01:55:54,663
NEED MOST OF IT TO GO THROUGH

3197
01:55:54,663 --> 01:55:56,332
AND PUT THE ENTIRE GENOMIC

3198
01:55:56,332 --> 01:55:57,466
PICTURE TOGETHER.

3199
01:55:57,466 --> 01:55:59,735
I AGREE WITH THAT.

3200
01:55:59,735 --> 01:56:01,637
I THINK YOU NEED THE DNA.

3201
01:56:01,637 --> 01:56:06,041
IT'S A GREAT ROADMAP.

3202
01:56:06,041 --> 01:56:07,109
>> AGREED.

3203
01:56:07,109 --> 01:56:07,743
REALLY UNDERSTAND THESE

3204
01:56:07,743 --> 01:56:09,945
STRUCTURAL EVENTS AND THESE

3205
01:56:09,945 --> 01:56:11,547
STRUCTURAL REARRANGEMENTS, THE

3206
01:56:11,547 --> 01:56:13,749
GENOME IS SO POWERFUL FOR THAT.

3207
01:56:13,749 --> 01:56:14,450
ARE THERE ANY ADDITIONAL

3208
01:56:14,450 --> 01:56:18,954
COMMENTS OR QUESTIONS?

3209
01:56:18,954 --> 01:56:21,056
IF NOT, THANK YOU VERY MUCH FOR

3210
01:56:21,056 --> 01:56:26,962
THAT FASCINATING PRESENTATION.

3211
01:56:26,962 --> 01:56:28,364
>> THANK YOU VERY MUCH.

3212
01:56:28,364 --> 01:56:28,597
GOODBYE.

3213
01:56:28,597 --> 01:56:31,367
>> SO NOW THE BOARD WILL

3214
01:56:31,367 --> 01:56:33,669
CONSIDER ONGOING AND NEW

3215
01:56:33,669 --> 01:56:36,172
BUSINESS RELATIVE TO ONGOING

3216
01:56:36,172 --> 01:56:36,438
BUSINESS.

3217
01:56:36,438 --> 01:56:38,607
THERE ARE THREE SUBCOMMITTEE --

3218
01:56:38,607 --> 01:56:40,976
THERE WERE THREE SUBCOMMITTEE

3219
01:56:40,976 --> 01:56:42,945
MEETINGS EARLIER TODAY AND NOW

3220
01:56:42,945 --> 01:56:44,613
THE REPORTS WILL BE GIVEN BY THE

3221
01:56:44,613 --> 01:56:45,381
SUBCOMMITTEE CHAIRS.

3222
01:56:45,381 --> 01:56:47,650
AND WE'LL VOTE ON THE ACCEPTANCE

3223
01:56:47,650 --> 01:56:49,485
OF EACH REPORT AFTER THEIR GIVEN

3224
01:56:49,485 --> 01:56:50,753
BY THE RESPECTIVE CHAIR.

3225
01:56:50,753 --> 01:56:58,160
SO THE FIRST REPORT WILL BE

3226
01:56:58,160 --> 01:57:02,198
GIVEN BY DR. A WINK WINK.

3227
01:57:02,198 --> 01:57:02,398
KARIN?

3228
01:57:02,398 --> 01:57:02,932
>> THANK YOU VERY MUCH.

3229
01:57:02,932 --> 01:57:04,066
AND I APPRECIATE THE OPPORTUNITY

3230
01:57:04,066 --> 01:57:05,201
TO SHARE A LITTLE BIT ABOUT WHAT

3231
01:57:05,201 --> 01:57:07,536
WE DISCUSSED AT OUR AD-HOC

3232
01:57:07,536 --> 01:57:09,371
SUBCOMMITTEE MEETING TODAY.

3233
01:57:09,371 --> 01:57:11,273
WE ACTUALLY SPENT JUST VERY

3234
01:57:11,273 --> 01:57:12,775
BRIEFLY JUST REVIEWING WHAT THE

3235
01:57:12,775 --> 01:57:14,710
CHARGE WAS FOR THE SUBCOMMITTEE.

3236
01:57:14,710 --> 01:57:15,477
I THINK THAT IS IMPORTANT

3237
01:57:15,477 --> 01:57:17,379
BECAUSE WE HAD NEW MEMBERS JOIN.

3238
01:57:17,379 --> 01:57:22,017
AND THEN WE WERE VERY PLEASED TO

3239
01:57:22,017 --> 01:57:23,986
WELCOME DR. RATHMELL TO COME IN

3240
01:57:23,986 --> 01:57:25,387
AND SHE EMPHASIZED THE

3241
01:57:25,387 --> 01:57:27,189
IMPORTANCE OF THE WORK OF THE

3242
01:57:27,189 --> 01:57:27,590
SUBCOMMITTEE.

3243
01:57:27,590 --> 01:57:29,491
AND THE NIH EFFORTS GLOBALLY TO

3244
01:57:29,491 --> 01:57:31,393
JUST CHALLENGES RELATED TO

3245
01:57:31,393 --> 01:57:33,929
CANCER PREVENTION AND HEALTH

3246
01:57:33,929 --> 01:57:34,163
EQUITY.

3247
01:57:34,163 --> 01:57:35,030
THERE WERE SEVERAL KEY POINTS

3248
01:57:35,030 --> 01:57:36,398
THAT WERE RAISED IN THE MEETING

3249
01:57:36,398 --> 01:57:38,934
AND I THINK WE SPENT A VERY LONG

3250
01:57:38,934 --> 01:57:40,803
TIME DISCUSSING THE WORK THAT IS

3251
01:57:40,803 --> 01:57:43,172
ALREADY ONGOING AT THE NATIONAL

3252
01:57:43,172 --> 01:57:43,639
INSTITUTES OF HEALTH.

3253
01:57:43,639 --> 01:57:46,809
WE WERE VERY PLEASED TO HAVE

3254
01:57:46,809 --> 01:57:48,410
DR. KATRINA G. GODDARD WHO

3255
01:57:48,410 --> 01:57:50,613
PRESENTED AN UPDATE ON THE

3256
01:57:50,613 --> 01:57:51,614
WORKING GROUP EFFORTS ON SOCIAL

3257
01:57:51,614 --> 01:57:52,414
DETERMINANTS OF HEALTH.

3258
01:57:52,414 --> 01:57:55,417
SHE PROVIDED THAT UPDATE.

3259
01:57:55,417 --> 01:57:57,419
THE SOCIAL DETERMINANTS OF

3260
01:57:57,419 --> 01:57:58,888
HEALTH RESEARCH COORDINATING

3261
01:57:58,888 --> 01:58:01,824
COMMITTEE OR RCC, THE WORK IS

3262
01:58:01,824 --> 01:58:04,426
REALLY VITALLY IMPORTANT BECAUSE

3263
01:58:04,426 --> 01:58:05,828
AS DR. GODDARD POINTED OUT,

3264
01:58:05,828 --> 01:58:07,496
SOCIAL DETERMINANTS OF HEALTH

3265
01:58:07,496 --> 01:58:10,099
ACCOUNT FOR HALF OF THE

3266
01:58:10,099 --> 01:58:11,700
VARIATION IN HEALTH OUTCOMES.

3267
01:58:11,700 --> 01:58:15,604
IF WE ARE TO REDUCEICANCY

3268
01:58:15,604 --> 01:58:19,241
MORTALITY BY 25% IN 25 YEARS

3269
01:58:19,241 --> 01:58:21,343
AND -- REALLY UNDERSTANDING

3270
01:58:21,343 --> 01:58:21,977
SOCIALITY DETERMINANTS OF HEALTH

3271
01:58:21,977 --> 01:58:23,612
AND IDENTIFYING THE APPROPRIATE

3272
01:58:23,612 --> 01:58:25,547
WAY TO IMPLEMENT CHANGES WITHIN

3273
01:58:25,547 --> 01:58:26,649
THE HEALTH CARE SYSTEM TO

3274
01:58:26,649 --> 01:58:27,716
ADDRESS THESE IS REALLY

3275
01:58:27,716 --> 01:58:27,983
CRITICAL.

3276
01:58:27,983 --> 01:58:31,420
SO THE RCC WAS ESTABLISHED IN

3277
01:58:31,420 --> 01:58:31,620
2022.

3278
01:58:31,620 --> 01:58:33,722
IT WAS REALLY BORNE OUT OF AN

3279
01:58:33,722 --> 01:58:35,124
URGENT NEED TO DEVELOP A

3280
01:58:35,124 --> 01:58:36,992
COORDINATED STRATEGY TO PROPEL

3281
01:58:36,992 --> 01:58:38,027
DISCOVERIES AND TO IMPROVE

3282
01:58:38,027 --> 01:58:39,962
INDIVIDUAL AND POPULATION

3283
01:58:39,962 --> 01:58:41,397
HEALTH, TO REDUCE HEALTH

3284
01:58:41,397 --> 01:58:43,399
DISPARITIES AND ADVANCE HEALTH

3285
01:58:43,399 --> 01:58:43,632
EQUITY.

3286
01:58:43,632 --> 01:58:45,734
IT WAS BORNE OUT OF A GRASS ROOT

3287
01:58:45,734 --> 01:58:47,336
EFFORT BY STAFF ACROSS THE NIH

3288
01:58:47,336 --> 01:58:50,706
WITH THE GOAL OF ACCELERATING

3289
01:58:50,706 --> 01:58:52,775
NIH-WIDE SOCIAL DETERMINANTS OF

3290
01:58:52,775 --> 01:58:53,776
HEALTH RESEARCH ACROSS DECEASES

3291
01:58:53,776 --> 01:58:54,209
AND CONDITIONS.

3292
01:58:54,209 --> 01:58:56,111
WE CAN LEARN IN A

3293
01:58:56,111 --> 01:58:56,745
MULTIDISCIPLINARY FASHION FROM

3294
01:58:56,745 --> 01:59:00,616
ALL THE EFFORTS THAT ARE

3295
01:59:00,616 --> 01:59:02,217
HAPPENING AND IT FOCUSED ON

3296
01:59:02,217 --> 01:59:03,218
LEVERAGING SOME OF THE SOCIAL

3297
01:59:03,218 --> 01:59:04,954
DETERMINANTS OF HEALTH

3298
01:59:04,954 --> 01:59:07,656
INVESTMENTS THAT HAVE BEEN MADE,

3299
01:59:07,656 --> 01:59:08,857
THE INNOVATIONS AND ACROSS THE

3300
01:59:08,857 --> 01:59:11,226
NIH INSTITUTES AND CENTERS.

3301
01:59:11,226 --> 01:59:15,164
AND THEN 2023 THE RCC RELEASED A

3302
01:59:15,164 --> 01:59:16,332
UNIFIED CONCEPTUAL FRAMEWORK FOR

3303
01:59:16,332 --> 01:59:20,035
SOCIAL DETERMINANTS OF HEALTH.

3304
01:59:20,035 --> 01:59:20,803
DR. GODDARD REVIEWED THAT.

3305
01:59:20,803 --> 01:59:21,837
THESE ARE ON LINE AND AVAILABLE

3306
01:59:21,837 --> 01:59:24,273
FOR PUBLIC REVIEW AS IS THE U.S.

3307
01:59:24,273 --> 01:59:25,841
PLAY BOOK ON SOCIAL DETERMINANTS

3308
01:59:25,841 --> 01:59:27,242
OF HEALTH THAT WAS RELEASED IN

3309
01:59:27,242 --> 01:59:30,379
NOVEMBER OF 2023 AND THE PLAY

3310
01:59:30,379 --> 01:59:32,114
BOOK OUTLINES AN INITIAL SET OF

3311
01:59:32,114 --> 01:59:34,950
STRUCTURAL ACTIONS UNDER THREE

3312
01:59:34,950 --> 01:59:36,418
MAIN PILLARS THAT FEDERAL

3313
01:59:36,418 --> 01:59:37,853
AGENCIES ARE UNDERTAKING TO

3314
01:59:37,853 --> 01:59:40,522
BREAKDOWN SILOS AND SUPPORT

3315
01:59:40,522 --> 01:59:43,659
EQUITABLE HEALTH AND OUTCOMES BY

3316
01:59:43,659 --> 01:59:44,560
IMPROVING SOCIAL CIRCUMSTANCES

3317
01:59:44,560 --> 01:59:47,129
OF INDIVIDUALS AND COMMUNITIES.

3318
01:59:47,129 --> 01:59:47,730
DR. GODDARD SHARED SEVERAL OF

3319
01:59:47,730 --> 01:59:50,232
THE NCI SUPPORTED SOCIAL

3320
01:59:50,232 --> 01:59:50,733
DETERMINANTS OF HEALTH

3321
01:59:50,733 --> 01:59:52,234
INITIATIVES INCLUDING THE

3322
01:59:52,234 --> 01:59:54,169
ADVANCING CANCER CONTROL EQUITY

3323
01:59:54,169 --> 01:59:55,938
RESEARCH THROUGH TRANSFORMATIVE

3324
01:59:55,938 --> 01:59:58,941
SOLUTIONS OR ASSERT CONSORTIUM.

3325
01:59:58,941 --> 02:00:00,976
AND THE NIH COMMON FUND

3326
02:00:00,976 --> 02:00:02,978
COMMUNITY PARTNERSHIPS TO

3327
02:00:02,978 --> 02:00:05,080
ADVANCE SCIENCE FOR SOCIETY OR

3328
02:00:05,080 --> 02:00:05,547
THE COMPASS PROGRAM.

3329
02:00:05,547 --> 02:00:10,552
SHE SHARED THAT THE ADVANCING OR

3330
02:00:10,552 --> 02:00:12,654
THE ASSERT, U19 MECHANISM

3331
02:00:12,654 --> 02:00:13,789
LAUNCHED IN 2023.

3332
02:00:13,789 --> 02:00:15,224
THE EXPECTATION OF THESE FUNDS

3333
02:00:15,224 --> 02:00:17,059
WILL SUPPORT INNOVATIVE

3334
02:00:17,059 --> 02:00:18,360
STRATEGIES THAT ADDRESS

3335
02:00:18,360 --> 02:00:19,395
MULTILEVEL SOCIAL DETERMINANTS

3336
02:00:19,395 --> 02:00:20,596
OF HEALTH INTERVENTIONS AND

3337
02:00:20,596 --> 02:00:22,765
RESEARCH PROJECTS NOT JUST FORK

3338
02:00:22,765 --> 02:00:24,533
USED ON ONE ASPECT OF SOCIAL

3339
02:00:24,533 --> 02:00:25,667
DETERMINANTS OF HEALTH BUT

3340
02:00:25,667 --> 02:00:28,470
HAVING EXPECTATION AS WELL THAT

3341
02:00:28,470 --> 02:00:29,972
THERE WILL BE COMMUNITY

3342
02:00:29,972 --> 02:00:31,573
RESPONSIVE PROJECTS INTEGRATED

3343
02:00:31,573 --> 02:00:34,576
OVER THE COURSE OF THE GRANT

3344
02:00:34,576 --> 02:00:35,377
PERIOD.

3345
02:00:35,377 --> 02:00:36,678
PROPOSALS WERE RECEIVED IN

3346
02:00:36,678 --> 02:00:38,981
SEPTEMBER AND THE INTENT IS TO

3347
02:00:38,981 --> 02:00:41,283
FUND FOUR OF THOSE PROPOSALS.

3348
02:00:41,283 --> 02:00:43,685
SHE ALSO REVIEWED HOW THE RCC

3349
02:00:43,685 --> 02:00:45,187
HAS CONCEPTUALIZED SOCIAL

3350
02:00:45,187 --> 02:00:45,988
DETERMINANTS OF HEALTH AND I

3351
02:00:45,988 --> 02:00:47,222
THINK THAT IS IMPORTANT BECAUSE

3352
02:00:47,222 --> 02:00:50,092
SHE PROVIDED SOME SHARED

3353
02:00:50,092 --> 02:00:52,094
DEFINITIONS, NOMENCLATURE, THAT

3354
02:00:52,094 --> 02:00:53,896
REALLY TO ENSURE THERE IS A

3355
02:00:53,896 --> 02:00:54,897
COMMON LANGUAGE TO BE USED IN

3356
02:00:54,897 --> 02:00:55,497
THIS SPACE.

3357
02:00:55,497 --> 02:00:57,066
THERE IS A DIFFERENCE BETWEEN

3358
02:00:57,066 --> 02:00:59,068
SOCIAL NEEDS, SOCIAL

3359
02:00:59,068 --> 02:01:00,869
DETERMINANTS AND SOCIAL RISK AND

3360
02:01:00,869 --> 02:01:02,538
THE WORKING DEFINITIONS FOR

3361
02:01:02,538 --> 02:01:03,872
THESE TERMS WERE SHARED WITH THE

3362
02:01:03,872 --> 02:01:05,374
SUBCOMMITTEE AND AGAIN, REALLY

3363
02:01:05,374 --> 02:01:08,210
IMPORTANT TO DEFINE THESE SO AS

3364
02:01:08,210 --> 02:01:10,179
RESEARCHERS AND THESE GRANTS ARE

3365
02:01:10,179 --> 02:01:11,680
BEING FUNDED, THAT ALL THE

3366
02:01:11,680 --> 02:01:12,881
RESEARCHERS ARE SPEAKING A

3367
02:01:12,881 --> 02:01:14,349
COMMON LANGUAGE AND THE OUTCOMES

3368
02:01:14,349 --> 02:01:18,087
WILL BE COMPARABLE OR COMPARABLE

3369
02:01:18,087 --> 02:01:20,689
ACROSS STUDY PROGRAMS AND

3370
02:01:20,689 --> 02:01:20,989
INITIATIVES.

3371
02:01:20,989 --> 02:01:22,591
THERE WERE ROBUST DISCUSSION

3372
02:01:22,591 --> 02:01:23,992
THAT FOLLOWED INCLUDING SOME

3373
02:01:23,992 --> 02:01:24,960
RECOMMENDATIONS FROM THE

3374
02:01:24,960 --> 02:01:27,696
SUBCOMMITTEE THAT INCLUDED

3375
02:01:27,696 --> 02:01:28,697
SUGGESTIONS AROUND DISSEMINATION

3376
02:01:28,697 --> 02:01:30,499
OF THE RCC PROGRAMS AND OUTCOMES

3377
02:01:30,499 --> 02:01:32,167
THAT COME BACK AND MAKING SURE

3378
02:01:32,167 --> 02:01:35,204
THAT THE DISSEMINATION INCLUDES

3379
02:01:35,204 --> 02:01:36,839
INTENTIONAL DISSEMINATION BACK

3380
02:01:36,839 --> 02:01:37,406
TO THE COMMUNITIES.

3381
02:01:37,406 --> 02:01:38,974
THAT'S A REALLY IMPORTANT

3382
02:01:38,974 --> 02:01:39,408
COMPONENT.

3383
02:01:39,408 --> 02:01:40,409
ALSO THERE WAS A SUGGESTION TO

3384
02:01:40,409 --> 02:01:41,877
MAKE SURE THERE IS INCLUSION OF

3385
02:01:41,877 --> 02:01:43,512
PATIENT ADVOCATES AND COMMUNITY

3386
02:01:43,512 --> 02:01:45,280
VOICES IN THE WORK THAT IS BEING

3387
02:01:45,280 --> 02:01:47,916
DONE NOT JUST AT THE NIH BUT

3388
02:01:47,916 --> 02:01:51,520
ALSO AS PART OF THESE GRANTS.

3389
02:01:51,520 --> 02:01:53,021
AND A SUGGESTION THAT THERE BE A

3390
02:01:53,021 --> 02:01:55,090
CRITICAL REVIEW OF THE PROPOSALS

3391
02:01:55,090 --> 02:01:56,792
SUBMITTED RELATED TO SOCIAL

3392
02:01:56,792 --> 02:01:58,293
DETERMINANTS OF HEALTH TO ENSURE

3393
02:01:58,293 --> 02:02:01,797
THAT THE OBJECTIVES OF THE GRANT

3394
02:02:01,797 --> 02:02:03,132
IS BEING ADDRESSED IN A

3395
02:02:03,132 --> 02:02:05,200
SUBSTANTIVE WAY AND NOT JUST

3396
02:02:05,200 --> 02:02:07,002
PLAYING LIP SERVICE BUT REAL

3397
02:02:07,002 --> 02:02:07,603
PARTNERSHIPS THAT ARE BEING

3398
02:02:07,603 --> 02:02:08,904
BUILT PARTICULARLY WITH

3399
02:02:08,904 --> 02:02:10,005
COMMUNITIES THAT ARE MOST

3400
02:02:10,005 --> 02:02:11,340
IMPACTED BY SOCIAL DETERMINANTS

3401
02:02:11,340 --> 02:02:12,407
OF HEALTH.

3402
02:02:12,407 --> 02:02:15,944
SO AFTER DR. GODDARD GAVE HER

3403
02:02:15,944 --> 02:02:17,412
PRESENTATION, WE HAD

3404
02:02:17,412 --> 02:02:17,980
CONVERSATION AND TURNED TO

3405
02:02:17,980 --> 02:02:19,148
CONSIDERATION OF WHERE THE

3406
02:02:19,148 --> 02:02:20,716
SUBCOMMITTEE WANTS TO FOCUS THE

3407
02:02:20,716 --> 02:02:22,784
EFFORT OVER THE NEXT YEAR OR SO

3408
02:02:22,784 --> 02:02:25,621
AND IT'S THAT CONVERSATION THAT

3409
02:02:25,621 --> 02:02:27,289
SPARKED THE NEED FOR NOVEL

3410
02:02:27,289 --> 02:02:28,323
MEASURES AND MEASURE LITTLE.

3411
02:02:28,323 --> 02:02:30,359
ALL OF GOVERNMENT EFFORT IS

3412
02:02:30,359 --> 02:02:31,827
NEEDED TO MITIGATE CROSSCUTTING

3413
02:02:31,827 --> 02:02:33,428
CHALLENGES IN HEALTH EQUITY, FOR

3414
02:02:33,428 --> 02:02:34,696
EXAMPLE, HOUSING INSECURITY,

3415
02:02:34,696 --> 02:02:36,165
LACK OF TRANSPORTATION,

3416
02:02:36,165 --> 02:02:37,199
GOVERNMENT AGENCIES THAT WORK

3417
02:02:37,199 --> 02:02:38,700
WITH THAT, WITH THOSE TWO

3418
02:02:38,700 --> 02:02:38,934
ISSUES.

3419
02:02:38,934 --> 02:02:40,736
BUT WE REALLY NEED TO FIGURE OUT

3420
02:02:40,736 --> 02:02:42,237
WAYS TO MINIMIZE

3421
02:02:42,237 --> 02:02:43,539
MISCOMMUNICATIONS AND DUPLICATE

3422
02:02:43,539 --> 02:02:45,307
EFFORTS TO HAVE STANDARDIZED

3423
02:02:45,307 --> 02:02:46,542
MEASURES FOR SOCIAL DETERMINANTS

3424
02:02:46,542 --> 02:02:48,310
OF HEALTH AND FIGURE OUT HOW TO

3425
02:02:48,310 --> 02:02:49,044
IMPLEMENT THEM.

3426
02:02:49,044 --> 02:02:51,647
AND REALLY THE TRADITIONAL

3427
02:02:51,647 --> 02:02:54,483
EPIDEMIOLOGY METHODS ARE

3428
02:02:54,483 --> 02:02:55,651
INSUFFICIENT TO ADDRESS SOME OF

3429
02:02:55,651 --> 02:02:56,652
THESE NEW TECHNOLOGIES.

3430
02:02:56,652 --> 02:02:59,855
IT REALLY PROVIDES JUST A STATIC

3431
02:02:59,855 --> 02:03:01,323
SNAPSHOT THAT DOESN'T ALWAYS

3432
02:03:01,323 --> 02:03:02,824
TAKE INTO CONSIDERATION THE

3433
02:03:02,824 --> 02:03:04,226
COMPLEXITY OF HOW SOCIAL

3434
02:03:04,226 --> 02:03:05,027
DETERMINANTS MAY CHANGE OVER

3435
02:03:05,027 --> 02:03:06,929
TIME AND HOW THEY MIGHT IMPACT

3436
02:03:06,929 --> 02:03:08,430
THE BIOLOGIC BASIS OF HEALTH.

3437
02:03:08,430 --> 02:03:10,632
AND SO REALLY HAVING SOME NOVEL

3438
02:03:10,632 --> 02:03:13,535
AND DYNAMIC TECHNIQUES TO

3439
02:03:13,535 --> 02:03:13,869
METHODOLOGIES.

3440
02:03:13,869 --> 02:03:15,871
THOSE ARE THINGS THAT NEED TO BE

3441
02:03:15,871 --> 02:03:17,706
DEVELOPED, VALIDATED AND

3442
02:03:17,706 --> 02:03:18,006
IMPLEMENTED.

3443
02:03:18,006 --> 02:03:20,209
WE ALSO SUGGESTED THAT THERE BE

3444
02:03:20,209 --> 02:03:22,978
AN IMPROVED -- WE START TO THINK

3445
02:03:22,978 --> 02:03:23,745
ABOUT BIDIRECTIONAL

3446
02:03:23,745 --> 02:03:24,313
COMMUNICATION BETWEEN THE

3447
02:03:24,313 --> 02:03:25,814
RESEARCHERS AND THE COMMUNITY.

3448
02:03:25,814 --> 02:03:27,316
ALREADY EFFORTS WITH THAT.

3449
02:03:27,316 --> 02:03:29,918
BUT AGAIN, AS POINTED OUT,

3450
02:03:29,918 --> 02:03:30,752
HAVING DIVERSE COMMUNITY VOICES

3451
02:03:30,752 --> 02:03:32,421
AND PATIENT ADVOCATES BEING

3452
02:03:32,421 --> 02:03:33,755
INCLUDED IN SOCIAL DETERMINANTS

3453
02:03:33,755 --> 02:03:35,224
OF HEALTH RELATED PROGRAMS AS

3454
02:03:35,224 --> 02:03:37,259
MEMBERS OF THE EXECUTIVE

3455
02:03:37,259 --> 02:03:38,260
COMMITTEES, REALLY IMPORTANT.

3456
02:03:38,260 --> 02:03:40,128
AND THE RESULTS OF THE NIH

3457
02:03:40,128 --> 02:03:41,730
RESEARCH SHOULD BE DISSEMINATED

3458
02:03:41,730 --> 02:03:45,133
AGAIN TO BROADER COMMUNITIES.

3459
02:03:45,133 --> 02:03:46,335
SO WE WOULD LOVE PERHAPS AS THE

3460
02:03:46,335 --> 02:03:47,736
SUB COMMITTEE TO FIGURE OUT WAYS

3461
02:03:47,736 --> 02:03:48,637
TO DO THAT.

3462
02:03:48,637 --> 02:03:50,739
WE ALSO THINK IT'S SO IMPORTANT

3463
02:03:50,739 --> 02:03:52,040
TO HAVE BASIC SCIENTISTS BE

3464
02:03:52,040 --> 02:03:55,744
ENGAGED IN THE CONVERSATIONS IS.

3465
02:03:55,744 --> 02:03:57,446
EXAMPLES OF SUCCESSFUL

3466
02:03:57,446 --> 02:03:58,447
ENGAGEMENT EFFORTS SHOULD BE

3467
02:03:58,447 --> 02:03:59,047
DISSEMINATED WITHIN THE

3468
02:03:59,047 --> 02:04:00,949
SCIENTIFIC AND BROADER

3469
02:04:00,949 --> 02:04:01,283
COMMUNITIES.

3470
02:04:01,283 --> 02:04:02,951
WE HAD WONDERFUL SUBCOMMITTEE

3471
02:04:02,951 --> 02:04:06,288
MEMBER DR. ANNA NEVIS INDICATED

3472
02:04:06,288 --> 02:04:08,757
SHE HAD EXAMPLES OF HOW

3473
02:04:08,757 --> 02:04:09,658
COMMUNITY ENGAGEMENT IMPACTED

3474
02:04:09,658 --> 02:04:11,360
THE DIRECTION OF BASIC AND

3475
02:04:11,360 --> 02:04:12,427
TRANSLATIONAL SCIENCE AND WE

3476
02:04:12,427 --> 02:04:13,562
WOULD BE HAPPY TO SHARE THAT.

3477
02:04:13,562 --> 02:04:15,330
SO THAT MAY BE SOMETHING TO

3478
02:04:15,330 --> 02:04:17,099
CONSIDER IN A FUTURE MEETING.

3479
02:04:17,099 --> 02:04:19,001
AND WE TALKED ABOUT WORKFORCE

3480
02:04:19,001 --> 02:04:20,135
TRAINING AND EARLY CAREER

3481
02:04:20,135 --> 02:04:20,369
SUPPORT.

3482
02:04:20,369 --> 02:04:22,437
THERE IS SUCH A GROWING NEED IN

3483
02:04:22,437 --> 02:04:23,639
PUBLIC HEALTH THAT REALLY

3484
02:04:23,639 --> 02:04:25,140
REQUIRES A LARGER COMMUNITY

3485
02:04:25,140 --> 02:04:27,075
HEALTH CARE AND RESEARCH

3486
02:04:27,075 --> 02:04:27,342
WORKFORCE.

3487
02:04:27,342 --> 02:04:29,244
WE ARE IN A DEFSILT AND SO, WE

3488
02:04:29,244 --> 02:04:31,880
NEED TO HAVE MORE TRAINING

3489
02:04:31,880 --> 02:04:33,949
PROGRAMS TO SUPPORT CAREERS AND

3490
02:04:33,949 --> 02:04:35,250
PREVENTION, ESPECIALLY FOR

3491
02:04:35,250 --> 02:04:38,153
PEOPLE FROM MARGINALLITES AND

3492
02:04:38,153 --> 02:04:39,087
UNDERREPRESENTED COMMUNITIES AND

3493
02:04:39,087 --> 02:04:40,355
TO INCLUDE BASIC AND

3494
02:04:40,355 --> 02:04:41,857
TRANSLATIONAL RESEARCHERS.

3495
02:04:41,857 --> 02:04:43,058
SO AGAIN FOR ACTION ITEMS, I

3496
02:04:43,058 --> 02:04:44,960
THINK FOR OUR FUTURE MEETINGS,

3497
02:04:44,960 --> 02:04:46,061
WE ARE STILL GOING TO THINK

3498
02:04:46,061 --> 02:04:47,562
ABOUT WHAT WE'D LIKE TO ACHIEVE

3499
02:04:47,562 --> 02:04:50,098
BUT PERHAPS HAVING THE MEMBERS

3500
02:04:50,098 --> 02:04:50,899
OF THE COMPASS PROGRAM AND TEAMS

3501
02:04:50,899 --> 02:04:53,035
BE INVITED TO SPEAK AT THE NEXT

3502
02:04:53,035 --> 02:04:54,136
SUBCOMMITTEE MEETING ABOUT THE

3503
02:04:54,136 --> 02:04:55,370
BEST PRACTICES AND THINGS THAT

3504
02:04:55,370 --> 02:04:56,972
THEY ARE LEARNING FROM THOSE

3505
02:04:56,972 --> 02:04:57,973
PARTNERSHIP EFFORTS AND

3506
02:04:57,973 --> 02:04:59,775
CERTAINLY MAYBE EVEN IN ASKING

3507
02:04:59,775 --> 02:05:02,077
OUR OWN MEMBERS TO SHARE THEIR

3508
02:05:02,077 --> 02:05:03,712
EXPERIENCES REGARDING HOW

3509
02:05:03,712 --> 02:05:05,814
COMMUNITY ENGAGEMENT HAS REALLY

3510
02:05:05,814 --> 02:05:06,415
CHANGED THE FACE OF RESEARCH.

3511
02:05:06,415 --> 02:05:07,582
THOSE MIGHT BE SOME THINGS THAT

3512
02:05:07,582 --> 02:05:09,584
WE CAN START AS A WAY TO REALLY

3513
02:05:09,584 --> 02:05:12,521
HELP TO FIGURE OUT THE DIRECTION

3514
02:05:12,521 --> 02:05:13,755
THAT THE SUBCOMMITTEE WOULD LIKE

3515
02:05:13,755 --> 02:05:15,090
TO GO IN OVER THE NEXT YEAR.

3516
02:05:15,090 --> 02:05:16,758
THANK YOU FOR ALLOWING ME A

3517
02:05:16,758 --> 02:05:18,560
CHANCE TO GIVE A BRIEF UPDATE

3518
02:05:18,560 --> 02:05:21,396
AND THERE WILL BE FURTHER

3519
02:05:21,396 --> 02:05:22,497
UPDATES AS DOCUMENTATION IS

3520
02:05:22,497 --> 02:05:23,765
IMPROVED OVER THE NEXT WEEK OR

3521
02:05:23,765 --> 02:05:27,469
SO.

3522
02:05:27,469 --> 02:05:29,538
>> GREAT.

3523
02:05:29,538 --> 02:05:30,072
THANKS, KARIN.

3524
02:05:30,072 --> 02:05:31,606
I GUESS WE NEED TO KEEP THESE

3525
02:05:31,606 --> 02:05:37,979
ROUGHLY TO A 10-MINUTE OR SO --

3526
02:05:37,979 --> 02:05:39,181
FOR EACH ONE BECAUSE WE ONLY

3527
02:05:39,181 --> 02:05:42,384
HAVE ABOUT 30 MINUTES FOR THE

3528
02:05:42,384 --> 02:05:44,219
OVERALL SESSION.

3529
02:05:44,219 --> 02:05:46,421
SO, I GUESS ARE THERE ANY

3530
02:05:46,421 --> 02:05:48,590
QUESTIONS FOR KARIN?

3531
02:05:48,590 --> 02:05:57,199
ANY BURNING QUESTIONS?

3532
02:05:57,199 --> 02:05:59,368
THERE BEEN NONE, THEN WE NEED TO

3533
02:05:59,368 --> 02:06:00,702
VOTE TO ACCEPT THE REPORT FROM

3534
02:06:00,702 --> 02:06:03,238
THE SUBCOMMITTEE.

3535
02:06:03,238 --> 02:06:04,606
IS THERE A MOTION TO ACCEPT?

3536
02:06:04,606 --> 02:06:08,610
>> MOTION TO ACCEPT.

3537
02:06:08,610 --> 02:06:09,211
>> SECOND.

3538
02:06:09,211 --> 02:06:10,612
>> PROPERLY MOVED AND
SECONDED.

3539
02:06:10,612 --> 02:06:15,817
ANY FURTHER QUESTIONS OR

3540
02:06:15,817 --> 02:06:16,118
DISCUSSION?

3541
02:06:16,118 --> 02:06:21,890
THERE BEING NONE, WE WILL VOTE.

3542
02:06:21,890 --> 02:06:29,231
ARE THERE ANY NEIGHS? NAYs?

3543
02:06:29,231 --> 02:06:29,598
ABSTENTIONS.

3544
02:06:29,598 --> 02:06:31,400
>> IT'S UNANIMOUS.

3545
02:06:31,400 --> 02:06:31,767
>> WONDERFUL.

3546
02:06:31,767 --> 02:06:35,303
THE NEXT REPORT WILL BE GIVEN TO

3547
02:06:35,303 --> 02:06:38,206
US BY RICHARD WHO CHAIRS THE

3548
02:06:38,206 --> 02:06:40,308
AD-HOC COMMITTEE ON EXPERIMENTAL

3549
02:06:40,308 --> 02:06:42,210
THERAPEUTICS.

3550
02:06:42,210 --> 02:06:42,611
RICHARD.

3551
02:06:42,611 --> 02:06:43,145
>> THANK YOU VERY MUCH.

3552
02:06:43,145 --> 02:06:45,013
CAN YOU HEAR ME?

3553
02:06:45,013 --> 02:06:46,915
>> YES.

3554
02:06:46,915 --> 02:06:47,182
>> GOOD.

3555
02:06:47,182 --> 02:06:47,949
BECAUSE THERE WERE TECHNICAL

3556
02:06:47,949 --> 02:06:50,218
PROBLEMS EARLIER.

3557
02:06:50,218 --> 02:06:53,355
THE SUBCOMMITTEE MEMBERS MET AND

3558
02:06:53,355 --> 02:06:58,860
IT WAS REALLY THE PRINCIPLE

3559
02:06:58,860 --> 02:07:00,829
REASON FOR MEETING QUARTERLY IS

3560
02:07:00,829 --> 02:07:05,333
TO ALTER OR AT LEAST PERHAPS

3561
02:07:05,333 --> 02:07:08,537
IMPROVE OR UPDATE THE MISSION

3562
02:07:08,537 --> 02:07:11,239
STATEMENT FOR THE SUBCOMMITTEE

3563
02:07:11,239 --> 02:07:12,841
ON EXPERIMENTAL THERAPEUTICS

3564
02:07:12,841 --> 02:07:15,911
BECAUSE IT WAS LAST WRITTEN IN

3565
02:07:15,911 --> 02:07:20,549
2006.

3566
02:07:20,549 --> 02:07:25,220
THE UPDATED LANGUAGE WAS READ

3567
02:07:25,220 --> 02:07:28,423
CAREFULLY BUT AFTER A ROBUST

3568
02:07:28,423 --> 02:07:29,958
CONVERSATION, AND I THINK IT WAS

3569
02:07:29,958 --> 02:07:31,960
GREAT THAT WE WERE ABLE TO HAVE

3570
02:07:31,960 --> 02:07:34,062
THAT, WE DECIDED THAT WE WERE

3571
02:07:34,062 --> 02:07:35,797
GOING TO HAVE A SUBCOMMITTEE OF

3572
02:07:35,797 --> 02:07:37,432
THE SUB COMMITTEE.

3573
02:07:37,432 --> 02:07:39,935
IN OTHER WORDS, A FEW PEOPLE WHO

3574
02:07:39,935 --> 02:07:45,474
WOULD BE WILLING TO WRITE MAYBE

3575
02:07:45,474 --> 02:07:47,275
A MORE BROAD RATHER THAN MORE

3576
02:07:47,275 --> 02:07:49,044
SPECIFIC KIND OF MISSION

3577
02:07:49,044 --> 02:07:50,145
STATEMENT THAT WOULD HELP US

3578
02:07:50,145 --> 02:07:53,248
TODAY AND INTO THE FUTURE.

3579
02:07:53,248 --> 02:07:56,551
AND SO, THE RIGOROUS

3580
02:07:56,551 --> 02:08:02,224
CONVERSATION REALLY LED BY

3581
02:08:02,224 --> 02:08:05,327
DR. BARKER AND AMY AND JULIE,

3582
02:08:05,327 --> 02:08:06,728
ULTIMATELY WE DECIDED THAT IT

3583
02:08:06,728 --> 02:08:09,064
WOULD BE BETTER IF WE WERE TO

3584
02:08:09,064 --> 02:08:12,968
LOOK AT TRAINING AS WELL AS

3585
02:08:12,968 --> 02:08:17,539
OTHER ASPECTS THAT EXPERIMENTAL

3586
02:08:17,539 --> 02:08:19,374
THERAPEUTICS COULD OFFER THE NCA

3587
02:08:19,374 --> 02:08:22,744
ABOUT AND CANCER COMMUNITY IN

3588
02:08:22,744 --> 02:08:22,978
GENERAL.

3589
02:08:22,978 --> 02:08:24,946
THERE WAS CONVERSATION ABOUT THE

3590
02:08:24,946 --> 02:08:26,281
DIFFERENCES BETWEEN REQUIREMENTS

3591
02:08:26,281 --> 02:08:28,950
FOR ACADEMIC RESEARCH AND

3592
02:08:28,950 --> 02:08:31,453
REGULATORY APPROVAL LEADING TO

3593
02:08:31,453 --> 02:08:32,587
COMMERCIALIZATION WHICH OFTEN

3594
02:08:32,587 --> 02:08:33,855
CAUSES DEVELOPMENT OF

3595
02:08:33,855 --> 02:08:34,856
THERAPEUTICS TO FAIL.

3596
02:08:34,856 --> 02:08:37,459
SO THE SUBCOMMITTEE SOUGHT A

3597
02:08:37,459 --> 02:08:39,961
ROLE IN TRAINING ACADEMIC

3598
02:08:39,961 --> 02:08:41,263
COLLEAGUES IN THE REQUIREMENTS

3599
02:08:41,263 --> 02:08:45,967
OF THIS WOULD BE ADVANTAGEOUS.

3600
02:08:45,967 --> 02:08:48,436
AND SO, RATHER THAN THE ACTION

3601
02:08:48,436 --> 02:08:54,376
ITEM FOR THE NCAB WAS GOING TO

3602
02:08:54,376 --> 02:08:57,679
BE TO ACCEPT THE

3603
02:08:57,679 --> 02:08:59,915
PREVIOUSLY-THOUGHT OF UPDATED

3604
02:08:59,915 --> 02:09:00,148
VERSION.

3605
02:09:00,148 --> 02:09:02,050
AND THE BECAUSE WE DECIDED WE

3606
02:09:02,050 --> 02:09:03,652
ARE GOING TO UPDATE ANOTHER

3607
02:09:03,652 --> 02:09:05,387
TIME, WE ARE GOING TO PUT THAT

3608
02:09:05,387 --> 02:09:07,956
OFF UNTIL THE JUNE MEETING.

3609
02:09:07,956 --> 02:09:09,758
SO, FUNDAMENTALLY WHAT WE ALL

3610
02:09:09,758 --> 02:09:12,294
DECIDED WAS, THAT THERE WAS

3611
02:09:12,294 --> 02:09:16,765
ABSOLUTELY A GOOD REASON TO

3612
02:09:16,765 --> 02:09:18,333
UPDATE THE MISSION STATEMENT BUT

3613
02:09:18,333 --> 02:09:20,468
WE NEED TO WORK ON IT A LITTLE

3614
02:09:20,468 --> 02:09:21,303
BIT MORE.

3615
02:09:21,303 --> 02:09:24,272
SO THAT'S REALLY WHAT WE

3616
02:09:24,272 --> 02:09:25,974
DISCUSSED AND IT WAS AN

3617
02:09:25,974 --> 02:09:28,343
EXCELLENT DISCUSSION.

3618
02:09:28,343 --> 02:09:29,077
THANK YOU.

3619
02:09:29,077 --> 02:09:31,780
>> I HAVE A POINT OF
QUESTION.

3620
02:09:31,780 --> 02:09:32,847
GIVEN THAT THERE WAS GOING TO BE

3621
02:09:32,847 --> 02:09:36,384
A VOTE ABOUT THE REVISED MISSION

3622
02:09:36,384 --> 02:09:36,651
STATEMENT.

3623
02:09:36,651 --> 02:09:38,687
WE WILL FOREGO THAT VOTE.

3624
02:09:38,687 --> 02:09:41,323
>> THE BOARD HAD TWO
ACTIONS.

3625
02:09:41,323 --> 02:09:44,092
ONE WAS TO ACCEPT THE REPORT

3626
02:09:44,092 --> 02:09:45,894
THAT RICHARD JUST GAVE US.

3627
02:09:45,894 --> 02:09:49,864
AND THE SECOND WAS TO ACCEPT THE

3628
02:09:49,864 --> 02:09:52,000
MISSION STATEMENT.

3629
02:09:52,000 --> 02:09:54,469
WE WILL NOT ACCEPT THE MISSION

3630
02:09:54,469 --> 02:09:55,136
STATEMENT TODAY.

3631
02:09:55,136 --> 02:09:58,406
WE DO NEED TO ACCEPT THE REPORT.

3632
02:09:58,406 --> 02:09:59,474
>> GOT IT.

3633
02:09:59,474 --> 02:10:02,210
ARE THERE ANY ADDITIONAL

3634
02:10:02,210 --> 02:10:07,916
QUESTIONS FOR DR. BOXER?

3635
02:10:07,916 --> 02:10:10,185
THERE BEING NONE, WE WILL NOW

3636
02:10:10,185 --> 02:10:12,520
VOTE TO ACCEPT HIS REPORT.

3637
02:10:12,520 --> 02:10:17,926
IS THERE A MOTION TO ACCEPT?

3638
02:10:17,926 --> 02:10:20,795
>> SO MOVED.

3639
02:10:20,795 --> 02:10:23,798
>> SECOND?

3640
02:10:23,798 --> 02:10:24,532
>> SECOND.

3641
02:10:24,532 --> 02:10:26,968
>> PROPERLY MOVED AND
SECONDED.

3642
02:10:26,968 --> 02:10:29,738
ANY FURTHER DISCUSSION OR

3643
02:10:29,738 --> 02:10:30,005
QUESTIONS?

3644
02:10:30,005 --> 02:10:32,507
THERE BEING NONE, WE'LL GO AHEAD

3645
02:10:32,507 --> 02:10:33,708
AND VOTE.

3646
02:10:33,708 --> 02:10:37,712
ARE THERE ANY NAYs?

3647
02:10:37,712 --> 02:10:42,317
ANY ABSTENTIONS?

3648
02:10:42,317 --> 02:10:46,621
THERE BEING NONE, IT'S UNANIM 

3649
02:10:46,621 --> 02:10:47,622
UNANIMOUS.

3650
02:10:47,622 --> 02:10:48,723
>> CORRECT.

3651
02:10:48,723 --> 02:10:49,124
>> GREAT.

3652
02:10:49,124 --> 02:10:50,725
AND OUR FINAL REPORT WILL BE

3653
02:10:50,725 --> 02:10:53,828
BROUGHT TO US BY ANN BARKER WHO

3654
02:10:53,828 --> 02:10:55,830
CHAIRS THE SUBCOMMITTEE ON

3655
02:10:55,830 --> 02:10:56,831
PLANNING AND BUDGET.

3656
02:10:56,831 --> 02:11:00,435
SO ANN WILL GIVE THAT REPORT.

3657
02:11:00,435 --> 02:11:01,136
>> YES, THANK YOU, JOHN.

3658
02:11:01,136 --> 02:11:03,338
FIRST I WANT TO THANK THE

3659
02:11:03,338 --> 02:11:03,605
COMMITTEE.

3660
02:11:03,605 --> 02:11:04,839
IT WAS A REALLY GOOD DISCUSSION,

3661
02:11:04,839 --> 02:11:06,408
ONE OF THE BEST WE'VE HAD.

3662
02:11:06,408 --> 02:11:09,144
AND I WANT TO THANK WEST ON WHO

3663
02:11:09,144 --> 02:11:11,746
GAVE US A REALLY SCARY,

3664
02:11:11,746 --> 02:11:13,748
SOMEWHAT, BUT REALLY INTERESTING

3665
02:11:13,748 --> 02:11:17,485
OVERVIEW OF THE BUDGET PROCESS

3666
02:11:17,485 --> 02:11:21,456
FOR THE NCI.

3667
02:11:21,456 --> 02:11:23,291
AND WE TALKED ABOUT THE

3668
02:11:23,291 --> 02:11:25,927
LEGISLATIVE SIDE OF THAT, WHICH

3669
02:11:25,927 --> 02:11:27,328
IS ALWAYS TWO THINGS THAT ARE

3670
02:11:27,328 --> 02:11:29,064
HIGHLY CONNECTED, OBVIOUSLY.

3671
02:11:29,064 --> 02:11:30,932
WE STARTED WITH ACTUALLY

3672
02:11:30,932 --> 02:11:32,667
REVIEWING A CHARGE FOR THIS

3673
02:11:32,667 --> 02:11:34,302
COMMITTEE AND IT'S PRETTY

3674
02:11:34,302 --> 02:11:34,536
SIMPLE.

3675
02:11:34,536 --> 02:11:35,637
IT COMES DOWN TO ESSENTIALLY

3676
02:11:35,637 --> 02:11:41,276
WHAT CAN WE DO TO ASSIST OUR NEW

3677
02:11:41,276 --> 02:11:41,543
DIRECTOR?

3678
02:11:41,543 --> 02:11:43,845
AND SHE WAS KIND ENOUGH TO JOIN

3679
02:11:43,845 --> 02:11:46,147
US AND MADE IT VERY CLEAR THAT

3680
02:11:46,147 --> 02:11:47,749
SHE WOULD BE LOOKING TO THIS

3681
02:11:47,749 --> 02:11:50,151
SUBCOMMITTEE FOR HELP.

3682
02:11:50,151 --> 02:11:52,387
SO, WE ARE THERE AND HOPING THAT

3683
02:11:52,387 --> 02:11:53,054
WE CAN HELP.

3684
02:11:53,054 --> 02:11:55,023
AND I'M HOPING AT OUR

3685
02:11:55,023 --> 02:11:57,158
SUBCOMMITTEE, WE WILL REALLY

3686
02:11:57,158 --> 02:11:58,727
DEDICATE ITSELF TO THINKING MORE

3687
02:11:58,727 --> 02:12:01,062
ABOUT HOW WE MIGHT DO THIS.

3688
02:12:01,062 --> 02:12:02,964
AND SO, A COUPLE OF THINGS WE

3689
02:12:02,964 --> 02:12:05,467
TRIED TO DO WITH THIS MEETING

3690
02:12:05,467 --> 02:12:08,570
TODAY IS TO GIVE EVERYBODY AN

3691
02:12:08,570 --> 02:12:10,805
OVERVIEW OF VERY COMPLEX PROCESS

3692
02:12:10,805 --> 02:12:13,475
THAT IS THE NCI'S BUDGET

3693
02:12:13,475 --> 02:12:13,875
PROCESS.

3694
02:12:13,875 --> 02:12:15,877
AND THERE ARE SO MANY STEPS IN

3695
02:12:15,877 --> 02:12:19,013
THIS THAT IT'S REALLY HARD TO

3696
02:12:19,013 --> 02:12:23,251
CAPTURE BUT I THINK WESTON DID A

3697
02:12:23,251 --> 02:12:25,253
BEAUTIFUL JOB OF DOING THIS.

3698
02:12:25,253 --> 02:12:26,354
IT'S IMPORTANT THAT WE

3699
02:12:26,354 --> 02:12:27,589
UNDERSTAND THIS BECAUSE THERE

3700
02:12:27,589 --> 02:12:30,759
ARE SO MANY PLACES IN THIS

3701
02:12:30,759 --> 02:12:33,394
PROCESS WHERE INFLUENCE CAN BE

3702
02:12:33,394 --> 02:12:35,964
APPLIED, NOT NECESSARILY AS A

3703
02:12:35,964 --> 02:12:39,067
BOARD BUT AS INDIVIDUAL

3704
02:12:39,067 --> 02:12:40,668
CONTRIBUTORS TO OUR INSTITUTIONS

3705
02:12:40,668 --> 02:12:42,570
OR INDIVIDUALLY.

3706
02:12:42,570 --> 02:12:46,875
AND ALSO I THINK THE NCI HAS ITS

3707
02:12:46,875 --> 02:12:47,675
OWN OPPORTUNITIES TO INFLUENCE

3708
02:12:47,675 --> 02:12:49,410
THIS PROCESS, BUT MOSTLY IT'S

3709
02:12:49,410 --> 02:12:50,712
THE EXTRAMURAL COMMUNITY THAT

3710
02:12:50,712 --> 02:12:56,284
CAN INFLUENCE THIS PROCESS.

3711
02:12:56,284 --> 02:12:59,654
SO, I THINK WITH DR. RATHMELL WE

3712
02:12:59,654 --> 02:13:01,856
HAD A GOOD DISCUSSION ABOUT HOW

3713
02:13:01,856 --> 02:13:04,058
WE MIGHT BE MOST HELPFUL.

3714
02:13:04,058 --> 02:13:06,661
I WON'T SAY MUCH ABOUT THE

3715
02:13:06,661 --> 02:13:08,396
SLIDES THAT WESTON SHOWED, I

3716
02:13:08,396 --> 02:13:09,364
THINK THOSE WILL BE AVAILABLE TO

3717
02:13:09,364 --> 02:13:09,531
YOU.

3718
02:13:09,531 --> 02:13:11,766
BUT ESSENTIALLY, THE PROCESS FOR

3719
02:13:11,766 --> 02:13:13,201
NCI IS A BIT DIFFERENT AND I

3720
02:13:13,201 --> 02:13:15,603
THINK WE ALL KNOW THIS.

3721
02:13:15,603 --> 02:13:18,673
WE HAVE THE REGULAR PRESIDENT'S

3722
02:13:18,673 --> 02:13:20,475
BUDGET THAT COMES THROUGH, THAT

3723
02:13:20,475 --> 02:13:22,710
BUDGET IS INFORMED BY WHAT NCI

3724
02:13:22,710 --> 02:13:25,847
HAS SUBMITTED FOR ITS BUDGET

3725
02:13:25,847 --> 02:13:26,681
REQUEST.

3726
02:13:26,681 --> 02:13:28,616
THAT GETS TAKEN INTO

3727
02:13:28,616 --> 02:13:33,655
CONSIDERATION BUT WE HAVE

3728
02:13:33,655 --> 02:13:35,123
ANOTHER AVENUE WHICH GOES BACK

3729
02:13:35,123 --> 02:13:36,057
TO 1971 WHERE WE CAN SUBMIT A

3730
02:13:36,057 --> 02:13:37,091
BYPASS BUDGET AND THEN IN THE

3731
02:13:37,091 --> 02:13:38,126
EARLY DAYS OF THE NATIONAL

3732
02:13:38,126 --> 02:13:40,261
CANCER ACT WAS TO GO RIGHT TO

3733
02:13:40,261 --> 02:13:42,597
THE PRESIDENT AND IN THEORY, NOW

3734
02:13:42,597 --> 02:13:47,869
THE PRESIDENT COULD ACT AND WORK

3735
02:13:47,869 --> 02:13:48,236
AROUND CONGRESS.

3736
02:13:48,236 --> 02:13:48,903
THAT HASN'T HAPPENED IN A LONG

3737
02:13:48,903 --> 02:13:49,103
TIME.

3738
02:13:49,103 --> 02:13:51,706
BUT I THINK ONE OF THE THINGS

3739
02:13:51,706 --> 02:13:54,609
THAT THE BYPASS BUDGET OFFERS US

3740
02:13:54,609 --> 02:13:56,511
AND DR. RATHMELL WAS VERY CLEAR,

3741
02:13:56,511 --> 02:13:59,981
THAT WE CAN HELP HERE, IS HAVING

3742
02:13:59,981 --> 02:14:02,083
INPUT, THE SUBCOMMITTEE AND THE

3743
02:14:02,083 --> 02:14:03,318
NCAB OVERALL THROUGH THE

3744
02:14:03,318 --> 02:14:12,026
SUBCOMMITTEE TO HAVE INPUT INTO

3745
02:14:12,026 --> 02:14:12,360
THAT PROCESS.

3746
02:14:12,360 --> 02:14:12,994
MAYBE WE CAN, AND I'M HOPING WE

3747
02:14:12,994 --> 02:14:13,595
CAN HELP IN TERMS OF ASSISTING

3748
02:14:13,595 --> 02:14:14,028
NCI IN THIS REGARD.

3749
02:14:14,028 --> 02:14:14,662
IT'S VERY COMPLEX PROCESS THAT

3750
02:14:14,662 --> 02:14:17,498
WE WENT THROUGH A FEW TIMES.

3751
02:14:17,498 --> 02:14:23,671
THE OTHER THING ABOUT THE BYPASS

3752
02:14:23,671 --> 02:14:24,272
BUDGET IS THAT WE NEED TO MAKE

3753
02:14:24,272 --> 02:14:28,142
PEOPLE AWARE OF THIS BUDGET.

3754
02:14:28,142 --> 02:14:28,643
ON THE HILL, EACH IN THE

3755
02:14:28,643 --> 02:14:29,077
PRESIDENT'S OFFICE.

3756
02:14:29,077 --> 02:14:34,929
ALL KINDS OF WE CAN TALK

3757
02:14:34,929 --> 02:19:35,974
[ TECHNICAL DIFFICULTIES ]

3758
02:19:35,974 --> 02:19:37,576
>> THIS IS GREAT DIALOGUE.

3759
02:19:37,576 --> 02:19:40,345
THIS IS REALLY IMPORTANT

3760
02:19:40,345 --> 02:19:40,612
ACTIVITY.

3761
02:19:40,612 --> 02:19:45,450
ANY ADDITIONAL QUESTIONS OR

3762
02:19:45,450 --> 02:19:46,351
COMMENTS?

3763
02:19:46,351 --> 02:19:50,322
IF NOT, WE NEED TO -- WE NEED A

3764
02:19:50,322 --> 02:19:52,391
MOTION TO ACCEPT THE REPORT

3765
02:19:52,391 --> 02:19:53,258
GIVEN BY ANN.

3766
02:19:53,258 --> 02:19:54,926
IS THERE A MOTION?

3767
02:19:54,926 --> 02:19:57,896
>> SO MOVED.

3768
02:19:57,896 --> 02:19:58,397
>> SECOND.

3769
02:19:58,397 --> 02:19:59,064
>> SECOND.

3770
02:19:59,064 --> 02:20:00,032
PROPERLY MOVED AND SECONDED.

3771
02:20:00,032 --> 02:20:03,368
ANY ADDITIONAL QUESTIONS OR

3772
02:20:03,368 --> 02:20:03,669
DISCUSSION?

3773
02:20:03,669 --> 02:20:04,770
THERE BEING NONE, WE NEED TO

3774
02:20:04,770 --> 02:20:07,506
VOTE TO ACCEPT THE REPORT.

3775
02:20:07,506 --> 02:20:11,710
I WILL ASK ARE THERE ANY NAYs?

3776
02:20:11,710 --> 02:20:16,381
ANY ABSTENTIONS?

3777
02:20:16,381 --> 02:20:22,921
THERE BEING NONE, IT'S UNANIM 

3778
02:20:22,921 --> 02:20:23,188
UNANIMOUS.

3779
02:20:23,188 --> 02:20:23,488
>> IT IS.

3780
02:20:23,488 --> 02:20:24,523
>> OKAY, FANTASTIC.

3781
02:20:24,523 --> 02:20:28,593
SO NOW MOVING ON TO OTHER

3782
02:20:28,593 --> 02:20:29,027
BUSINESS.

3783
02:20:29,027 --> 02:20:29,828
THERE WAS THE MISSION STATEMENT

3784
02:20:29,828 --> 02:20:32,564
BUT I THINK WE'RE GOING TO

3785
02:20:32,564 --> 02:20:37,335
FOREGO THAT VOTE AND TABLE IT

3786
02:20:37,335 --> 02:20:39,671
UNTIL --

3787
02:20:39,671 --> 02:20:41,707
>> RIGHT.

3788
02:20:41,707 --> 02:20:47,012
>> YES, PAULETTE?

3789
02:20:47,012 --> 02:20:47,946
>> WE NEED TO ESTABLISH A

3790
02:20:47,946 --> 02:20:50,382
WORKING GROUP AND IT WILL BE

3791
02:20:50,382 --> 02:21:00,659
PRESENTED TO US.

3792
02:21:07,510 --> 02:21:09,412
>> THE TIMING TO TALK TO
YOU

3793
02:21:09,412 --> 02:21:11,348
ABOUT THIS, BECAUSE THIS IS A

3794
02:21:11,348 --> 02:21:13,617
WORKING GROUP -- WHATEVER KARIN

3795
02:21:13,617 --> 02:21:18,188
IS -- YOUR AD-HOC COMMITTEE.

3796
02:21:18,188 --> 02:21:19,823
IT'S AN OVERARCHING UMBRELLA OF

3797
02:21:19,823 --> 02:21:20,957
WHAT I'M ASKING THIS WORKING

3798
02:21:20,957 --> 02:21:22,225
GROUP TO TAKE A LOOK AT.

3799
02:21:22,225 --> 02:21:25,662
IN THE EARLY WEEKS OF MY ROLE,

3800
02:21:25,662 --> 02:21:28,164
IT'S BEEN REALLY APPARENT HOW

3801
02:21:28,164 --> 02:21:32,035
MUCH ATTENTION THERE IS TO THE

3802
02:21:32,035 --> 02:21:34,137
PARTICULARLY RURAL URBAN CANCER

3803
02:21:34,137 --> 02:21:36,973
DISPARITIES IN OUTCOME, BUT MORE

3804
02:21:36,973 --> 02:21:38,875
THAN RURAL.

3805
02:21:38,875 --> 02:21:44,714
IT'S MORE ISSUES OF ACCESS TO

3806
02:21:44,714 --> 02:21:47,150
CARE AND HOW BEST THE RESEARCH

3807
02:21:47,150 --> 02:21:49,986
COMMUNITY CAN SUPPORT IMPROVING

3808
02:21:49,986 --> 02:21:50,820
OUTCOMES TO PATIENTS ACROSS ALL

3809
02:21:50,820 --> 02:21:52,088
OF AMERICA.

3810
02:21:52,088 --> 02:21:53,723
IT'S A BIG VERY DIFFUSE

3811
02:21:53,723 --> 02:21:54,357
QUESTION.

3812
02:21:54,357 --> 02:21:55,392
I'M GETTING IT FROM THE WHITE

3813
02:21:55,392 --> 02:21:59,496
HOUSE, FROM OTHER PLACES, AND SO

3814
02:21:59,496 --> 02:22:00,964
EARLY INITIATIVES THAT WERE

3815
02:22:00,964 --> 02:22:05,502
HAPPENING LAST YEAR HAVE NOT

3816
02:22:05,502 --> 02:22:05,936
REALLY QUITE LANDED.

3817
02:22:05,936 --> 02:22:07,938
SO WHAT I DECIDED WE NEEDED WAS

3818
02:22:07,938 --> 02:22:09,306
MORE INFORMATION.

3819
02:22:09,306 --> 02:22:11,908
WHEN I SEE LOTS AND LOTS OF BITS

3820
02:22:11,908 --> 02:22:13,810
COMING AT ME IS, WHAT I THINK IS

3821
02:22:13,810 --> 02:22:15,078
WE NEED SMART PEOPLE TO SIT DOWN

3822
02:22:15,078 --> 02:22:17,113
IN A ROOM AND THINK ABOUT WHAT

3823
02:22:17,113 --> 02:22:22,686
WE COULD DO IN THIS SPACE.

3824
02:22:22,686 --> 02:22:23,887
SO, WHAT I ASKED SOME FOLKS TO

3825
02:22:23,887 --> 02:22:25,855
DO AND I HAVEN'T CHARGED THE

3826
02:22:25,855 --> 02:22:27,490
ENTIRE GROUP, TO MAKE A SMALL

3827
02:22:27,490 --> 02:22:29,259
READING GROUP TO WORK FOR A

3828
02:22:29,259 --> 02:22:32,095
PERIOD OF SIX MONTHS TO LOOK AT

3829
02:22:32,095 --> 02:22:34,998
WHAT PROBLEMS WE CAN SOLVE IN

3830
02:22:34,998 --> 02:22:36,599
THE SHORT TERM AND MEDIUM-TERM

3831
02:22:36,599 --> 02:22:36,833
FUTURE.

3832
02:22:36,833 --> 02:22:41,604
WHAT THE NCI'S ROLE SHOULD BE IN

3833
02:22:41,604 --> 02:22:47,010
TACKLING ISSUES AROUND OBTAINING

3834
02:22:47,010 --> 02:22:49,312
OPTIMAL CARE TO THE POINT OF THE

3835
02:22:49,312 --> 02:22:50,680
NATIONAL CANCER PLAN.

3836
02:22:50,680 --> 02:22:56,987
AND WHAT OTHER RESOURCES OR

3837
02:22:56,987 --> 02:22:59,723
COMPONENTS OF THE GOVERNMENT --

3838
02:22:59,723 --> 02:23:01,324
HERE I'M TALKING ABOUT SHOULD WE

3839
02:23:01,324 --> 02:23:07,297
BE PARTNERING WITH THE V.A --

3840
02:23:07,297 --> 02:23:09,899
AND I'M PULLING THAT OUT AS ONE

3841
02:23:09,899 --> 02:23:10,233
OPTION.

3842
02:23:10,233 --> 02:23:15,505
OTHER PLACES TO BE USING

3843
02:23:15,505 --> 02:23:17,240
EXISTING NETWORKS TO TRY TO

3844
02:23:17,240 --> 02:23:18,875
REACH PEOPLE.

3845
02:23:18,875 --> 02:23:19,142
SORRY.

3846
02:23:19,142 --> 02:23:20,944
IT'S COMING OUT A LITTLE BIT

3847
02:23:20,944 --> 02:23:22,178
JUMBLED BUT HOPEFULLY THAT MAKES

3848
02:23:22,178 --> 02:23:22,379
SENSE.

3849
02:23:22,379 --> 02:23:24,414
I NEED MORE INFORMATION TO KNOW

3850
02:23:24,414 --> 02:23:26,182
WHERE TO PUT INVESTMENTS AND

3851
02:23:26,182 --> 02:23:28,718
WHERE WE NEED TO TAKE SOME OF

3852
02:23:28,718 --> 02:23:29,419
THIS FORWARD.

3853
02:23:29,419 --> 02:23:31,287
WHAT I WAS THINKING IS A

3854
02:23:31,287 --> 02:23:34,824
GROUP -- AND YOU SEEN THE CHARGE

3855
02:23:34,824 --> 02:23:36,493
THAT I'VE ASKED FROM THEM.

3856
02:23:36,493 --> 02:23:38,895
I WAS THINKING ABOUT HAVING THIS

3857
02:23:38,895 --> 02:23:41,464
ROLE UP TO REPORT TO THE BSA IN

3858
02:23:41,464 --> 02:23:43,099
PART BECAUSE SOME OF THE FOLKS

3859
02:23:43,099 --> 02:23:47,303
THAT WE INITIALLY ASKED WERE BSA

3860
02:23:47,303 --> 02:23:47,537
MEMBERS.

3861
02:23:47,537 --> 02:23:49,472
BUT WORKING GROUPS LIKE THIS

3862
02:23:49,472 --> 02:23:52,108
HAVE TO BE AUTHORIZED BY THE

3863
02:23:52,108 --> 02:23:52,809
NCAB.

3864
02:23:52,809 --> 02:23:56,780
I WILL HAVE NCBA REPRESENTATION

3865
02:23:56,780 --> 02:24:01,518
ON THAT WORKING GROUP AND WE'LL

3866
02:24:01,518 --> 02:24:04,287
HAVE REPORTS SO THAT BOTH BOARDS

3867
02:24:04,287 --> 02:24:08,691
GET TO SEE WHAT THEY COME UP

3868
02:24:08,691 --> 02:24:09,225
WITH.

3869
02:24:09,225 --> 02:24:12,996
I'LL STOP THERE AND ANSWER ANY

3870
02:24:12,996 --> 02:24:13,296
QUESTIONS.

3871
02:24:13,296 --> 02:24:19,369
>> YES ISABEL?

3872
02:24:19,369 --> 02:24:20,236
>> THANK YOU.

3873
02:24:20,236 --> 02:24:23,106
YOU'RE REMINDING ME OF A

3874
02:24:23,106 --> 02:24:23,840
COMMITTEE ASKING THEM TO LOOK AT

3875
02:24:23,840 --> 02:24:24,774
THE ISSUES.

3876
02:24:24,774 --> 02:24:33,216
I WOULD ASK THAT YOU ASK

3877
02:24:33,216 --> 02:24:34,517
SCIENTISTS TO SHARE SOME OF THE

3878
02:24:34,517 --> 02:24:36,086
BEST OUTCOMES IN WORKING WITH

3879
02:24:36,086 --> 02:24:37,520
COMMUNITY-BASED ORGANIZATIONS

3880
02:24:37,520 --> 02:24:38,254
WHICH YOU CAN THEN SAY, THESE

3881
02:24:38,254 --> 02:24:40,890
ARE BEST PRACTICES.

3882
02:24:40,890 --> 02:24:41,758
THEY HAVE BEEN WORKING HERE.

3883
02:24:41,758 --> 02:24:42,459
THEY WORKED THIS WAY.

3884
02:24:42,459 --> 02:24:44,494
THAT WAY YOU'RE INCLUDING

3885
02:24:44,494 --> 02:24:45,695
COMMUNITY IN YOUR WORKING ACROSS

3886
02:24:45,695 --> 02:24:47,897
THAT BRIDGE AND YOU'RE REALLY

3887
02:24:47,897 --> 02:24:49,632
STARTING TO MOVE FROM -- I MEAN

3888
02:24:49,632 --> 02:24:50,100
RESEARCH IS GREAT.

3889
02:24:50,100 --> 02:24:52,836
A LOT OF US CAN'T WAIT FOR

3890
02:24:52,836 --> 02:24:54,104
RESEARCH, YOU KNOW, BECAUSE

3891
02:24:54,104 --> 02:24:55,405
WE'RE SICK NOW.

3892
02:24:55,405 --> 02:24:58,308
AND SO MOVING IT INTO COMMUNITY

3893
02:24:58,308 --> 02:25:01,344
USING THEIR BEST PRACTICES IS A

3894
02:25:01,344 --> 02:25:04,214
WAY TO INVEST NOT JUST RESEARCH

3895
02:25:04,214 --> 02:25:07,750
BUT IN COMMUNITY ENGAGEMENT, BE

3896
02:25:07,750 --> 02:25:08,251
IT COMPASS OR WHATEVER.

3897
02:25:08,251 --> 02:25:08,952
BUT REALLY, WHAT IS THE WORD I

3898
02:25:08,952 --> 02:25:09,786
WANT TO SAY.

3899
02:25:09,786 --> 02:25:14,691
NOT ONLY FOR IMPACT, BUT FOR

3900
02:25:14,691 --> 02:25:14,991
SCALING.

3901
02:25:14,991 --> 02:25:16,693
BECAUSE THERE ARE THOSE PEOPLE

3902
02:25:16,693 --> 02:25:17,760
IN COMMUNITY DOING WORK RIGHT

3903
02:25:17,760 --> 02:25:20,463
NOW JUST GETTING PEOPLE INTO

3904
02:25:20,463 --> 02:25:22,732
SCREENINGS, HELPING PEOPLE

3905
02:25:22,732 --> 02:25:24,868
THROUGH SYSTEMS AND ET CETERA.

3906
02:25:24,868 --> 02:25:27,637
IF YOU FOUND SOME GREAT BEST

3907
02:25:27,637 --> 02:25:28,638
PRACTICES, THEY COULD BE PUSHED

3908
02:25:28,638 --> 02:25:30,907
OUT BY THE NCI AS RESEARCHERS

3909
02:25:30,907 --> 02:25:34,511
WHEN YOU DO THIS, HERE IS THIS,

3910
02:25:34,511 --> 02:25:35,011
RIGHT?

3911
02:25:35,011 --> 02:25:36,279
I MEAN I JUST THINK --

3912
02:25:36,279 --> 02:25:38,982
>> THAT'S EXACTLY -- WE
HAD SOME

3913
02:25:38,982 --> 02:25:39,883
THINKING MEETINGS BEFORE WE GOT

3914
02:25:39,883 --> 02:25:41,451
TO THIS POINT AND THE IDEA

3915
02:25:41,451 --> 02:25:45,288
AROUND BRINGING IMPLEMENTATION

3916
02:25:45,288 --> 02:25:46,256
SCIENCE HERE FOR SURE, ONE OF

3917
02:25:46,256 --> 02:25:48,725
THE PEOPLE WE TALKED TO FROM THE

3918
02:25:48,725 --> 02:25:51,394
BSA IS THE ROB WIN WHO WORKED

3919
02:25:51,394 --> 02:25:52,962
WITH FEDERALLY QUALIFIED HEALTH

3920
02:25:52,962 --> 02:25:55,098
CARE CENTERS WHO -- YES, THEY

3921
02:25:55,098 --> 02:25:56,799
ARE REALLY GREAT EXAMPLES OF

3922
02:25:56,799 --> 02:25:57,834
PLACES THAT ARE DOING THIS WELL.

3923
02:25:57,834 --> 02:25:59,669
AND TRYING TO NOT REINVENT THE

3924
02:25:59,669 --> 02:26:02,605
WHEEL IS 100% --

3925
02:26:02,605 --> 02:26:07,977
>> LET ME ADD AND I STAY
PERHAPS

3926
02:26:07,977 --> 02:26:15,838
IRREVERENTLY.

3927
02:26:15,838 --> 02:26:17,540
THE COMMUNITY USES LOGIC AND

3928
02:26:17,540 --> 02:26:19,642
GOES TO WORK.

3929
02:26:19,642 --> 02:26:26,582
>> I LIKE THAT.

3930
02:26:26,582 --> 02:26:26,883
>> GREAT.

3931
02:26:26,883 --> 02:26:28,484
IF THERE IS NO FURTHER

3932
02:26:28,484 --> 02:26:29,218
DISCUSSION, WE NEED --

3933
02:26:29,218 --> 02:26:31,854
>> I THOUGHT I I SAW
ANOTHER

3934
02:26:31,854 --> 02:26:32,755
HAND.

3935
02:26:32,755 --> 02:26:33,623
>> YES.

3936
02:26:33,623 --> 02:26:35,825
>> OKAY, WAS IT YOU, FRED?

3937
02:26:35,825 --> 02:26:37,794
>> YES, QUICK COMMENT.

3938
02:26:37,794 --> 02:26:39,595
WONDERING WHETHER THERE ARE ANY

3939
02:26:39,595 --> 02:26:41,597
THOUGHTS OF INVOLVING MAYBE

3940
02:26:41,597 --> 02:26:48,371
SOMEONE FROM CDC, CANCER CONTROL

3941
02:26:48,371 --> 02:26:50,773
THAT ALSO GO OUT TO COMMUNITIES

3942
02:26:50,773 --> 02:26:54,077
AND MAYBE SOMETHING IN TERMS OF

3943
02:26:54,077 --> 02:26:56,379
NOT DUPLICATING EFFORT, MAYBE.

3944
02:26:56,379 --> 02:26:59,082
>> THAT IS A VERY GOOD
THOUGHT.

3945
02:26:59,082 --> 02:27:00,550
I DON'T KNOW IF WE TALKED ABOUT

3946
02:27:00,550 --> 02:27:00,817
CDC.

3947
02:27:00,817 --> 02:27:06,189
THE PEOPLE I'M ASKING TO

3948
02:27:06,189 --> 02:27:07,123
CO-CHAIR INCLUDE THE AMERICAN

3949
02:27:07,123 --> 02:27:09,325
CANCER SOCIETY, SO THEY ARE VERY

3950
02:27:09,325 --> 02:27:10,426
EMBEDDED IN COMMUNITIES.

3951
02:27:10,426 --> 02:27:19,502
BUT CDC IS A GREAT SUGGESTION.

3952
02:27:19,502 --> 02:27:19,869
>> FANTASTIC.

3953
02:27:19,869 --> 02:27:23,106
OKAY, SO IS THERE A MOTION TO

3954
02:27:23,106 --> 02:27:24,974
APPROVE THE ESTABLISHMENT OF THE

3955
02:27:24,974 --> 02:27:27,376
AD-HOC BSA WORKING GROUP IN

3956
02:27:27,376 --> 02:27:29,145
SUPPORT OF EFFORTS TO ENHANCE

3957
02:27:29,145 --> 02:27:31,981
COMMUNITY CANCER RESEARCH AND

3958
02:27:31,981 --> 02:27:32,682
QUALITY CARE?

3959
02:27:32,682 --> 02:27:34,250
>> SO MOVED.

3960
02:27:34,250 --> 02:27:34,917
>> SECOND.

3961
02:27:34,917 --> 02:27:35,218
>> GREAT.

3962
02:27:35,218 --> 02:27:37,253
IT'S BEEN PROPERLY MOVED AND

3963
02:27:37,253 --> 02:27:37,520
SECONDED.

3964
02:27:37,520 --> 02:27:39,989
ANY ADDITIONAL QUESTIONS?

3965
02:27:39,989 --> 02:27:41,190
THERE BEING NONE, WE NEED TO

3966
02:27:41,190 --> 02:27:43,059
VOTE TO APPROVE THE

3967
02:27:43,059 --> 02:27:44,927
ESTABLISHMENT OF THIS AD-HOC BSA

3968
02:27:44,927 --> 02:27:46,295
WORKING GROUP IN SUPPORT OF

3969
02:27:46,295 --> 02:27:47,830
EFFORTS TO ENHANCE COMMUNITY

3970
02:27:47,830 --> 02:27:50,166
CANCER RESEARCH AND QUALITY

3971
02:27:50,166 --> 02:27:50,466
CARE.

3972
02:27:50,466 --> 02:27:56,105
I WILL ASK ARE THERE ANY NAYs?

3973
02:27:56,105 --> 02:28:03,012
ANY ABSTENTIONS?

3974
02:28:03,012 --> 02:28:05,982
THERE BEING NONE, IT'S

3975
02:28:05,982 --> 02:28:06,249
UNANIMOUS.

3976
02:28:06,249 --> 02:28:08,918
>> IT IS UNANIMOUS
APPROVAL.

3977
02:28:08,918 --> 02:28:11,521
>> THANK YOU.

3978
02:28:11,521 --> 02:28:11,988
>> OKAY, FANTASTIC.

3979
02:28:11,988 --> 02:28:14,624
SO PRIOR TO ADJOURNING OPEN

3980
02:28:14,624 --> 02:28:15,925
SESSION, ARE THERE ANY OTHER

3981
02:28:15,925 --> 02:28:17,760
ISSUES OR FUTURE AGENDA ITEMS

3982
02:28:17,760 --> 02:28:21,364
THAT ANYONE WOULD LIKE TO BRING

3983
02:28:21,364 --> 02:28:24,267
TO THE TABLE?

3984
02:28:24,267 --> 02:28:26,269
I KNOW I'D LOVE TO HEAR A LITTLE

3985
02:28:26,269 --> 02:28:27,436
BIT MORE ABOUT NCI'S PLANS

3986
02:28:27,436 --> 02:28:30,873
AROUND AI AND I THINK THAT

3987
02:28:30,873 --> 02:28:31,707
THAT -- DATA SCIENCE.

3988
02:28:31,707 --> 02:28:33,476
I THINK THAT WOULD BE A

3989
02:28:33,476 --> 02:28:34,010
IMPORTANT AGENDA ITEM.

3990
02:28:34,010 --> 02:28:39,315
I THINK WE ALSO WILL HAVE THE --

3991
02:28:39,315 --> 02:28:41,817
REVISITING THE EXPERIMENTAL

3992
02:28:41,817 --> 02:28:42,952
THERAPEUTICS MISSION STATEMENT.

3993
02:28:42,952 --> 02:28:45,421
SO I'M SURE THAT WILL BE ON A

3994
02:28:45,421 --> 02:28:48,157
FUTURE -- AND I ALSO THOUGHT

3995
02:28:48,157 --> 02:28:50,560
ABOUT NCORP AND WHERE IT IS NOW

3996
02:28:50,560 --> 02:28:52,295
AND WHERE IT IS LOOKING TO GO IN

3997
02:28:52,295 --> 02:28:54,197
THE FUTURE AND CAN BE PART OF

3998
02:28:54,197 --> 02:28:56,899
SOME OF THE, YOU WERE JUST

3999
02:28:56,899 --> 02:28:58,367
TALKING ABOUT, KIM, AS WE THINK

4000
02:28:58,367 --> 02:28:59,569
ABOUT COMMUNITY CANCER RESEARCH

4001
02:28:59,569 --> 02:29:05,474
AND QUALITY CARE.

4002
02:29:05,474 --> 02:29:06,108
>> JOHN?

4003
02:29:06,108 --> 02:29:07,510
>> SUSAN'S HAND AND THEN
ISABEL,

4004
02:29:07,510 --> 02:29:09,512
LET ME GO TO SUSAN FIRST.

4005
02:29:09,512 --> 02:29:10,513
>> JOHN, I DON'T WANT KNOW
IF

4006
02:29:10,513 --> 02:29:13,115
IT'S APPROPRIATE FOR NCAB BUT I

4007
02:29:13,115 --> 02:29:15,885
WOULD LOVE TO HEAR A

4008
02:29:15,885 --> 02:29:17,687
PRESENTATION ABOUT THE HRSA

4009
02:29:17,687 --> 02:29:20,856
ACCESS TO CANCER SCREENING WHERE

4010
02:29:20,856 --> 02:29:22,225
THE FEDERALLY QUALIFIED HEALTH

4011
02:29:22,225 --> 02:29:24,093
CENTERS HAD TO PARTNER WITH AN

4012
02:29:24,093 --> 02:29:24,727
NCI CENTER.

4013
02:29:24,727 --> 02:29:26,929
SO I THINK THERE IS RELEVANCE

4014
02:29:26,929 --> 02:29:28,464
HERE AND TOUCHES ON A LOT OF THE

4015
02:29:28,464 --> 02:29:31,000
THINGS WE ARE TRYING TO ADVANCE,

4016
02:29:31,000 --> 02:29:33,903
IF IT'S APPROPRIATE.

4017
02:29:33,903 --> 02:29:39,308
>> I THINK IT SHOULD BE.

4018
02:29:39,308 --> 02:29:41,744
WE'VE HEARD OTHER PARTNERSHIP

4019
02:29:41,744 --> 02:29:42,812
TYPES OF INITIATIVES BROUGHT TO

4020
02:29:42,812 --> 02:29:45,181
THE NCAB.

4021
02:29:45,181 --> 02:29:45,815
>> JOHN?

4022
02:29:45,815 --> 02:29:46,148
>> HOLD ON.

4023
02:29:46,148 --> 02:29:46,616
WAIT A MINUTE.

4024
02:29:46,616 --> 02:29:48,351
I'M TRYING TO GO IN ORDER.

4025
02:29:48,351 --> 02:29:50,419
I THINK ISABEL AND THEN ANN AND

4026
02:29:50,419 --> 02:29:52,421
THEN I'LL COME BACK TO YOU,

4027
02:29:52,421 --> 02:29:52,855
HOWARD.

4028
02:29:52,855 --> 02:29:53,222
>> THANK YOU.

4029
02:29:53,222 --> 02:29:55,424
I JUST SIMPLY WANTED TO

4030
02:29:55,424 --> 02:29:57,460
FOLLOWING UP ON YOUR

4031
02:29:57,460 --> 02:29:59,161
CONSIDERATION OF AI AT ONE OF

4032
02:29:59,161 --> 02:30:00,429
OUR NEXT MEETINGS TO HAVE A

4033
02:30:00,429 --> 02:30:00,930
LONGER DISCUSSION.

4034
02:30:00,930 --> 02:30:02,231
I WOULD LOVE FOR US TO BE ABLE

4035
02:30:02,231 --> 02:30:03,199
TO INVITE THEM.

4036
02:30:03,199 --> 02:30:05,568
I DON'T KNOW IF THAT'S POSSIBLE.

4037
02:30:05,568 --> 02:30:06,168
SOME OF THE PATIENT ADVOCATES

4038
02:30:06,168 --> 02:30:08,337
WHO ARE WORKING ON THESE BILL OF

4039
02:30:08,337 --> 02:30:10,373
RIGHTS SO YOU CAN HEAR THAT

4040
02:30:10,373 --> 02:30:11,007
PERSPECTIVE.

4041
02:30:11,007 --> 02:30:13,743
I'D LOVE TO BE ABLE TO INVITE

4042
02:30:13,743 --> 02:30:15,945
THEM TO THE TABLE.

4043
02:30:15,945 --> 02:30:17,713
IS IT APPROPRIATE?

4044
02:30:17,713 --> 02:30:21,317
>> AS PART OF THE OPEN
MEETING,

4045
02:30:21,317 --> 02:30:21,584
PAULETTE?

4046
02:30:21,584 --> 02:30:24,120
IS THAT POSSIBLE?

4047
02:30:24,120 --> 02:30:24,353
YES.

4048
02:30:24,353 --> 02:30:26,188
SO PAULETTE IS NODDING.

4049
02:30:26,188 --> 02:30:29,191
SO WE CAN CIRCLE BACK ON THAT,

4050
02:30:29,191 --> 02:30:29,558
ISABEL.

4051
02:30:29,558 --> 02:30:30,793
GREAT IDEA.

4052
02:30:30,793 --> 02:30:33,529
ANN AND THEN HOWARD.

4053
02:30:33,529 --> 02:30:35,131
>> I WONDER IF IT WOULD BE
GOOD

4054
02:30:35,131 --> 02:30:37,633
SOMETIME THIS YEAR TO GET AN

4055
02:30:37,633 --> 02:30:41,904
UPDATE ON WHAT ARPA-H IS DOING.

4056
02:30:41,904 --> 02:30:43,606
I GET A CALL EVERY OTHER WEEK

4057
02:30:43,606 --> 02:30:45,508
ASKING FOR A LETTER OF

4058
02:30:45,508 --> 02:30:48,210
RECOMMENDATION FOR THINGS THAT I

4059
02:30:48,210 --> 02:30:50,780
WISH THAT WE WERE DOING AT NCI,

4060
02:30:50,780 --> 02:30:53,716
OR MAYBE WE HAVE DONE AT NCI.

4061
02:30:53,716 --> 02:30:56,619
SO I THINK WE NEED TO CATCH-UP

4062
02:30:56,619 --> 02:30:58,587
AS A BOARD AND SEE HOW MUCH

4063
02:30:58,587 --> 02:30:59,955
OVERLAP DO WE HAVE?

4064
02:30:59,955 --> 02:31:02,458
HOW IS ARPA-H PROCEEDING?

4065
02:31:02,458 --> 02:31:03,826
IT'S VERY INTERESTING, DON'T GET

4066
02:31:03,826 --> 02:31:05,494
ME WRONG, VERY INTERESTING

4067
02:31:05,494 --> 02:31:06,729
PROJECTS BEING FUNDED BUT I

4068
02:31:06,729 --> 02:31:07,463
THINK IT WOULD BE JUST GOOD FOR

4069
02:31:07,463 --> 02:31:10,433
THE BOARD TO HEAR ABOUT THAT IN

4070
02:31:10,433 --> 02:31:13,869
TERMS OF HOW WE MIGHT EXTEND OUR

4071
02:31:13,869 --> 02:31:15,538
RESOURCES MORE AND MORE

4072
02:31:15,538 --> 02:31:15,938
STRATEGICALLY.

4073
02:31:15,938 --> 02:31:16,639
>> I REMEMBER THERE WAS
GOING TO

4074
02:31:16,639 --> 02:31:19,041
BE A PRESENTATION BUT I THINK IT

4075
02:31:19,041 --> 02:31:22,345
GOT PULLED AT THE LAST MINUTE.

4076
02:31:22,345 --> 02:31:25,448
SO IT WOULD BE GREAT, IF YOU GET

4077
02:31:25,448 --> 02:31:26,615
TO THE A CHANCE TO CIRCLE BACK

4078
02:31:26,615 --> 02:31:28,784
WITH THE ARPA-H LEADERSHIP TO

4079
02:31:28,784 --> 02:31:29,885
MAYBE PRESENT ANYTHING THAT IS

4080
02:31:29,885 --> 02:31:32,121
GOING ON, COLLABORATIVELY

4081
02:31:32,121 --> 02:31:33,255
BETWEEN THOSE AGENCIES.

4082
02:31:33,255 --> 02:31:34,156
>> THAT WOULD BE GOOD.

4083
02:31:34,156 --> 02:31:36,292
AND I WANT PEOPLE TO KNOW THAT I

4084
02:31:36,292 --> 02:31:38,427
AM MEETING WITH THE LEADERSHIP

4085
02:31:38,427 --> 02:31:41,831
OF ARPA-H REGULARLY SO WE STAY

4086
02:31:41,831 --> 02:31:43,499
IN SYNC.

4087
02:31:43,499 --> 02:31:44,667
SO BUT DEFINITELY ESPECIALLY NOW

4088
02:31:44,667 --> 02:31:46,068
THE PROJECTS ARE STARTING TO GET

4089
02:31:46,068 --> 02:31:46,902
OFF THE GROUND.

4090
02:31:46,902 --> 02:31:48,771
THIS WILL BE A GOOD TIME FOR

4091
02:31:48,771 --> 02:31:51,741
THEM TO COME BACK.

4092
02:31:51,741 --> 02:31:52,041
>> GREAT.

4093
02:31:52,041 --> 02:31:54,243
IN THE INTEREST OF TIME --

4094
02:31:54,243 --> 02:31:55,878
ANYONE HAVE ANY OTHER THOUGHTS

4095
02:31:55,878 --> 02:31:57,780
OR COMMENTS OR QUESTIONS?

4096
02:31:57,780 --> 02:31:59,382
MAKE SURE YOU SEND THEM TO

4097
02:31:59,382 --> 02:32:01,484
PAULETTE WITHIN THE NEXT COUPLE

4098
02:32:01,484 --> 02:32:03,352
OF DAYS AND WE'LL SEE IF WE CAN

4099
02:32:03,352 --> 02:32:05,888
GET THOSE THINGS ADDED TO AN

4100
02:32:05,888 --> 02:32:07,790
UPCOMING AGENDA.

4101
02:32:07,790 --> 02:32:10,192
SO WE'LL GO AHEAD AND ADJOURN

4102
02:32:10,192 --> 02:32:10,593
THE OPEN SESSION.

4103
02:32:10,593 --> 02:32:13,329
THIS CONCLUDES THE OPEN SESSION.

4104
02:32:13,329 --> 02:32:17,400
THERE IS ROUGHLY NINE MINUTE

4105
02:32:17,400 --> 02:32:17,833
BREAK NOW.

4106
02:32:17,833 --> 02:32:20,169
SO ONLY BOARD MEMBERS AND

4107
02:32:20,169 --> 02:32:23,072
DESIGNATED NCI STAFF SHOULD

4108
02:32:23,072 --> 02:32:23,773
RETURN.

4109
02:32:23,773 --> 02:32:25,007
ALL OTHERS SHOULD SIGN OFF NOW

4110
02:32:25,007 --> 02:32:27,176
AND THOSE WHO ARE ATTENDING THE

4111
02:32:27,176 --> 02:32:28,577
CLOSED SESSION, SHOULD SIGN BACK

4112
02:32:28,577 --> 02:32:32,248
ON AGAIN IN ABOUT 8 OR 9 MINUTES

4113
02:32:32,248 --> 02:32:33,682
USING THE SEPARATE LINK THAT WAS

4114
02:32:33,682 --> 02:32:35,117
SENT IN THE E-MAIL.

4115
02:32:35,117 --> 02:32:37,319
SO YOU'LL LOG OFF OF HERE AND GO

4116
02:32:37,319 --> 02:32:39,588
TO THE NEW LINK AND AGAIN WE'LL

4117
02:32:39,588 --> 02:32:49,698
START