1 00:00:06,440 --> 00:00:08,040 >>WELCOME 2 00:00:08,040 --> 00:00:11,480 TO THE SUMMER NCRA MEETING AND I 3 00:00:11,480 --> 00:00:12,800 TOLD MOST OF YOU INDIVIDUALLY 4 00:00:12,800 --> 00:00:14,800 WHEN YOU JOINED, THANK YOU SO 5 00:00:14,800 --> 00:00:16,960 MUCH FOR JOINING US VIRTUALLY 6 00:00:16,960 --> 00:00:19,040 TODAY. WE KNOW YOU ARE BUSY. 7 00:00:19,040 --> 00:00:21,160 AS ALWAYS, WE THANK YOU FOR 8 00:00:21,160 --> 00:00:22,360 MAKING TIME AND KAFBING OUT 9 00:00:22,360 --> 00:00:24,800 SPACE IN WHAT I KNOW ARE BUSY 10 00:00:24,800 --> 00:00:27,240 DAYS AS ADVOCATES WHERE YOU ARE 11 00:00:27,240 --> 00:00:28,480 JUGGLING MANY DIFFERENT THINGS 12 00:00:28,480 --> 00:00:32,360 ON BEHALF OF PATIENTS. 13 00:00:32,360 --> 00:00:34,160 WE APPRECIATE IT. 14 00:00:34,160 --> 00:00:36,200 I THINK WE HAVE A TERRIFIC 15 00:00:36,200 --> 00:00:38,080 MEETING PLANNED FOR US THIS 16 00:00:38,080 --> 00:00:41,200 AFTERNOON. I WILL HAVEND IT TO 17 00:00:41,200 --> 00:00:44,120 OUR TRUSTEE CHAIR, ANNIE, 18 00:00:44,120 --> 00:00:45,680 MOMENTARILY. I WILL SHARE ABOUT 19 00:00:45,680 --> 00:00:47,440 WHAT WE PLAN TO DO IN THE NEXT 20 00:00:47,440 --> 00:00:48,600 COUPLE OF HOURS. 21 00:00:48,600 --> 00:00:51,440 AS YOU ALL SAW WHEN YOU JOINED 22 00:00:51,440 --> 00:00:54,040 IN PREMEETING MATERIALS, WE ARE 23 00:00:54,040 --> 00:00:57,160 JOINED THIS AFTERNOON BY 24 00:00:57,160 --> 00:01:01,200 PRINCIPLE DEPUTY DIRECTOR DOUG 25 00:01:01,200 --> 00:01:02,600 LOWY THAT MOST KNOW AND WORKED 26 00:01:02,600 --> 00:01:05,120 WITH IN THE PAST AND LE JOIN 27 00:01:05,120 --> 00:01:07,920 GIVING A DIRECTOR'S UPDATE THAT 28 00:01:07,920 --> 00:01:09,640 HIGHLIGHTS ACROSS OUR RESEARCH 29 00:01:09,640 --> 00:01:11,720 PORTFOLIO AND PLENTY OF TIME FOR 30 00:01:11,720 --> 00:01:13,840 QUESTION AND ANSWER DISCUSSION 31 00:01:13,840 --> 00:01:14,120 AFTERWARDS. 32 00:01:14,120 --> 00:01:17,200 AFTER DR. LOWY, WE WILL BE 33 00:01:17,200 --> 00:01:19,920 JOINED BY DR. MEREDITH SHIELDS A 34 00:01:19,920 --> 00:01:22,680 SENIOR NCI INVESTIGATOR THAT 35 00:01:22,680 --> 00:01:25,160 WILL TALK ABOUT A RECENT STUDY 36 00:01:25,160 --> 00:01:27,400 SHE CREATED THAT RELATES TO 37 00:01:27,400 --> 00:01:29,200 OUTLINING OPPORTUNITIES TO 38 00:01:29,200 --> 00:01:31,160 ACHIEVE SOME MOONSHOT GOALS AND 39 00:01:31,160 --> 00:01:33,680 SOME MAY REMEMBER THIS WAS 40 00:01:33,680 --> 00:01:36,880 HIGHLIGHTED AT AACR AND WE SENT 41 00:01:36,880 --> 00:01:38,600 BACK TO YOU IN APRIL AND CHANCE 42 00:01:38,600 --> 00:01:41,160 TO HEAR FROM YOU THE 43 00:01:41,160 --> 00:01:42,440 INVESTIGATOR AND TALK A LITTLE 44 00:01:42,440 --> 00:01:43,720 TOGETHER WITH HER AND EACH OTHER 45 00:01:43,720 --> 00:01:47,800 ABOUT WHAT IS COVERED IN THAT 46 00:01:47,800 --> 00:01:48,560 STUDY. 47 00:01:48,560 --> 00:01:51,440 AND FOLLOWING THAT THIS 48 00:01:51,440 --> 00:01:53,360 AFTERNOON WE WILL TALK ABOUT THE 49 00:01:53,360 --> 00:01:55,360 RECENTLY ANNOUNCED CLINICAL 50 00:01:55,360 --> 00:01:57,120 TRIALS INNOVATION UNIT. I 51 00:01:57,120 --> 00:01:58,320 TALKED TO SOME INDIVIDUALLY 52 00:01:58,320 --> 00:02:00,080 ABOUT THAT. THIS IS AN 53 00:02:00,080 --> 00:02:01,760 INTERESTING PROGRAM AND REAL 54 00:02:01,760 --> 00:02:03,600 SWEET SPOT FOR ADVOCACY 55 00:02:03,600 --> 00:02:09,120 CONSIDERING IT IS SORT OF ON THE 56 00:02:09,120 --> 00:02:11,000 CLINICAL END OF OUR CONTINUUM 57 00:02:11,000 --> 00:02:12,400 AND CLINICAL TRIALS AND SHOULD 58 00:02:12,400 --> 00:02:14,280 BE A NICE DISCUSSION AS WELL AND 59 00:02:14,280 --> 00:02:17,160 WE WILL ALWAYS CONCLUDE WITH 60 00:02:17,160 --> 00:02:18,840 LEDGE UPDATE AND DOUG WILL TALK 61 00:02:18,840 --> 00:02:22,800 A LITTLE ABOUT BUDGET IN HIS 62 00:02:22,800 --> 00:02:24,760 UPDATE. WE WILL BE JOINED BY 63 00:02:24,760 --> 00:02:27,120 LEGISLATIVE AND GOVERNMENT 64 00:02:27,120 --> 00:02:30,320 AFFAIRS OFFICE FOR ALL 65 00:02:30,320 --> 00:02:31,560 ENCOMPASSING UPDATE WITH THE 66 00:02:31,560 --> 00:02:32,920 MEETING AND WITH THAT MANY 67 00:02:32,920 --> 00:02:34,160 THANKS FOR YOUR TIME TODAY AND 68 00:02:34,160 --> 00:02:35,160 FOR JOINING US. 69 00:02:35,160 --> 00:02:38,560 I WILL TURN IT OVER TO ANNIE TO 70 00:02:38,560 --> 00:02:39,720 GET US UNDERWAY. 71 00:02:39,720 --> 00:02:43,040 >>THANK YOU SO MUCH, ANNIE. 72 00:02:43,040 --> 00:02:44,520 THANK YOU, EVERYONE, FOR BEING 73 00:02:44,520 --> 00:02:46,000 HERE. I WILL OFFICIAL WILL I 74 00:02:46,000 --> 00:02:47,640 CALL THE MEETING TO ORDER AND TO 75 00:02:47,640 --> 00:02:51,640 BEGIN I HAVE TO READ THE OPENING 76 00:02:51,640 --> 00:02:52,960 STATEMENT. AS COMMITTEE 77 00:02:52,960 --> 00:02:55,640 MEMBERS, I MUST REMIND YOU TO 78 00:02:55,640 --> 00:02:57,160 ABSENT YOURSELVES DURING 79 00:02:57,160 --> 00:02:58,240 SPECIFIC DISCUSSIONS. 80 00:02:58,240 --> 00:02:59,840 WHENEVER YOUR PARTICIPATION AND 81 00:02:59,840 --> 00:03:01,360 DELIBERATIONS ON A PARTICULAR 82 00:03:01,360 --> 00:03:03,360 PRODUCT, PROGRAM OR OTHER 83 00:03:03,360 --> 00:03:04,720 SPECIFIC MATTER WOULD CONSTITUTE 84 00:03:04,720 --> 00:03:07,560 A CONFLICT OF INTEREST OR CREATE 85 00:03:07,560 --> 00:03:09,920 APPEARANCE OF ONE. 86 00:03:09,920 --> 00:03:12,080 IT IS ENCOMBANT UPON YOU TO 87 00:03:12,080 --> 00:03:13,680 ADVISE THE EXECUTIVE SECRETARY 88 00:03:13,680 --> 00:03:15,600 AND ABSTAIN FROM PARTICIPATION 89 00:03:15,600 --> 00:03:16,720 AND DISCUSSION OF ACTION 90 00:03:16,720 --> 00:03:17,800 REGARDING THAT MATTER AND IN 91 00:03:17,800 --> 00:03:20,280 LIGHT OF CURRENT POLICIES 92 00:03:20,280 --> 00:03:21,640 GOVERNING -- HOLDINGS OF SPECIAL 93 00:03:21,640 --> 00:03:23,000 GOVERNMENT EMPLOYEES THAT 94 00:03:23,000 --> 00:03:24,960 INCLUDE ALL MEMBERS OF THIS 95 00:03:24,960 --> 00:03:26,680 COMMITTEE WE MUST DEPEND ON YOU 96 00:03:26,680 --> 00:03:29,160 TO VOLUNTARILY ABSENT YOURSELF 97 00:03:29,160 --> 00:03:31,680 DURING ANY AND ALL DISCUSSIONS 98 00:03:31,680 --> 00:03:33,320 AND MATTERS TO CONCEIVABLY 99 00:03:33,320 --> 00:03:35,360 IMPACT STATUS OF HOLDINGS AND 100 00:03:35,360 --> 00:03:36,960 TRUST YOUR JUDGMENTS IN 101 00:03:36,960 --> 00:03:40,560 INSTANCES AND BY LAW A QUORUM OF 102 00:03:40,560 --> 00:03:42,640 BOARD MEMBERS IS ACQUIRED FOR 103 00:03:42,640 --> 00:03:44,120 INSTANCE THAT OPEN VOTE OCCURS 104 00:03:44,120 --> 00:03:47,000 IN OPEN SESSION AND MINIMUM OF 8 105 00:03:47,000 --> 00:03:49,080 APPOINTED MEMBERS MUST BE 106 00:03:49,080 --> 00:03:50,440 PRESENT TO VOICE THEIR VOTES. 107 00:03:50,440 --> 00:03:53,480 ARE WE THERE, AMY? 108 00:03:53,480 --> 00:03:55,440 EXCELLENT. NEW MEMBERS NOT 109 00:03:55,440 --> 00:03:58,440 CURRENT MEMBERS OF ANOTHER NCI 110 00:03:58,440 --> 00:04:01,200 ADVISORY BOARD ARE NOT VOTING 111 00:04:01,200 --> 00:04:03,280 UNTIL THEY ARE CLEARED BY ETHICS 112 00:04:03,280 --> 00:04:04,920 OFFICE AND OFFICE OF HUMAN 113 00:04:04,920 --> 00:04:06,760 RESOURCES AND I WILL READ THE 114 00:04:06,760 --> 00:04:07,920 PUBLIC COMMENT STACHLT. MEMBERS 115 00:04:07,920 --> 00:04:10,200 OF THE PUBLIC WISHING TO EXPRESS 116 00:04:10,200 --> 00:04:12,320 VIEWS REGARDING ANY ITEMS 117 00:04:12,320 --> 00:04:14,520 DISCUSSED DURING THIS MEETING 118 00:04:14,520 --> 00:04:18,160 MAY DO SO WRITING AMY WILLIAMS 119 00:04:18,160 --> 00:04:19,760 EXECUTIVE SECRETARY WITHIN 10 120 00:04:19,760 --> 00:04:21,640 DAYS OF THE MEETING AND WRITTEN 121 00:04:21,640 --> 00:04:23,840 STATEMENTS BY MEMBERS OF THE 122 00:04:23,840 --> 00:04:25,200 PUBLIC WILL RECEIVE CAREFUL 123 00:04:25,200 --> 00:04:25,600 CONSIDERATION. 124 00:04:25,600 --> 00:04:27,800 I AM REALLY THRILLED, AGAIN, 125 00:04:27,800 --> 00:04:31,680 THAT WE ARE TOGETHER AGAIN. 126 00:04:31,680 --> 00:04:33,280 ESPECIALLY AFTER GETTING TO KNOW 127 00:04:33,280 --> 00:04:34,880 EVERYONE A LITTLE BIT A LITTLE 128 00:04:34,880 --> 00:04:36,320 MORE AT THE LAST MEETING. 129 00:04:36,320 --> 00:04:40,160 WE WILL GO AHEAD AND PROCEED 130 00:04:40,160 --> 00:04:42,640 WITH THE PRINCIPLE DEPUTY 131 00:04:42,640 --> 00:04:44,080 DIRECTOR'S UPDATE. AT THIS TIME 132 00:04:44,080 --> 00:04:47,360 I WOULD LIKE TO WELCOME DOUG 133 00:04:47,360 --> 00:04:51,400 LOWY NCI'S PRINCIPLE DEPUTY 134 00:04:51,400 --> 00:04:53,400 DIRECTOR TO DELIVER HIS UPDATE 135 00:04:53,400 --> 00:04:57,200 AND AS YOU KNOW HE IS PRINCIPLE 136 00:04:57,200 --> 00:05:01,440 DEPUTY DIRECTOR SINCE JULY 2010 137 00:05:01,440 --> 00:05:04,440 AND HELPING TO LEAD KEY 138 00:05:04,440 --> 00:05:05,320 SCIENTIFIC INITIATIVES AND 139 00:05:05,320 --> 00:05:07,480 ACTING DIRECTOR SEVERAL TIMES 140 00:05:07,480 --> 00:05:09,680 RECENTLY IN APRIL 2022 TO 141 00:05:09,680 --> 00:05:11,880 SEPTEMBER OF 2022 IN ADDITION TO 142 00:05:11,880 --> 00:05:13,960 SERVING AS NCI PERFECT INSIM 143 00:05:13,960 --> 00:05:17,440 DEPUTY DIRECTOR, HE IS CHIEF OF 144 00:05:17,440 --> 00:05:18,920 LABORATORY OF CELLULAR ONCOLOGY 145 00:05:18,920 --> 00:05:21,160 AND NCI CENTER FOR CANCER 146 00:05:21,160 --> 00:05:23,040 RESEARCH AND MEMBER OF NATIONAL 147 00:05:23,040 --> 00:05:24,760 ACADEMY OF SCIENCES AND 148 00:05:24,760 --> 00:05:27,440 INSTITUTE OF MEDICINE OF NAS. 149 00:05:27,440 --> 00:05:34,000 SO, DR. LOWY, THA THANKS SO MUC 150 00:05:34,000 --> 00:05:35,200 FOR BEING WITH US AND PROVIDING 151 00:05:35,200 --> 00:05:35,760 THIS UPDATE. 152 00:05:35,760 --> 00:05:39,400 >>EVEN, IT IS A REAL PLEASURE 153 00:05:39,400 --> 00:05:40,840 TO BE HERE AND I'M LOOKING 154 00:05:40,840 --> 00:05:43,400 FORWARD TO TALKING FOR AROUND A 155 00:05:43,400 --> 00:05:45,880 HALF HOUR OR SO AND THEN TO BE 156 00:05:45,880 --> 00:05:48,520 ABLE TO RESPOND TO COMMENTS AND 157 00:05:48,520 --> 00:05:50,880 QUESTIONS WHERE I THINK WE WILL 158 00:05:50,880 --> 00:05:53,160 HAVE A FAIR AMOUNT OF TIME. 159 00:05:53,160 --> 00:05:58,000 AND AS AMY HAS POINTED OUT, 160 00:05:58,000 --> 00:06:00,400 THERE IS REALLY A LOT OF GOOD 161 00:06:00,400 --> 00:06:02,120 TOPICS THAT WILL BE COVERED 162 00:06:02,120 --> 00:06:02,600 TODAY. 163 00:06:02,600 --> 00:06:05,880 FIRST, IF I COULD HAVE THE NEXT 164 00:06:05,880 --> 00:06:06,240 SLIDE. 165 00:06:06,240 --> 00:06:12,000 I AM TALKING ABOUT A NUMBER OF 166 00:06:12,000 --> 00:06:15,400 DIFFERENT ISSUES THIS AFTERNOON. 167 00:06:15,400 --> 00:06:19,880 FIRST, I WANT TO GO OVER THE 168 00:06:19,880 --> 00:06:21,240 DEBT CEILING AGREEMENT AND NOT 169 00:06:21,240 --> 00:06:23,320 SURE THAT PEOPLE UNDERSTAND IT 170 00:06:23,320 --> 00:06:25,520 ACTUALLY HAS LIKELY IMPORTANT 171 00:06:25,520 --> 00:06:29,000 IMPLICATIONS FOR NCI BUDGET. 172 00:06:29,000 --> 00:06:31,400 THEN ALSO TO TALK ABOUT THE 173 00:06:31,400 --> 00:06:34,000 CANCER DRUG SHORTAGES THAT HAVE 174 00:06:34,000 --> 00:06:37,200 BEEN IN THE NEWS RECORRECTLY AND 175 00:06:37,200 --> 00:06:41,200 TALK ABOUT RESEARCH INITIATIVES 176 00:06:41,200 --> 00:06:45,520 AND RESEARCH ADVANCES AND THEN A 177 00:06:45,520 --> 00:06:49,080 LAST TOPIC THAT IS RELATED TO 178 00:06:49,080 --> 00:06:50,840 CANCER POLICY. 179 00:06:50,840 --> 00:06:54,920 SO, IF I COULD HAVE THE NEXT 180 00:06:54,920 --> 00:06:55,600 SLIDE. 181 00:06:55,600 --> 00:06:59,040 THIS SLIDE SUMMARIZES SOME OF 182 00:06:59,040 --> 00:07:02,160 THE SALIENT FEATURES OF THE DEBT 183 00:07:02,160 --> 00:07:06,120 CEILING AGREEMENT THAT WAS MADE 184 00:07:06,120 --> 00:07:07,400 EARLIER THIS MONTH. 185 00:07:07,400 --> 00:07:09,600 AND ON THE ONE HAPPENED, THE 186 00:07:09,600 --> 00:07:11,960 FIRST BULLET POINT TELLS YOU 187 00:07:11,960 --> 00:07:16,360 THAT THE GOAL WAS TO RAISE THE 188 00:07:16,360 --> 00:07:19,240 DEBT LIMIT THROUGH 2025. 189 00:07:19,240 --> 00:07:22,560 BUT, IT ALSO IMPOSES CAPS ON 190 00:07:22,560 --> 00:07:23,400 GOVERNMENT SPENDING FOR THE NEXT 191 00:07:23,400 --> 00:07:26,680 TWO FISCAL YEARS THAT IS FOR 192 00:07:26,680 --> 00:07:30,320 FY24 AND FOR FY25. 193 00:07:30,320 --> 00:07:34,560 AND THE AGREEMENT AS SHOWN IN 194 00:07:34,560 --> 00:07:38,240 THE THIRD BULLET POINT IS 195 00:07:38,240 --> 00:07:42,360 FUNDING LEVEL 24 IS HELD AT FY23 196 00:07:42,360 --> 00:07:45,920 LEVELS FOR NEXT FISCAL YEAR FOR 197 00:07:45,920 --> 00:07:46,600 NONDEFENSE DISCRETIONARY 198 00:07:46,600 --> 00:07:48,680 SPENDING THAT IS WHERE THE NIH 199 00:07:48,680 --> 00:07:53,680 AND NCI BUDGET FALL. 200 00:07:53,680 --> 00:07:55,840 THE LAST BULLET POINT WILL 201 00:07:55,840 --> 00:08:00,560 LIKELY EFFECT FUNDING FOR MANY 202 00:08:00,560 --> 00:08:02,040 GOVERNMENT AGENCIES INCLUDING 203 00:08:02,040 --> 00:08:05,000 AND INCLUDING NIH. 204 00:08:05,000 --> 00:08:05,840 NEXT SLIDE. 205 00:08:05,840 --> 00:08:10,520 THIS SLIDE DEPICTS FOR YOU WHAT 206 00:08:10,520 --> 00:08:14,440 HAS HAPPENED OVER THE LAST 20 207 00:08:14,440 --> 00:08:17,560 YEARS TO THE NCI BUDGET STARTING 208 00:08:17,560 --> 00:08:23,320 IN 2023 AND ENDING WITH 2023. 209 00:08:23,320 --> 00:08:25,960 IF YOU LOOK AT THE RED LINE, 210 00:08:25,960 --> 00:08:28,760 WHAT I HOPE YOU CAN APPRECIATE 211 00:08:28,760 --> 00:08:32,920 IS THAT DURING THE FIRST 10 212 00:08:32,920 --> 00:08:36,440 YEARS, BETWEEN 2003 AND 2013, 213 00:08:36,440 --> 00:08:40,360 THE NCI BUDGET IN 2003 DOLLARS 214 00:08:40,360 --> 00:08:42,240 THAT IS REALLY WHAT IS THE 215 00:08:42,240 --> 00:08:45,160 PURCHASING POWER OF THE NCI 216 00:08:45,160 --> 00:08:49,200 BUDGET THAT IT WENT DOWN 217 00:08:49,200 --> 00:08:52,960 SUBSTANTIALLY OVER THAT 10 YEAR 218 00:08:52,960 --> 00:08:54,120 PERIOD. 219 00:08:54,120 --> 00:08:56,760 STARTING AROUND 2015 AS MOST OF 220 00:08:56,760 --> 00:09:02,280 YOU ARE AWARE, NIH, INCLUDING 221 00:09:02,280 --> 00:09:05,160 NCI HAVE RECEIVED ANNUAL 222 00:09:05,160 --> 00:09:08,000 INCREASES TO THE BUDGET. 223 00:09:08,000 --> 00:09:10,200 THIS HAS RESULTED, AS SHOWN IN 224 00:09:10,200 --> 00:09:13,520 THE RED, THAT THE PURCHASING 225 00:09:13,520 --> 00:09:15,920 POWER HAS GONE UP SOMEWHAT. 226 00:09:15,920 --> 00:09:21,440 IF YOU LOOK AT THE RED LINE FROM 227 00:09:21,440 --> 00:09:26,040 2003 COMPARED TO 2023, THE 228 00:09:26,040 --> 00:09:29,840 PURCHASING POWER OF THE CURRENT 229 00:09:29,840 --> 00:09:35,920 NCI BUDGET IS ABOUT 87% OF WHAT 230 00:09:35,920 --> 00:09:39,960 IT WAS IN 2003. 231 00:09:39,960 --> 00:09:43,160 SO, THAT WE ACTUALLY DESPITE THE 232 00:09:43,160 --> 00:09:45,160 GENEROSITY OF CONGRESS OVER THE 233 00:09:45,160 --> 00:09:49,160 LAST FEW YEARS, OUR PURCHASING 234 00:09:49,160 --> 00:09:51,960 POWER FOR RESEARCH IN 2023 IS 235 00:09:51,960 --> 00:09:55,560 ACTUALLY SOMEWHAT LOWER THAN IT 236 00:09:55,560 --> 00:10:02,840 WAS IN 2003, 20 YEARS EARLIER. 237 00:10:02,840 --> 00:10:06,640 THE NEXT SLIDE THEN TELLS YOU 238 00:10:06,640 --> 00:10:09,680 ABOUT THE PRESIDENT'S BUDGET 239 00:10:09,680 --> 00:10:15,920 PROPOSAL FOR NCI FOR FISCAL YEAR 240 00:10:15,920 --> 00:10:17,040 '24. 241 00:10:17,040 --> 00:10:19,480 AND BASICALLY, WHAT IT IS 242 00:10:19,480 --> 00:10:21,640 PROPOSING, DEPENDING ON HOW YOU 243 00:10:21,640 --> 00:10:24,440 CALCULATE THINGS IS EITHER A 244 00:10:24,440 --> 00:10:28,800 $500 MILLION INCREASE OR A $700 245 00:10:28,800 --> 00:10:29,960 MILLION INCREASE. 246 00:10:29,960 --> 00:10:31,680 THE REASON THERE IS A LITTLE BIT 247 00:10:31,680 --> 00:10:36,160 OF AMBIGUITY IS THAT THE NCI, IN 248 00:10:36,160 --> 00:10:40,720 ADDITION TO THE BASE BUDGET, OF 249 00:10:40,720 --> 00:10:45,560 $7 BILLION FOR FY23 HAS AN 250 00:10:45,560 --> 00:10:48,680 ADDITIONAL $216 MILLION FOR 251 00:10:48,680 --> 00:10:52,880 PHASE 1 OF THE CANCER MOONSHOT. 252 00:10:52,880 --> 00:10:57,040 SO, THAT ASPECT, THAT 216 IS 253 00:10:57,040 --> 00:11:01,160 PROPOSED TO BE ADDED TO THE NCI 254 00:11:01,160 --> 00:11:03,120 BUDGET FOR FY24. 255 00:11:03,120 --> 00:11:07,280 ON TOP OF THAT, ANOTHER $500 256 00:11:07,280 --> 00:11:11,320 MILLION FOR THE CANCER MOONSHOT, 257 00:11:11,320 --> 00:11:14,320 THE REIGNITED ONE, 2.0. 258 00:11:14,320 --> 00:11:19,160 SO, THERE IS A TOTAL OF 716 259 00:11:19,160 --> 00:11:19,480 MILLION. 260 00:11:19,480 --> 00:11:21,760 IF YOU LOOK DOWN AT THE BOTTOM, 261 00:11:21,760 --> 00:11:24,760 YOU WILL SEE THAT WHAT HAS 262 00:11:24,760 --> 00:11:27,880 HAPPENED IN ADDITION IS AN 263 00:11:27,880 --> 00:11:28,920 UNUSUAL SITUATION WHERE THE 264 00:11:28,920 --> 00:11:30,760 BIDEN ADMINISTRATION HAS IN 265 00:11:30,760 --> 00:11:34,720 ADDITION TO THIS PROPOSAL FOR 266 00:11:34,720 --> 00:11:38,000 FY24 MADE AN ADDITIONAL INCREASE 267 00:11:38,000 --> 00:11:41,720 PROPOSED FOR FY25 AND 26 OF JUST 268 00:11:41,720 --> 00:11:47,360 UNDER $1.5 BILLION FOR NCI. 269 00:11:47,360 --> 00:11:53,160 AND I'M GOING OVER THIS BECAUSE 270 00:11:53,160 --> 00:11:57,720 REALLY THIS IS, I THINK, GOING 271 00:11:57,720 --> 00:12:02,960 TO BE PLACED IN JEOPARDY BECAUSE 272 00:12:02,960 --> 00:12:06,360 OF THE -- THE DEBT CEILING 273 00:12:06,360 --> 00:12:06,680 AGREEMENT. 274 00:12:06,680 --> 00:12:09,200 LET'S GO TO THE NEXT TWO SLIDES 275 00:12:09,200 --> 00:12:11,680 AND TALK ABOUT SOME OF THE 276 00:12:11,680 --> 00:12:15,880 HEALTH ASPECTS THAT ARE PROPOSED 277 00:12:15,880 --> 00:12:20,400 FOR THE NEW PHASE OF THE CANCER 278 00:12:20,400 --> 00:12:20,800 MOONSHOT. 279 00:12:20,800 --> 00:12:24,080 ONE IS TO REDUCE CANCER DEATH 280 00:12:24,080 --> 00:12:27,960 RATE BY AT LEAST 50% OVER THE 281 00:12:27,960 --> 00:12:30,200 NEXT 25 YEARS. 282 00:12:30,200 --> 00:12:34,080 TWO TO OVERCOME CANCER 283 00:12:34,080 --> 00:12:35,800 DISPARITIES AND 3, END CANCER AS 284 00:12:35,800 --> 00:12:37,200 WE KNOW IT. 285 00:12:37,200 --> 00:12:41,160 THESE ARE VERY AMBITIOUS AND 286 00:12:41,160 --> 00:12:44,520 ASPIRATIONAL GOALS OF THE BIDEN 287 00:12:44,520 --> 00:12:45,200 ADMINISTRATION. 288 00:12:45,200 --> 00:12:48,040 ALTHOUGH THEY ARE THE GOALS OF 289 00:12:48,040 --> 00:12:49,440 THE BIDEN ADMINISTRATION, I 290 00:12:49,440 --> 00:12:51,760 THINK OF THEM AS BEING 291 00:12:51,760 --> 00:12:54,120 NONPARTISAN. IT IS REALLY 292 00:12:54,120 --> 00:12:57,600 TRYING TO HELP EVERYONE IN THE 293 00:12:57,600 --> 00:13:01,920 US TO LIVE LONGER, HAPPIER AND 294 00:13:01,920 --> 00:13:05,160 MORE FRUITFUL LIVES AS A RESULT 295 00:13:05,160 --> 00:13:08,200 OF IMPROVEMENT BECAUSE OF CANCER 296 00:13:08,200 --> 00:13:11,720 RESEARCH AND ITS APPLICATION. 297 00:13:11,720 --> 00:13:16,280 THE NEXT SLIDE IS BASICALLY 298 00:13:16,280 --> 00:13:19,000 TELLING YOU ABOUT WHERE WE ARE 299 00:13:19,000 --> 00:13:21,400 TODAY VERSUS WHERE WE WOULD NEED 300 00:13:21,400 --> 00:13:25,640 TO GO IN ORDER TO ACHIEVE THAT 301 00:13:25,640 --> 00:13:29,120 GOAL OF REDUCING CANCER 302 00:13:29,120 --> 00:13:31,440 MORTALITY OVER THE NEXT 25 YEARS 303 00:13:31,440 --> 00:13:33,960 BY AT LEAST 50%. 304 00:13:33,960 --> 00:13:38,000 AND THIS IS A PEER-REVIEWED 305 00:13:38,000 --> 00:13:40,760 PUBLICATION THAT WAS PUBLISHED 306 00:13:40,760 --> 00:13:41,320 IN APRIL. 307 00:13:41,320 --> 00:13:47,120 YOU ARE GOING TO BE PRIVILEGED 308 00:13:47,120 --> 00:13:51,760 TO HEAR MEREDITH SHIELS AFTER MY 309 00:13:51,760 --> 00:13:52,320 PRESENTATION. 310 00:13:52,320 --> 00:13:55,840 SHE IS THE PRINCIPLE AUTHOR OF 311 00:13:55,840 --> 00:13:57,920 THIS PEER REVIEW PUBLICATION 312 00:13:57,920 --> 00:14:01,000 WHOSE BOTTOM LINE CONCLUSION IS 313 00:14:01,000 --> 00:14:04,840 THAT WE ARE PART WAY THERE, BUT 314 00:14:04,840 --> 00:14:08,920 WE NEED TO HAVE MORE RESEARCH IN 315 00:14:08,920 --> 00:14:14,840 ORDER TO GET ALL THE WAY TO THE 316 00:14:14,840 --> 00:14:19,560 50% REDUCTION. DR. SHIELS IS A 317 00:14:19,560 --> 00:14:22,480 WORLD EXPERT ON POPULATION 318 00:14:22,480 --> 00:14:25,760 DYNAMICS AND POPULATION CANCER 319 00:14:25,760 --> 00:14:27,960 INCIDENTS AND CANCER MORTALITY 320 00:14:27,960 --> 00:14:31,200 AND INDEED INCIDENTS AND 321 00:14:31,200 --> 00:14:34,040 MORTALITY FROM OTHER DISEASES. 322 00:14:34,040 --> 00:14:38,360 SO, FOR EXAMPLE, SHE PUBLISHED 323 00:14:38,360 --> 00:14:42,240 SEVERAL NOTEWORTHY ARTICLES 324 00:14:42,240 --> 00:14:49,160 DURING THE SARS-COV-2 EPIDEMIC 325 00:14:49,160 --> 00:14:52,160 FROM EXCESS OF COV2 AS WELL AS 326 00:14:52,160 --> 00:14:53,480 OTHER DISEASES. 327 00:14:53,480 --> 00:14:57,200 TODAY, SHE WILL BE FOCUSED ON 328 00:14:57,200 --> 00:15:02,240 THIS CANCER PART. 329 00:15:02,240 --> 00:15:04,840 BECAUSE OF THE DEBT CEILING 330 00:15:04,840 --> 00:15:07,000 AGREEMENT AND REALLY INCREDIBLE 331 00:15:07,000 --> 00:15:09,680 PROPOSAL ON PART OF THE BIDEN 332 00:15:09,680 --> 00:15:11,120 ADMINISTRATION FOR INCREASES TO 333 00:15:11,120 --> 00:15:15,800 THE CANCER -- TO THE NCI BUDGET 334 00:15:15,800 --> 00:15:21,160 OVER THE NEXT FEW YEARS, THOSE 335 00:15:21,160 --> 00:15:24,120 INCREASES WILL PROBABLY BE IN 336 00:15:24,120 --> 00:15:27,640 JEOPARDY EITHER IN WHOLE OR IN 337 00:15:27,640 --> 00:15:33,120 FULL BECAUSE OF THE DEBT CEILING 338 00:15:33,120 --> 00:15:34,880 AGREEMENT. THIS WASN'T AN 339 00:15:34,880 --> 00:15:36,640 INTENDED CONSEQUENCE OF THE DEBT 340 00:15:36,640 --> 00:15:39,400 CEILING AGREEMENT BUT COULD BE 341 00:15:39,400 --> 00:15:41,160 AN UNINTENDED CONSEQUENCE. 342 00:15:41,160 --> 00:15:43,080 ENOUGH ABOUT THE BUDGET 343 00:15:43,080 --> 00:15:43,480 SITUATION. 344 00:15:43,480 --> 00:15:45,360 LET'S GO ON TO ANOTHER ISSUE, 345 00:15:45,360 --> 00:15:49,320 WHICH IS THE DRUG SHORTAGE 346 00:15:49,320 --> 00:15:49,560 ISSUE. 347 00:15:49,560 --> 00:15:52,960 AND I HAVE BASICALLY MADE THE 348 00:15:52,960 --> 00:15:55,160 HEADLINE ACTUALLY FROM THE 349 00:15:55,160 --> 00:15:58,120 HEADLINE FROM AN ARTICLE THAT 350 00:15:58,120 --> 00:16:03,920 WAS PUBLISHED YESTERDAY IN THE 351 00:16:03,920 --> 00:16:06,000 WASHINGTON POST OF ABOUT THE 352 00:16:06,000 --> 00:16:07,600 CANCER DRUG SHORTAGES. 353 00:16:07,600 --> 00:16:11,000 AND THIS IS SOMETHING THAT HAS 354 00:16:11,000 --> 00:16:14,040 BEEN AN INTERMITTENT AND 355 00:16:14,040 --> 00:16:15,920 REOCCURRING PROBLEM. 356 00:16:15,920 --> 00:16:20,600 RIGHT NOW IS REALLY HAVING A 357 00:16:20,600 --> 00:16:24,040 MAJOR NEGATIVE IMPACT BOTH WITH 358 00:16:24,040 --> 00:16:26,880 CANCER RESEARCH IN TERMS OF 359 00:16:26,880 --> 00:16:28,800 CLINICAL TRIALS AND DRUG 360 00:16:28,800 --> 00:16:31,200 AVAILABILITY AS WELL AS FOR 361 00:16:31,200 --> 00:16:35,680 PATIENTS, ESPECIALLY PEDIATRIC 362 00:16:35,680 --> 00:16:38,040 PATIENTS FOR WHOM SOME OF THESE 363 00:16:38,040 --> 00:16:41,200 BEST TREATMENTS DON'T HAVE VERY 364 00:16:41,200 --> 00:16:42,920 GOOD ALTERNATIVES. 365 00:16:42,920 --> 00:16:46,800 THIS LISTS FOR YOU A NUMBER OF 366 00:16:46,800 --> 00:16:52,400 THE DRUGS THAT CURRENTLY ARE IN 367 00:16:52,400 --> 00:16:56,040 VERY SHORT SUPPLY. 368 00:16:56,040 --> 00:17:00,320 THE CONGRESS, THE WHITE HOUSE, 369 00:17:00,320 --> 00:17:04,000 AND THE FD ACA ARE DOING A LOT 370 00:17:04,000 --> 00:17:09,480 THINGS TO TRY TO SUCCESSFULLY 371 00:17:09,480 --> 00:17:12,800 ADDRESS THIS PROBLEM BUT AT ITS 372 00:17:12,800 --> 00:17:15,800 FUNDAMENTAL CORE, THE 373 00:17:15,800 --> 00:17:19,160 MANUFACTURERS WHO MAKE THESE 374 00:17:19,160 --> 00:17:23,720 DRUGS THAT ARE GENERIC, THEIR 375 00:17:23,720 --> 00:17:26,960 FEELING IS THAT THEY ARE NOT 376 00:17:26,960 --> 00:17:31,040 ABLE TO GET ENOUGH PROFIT FROM 377 00:17:31,040 --> 00:17:33,280 SELLING THE DRUGS SO THESE ARE 378 00:17:33,280 --> 00:17:34,640 DRUGS THAT THEY STOPPED 379 00:17:34,640 --> 00:17:35,000 MANUFACTURING. 380 00:17:35,000 --> 00:17:36,800 MANY OF THE DRUGS HAVE VERY 381 00:17:36,800 --> 00:17:40,200 LIMITED NUMBERS OF 382 00:17:40,200 --> 00:17:40,560 MANUFACTURERS. 383 00:17:40,560 --> 00:17:47,640 SO, HOPEFULLY THERE WILL BE A 384 00:17:47,640 --> 00:17:49,680 SUCCESSFUL CONCLUSION TO 385 00:17:49,680 --> 00:17:52,640 OVERCOMING THIS PROBLEM. THIS 386 00:17:52,640 --> 00:17:54,880 IS A LONG-TERM ISSUE THAT 387 00:17:54,880 --> 00:17:57,080 CLEARLY NEEDS TO BE ADDRESSED. 388 00:17:57,080 --> 00:18:00,760 THE NEXT SLIDE SHOWS YOU JUST 389 00:18:00,760 --> 00:18:04,480 WHAT HAPPENS WITH OUR CURRENT 390 00:18:04,480 --> 00:18:09,800 TRIALS WITH THE ONCOLOGY AGENTS 391 00:18:09,800 --> 00:18:10,640 CURRENTLY IN SHORT SUPPLY. 392 00:18:10,640 --> 00:18:13,640 THE TRIALS GENERALLY ARE LOOKING 393 00:18:13,640 --> 00:18:15,400 AT NEW AGENTS. 394 00:18:15,400 --> 00:18:17,600 BUT, FREQUENTLY, THE NEW AGENTS 395 00:18:17,600 --> 00:18:20,040 ARE EITHER BEING ADDED TO 396 00:18:20,040 --> 00:18:23,400 ESTABLISHED AGENTS OR THE 397 00:18:23,400 --> 00:18:28,080 CONTROL GROUP IN THE TRIAL IS 398 00:18:28,080 --> 00:18:32,040 GETTING THE BEST IN CLASS 399 00:18:32,040 --> 00:18:33,080 CURRENT STANDARD OF CARE 400 00:18:33,080 --> 00:18:33,440 TREATMENT. 401 00:18:33,440 --> 00:18:35,280 WHAT I HOPE YOU CAN SEE IS THAT 402 00:18:35,280 --> 00:18:39,560 THERE ARE A LOT OF TRIALS WHOSE 403 00:18:39,560 --> 00:18:43,840 ACCRUAL IS BEING A SERIOUSLY 404 00:18:43,840 --> 00:18:49,800 EFFECTED BY THE -- BY THE DRUG 405 00:18:49,800 --> 00:18:50,160 SHORTAGE. 406 00:18:50,160 --> 00:18:53,240 IN THE NEXT SLIDE, THEN, YOU 407 00:18:53,240 --> 00:18:58,840 KNOW, SUMMARIZES FOR YOU SOME OF 408 00:18:58,840 --> 00:18:59,160 TH 409 00:18:59,160 --> 00:19:00,080 THIS. 410 00:19:00,080 --> 00:19:02,480 JUST KEEP IN MIND THAT AROUND 5% 411 00:19:02,480 --> 00:19:07,240 OF CANCER PATIENTS GO ON TO DRUG 412 00:19:07,240 --> 00:19:10,320 TRI 413 00:19:10,320 --> 00:19:10,520 TRIALS. 414 00:19:10,520 --> 00:19:12,440 THEREFORE, THERE IS A MUCH 415 00:19:12,440 --> 00:19:15,760 BIGGER PROBLEM FOR PEOPLE TRYING 416 00:19:15,760 --> 00:19:18,360 TO RECEIVE STANDARD OF CARE WHO 417 00:19:18,360 --> 00:19:21,200 ARE NOT IN TRIALS AND FOR WHOM 418 00:19:21,200 --> 00:19:26,120 THESE DRUG SHORTAGES ARE REALLY 419 00:19:26,120 --> 00:19:26,800 DIRE. 420 00:19:26,800 --> 00:19:28,240 SO, IT IS REALLY IMPORTANT THAT 421 00:19:28,240 --> 00:19:31,240 WE ARE WORKING WITH THE WHITE 422 00:19:31,240 --> 00:19:35,440 HOUSE, WITH THE FDA TO TRY TO 423 00:19:35,440 --> 00:19:39,400 HELP TO SUCCESSFULLY ADDRESS 424 00:19:39,400 --> 00:19:40,040 THESE SHORTAGES. 425 00:19:40,040 --> 00:19:44,400 SO, NOW, I WANT TO GO ON AND 426 00:19:44,400 --> 00:19:48,360 TALK ABOUT SOME OF THE NEW 427 00:19:48,360 --> 00:19:48,680 INITIATIVES. 428 00:19:48,680 --> 00:19:52,200 AND YOU ARE GOING TO BE HEARING 429 00:19:52,200 --> 00:19:56,920 FROM DR. PRINDIVILLE ABOUT THE 430 00:19:56,920 --> 00:19:59,240 CLINICAL TRIALS INNOVATION UNIT. 431 00:19:59,240 --> 00:20:01,680 I WANT TO JUST GIVE YOU A 432 00:20:01,680 --> 00:20:05,680 PREVIEW THAT ITS GOAL IS TO 433 00:20:05,680 --> 00:20:08,480 BUILD BETTER, FASTER, MORE 434 00:20:08,480 --> 00:20:09,320 ACCESSIBLE CANCER CLINICAL 435 00:20:09,320 --> 00:20:09,560 TRIALS. 436 00:20:09,560 --> 00:20:11,320 IT IS NOT GOING TO BE FOR ALL OF 437 00:20:11,320 --> 00:20:14,400 THE TRIALS THAT WE DO, BUT TO 438 00:20:14,400 --> 00:20:17,440 SELECT A FEW HIGH PRIORITY 439 00:20:17,440 --> 00:20:20,320 STUDIES AND TO SPEED CLINICAL 440 00:20:20,320 --> 00:20:24,480 TESTING TO DELIVER NEW 441 00:20:24,480 --> 00:20:26,200 APPROACHES. 442 00:20:26,200 --> 00:20:27,600 REALLY, LOOKING FOR INPUT FROM 443 00:20:27,600 --> 00:20:32,240 ALL STAKEHOLDERS AND AS I SAY, 444 00:20:32,240 --> 00:20:34,480 DR. PRINDIVILLE WILL TALK ABOUT 445 00:20:34,480 --> 00:20:37,920 THIS IN FAR MORE DETAIL. 446 00:20:37,920 --> 00:20:39,760 NEXT SLIDE. 447 00:20:39,760 --> 00:20:43,960 AND THIS SLIDE IS TALKING ABOUT 448 00:20:43,960 --> 00:20:46,840 A NEW CLINICAL TRIAL THAT IS -- 449 00:20:46,840 --> 00:20:50,160 THAT -- THAT IS ABOUT TO START 450 00:20:50,160 --> 00:20:54,000 THAT HAS JUST STARTED THAT IS 451 00:20:54,000 --> 00:20:59,040 CALLED COMBO MATCH. MANY OF YOU 452 00:20:59,040 --> 00:21:01,000 WILL REMEMBER THE MATCH TRIAL 453 00:21:01,000 --> 00:21:05,440 THAT WAS STARTED BACK IN 2016 454 00:21:05,440 --> 00:21:10,360 WITH THE FIRST CANCER MOONSHOT. 455 00:21:10,360 --> 00:21:12,040 IT WAS A TRIAL THAT WAS THE 456 00:21:12,040 --> 00:21:15,520 FASTEST ACCRUING TRIAL THAT NCI 457 00:21:15,520 --> 00:21:16,960 HAS EVER HAD. 458 00:21:16,960 --> 00:21:18,880 INSTEAD OF THE TRIAL BEING 459 00:21:18,880 --> 00:21:20,880 FOCUSED ON A SPECIFIC KIND OF 460 00:21:20,880 --> 00:21:25,160 CANCER, THE TRIAL WAS FOCUSED ON 461 00:21:25,160 --> 00:21:26,520 MOLECULAR ABNORMALITIES AND 462 00:21:26,520 --> 00:21:30,160 PEOPLE WITH SPECIFIC MOLECULAR 463 00:21:30,160 --> 00:21:31,920 ABNORMALITIES INDEPENDENT OF THE 464 00:21:31,920 --> 00:21:35,680 KIND OF CANCER THAT THEY HAD 465 00:21:35,680 --> 00:21:38,840 WERE THEN ELIGIBLE FOR TREATMENT 466 00:21:38,840 --> 00:21:40,560 WITH EITHER EXPERIMENTAL DRUGS 467 00:21:40,560 --> 00:21:45,160 OR FDA APPROVED DRUGS BUT FOR 468 00:21:45,160 --> 00:21:47,200 APPROVED INDICATIONS OTHER THAN 469 00:21:47,200 --> 00:21:51,000 WHAT THE PATIENT ACTUALLY HAD. 470 00:21:51,000 --> 00:21:54,920 THE MATCH TRIAL LED TO SEVERAL 471 00:21:54,920 --> 00:21:59,680 FDA APPROVALS FOR A SUBSET OF 472 00:21:59,680 --> 00:22:01,080 THE DRUGS THAT WERE BEING TESTED 473 00:22:01,080 --> 00:22:04,640 IN WHAT ENDED UP BEING A 474 00:22:04,640 --> 00:22:05,960 MULTI-ARM TRIAL MORE THAN 30 475 00:22:05,960 --> 00:22:08,040 ARMS IN THIS KIND OF TRIAL THAT 476 00:22:08,040 --> 00:22:09,960 IS REALLY IMPORTANT TO THINK 477 00:22:09,960 --> 00:22:13,920 ABOUT THE NUMBER ARMS. 478 00:22:13,920 --> 00:22:15,680 IT IS DIFFICULT FOR ANY ENTITY 479 00:22:15,680 --> 00:22:18,520 OTHER THAN NCI TO SPONLSOR THIS 480 00:22:18,520 --> 00:22:20,880 KIND OF TRIAL. 481 00:22:20,880 --> 00:22:25,880 THE INITIAL ARMS ARE GOING TO BE 482 00:22:25,880 --> 00:22:28,560 -- WILL BE 6 FOR COMBO MATCH. 483 00:22:28,560 --> 00:22:30,880 IT IS BASICALLY TESTING 484 00:22:30,880 --> 00:22:32,600 COMBINATIONS THAT ARE NOT YET 485 00:22:32,600 --> 00:22:36,000 FDA APPROVED BUT FOR WHICH THERE 486 00:22:36,000 --> 00:22:42,360 ARE REALLY STRONG INDICATIONS 487 00:22:42,360 --> 00:22:43,720 THAT THEY MIGHT WORK WELL 488 00:22:43,720 --> 00:22:44,000 TOGETHER. 489 00:22:44,000 --> 00:22:47,080 THE PROBLEM THAT THIS IS 490 00:22:47,080 --> 00:22:48,840 DESIGNED TO ADDRESS AND OVERCOME 491 00:22:48,840 --> 00:22:52,200 IS THAT THERE ARE MANY AREAS 492 00:22:52,200 --> 00:22:56,480 WHERE THERE ARE SINGLE AGENTS 493 00:22:56,480 --> 00:22:59,240 THAT GIVE GOOD SPONLSS, BUT THE 494 00:22:59,240 --> 00:23:02,720 GOOD RESPONSES TEND TO LAST FOR 495 00:23:02,720 --> 00:23:06,240 A FINITE TIME PERIOD. 496 00:23:06,240 --> 00:23:07,720 SO, COMBINATION TREATMENTS ARE A 497 00:23:07,720 --> 00:23:10,960 VERY IMPORTANT APPROACH TO TRY 498 00:23:10,960 --> 00:23:14,800 TO MAKE IT POSSIBLE FOR PEOPLE 499 00:23:14,800 --> 00:23:17,480 TO HAVE RESPONSES THAT WILL BE 500 00:23:17,480 --> 00:23:21,880 FAR MORE DURABLE OR LONG LASTING 501 00:23:21,880 --> 00:23:26,560 THAN THEY WOULD HAVE FROM SINGLE 502 00:23:26,560 --> 00:23:27,400 AGES. 503 00:23:27,400 --> 00:23:29,680 NEXT SLIDE. 504 00:23:29,680 --> 00:23:33,800 THIS IS A NEW AREA THAT HAS 505 00:23:33,800 --> 00:23:38,560 BECOME VERY IMPORTANT FOR NCI AS 506 00:23:38,560 --> 00:23:42,960 IT HAS BECOME SO IMPORTANT FOR 507 00:23:42,960 --> 00:23:49,680 CANCER, CANCER ISSUES NATIO 508 00:23:49,680 --> 00:23:50,040 NATIONALLY. 509 00:23:50,040 --> 00:23:53,160 WE PUBLISHED A PAPER THREE YEARS 510 00:23:53,160 --> 00:23:55,640 AGO THAT EMPHASIZED HOW 511 00:23:55,640 --> 00:23:59,080 IMPORTANT SOCIAL DETERMINANTS OF 512 00:23:59,080 --> 00:24:06,320 CANCER ARE BECOMING FOR CANCER 513 00:24:06,320 --> 00:24:06,840 OUTC 514 00:24:06,840 --> 00:24:07,680 OUTCOMES AND THAT THE AREAS OF 515 00:24:07,680 --> 00:24:11,320 THE COUNTRY WITH THE MOST -- THE 516 00:24:11,320 --> 00:24:14,920 MOST PERSISTENT POVERTY ALSO HAD 517 00:24:14,920 --> 00:24:18,360 MUCH HIGHER INCIDENTS AND POORER 518 00:24:18,360 --> 00:24:19,440 OUTCOMES OF CANCER. 519 00:24:19,440 --> 00:24:23,240 SO, THIS IS TO TRY TO ADDRESS 520 00:24:23,240 --> 00:24:26,920 THIS WITH A NEW PERSISTENT 521 00:24:26,920 --> 00:24:35,240 POVERTY INITIATIVE. 522 00:24:35,240 --> 00:24:36,760 THIS IS ONE OF WHAT I THINK WILL 523 00:24:36,760 --> 00:24:42,000 BE OTHER AREAS WHERE IT -- IT IS 524 00:24:42,000 --> 00:24:46,360 REALLY GOING TO BE SOCIOECONOMIC 525 00:24:46,360 --> 00:24:48,520 STATUS OR SOCIO DETERMINANTS OF 526 00:24:48,520 --> 00:24:50,720 HEALTH THAT ARE HAVING MORE AND 527 00:24:50,720 --> 00:24:53,440 MORE OF AN IMPACT ON CANCER 528 00:24:53,440 --> 00:24:56,840 HEALTH INCLUDING CANCER OUTCOMES 529 00:24:56,840 --> 00:25:00,160 AND TRYING TO BE MORE EQUITABLE 530 00:25:00,160 --> 00:25:04,600 AND OVERCOME THESE GAPS OF -- 531 00:25:04,600 --> 00:25:05,640 AND DISPARITIES THAT WILL BE 532 00:25:05,640 --> 00:25:09,440 MORE AND MORE LOOKING TOWARDS 533 00:25:09,440 --> 00:25:12,280 POVERTY IN ADDITION TO RACIAL 534 00:25:12,280 --> 00:25:16,240 AND ETHNIC ISSUES. 535 00:25:16,240 --> 00:25:22,720 NEXT SLIDE. 536 00:25:22,720 --> 00:25:25,160 THIS IS TO HIGHLIGHT A FEW 537 00:25:25,160 --> 00:25:28,920 ADVANCES THAT I WILL GO OVER 538 00:25:28,920 --> 00:25:29,720 THEM RELATIVELY QUICKLY. 539 00:25:29,720 --> 00:25:31,560 THESE SLIDES ARE AVAILABLE TO 540 00:25:31,560 --> 00:25:33,720 YOU. YOU CAN GO TO THE ACTUAL 541 00:25:33,720 --> 00:25:39,320 STUDIES THEMSELVES FOR THEM. 542 00:25:39,320 --> 00:25:42,400 MEG MOONY WHO HEADS UP CANCER 543 00:25:42,400 --> 00:25:48,760 THERAPY AND EVALUATION PROGRAM 544 00:25:48,760 --> 00:25:50,840 CTEP PRESENTED SOME OF THE 545 00:25:50,840 --> 00:25:54,240 RESULTS LAST WEEK AT JOINT 546 00:25:54,240 --> 00:25:56,160 NATIONAL CANCER BOARD AND 547 00:25:56,160 --> 00:25:57,560 SCIENTIFIC ADVISORY BOARD 548 00:25:57,560 --> 00:25:59,280 MEETING AND THOUGHT THEY REALLY 549 00:25:59,280 --> 00:26:00,600 REFLECTED SOME ADVANCES THAT 550 00:26:00,600 --> 00:26:02,200 HAVE BEEN MADE POSSIBLE THROUGH 551 00:26:02,200 --> 00:26:05,880 CLINICAL TRIALS RESEARCH 552 00:26:05,880 --> 00:26:09,240 SUPPORTED BY NCI. 553 00:26:09,240 --> 00:26:10,120 NEXT SLIDE. 554 00:26:10,120 --> 00:26:13,840 SO, THE FIRST WAS REALLY A 555 00:26:13,840 --> 00:26:17,840 RANDOMIZED STUDY FOR NEWLY 556 00:26:17,840 --> 00:26:22,120 DIAGNOSED ADVANCED STAGE HOJ 557 00:26:22,120 --> 00:26:25,120 KINES DISEASE IN RELATIVELY 558 00:26:25,120 --> 00:26:27,280 YOUNG ADULTS. 559 00:26:27,280 --> 00:26:34,440 AND IT WAS ESSENTIALLY ADD IING- 560 00:26:34,440 --> 00:26:41,800 I'M SORRY ADDING NOVOLOMAB TO 561 00:26:41,800 --> 00:26:45,040 CURRENT STANDARD OF CARE THAT IS 562 00:26:45,040 --> 00:26:48,200 MULTIDRUG CHEMOTHERAPY. 563 00:26:48,200 --> 00:26:52,200 THIS RESULTS IN IMPROVED 564 00:26:52,200 --> 00:26:54,880 REGRESSION FREE SURVIVAL 565 00:26:54,880 --> 00:26:57,840 COMPARED TO THE CURRENT 566 00:26:57,840 --> 00:26:58,440 TREATMENT. 567 00:26:58,440 --> 00:27:02,200 SO, THE TREATMENT WAS WELL 568 00:27:02,200 --> 00:27:05,360 TOLERATED AND VERY FEW RELATED 569 00:27:05,360 --> 00:27:07,880 ADVERSE EVENTS THAT REALLY IS A 570 00:27:07,880 --> 00:27:10,600 KEY STEP TOWARDS HARMONIZING 571 00:27:10,600 --> 00:27:14,080 PEDIATRIC AND ADULT THERAPY FOR 572 00:27:14,080 --> 00:27:16,040 ADVANCED HOJ KINES DISEASE AND 573 00:27:16,040 --> 00:27:17,680 IS POISED TO BECOME NEW STANDARD 574 00:27:17,680 --> 00:27:23,960 OF CARE TREATMENT FOR ADVANCED 575 00:27:23,960 --> 00:27:27,640 STAGE HODGE KINES DISEASE. 576 00:27:27,640 --> 00:27:29,840 NEXT SLIDE. 577 00:27:29,840 --> 00:27:32,400 THIS WAS FOR WHETHER RECTAL 578 00:27:32,400 --> 00:27:35,000 CANCER PASH YEVENTS COULD 579 00:27:35,000 --> 00:27:37,720 RECEIVE CURATIVE INTENTIONAL 580 00:27:37,720 --> 00:27:40,200 TREATMENT WITHOUT PELVIC 581 00:27:40,200 --> 00:27:43,600 CHEMORADIATION THAT IS WHAT IS 582 00:27:43,600 --> 00:27:49,160 CALLED A NON-INFERIORITY STUDY. 583 00:27:49,160 --> 00:27:51,920 BASICALLY, IT MET ITS ENDPOINT 584 00:27:51,920 --> 00:27:53,160 SUGGESTING THAT THIS CURATIVE 585 00:27:53,160 --> 00:27:56,720 INTENT TREATMENT CAN BE DONE 586 00:27:56,720 --> 00:28:01,760 WITHOUT PELVIC CHEMORADIATION. 587 00:28:01,760 --> 00:28:05,880 AGAIN, MAY BECOME STANDARD OF 588 00:28:05,880 --> 00:28:08,200 CARE IN THE NOT TOO DISTANT 589 00:28:08,200 --> 00:28:08,680 FUTURE. 590 00:28:08,680 --> 00:28:10,920 NEXT SLIDE. 591 00:28:10,920 --> 00:28:17,640 THIS SUMMARIZES ANALOGOUS 592 00:28:17,640 --> 00:28:21,000 ADVANCES, ONE FOR HIGH-RISK 593 00:28:21,000 --> 00:28:23,480 CLASSICAL HODGE KINES LYMPHOMA 594 00:28:23,480 --> 00:28:25,160 THAT IS NOT AS FAR ADVANCED WITH 595 00:28:25,160 --> 00:28:28,680 THE ORIGINAL TRIAL THAT I 596 00:28:28,680 --> 00:28:29,160 MENTIONED. 597 00:28:29,160 --> 00:28:34,800 ANOTHER ADVANCE FOR ACUTE LYMPHO 598 00:28:34,800 --> 00:28:38,040 BLASTIC LEUKEMIA IN ADULTS AND 599 00:28:38,040 --> 00:28:39,760 THEN ANOTHER ADVANCE FOR 600 00:28:39,760 --> 00:28:44,080 RECURRENT ENDOMETRIAL CANCER. 601 00:28:44,080 --> 00:28:46,320 NEXT SLIDE. 602 00:28:46,320 --> 00:28:52,160 SO, THIS SLIDE DISCUSSES A NEWLY 603 00:28:52,160 --> 00:28:53,160 PUBLISHED PAPER ABOUT THE 604 00:28:53,160 --> 00:28:56,880 CHILDHOOD CANCER DATA 605 00:28:56,880 --> 00:28:57,200 INITIATIVE. 606 00:28:57,200 --> 00:29:00,360 THIS IS A 10-YEAR 50 MILLION 607 00:29:00,360 --> 00:29:03,600 DOLLAR A YEAR INFUSION OF FUNDS 608 00:29:03,600 --> 00:29:06,440 FOR NCI THAT STARTED A LITTLE 609 00:29:06,440 --> 00:29:07,960 OVER THREE YEARS AGO. 610 00:29:07,960 --> 00:29:13,120 THIS PAPER THAT WAS PUBLISHED 611 00:29:13,120 --> 00:29:15,280 REALLY EXPLAINS THE 612 00:29:15,280 --> 00:29:19,560 ACCOMPLISHMENTS TO DATE OF THE 613 00:29:19,560 --> 00:29:21,160 CLINICAL OR CHILDHOOD CANCER 614 00:29:21,160 --> 00:29:22,920 DATA INITIATIVE DISCUSSING 615 00:29:22,920 --> 00:29:25,120 PRIORITIES FOR THE FUTURE OF THE 616 00:29:25,120 --> 00:29:25,520 INITIATIVE. 617 00:29:25,520 --> 00:29:29,240 I URGE YOU TO GO AND LOOK AT THE 618 00:29:29,240 --> 00:29:31,400 STUDY ITSELF. 619 00:29:31,400 --> 00:29:34,040 THIS IS REALLY ONE CRITICALLY 620 00:29:34,040 --> 00:29:36,120 IMPORTANT PART OF THE 621 00:29:36,120 --> 00:29:37,160 MULTI-FACETED APPROACH THAT WE 622 00:29:37,160 --> 00:29:42,320 ARE TAKING TO TRY TO IMPROVE THE 623 00:29:42,320 --> 00:29:46,720 OUTLOOK FOR CHILDREN WHO DEVELOP 624 00:29:46,720 --> 00:29:46,920 CANCER. 625 00:29:46,920 --> 00:29:49,640 NEXT SLIDE. 626 00:29:49,640 --> 00:29:57,800 SO, YOU ARE ALL AWARE OF THE 627 00:29:57,800 --> 00:30:00,000 SARS-COV2 VACCINES WHOSE RAPID 628 00:30:00,000 --> 00:30:01,600 DEVELOPMENT WAS ENABLED BECAUSE 629 00:30:01,600 --> 00:30:05,160 OF RNA TECHNOLOGY THAT HAD BEEN 630 00:30:05,160 --> 00:30:09,400 STRONGLY SUPPORTED BY THE NIH 631 00:30:09,400 --> 00:30:13,240 OVER A NUMBER OF YEARS THAT WAS 632 00:30:13,240 --> 00:30:17,160 POISED FOR THAT RAPID 633 00:30:17,160 --> 00:30:19,080 DEVELOPMENT. 634 00:30:19,080 --> 00:30:25,680 SARS-COV2 VAX AUTO EN -- 635 00:30:25,680 --> 00:30:28,120 VACCINE HAVE WORKED VERY WELL 636 00:30:28,120 --> 00:30:30,800 BUT DURATION HAS WANED 637 00:30:30,800 --> 00:30:32,880 RELATIVELY RAPIDLY AND THEY HAVE 638 00:30:32,880 --> 00:30:36,000 ALSO HAD TO DEAL WITH THE 639 00:30:36,000 --> 00:30:37,840 DEVELOPMENT OF VARIANCE. THIS 640 00:30:37,840 --> 00:30:40,080 IS A REQUEST FOR INFORMATION FOR 641 00:30:40,080 --> 00:30:44,760 TRYING TO USE RNA'S -- RNA-BASED 642 00:30:44,760 --> 00:30:46,680 CANCER VACCINES FOR CANCER 643 00:30:46,680 --> 00:30:49,720 TREATMENT PRIMARILY RATHER THAN 644 00:30:49,720 --> 00:30:53,320 FOR PREVENTION. 645 00:30:53,320 --> 00:30:55,760 RNA-BASED VACCINES MIGHT 646 00:30:55,760 --> 00:31:00,040 ACTUALLY BE EVEN BETTER FOR 647 00:31:00,040 --> 00:31:03,680 CANCER TREATMENT THAN THEY HAVE 648 00:31:03,680 --> 00:31:08,040 BEEN FOR CANCER PREVENTION. 649 00:31:08,040 --> 00:31:12,640 CANCER PREVENTION IS BEING GIVEN 650 00:31:12,640 --> 00:31:14,640 VACCINES TO PEOPLE THAT ARE 651 00:31:14,640 --> 00:31:18,120 OTHERWISE NORMAL AND HAS BEEN A 652 00:31:18,120 --> 00:31:21,160 REAL FALL OFF IN UPTAKE OF 653 00:31:21,160 --> 00:31:23,040 VACCINES AS TIME HAS GONE ON. 654 00:31:23,040 --> 00:31:24,920 ON THE OTHER HAND, WHEN COMING 655 00:31:24,920 --> 00:31:30,440 TO CANCER THERAPEUTIC VACCINES, 656 00:31:30,440 --> 00:31:31,760 THESE ARE PEOPLE WHO HAVE CANCER 657 00:31:31,760 --> 00:31:36,240 AND BY AND LARGE ARE HIGHLY 658 00:31:36,240 --> 00:31:38,480 MOTIVATED TO TRY TO TAKE 659 00:31:38,480 --> 00:31:40,000 ADVANTAGE OF ADVANCES IN 660 00:31:40,000 --> 00:31:42,560 TREATMENT AND BEING -- IF THERE 661 00:31:42,560 --> 00:31:48,520 IS A NECESSITY TO TAKE THESE 662 00:31:48,520 --> 00:31:50,040 VACCINES MORE THAN ONCE OR 663 00:31:50,040 --> 00:31:54,400 TWICE, THEY WILL BE HIGHLY 664 00:31:54,400 --> 00:31:54,680 MOTIVATED. 665 00:31:54,680 --> 00:31:57,720 OF COURSE, THIS IS ALL 666 00:31:57,720 --> 00:31:58,920 THEORETICAL AT THE MOMENT AND 667 00:31:58,920 --> 00:32:04,600 ARE NOT RNA-BASED VACCINES AND 668 00:32:04,600 --> 00:32:05,960 CONSIDERABLE POTENTIAL FOR 669 00:32:05,960 --> 00:32:08,720 FUTURE DEVELOPMENT AND THEREFORE 670 00:32:08,720 --> 00:32:14,560 HAVE THIS REQUEST FOR 671 00:32:14,560 --> 00:32:15,720 INFORMATION FOR THEM. 672 00:32:15,720 --> 00:32:20,360 NEXT SLIDE. 673 00:32:20,360 --> 00:32:22,760 SO, I NOW WANT TO GET TO THE 674 00:32:22,760 --> 00:32:25,600 LAST TOPIC OF MY PRESENTATION, 675 00:32:25,600 --> 00:32:29,160 WHICH REALLY HAS TO DO WITH 676 00:32:29,160 --> 00:32:30,680 ANOTHER ADVANCE. 677 00:32:30,680 --> 00:32:34,840 THIS IS A PHASE 3 TRIAL THAT WAS 678 00:32:34,840 --> 00:32:38,280 PUBLISHED EARLIER THIS MONTH AND 679 00:32:38,280 --> 00:32:42,120 IN THE NEW ENGLAND JOURNAL OF 680 00:32:42,120 --> 00:32:43,760 MEDICINE THAT WAS BASICALLY 681 00:32:43,760 --> 00:32:47,080 TAKING AN APPROACH THAT HAS 682 00:32:47,080 --> 00:32:49,840 BECOME STANDARD OF CARE FOR 683 00:32:49,840 --> 00:32:52,840 ADVANCED LUNG CANCER AND ASKING 684 00:32:52,840 --> 00:32:56,080 WILL IT BE USEFUL FOR PATIENTS 685 00:32:56,080 --> 00:32:57,640 WHO HAVE LESS ADVANCED LUNG 686 00:32:57,640 --> 00:33:00,040 CANCER THAT IS FOCUSED ON WHAT 687 00:33:00,040 --> 00:33:03,400 ARE CALLED NON-SMALL CELL LUNG 688 00:33:03,400 --> 00:33:06,120 CANCER, WHICH REPRESENTS ABOUT 689 00:33:06,120 --> 00:33:13,160 3/4 TO 80% OF LUNG CANCER TODAY. 690 00:33:13,160 --> 00:33:16,600 SO, PATIENTS IN THIS CLINICAL 691 00:33:16,600 --> 00:33:23,280 TRIAL WERE -- WHEN THEY HAD 692 00:33:23,280 --> 00:33:24,840 EARLIER STAGE LUNG CANCER 693 00:33:24,840 --> 00:33:26,600 DIAGNOSED, THEY WERE TESTED FOR 694 00:33:26,600 --> 00:33:28,480 WHETHER OR NOT THEY HAD 695 00:33:28,480 --> 00:33:31,280 MUTATIONS FOR EGF RECEPTOR THAT 696 00:33:31,280 --> 00:33:35,520 AS I SAY ARE EGF RECEPTOR 697 00:33:35,520 --> 00:33:37,760 INHIBITORS THAT ARE APPROVED FOR 698 00:33:37,760 --> 00:33:40,320 TREATMENT IN ADVANCED NON-SMALL 699 00:33:40,320 --> 00:33:42,200 CELL LUNG CANCER THAT IS LOOKING 700 00:33:42,200 --> 00:33:43,520 AT EARLIER. 701 00:33:43,520 --> 00:33:50,960 PATIENTS WERE RANDOMIZED ONCE 702 00:33:50,960 --> 00:33:54,800 THOSE WHO HAD MOLECULAR 703 00:33:54,800 --> 00:33:57,640 ABNORMALITY EITHER TO RECEIVING 704 00:33:57,640 --> 00:34:00,360 INHIBITOR FOR EGF RECEPTOR OR 705 00:34:00,360 --> 00:34:09,000 PLACEBO. WHAT I HOPE YOU CAN 706 00:34:09,000 --> 00:34:09,680 APPRECIATE FROM KAPLAN-MEYER 707 00:34:09,680 --> 00:34:12,520 CURVE IS A TREMENDOUS MORTALITY 708 00:34:12,520 --> 00:34:14,200 BENEFIT FOR PATIENTS THAT 709 00:34:14,200 --> 00:34:21,400 RECEIVE EGF RECEPTOR INHIBITOR 710 00:34:21,400 --> 00:34:23,400 THIS IS NOT YET STANDARD OF CARE 711 00:34:23,400 --> 00:34:25,920 BUT AS WITH OTHER RESULTS I 712 00:34:25,920 --> 00:34:28,560 MENTIONED EARLIER IS LIKELY TO 713 00:34:28,560 --> 00:34:31,480 BECOME STANDARD OF CARE IN THE 714 00:34:31,480 --> 00:34:35,560 NOT TOO DISTANT FUTURE THAT THIS 715 00:34:35,560 --> 00:34:39,120 LEADS TO MY LAST POINT. 716 00:34:39,120 --> 00:34:40,920 NEXT SLIDE. 717 00:34:40,920 --> 00:34:46,760 WHICH HAS TO DO WITH THE 718 00:34:46,760 --> 00:34:49,120 POSSIBLE ROLE OF NCI TO 719 00:34:49,120 --> 00:34:51,480 INCREASING ACCESS TO CANCER CARE 720 00:34:51,480 --> 00:34:54,000 AND CONTROL ONE OF THE IMPORTANT 721 00:34:54,000 --> 00:35:02,680 GOALS OF CANCER MOONSHOT. 722 00:35:02,680 --> 00:35:05,160 NCI IS ABOUT CANCER RESEARCH WE 723 00:35:05,160 --> 00:35:11,280 DON'T SET HEALTH CARE DELIVERY 724 00:35:11,280 --> 00:35:13,200 POLICY BUT ARE TALKING AMONGST 725 00:35:13,200 --> 00:35:14,840 OURSELVES WHETHER IT MIGHT BE 726 00:35:14,840 --> 00:35:15,960 FRUITFUL FOR US TO WORK WITH 727 00:35:15,960 --> 00:35:20,080 OTHER GROUPS TO ACHIEVE WIDER 728 00:35:20,080 --> 00:35:23,960 AND MORE EQUITABLE DISSEMINATION 729 00:35:23,960 --> 00:35:26,800 AND ACCESS TO CARE DELIVERY THAT 730 00:35:26,800 --> 00:35:29,800 IS AN IMPORTANT GOAL OF THE 731 00:35:29,800 --> 00:35:30,720 CANCER MOONSHOT. 732 00:35:30,720 --> 00:35:34,680 AND IN CONTEXT WHAT I SHOWED YOU 733 00:35:34,680 --> 00:35:40,240 IN THE PREVIOUS SLIDE ONE 734 00:35:40,240 --> 00:35:43,880 POSSIBLE EXAMPLE OF ACCESS TO 735 00:35:43,880 --> 00:35:45,760 UPTAKE OF TUMOR SEEK WENCY WHERE 736 00:35:45,760 --> 00:35:49,120 SEEK WENCY IS RECOMMENDED BY 737 00:35:49,120 --> 00:35:50,120 GUIDELINES. 738 00:35:50,120 --> 00:35:55,040 IT TURNS OUT THAT THERE ARE SOME 739 00:35:55,040 --> 00:35:58,960 IMPEDIMENTS TO PATIENTS GETTING 740 00:35:58,960 --> 00:36:02,360 TUMOR DNA SEQUENCE. 741 00:36:02,360 --> 00:36:09,040 AND THESE ARE LARGELY BASED ON 742 00:36:09,040 --> 00:36:11,040 SOCIAL DETERMINANTS OF HEALTH IN 743 00:36:11,040 --> 00:36:12,320 TERMS WHETHER THEY GET 744 00:36:12,320 --> 00:36:12,640 SEQUENCED. 745 00:36:12,640 --> 00:36:15,480 WE ARE THINKING ABOUT AS PART OF 746 00:36:15,480 --> 00:36:18,480 FURTHERING GOALS OF CANCER 747 00:36:18,480 --> 00:36:21,680 MOONSHOT POTENTIALLY WORKING 748 00:36:21,680 --> 00:36:25,160 WITH OTHER GROUPS, THE CANCER 749 00:36:25,160 --> 00:36:26,960 CENTERS AND AMERICAN CANCER 750 00:36:26,960 --> 00:36:31,280 SOCIETY AND OTHER STAKEHOLDERS 751 00:36:31,280 --> 00:36:34,560 TO TRY TO MAKE IT EASIER FOR ALL 752 00:36:34,560 --> 00:36:37,160 PATIENTS TO HAVE WHEN IT IS 753 00:36:37,160 --> 00:36:41,640 APPROPRIATE TO HAVE ACCESS TO AN 754 00:36:41,640 --> 00:36:44,440 UPTAKE OF TUMOR DNA SEQUENCING 755 00:36:44,440 --> 00:36:46,640 THAT IS A SPECIFIC EXAMPLE OF 756 00:36:46,640 --> 00:36:49,680 WHAT WE MIGHT CONSIDER HAVING 757 00:36:49,680 --> 00:36:56,120 SOME INVOLVEMENT WITH CONVENERS 758 00:36:56,120 --> 00:37:03,120 MORE THAN ANYTHING ELSE. 759 00:37:03,120 --> 00:37:07,480 I HAVE GONE THROUGH A NUMBER OF 760 00:37:07,480 --> 00:37:09,000 DIFFERENT ISSUES THIS AFTERNOON 761 00:37:09,000 --> 00:37:11,080 TALKING A BIT ABOUT BUDGET AND 762 00:37:11,080 --> 00:37:12,920 CANCER AND DRUG SHORTAGES AND 763 00:37:12,920 --> 00:37:16,200 RESEARCH INITIATIVES AND 764 00:37:16,200 --> 00:37:20,040 RESEARCH ADVANCES AND THIS LAST 765 00:37:20,040 --> 00:37:21,360 TOPIC LOOKING FORWARD TO YOUR 766 00:37:21,360 --> 00:37:22,880 COMMENTS AND QUESTIONS AND 767 00:37:22,880 --> 00:37:25,960 THANKS VERY MUCH FOR YOUR 768 00:37:25,960 --> 00:37:29,320 ATTENT 769 00:37:29,320 --> 00:37:29,640 ATTENTION. 770 00:37:29,640 --> 00:37:32,400 >>WELL, DR. LOWY, THAT WAS A 771 00:37:32,400 --> 00:37:35,440 LOT. A LOT OF EXCITING -- THERE 772 00:37:35,440 --> 00:37:37,960 IS SO MUCH HAPPENING. 773 00:37:37,960 --> 00:37:40,200 WHAT IS JUMPING OUT TO ME RIGHT 774 00:37:40,200 --> 00:37:44,000 NOW IS, YOU KNOW, I WILL TALK 775 00:37:44,000 --> 00:37:47,000 ABOUT PERSISTENT POVERTY THAT 776 00:37:47,000 --> 00:37:51,200 YOU KNOW HAUNTS ME. I'M VERY 777 00:37:51,200 --> 00:37:52,800 EXCITED ABOUT THAT PERSISTENT 778 00:37:52,800 --> 00:37:57,040 POVERTY INITIATIVE BRINGING IT 779 00:37:57,040 --> 00:37:59,360 TO THE FOREFRONT. 780 00:37:59,360 --> 00:38:02,920 I THINK [INDISCERNIBLE] FOR 781 00:38:02,920 --> 00:38:06,280 WORKING ON THAT. 782 00:38:06,280 --> 00:38:08,880 >>YES. JUST SO YOU KNOW -- 783 00:38:08,880 --> 00:38:13,640 AMY, LET ME JUST SAY TWO THINGS. 784 00:38:13,640 --> 00:38:15,360 OKAY? 785 00:38:15,360 --> 00:38:15,800 >>OKAY. 786 00:38:15,800 --> 00:38:19,360 >>FIRST, RURAL AREAS ARE AREAS 787 00:38:19,360 --> 00:38:22,560 THAT IF YOU WILL PREFERENTIALLY 788 00:38:22,560 --> 00:38:25,000 HAVE PERSISTENT POVERTY. 789 00:38:25,000 --> 00:38:30,760 20 YEARS AGO THERE WAS NO 790 00:38:30,760 --> 00:38:32,520 DIFFERENCE IN CANCER OUTCOMES 791 00:38:32,520 --> 00:38:35,440 AND MORTALITY RATES FOR PEOPLE 792 00:38:35,440 --> 00:38:39,560 IN RURAL AREAS VERSUS URBAN 793 00:38:39,560 --> 00:38:40,400 AREAS. 794 00:38:40,400 --> 00:38:44,560 IT WAS RECOGNIZED BACK IN 2015 795 00:38:44,560 --> 00:38:49,200 THAT LARGELY BECAUSE OF ADVANCES 796 00:38:49,200 --> 00:38:53,160 IN CANCER TREATMENT AND CANCER 797 00:38:53,160 --> 00:38:56,240 SCREENING AND PREVENTION. 798 00:38:56,240 --> 00:38:57,800 ALTHOUGH THERE WAS IXPROVEMENT 799 00:38:57,800 --> 00:38:59,760 OF PEOPLE IN RURAL AREAS IN 800 00:38:59,760 --> 00:39:02,080 TERMS OF MORTALITY, THEY WERE 801 00:39:02,080 --> 00:39:03,680 FALLING PROGRESSIVELY BEHIND 802 00:39:03,680 --> 00:39:07,240 PEOPLE IN URBAN AREAS. 803 00:39:07,240 --> 00:39:09,800 SO, WHEN WE RECOGNIZED THIS 804 00:39:09,800 --> 00:39:14,360 STARTING IN 2016 IN CONJUNCTION 805 00:39:14,360 --> 00:39:17,160 WITH FIRST CANCER MOONSHOT, WE 806 00:39:17,160 --> 00:39:19,720 HAVE FOCUSED BOTH INITIALLY 807 00:39:19,720 --> 00:39:21,960 MAINLY ON RURAL AREAS AND NOW 808 00:39:21,960 --> 00:39:25,840 ALSO ON PERSISTENT POVERTY 809 00:39:25,840 --> 00:39:26,200 AS-IS. 810 00:39:26,200 --> 00:39:30,720 IF I INTERRUPTED, I APOLOGIZE. 811 00:39:30,720 --> 00:39:32,400 WE CONCUR THAT THEY ARE REALLY 812 00:39:32,400 --> 00:39:34,520 IMPORTANT AREAS. 813 00:39:34,520 --> 00:39:35,640 >>YEAH. 814 00:39:35,640 --> 00:39:39,240 YEAH. I DO THANK YOU SO MUCH 815 00:39:39,240 --> 00:39:42,160 FOR THAT. 816 00:39:42,160 --> 00:39:44,000 KRISTEN, I SEE YOU HAD YOUR HAND 817 00:39:44,000 --> 00:39:44,440 UP? 818 00:39:44,440 --> 00:39:46,600 >>I HAVE A BIT THAT TIES TO 819 00:39:46,600 --> 00:39:48,800 THIS AS WELL. DR. LOWY, THANK 820 00:39:48,800 --> 00:39:52,160 YOU FOR YOUR OVERVIEW. FOR ME, 821 00:39:52,160 --> 00:39:54,000 IT WAS EASY TO FOLLOW AND DIGEST 822 00:39:54,000 --> 00:39:56,480 AND I APPRECIATE IT. NICE TO 823 00:39:56,480 --> 00:39:57,160 SEE YOU AGAIN. 824 00:39:57,160 --> 00:39:59,200 LONGEVITY IS INTERESTED IN 825 00:39:59,200 --> 00:40:01,160 INCREASING ACCESS TO WHAT 826 00:40:01,160 --> 00:40:02,760 BIOMARKERS ARE SAYING AND THAT 827 00:40:02,760 --> 00:40:05,360 DNA AND ALL OF THE TERMINOLOGY 828 00:40:05,360 --> 00:40:07,760 CONFUSES ME AND WHY WE WORKED ON 829 00:40:07,760 --> 00:40:10,040 TRYING TO STREAMLINE THAT IN THE 830 00:40:10,040 --> 00:40:11,480 PAST. I HAVE A QUESTION AND 831 00:40:11,480 --> 00:40:13,680 THEN A COMMENT TO WHAT ANDY WAS 832 00:40:13,680 --> 00:40:15,360 SAYING AND CURIOUS AS FAR AS 833 00:40:15,360 --> 00:40:18,480 WHAT IT LOOKS LIKE FOR NCI TO 834 00:40:18,480 --> 00:40:20,200 CONVENE GROUPS AND SOMETHING 835 00:40:20,200 --> 00:40:22,240 THAT LONGEVITY WOULD BE 836 00:40:22,240 --> 00:40:23,640 INTERESTED IN AND OTHER GROUPS 837 00:40:23,640 --> 00:40:25,160 YOU MENTIONED WOULD BE AS WELL 838 00:40:25,160 --> 00:40:27,800 AND EXCITED TO HEAR BACK. 839 00:40:27,800 --> 00:40:29,520 >>THIS IS STILL UNDER 840 00:40:29,520 --> 00:40:29,800 DISCUSSION. 841 00:40:29,800 --> 00:40:31,560 >>OKAY. 842 00:40:31,560 --> 00:40:35,440 >>BECAUSE WE -- WE NEED TO 843 00:40:35,440 --> 00:40:38,400 RESPECT THERE ARE OTHER ENTITIES 844 00:40:38,400 --> 00:40:39,560 THAT SET POLICY. 845 00:40:39,560 --> 00:40:41,280 WE CAN'T BE IN A POSITION OF 846 00:40:41,280 --> 00:40:44,080 TELLING THEM WHAT TO DO. 847 00:40:44,080 --> 00:40:47,080 BUT, WE MIGHT BE ABLE TO HELP TO 848 00:40:47,080 --> 00:40:51,720 BRING TOGETHER GROUPS OF PEOPLE 849 00:40:51,720 --> 00:40:53,320 THAT COULD MORE CLEARLY EXPLAIN 850 00:40:53,320 --> 00:40:57,720 SOME OF THE ACCESS ISSUES AND 851 00:40:57,720 --> 00:40:59,720 WHETHER THERE MIGHT BE WAYS OF 852 00:40:59,720 --> 00:41:03,200 NOT MAKING THINGS PERFECT BUT 853 00:41:03,200 --> 00:41:05,200 MAKING THEM BETTER. 854 00:41:05,200 --> 00:41:07,560 >>THAT SOUNDS FANTASTIC. THERE 855 00:41:07,560 --> 00:41:10,160 IS -- I MEAN, LOTS OF THE SAME 856 00:41:10,160 --> 00:41:12,520 ISSUES THAT EXIST FOR ALL OF THE 857 00:41:12,520 --> 00:41:15,560 OTHER ACCESS PROBLEMS WE SEE BUT 858 00:41:15,560 --> 00:41:16,640 PROVIDER AWARENESS AND 859 00:41:16,640 --> 00:41:18,840 TECHNOLOGY AND PATIENT 860 00:41:18,840 --> 00:41:20,720 AWARENESS, EVERYTHING IS ALL 861 00:41:20,720 --> 00:41:21,800 ROLLED UP INTO THAT. 862 00:41:21,800 --> 00:41:23,440 THERE WAS A -- 863 00:41:23,440 --> 00:41:26,600 >>YEAH. GO AHEAD. 864 00:41:26,600 --> 00:41:30,200 >>I APOLOGIZE IF I'M 865 00:41:30,200 --> 00:41:32,360 INTERRUPTING BUT WE WANT TO TRY 866 00:41:32,360 --> 00:41:34,040 TO START SMALL, IF YOU WILL. 867 00:41:34,040 --> 00:41:36,920 IT IS NOT SOMETHING WE HAVE 868 00:41:36,920 --> 00:41:37,440 TRADITIONALLY DONE. 869 00:41:37,440 --> 00:41:40,520 WE WOULD LIKE TO KIND OF BE 870 00:41:40,520 --> 00:41:42,200 SUCCESSFUL, YOU KNOW? 871 00:41:42,200 --> 00:41:45,160 OR HELP BEING SUCCESSFUL BEFORE 872 00:41:45,160 --> 00:41:48,000 EMBARKING ON TOO MANY THINGS. 873 00:41:48,000 --> 00:41:50,080 NOW, I WILL TURN THE MIC BACK TO 874 00:41:50,080 --> 00:41:51,400 YOU. OKAY? 875 00:41:51,400 --> 00:41:53,560 >>YOU ARE NOT INTERRUPTING AT 876 00:41:53,560 --> 00:41:56,360 ALL. I THINK IT MAKES SENSE. 877 00:41:56,360 --> 00:42:01,400 WE ARE LOOKING AT KIND OF DOG 878 00:42:01,400 --> 00:42:06,560 PILOTS AND LOOKING AT EHRS OR 879 00:42:06,560 --> 00:42:08,560 GANTT CHARTS TO MAKE SURE IF 880 00:42:08,560 --> 00:42:12,200 SOMEONE HAS A BIOPSY IT IS SENT 881 00:42:12,200 --> 00:42:13,440 IMMEDIATELY REFLEX TESTING AND 882 00:42:13,440 --> 00:42:14,760 APPLYING TO OTHER DISEASE AREAS 883 00:42:14,760 --> 00:42:16,640 AS WELL AND ONCE WE APPROVE IT 884 00:42:16,640 --> 00:42:20,080 AND CAN HELP MOVE THINGS ALONG 885 00:42:20,080 --> 00:42:22,680 AND AGREE IT MAKES SENSE. 886 00:42:22,680 --> 00:42:24,280 TO ANNIE'S POINT THERE WAS A 887 00:42:24,280 --> 00:42:26,440 STUDY RECENTLY AND I FEEL 888 00:42:26,440 --> 00:42:28,480 HORRIBLE BUT CAN'T REMEMBER IT 889 00:42:28,480 --> 00:42:32,560 AND MAKING SURE TO POP INTO YOUR 890 00:42:32,560 --> 00:42:34,320 HEADS RACIAL AND ETHNIC 891 00:42:34,320 --> 00:42:36,840 MINORITIES ARE WAY BEHIND 892 00:42:36,840 --> 00:42:38,160 GETTING BIOMARKER TESTING DONE 893 00:42:38,160 --> 00:42:40,600 THAT IS INCREDIBLY SERVING NOT 894 00:42:40,600 --> 00:42:43,160 LOOKING AT RURAL VERSUS URBAN 895 00:42:43,160 --> 00:42:44,600 DON'T REMEMBER WHAT IT WAS 896 00:42:44,600 --> 00:42:46,600 LOOKING AT OR IF IT IS RINGING A 897 00:42:46,600 --> 00:42:48,720 BELL BUT ALL OF THE FLAGS ARE 898 00:42:48,720 --> 00:42:48,960 THERE. 899 00:42:48,960 --> 00:42:52,280 >>THERE IS A NUMBER OF STUDIES. 900 00:42:52,280 --> 00:42:55,440 WHAT WE REALLY WANT TO FOCUS ON 901 00:42:55,440 --> 00:42:59,280 IS NOT SO MUCH THE PAST AS WHAT 902 00:42:59,280 --> 00:43:02,560 IS HAPPENING TODAY AND WHAT IS 903 00:43:02,560 --> 00:43:04,200 LIKELY TO HAPPEN TOMORROW SO 904 00:43:04,200 --> 00:43:05,880 THAT WE CAN TRY TO HAVE A 905 00:43:05,880 --> 00:43:10,400 POSITIVE IMPACT ON WHAT ACTUALLY 906 00:43:10,400 --> 00:43:11,240 HAPPENS TOMORROW. 907 00:43:11,240 --> 00:43:11,520 >>COOL. 908 00:43:11,520 --> 00:43:13,720 >>WELL, SOUNDS -- I MEAN, I 909 00:43:13,720 --> 00:43:15,880 ASSUME WE ARE ALL ON BOARD. 910 00:43:15,880 --> 00:43:17,320 THANKS FOR HIGHLIGHTING THAT AS 911 00:43:17,320 --> 00:43:18,240 AN OPPORTUNITY. 912 00:43:18,240 --> 00:43:21,240 >>I AM -- I'M BRINGING THIS TO 913 00:43:21,240 --> 00:43:22,440 YOUR ATTENTION BECAUSE I THINK 914 00:43:22,440 --> 00:43:27,160 THAT YOU CAN BE REALLY HELPFUL 915 00:43:27,160 --> 00:43:29,040 FOR US IF WE EMBARK ON THIS. 916 00:43:29,040 --> 00:43:32,560 AND WE HAVE SOME SUCCESS THAN 917 00:43:32,560 --> 00:43:35,600 TRYING TO PRIORITIZE WHERE TO GO 918 00:43:35,600 --> 00:43:40,520 AND HOW TO GO ABOUT DOING IT. 919 00:43:40,520 --> 00:43:40,920 OKAY? 920 00:43:40,920 --> 00:43:43,520 >>EXCELLENT. WE ARE ON BOARD. 921 00:43:43,520 --> 00:43:46,960 IS IT PRIORITY FOR LONGEVITY? 922 00:43:46,960 --> 00:43:47,720 AWESOME. THANK YOU. 923 00:43:47,720 --> 00:43:50,640 >>ADDING ON TO WHAT YOU WERE 924 00:43:50,640 --> 00:43:51,800 TALKING ABOUT. WE ALSO BELIEVE 925 00:43:51,800 --> 00:43:55,640 IT IS A PRIORITY AT AMERICAN 926 00:43:55,640 --> 00:43:57,200 BRAIN TUMOR ASSOCIATION FOR 927 00:43:57,200 --> 00:43:59,320 BRAIN TUMORS AND GENETIC TESTING 928 00:43:59,320 --> 00:44:01,640 AND FINDING MORE AND MORE 929 00:44:01,640 --> 00:44:05,200 METHYLATION IS ALSO CRITICAL FOR 930 00:44:05,200 --> 00:44:08,160 BRAIN TUMORS AND APPRECIATE 931 00:44:08,160 --> 00:44:09,760 PATIENT ADVOCACY ORGANIZATIONS 932 00:44:09,760 --> 00:44:11,720 AND RESEARCH COMMUNITY IN 933 00:44:11,720 --> 00:44:13,200 HELPING TO DIRECT WHAT ARE MOST 934 00:44:13,200 --> 00:44:15,800 IMPORTANT AREAS TO FOCUS ON IF 935 00:44:15,800 --> 00:44:17,640 WE START TO COLLECT THIS TUMOR 936 00:44:17,640 --> 00:44:20,320 DATA AND, YOU KNOW, MOLECULAR 937 00:44:20,320 --> 00:44:23,200 DATA NOT ONLY GENETIC BUT 938 00:44:23,200 --> 00:44:24,480 POTENTIALLY METHYLATION AND 939 00:44:24,480 --> 00:44:26,400 OTHER AREAS OF IMPORTANCE. 940 00:44:26,400 --> 00:44:29,480 >>JUST TO BRING EVERYBODY INTO 941 00:44:29,480 --> 00:44:33,480 THE CONVERSATION, METHYLATION IS 942 00:44:33,480 --> 00:44:35,680 IN CANCER IS A MARK THAT IS PUT 943 00:44:35,680 --> 00:44:40,680 ON DNA. OKAY? 944 00:44:40,680 --> 00:44:44,160 WHAT IT TENDS TO MEAN IS GENES 945 00:44:44,160 --> 00:44:49,360 THAT ARE METHYLATED TEND TO BE 946 00:44:49,360 --> 00:44:51,240 UNDEREXPRESSED. FREQUENTLY 947 00:44:51,240 --> 00:44:53,160 MEANS THAT THEY ARE TUMOR 948 00:44:53,160 --> 00:44:58,200 SUPPRESSOR GENES OR ANTICANCER 949 00:44:58,200 --> 00:44:58,440 GENES. 950 00:44:58,440 --> 00:45:02,840 THEY CAN HAVE A PROGNOSTIC OR 951 00:45:02,840 --> 00:45:05,200 THERAPEUTIC IMPLICATIONS BECAUSE 952 00:45:05,200 --> 00:45:07,280 OF INACTIVATION IN THOSE GENES 953 00:45:07,280 --> 00:45:10,440 THAT CAN MAKE VERY IMPORTANT 954 00:45:10,440 --> 00:45:14,160 CONTRIBUTIONS TO THE CANCER AND 955 00:45:14,160 --> 00:45:15,680 ITS SEVERITY. 956 00:45:15,680 --> 00:45:16,760 NICOLE, WAS THAT FAIR? 957 00:45:16,760 --> 00:45:19,880 >>YES. EXACTLY. THANK YOU. 958 00:45:19,880 --> 00:45:21,640 I SHOULD HAVE EXPLAINED THAT 959 00:45:21,640 --> 00:45:21,880 BETTER. 960 00:45:21,880 --> 00:45:23,760 >>NO. THAT IS FINE. I JUST -- 961 00:45:23,760 --> 00:45:25,840 YOU KNOW, I JUST THINK THAT PART 962 00:45:25,840 --> 00:45:28,440 OF THIS IS WHERE -- WE ARE 963 00:45:28,440 --> 00:45:31,160 EDUCATING EACH OTHER. OKAY? 964 00:45:31,160 --> 00:45:33,400 REALLY IMPORTANT WHAT WE DO. 965 00:45:33,400 --> 00:45:36,640 >>AS YOU MENTIONED, THERE IS AN 966 00:45:36,640 --> 00:45:38,160 INCREASING UNDERSTANDING OF THE 967 00:45:38,160 --> 00:45:40,640 ROLE OF SOCIAL DETERMINANTS OF 968 00:45:40,640 --> 00:45:43,560 HEALTH PLACE SINCE 2014 OR 2015 969 00:45:43,560 --> 00:45:46,800 AND NCCN IS IN THE PROCESS OF 970 00:45:46,800 --> 00:45:48,680 MAKING SOCIAL DETERMINANTS OF 971 00:45:48,680 --> 00:45:53,120 HEALTH SCREENING GUIDELINE AND 972 00:45:53,120 --> 00:45:53,760 RECOMMENDATION TO CMS IDEA BEING 973 00:45:53,760 --> 00:45:56,880 WE HAVE TO GO REALLY FROM A ZIP 974 00:45:56,880 --> 00:45:58,400 CODE LEVEL TO INDIVIDUAL PATIENT 975 00:45:58,400 --> 00:46:00,000 LEVEL UNDERSTANDING OF SOCIAL 976 00:46:00,000 --> 00:46:01,800 DETERMINANTS OF HEALTH AND BEING 977 00:46:01,800 --> 00:46:05,720 ABLE TO CREATE INTERVENTION 978 00:46:05,720 --> 00:46:06,320 RELATED TO THAT. 979 00:46:06,320 --> 00:46:09,760 ONE PUSHBACK WE GET IS CLINICAL 980 00:46:09,760 --> 00:46:12,320 TRIALS FOR THAT MATTER REALLY 981 00:46:12,320 --> 00:46:15,800 MEDICINE OR POLICY OR 982 00:46:15,800 --> 00:46:18,280 LEGISLATION CANNOT ADDRESS 983 00:46:18,280 --> 00:46:20,280 POVERTY OR ADDRESS RURALNESS OR 984 00:46:20,280 --> 00:46:23,600 OVERALL SOCIAL DETERMINANTS OF 985 00:46:23,600 --> 00:46:24,000 HEALTH. 986 00:46:24,000 --> 00:46:28,320 HOW WOULD YOU ADVISE US THAT WE 987 00:46:28,320 --> 00:46:30,280 ADDRESS PUSHBACK OR QUESTIONS. 988 00:46:30,280 --> 00:46:34,320 >>I AM NOT SURE THAT I AM THE 989 00:46:34,320 --> 00:46:36,880 RIGHT PERSON TO GIVE YOU AN 990 00:46:36,880 --> 00:46:37,320 ANSWER. 991 00:46:37,320 --> 00:46:39,280 I WOULD BE MORE THAN HAPPY TO 992 00:46:39,280 --> 00:46:43,440 DISCUSS IT WITH NCI COLLEAGUES 993 00:46:43,440 --> 00:46:46,000 AND TO MAKE SOME SUGGESTIONS. 994 00:46:46,000 --> 00:46:47,040 OKAY? 995 00:46:47,040 --> 00:46:50,160 I THINK YOU ARE ASKING A VERY 996 00:46:50,160 --> 00:46:50,880 IMPORTANT QUESTION. 997 00:46:50,880 --> 00:46:54,480 >>THANK YOU. NAJ ANNEL, I SEE 998 00:46:54,480 --> 00:46:55,160 YOUR HAND UP. 999 00:46:55,160 --> 00:46:57,320 >>THANK YOU, ANNIE AND DR. 1000 00:46:57,320 --> 00:46:59,320 LOWY. REALLY GREAT AND 1001 00:46:59,320 --> 00:47:00,240 FANTASTIC PRESENTATION. 1002 00:47:00,240 --> 00:47:01,840 I WANT TO CONTINUE THAT 1003 00:47:01,840 --> 00:47:02,960 CONVERSATION AT PARTICULARLY AS 1004 00:47:02,960 --> 00:47:05,560 WE TALKED ABOUT, YOU KNOW, THE 1005 00:47:05,560 --> 00:47:06,920 PERSISTENT POVERTY COMING DOWN 1006 00:47:06,920 --> 00:47:09,680 THE PIPELINE AND LOOKING AT THAT 1007 00:47:09,680 --> 00:47:11,600 IN RURAL AND FRONTIER AREAS. 1008 00:47:11,600 --> 00:47:14,240 I THINK SOMETHING I NOTICED 1009 00:47:14,240 --> 00:47:18,240 FREQUENTLY IS THAT THE LEADING 1010 00:47:18,240 --> 00:47:19,960 DEFINITION OF RURALITY IS 1011 00:47:19,960 --> 00:47:21,040 PRIMARILY DOMINANT. 1012 00:47:21,040 --> 00:47:24,120 >>SORRY LEADING DEFINITION OF 1013 00:47:24,120 --> 00:47:24,360 WHAT? 1014 00:47:24,360 --> 00:47:26,400 >>RURALITY OR BEING IN A RURAL 1015 00:47:26,400 --> 00:47:26,600 AREA. 1016 00:47:26,600 --> 00:47:27,880 >> YES. THANK YOU. 1017 00:47:27,880 --> 00:47:30,160 >>IS PRIMARILY DOMINATED BY 1018 00:47:30,160 --> 00:47:31,600 EAST COAST PERSPECTIVE OF THAT 1019 00:47:31,600 --> 00:47:34,600 AND NOT FOR A LONG TIME INVOLVED 1020 00:47:34,600 --> 00:47:38,520 A MOUNTAIN WEST, MID-WEST AND 1021 00:47:38,520 --> 00:47:41,440 WEST COAST PERSPECTIVE WHAT 1022 00:47:41,440 --> 00:47:44,160 RURALITY IS AND WE SEE THAT TERM 1023 00:47:44,160 --> 00:47:45,960 DIFFERENTLY ACROSS THE COUNTRY 1024 00:47:45,960 --> 00:47:47,480 THAT IS NOT NECESSARILY 1025 00:47:47,480 --> 00:47:48,600 TRANSLATING AND THINK THERE IS 1026 00:47:48,600 --> 00:47:50,800 KIND OF SCHOOLS OF THOUGHT OF 1027 00:47:50,800 --> 00:47:52,320 DEFINING WHAT IS RURAL VIA LAND 1028 00:47:52,320 --> 00:47:55,040 MASS OR DIVINING WHAT IS RURAL 1029 00:47:55,040 --> 00:47:57,080 VIA CONCENTRATION OR 1030 00:47:57,080 --> 00:47:57,400 POPULATIONS. 1031 00:47:57,400 --> 00:48:00,480 I'M WONDERING IF, YOU KNOW, THE 1032 00:48:00,480 --> 00:48:02,880 NCI PLANS TO PROVIDE FURTHER 1033 00:48:02,880 --> 00:48:04,200 GUIDANCE IN FUNDING 1034 00:48:04,200 --> 00:48:05,600 ANNOUNCEMENTS AND REQUEST FOR 1035 00:48:05,600 --> 00:48:07,560 PROPOSAL AS TO WHAT THEY ARE 1036 00:48:07,560 --> 00:48:09,200 DEFINING AS BEING RURAL AND IF 1037 00:48:09,200 --> 00:48:11,120 THEY WILL ACTUALLY DEFINE THAT 1038 00:48:11,120 --> 00:48:14,160 AS BEING A DISPARITY IN AND OF 1039 00:48:14,160 --> 00:48:14,360 ITSELF. 1040 00:48:14,360 --> 00:48:16,640 >>YEAH. INTERESTING POINT. 1041 00:48:16,640 --> 00:48:20,040 I'M SURE THAT YOU KNOW, BUT 1042 00:48:20,040 --> 00:48:22,000 PROBABLY MOST OF THE REST OF THE 1043 00:48:22,000 --> 00:48:26,240 PEOPLE DON'T KNOW THAT DR. 1044 00:48:26,240 --> 00:48:29,040 MONICA BURTONOLI WHO IS NCI 1045 00:48:29,040 --> 00:48:32,480 DIRECTOR IS FROM WYOMING AND HAS 1046 00:48:32,480 --> 00:48:38,120 A VERY STRONG CONNECTIONS THERE. 1047 00:48:38,120 --> 00:48:39,520 I DON'T KNOW THAT THEY ARE 1048 00:48:39,520 --> 00:48:42,120 SPECIFICALLY GOING TO BE 1049 00:48:42,120 --> 00:48:43,960 ADDRESSING EASTERN VERSUS 1050 00:48:43,960 --> 00:48:44,320 FRONTIER. 1051 00:48:44,320 --> 00:48:46,960 LET ME -- LET ME -- LET ME ASK 1052 00:48:46,960 --> 00:48:48,960 HER ABOUT THAT AND WHETHER IN -- 1053 00:48:48,960 --> 00:48:50,040 I AM NOT SURE. 1054 00:48:50,040 --> 00:48:52,080 DO YOU THINK THAT THE UNIVERSITY 1055 00:48:52,080 --> 00:48:55,880 OF UTAH HAS BEEN DISADVANTAGED 1056 00:48:55,880 --> 00:48:57,040 IN THAT REGARD? 1057 00:48:57,040 --> 00:49:01,760 >>I WOULD SAY IN -- YES. DR. 1058 00:49:01,760 --> 00:49:03,480 BURTONOLI WENT TO SCHOOL OF 1059 00:49:03,480 --> 00:49:05,360 MEDICINE AT UNIVERSITY OF UTAH 1060 00:49:05,360 --> 00:49:07,080 AND HOLDS PRIVY THAT INFORMATION 1061 00:49:07,080 --> 00:49:10,760 AS WELL. I JUST THINK THAT IN 1062 00:49:10,760 --> 00:49:11,760 THE CONTEXT IS SOMETHING TO 1063 00:49:11,760 --> 00:49:14,760 BRING UP IN THE PERSPECTIVE THAT 1064 00:49:14,760 --> 00:49:16,480 SUB-WESTERN COUNTIES ARE SIZE OF 1065 00:49:16,480 --> 00:49:18,520 EASTERN STATES AND IF YOU DEFINE 1066 00:49:18,520 --> 00:49:20,480 ON COUNTY LEVEL, FOR EXAMPLE, 1067 00:49:20,480 --> 00:49:25,720 WHAT IS RURAL, THE DEFINITION 1068 00:49:25,720 --> 00:49:27,360 MAY BE VERY DIFFERENT THAT I 1069 00:49:27,360 --> 00:49:28,640 THINK IS SOMETHING TO JUST KEEP 1070 00:49:28,640 --> 00:49:31,760 IN MIND AS WE USE THIS TERM 1071 00:49:31,760 --> 00:49:33,200 RURAL TO ENCOMPASS. 1072 00:49:33,200 --> 00:49:35,080 >>THAT IS ACTION ITEM 2. 1073 00:49:35,080 --> 00:49:37,160 >>YES. SO, I THINK IT MIGHT BE 1074 00:49:37,160 --> 00:49:42,480 A DEFINITIONS THING THAT NCI MAY 1075 00:49:42,480 --> 00:49:43,520 WANT TO CONSIDER. 1076 00:49:43,520 --> 00:49:46,520 >>YEAH. 1077 00:49:46,520 --> 00:49:50,200 >>THANK YOU, NAJ ANNEL. JOY 1078 00:49:50,200 --> 00:49:50,920 YA, YOUR HAND SUP. 1079 00:49:50,920 --> 00:49:54,440 >>I DON'T WANT TO GO AFTER 1080 00:49:54,440 --> 00:49:55,440 [INDISCERNIBLE] QUESTION. IT 1081 00:49:55,440 --> 00:49:57,200 WAS GREAT. GREAT QUESTION. I 1082 00:49:57,200 --> 00:49:58,680 LOVE WHEN SOMETHING CHALLENGES 1083 00:49:58,680 --> 00:50:00,040 HOW WE THINK ABOUT SOMETHING OR 1084 00:50:00,040 --> 00:50:01,600 WHAT WE SHOULD CONSIDER AND I 1085 00:50:01,600 --> 00:50:03,880 HAVE A QUESTION ABOUT THE CANCER 1086 00:50:03,880 --> 00:50:05,160 DRUG SHORTAGE AND THANKS FOR 1087 00:50:05,160 --> 00:50:06,400 BRINGING THE ARTICLE TO MY 1088 00:50:06,400 --> 00:50:09,320 ATTENTION AND SEE THE ARTICLE IN 1089 00:50:09,320 --> 00:50:11,400 STACK MAGAZINE BY KRISTEN RICE 1090 00:50:11,400 --> 00:50:13,640 AND HEADLINE WAS CAPTIVATING AND 1091 00:50:13,640 --> 00:50:15,880 WAS LIKE CANCER PASH YEVENTS 1092 00:50:15,880 --> 00:50:19,320 SHOULD BE RIDING IN THE STREETS 1093 00:50:19,320 --> 00:50:21,480 ALMOST. IT IS NOT OKAY. SHE 1094 00:50:21,480 --> 00:50:25,160 CALLS OUT SOME IN THE ARTICLE 1095 00:50:25,160 --> 00:50:30,280 SHE CALLS OUT SOME DEFINITELY 1096 00:50:30,280 --> 00:50:32,080 ONUS ON PRIVATE SECTOR TO FIX 1097 00:50:32,080 --> 00:50:34,640 THIS AND CANCER PASH YEVENTS 1098 00:50:34,640 --> 00:50:36,160 SHOULD RIDE IN THE STREETS ABOUT 1099 00:50:36,160 --> 00:50:37,640 THIS. ANYTHING WE CAN OR SHOULD 1100 00:50:37,640 --> 00:50:41,440 DO OR TYPE OF COLLECTIVE IF 1101 00:50:41,440 --> 00:50:42,720 APPROPRIATE SIGN OFF OR WHO 1102 00:50:42,720 --> 00:50:44,080 WOULD WE SUBMIT IT? 1103 00:50:44,080 --> 00:50:48,600 ALL THESE -- WHAT COULD WE DO? 1104 00:50:48,600 --> 00:50:54,000 >>I THINK WHAT YOU COULD DO IS 1105 00:50:54,000 --> 00:50:57,560 SIMPLY, YOU KNOW, CALL ATTENTION 1106 00:50:57,560 --> 00:51:01,560 TO -- CALL ATTENTION TO THIS 1107 00:51:01,560 --> 00:51:04,720 PROBLEM THAT, YOU KNOW, IT 1108 00:51:04,720 --> 00:51:07,000 PLACES PEOPLE'S LIVES IN 1109 00:51:07,000 --> 00:51:07,320 JEOPARDY. 1110 00:51:07,320 --> 00:51:13,000 I MEAN, IT DELAYS ABILITY TO 1111 00:51:13,000 --> 00:51:15,360 DETERMINE IF NEW APPROACHES TO 1112 00:51:15,360 --> 00:51:18,200 CANCER TREATMENT WILL BE EVEN 1113 00:51:18,200 --> 00:51:19,480 BETTER THAN CURRENT APPROACHES. 1114 00:51:19,480 --> 00:51:23,320 I MEAN, IT HAS -- IT HAS MAJOR 1115 00:51:23,320 --> 00:51:26,880 NEGATIVE IMPLICATIONS BOTH FOR 1116 00:51:26,880 --> 00:51:29,600 PEOPLE WHO ARE SIMPLY, YOU KNOW, 1117 00:51:29,600 --> 00:51:31,520 HAVE CANCER AND NEED TREATMENT 1118 00:51:31,520 --> 00:51:32,800 OR THOSE THAT HAVE CANCER AND 1119 00:51:32,800 --> 00:51:34,760 WANT TO BE IN CLINICAL TRIALS. 1120 00:51:34,760 --> 00:51:41,200 I DON'T THINK THAT I HAVE A 1121 00:51:41,200 --> 00:51:43,200 SPECIFIC RECOMMENDATION OF HOW 1122 00:51:43,200 --> 00:51:44,480 TO -- OF HOW TO DO IT. 1123 00:51:44,480 --> 00:51:49,080 I THINK THAT CALLING ATTENTION 1124 00:51:49,080 --> 00:51:52,080 TO THIS PROBLEM AND THAT THIS IS 1125 00:51:52,080 --> 00:51:54,880 -- WHAT -- WHAT BOTHERS ME ABOUT 1126 00:51:54,880 --> 00:51:58,440 IT IS THAT IT IS PERSISTENT. 1127 00:51:58,440 --> 00:51:59,000 OKAY? 1128 00:51:59,000 --> 00:51:59,920 >>RIGHT. 1129 00:51:59,920 --> 00:52:01,560 >>IT -- IT CYCLES. 1130 00:52:01,560 --> 00:52:03,560 IN OTHER WORDS, SOMETIMES, YOU 1131 00:52:03,560 --> 00:52:06,720 KNOW, YOU GET OVER IT. WE -- WE 1132 00:52:06,720 --> 00:52:11,200 -- I REMEMBER TALKING ABOUT DRUG 1133 00:52:11,200 --> 00:52:15,040 SHORTAGE PROBLEM PROBABLY 10 1134 00:52:15,040 --> 00:52:16,240 YEARS AGO. 1135 00:52:16,240 --> 00:52:18,600 WE HAVE NOT -- IT REQUIRES IN 1136 00:52:18,600 --> 00:52:20,800 THE LONG RUN, I -- YOU KNOW, I'M 1137 00:52:20,800 --> 00:52:23,000 NOT AN EXPERT IN THIS AREA. 1138 00:52:23,000 --> 00:52:25,680 SEEMS TO ME THAT IT REQUIRES 1139 00:52:25,680 --> 00:52:26,280 STRUCTURAL CHANGE. 1140 00:52:26,280 --> 00:52:28,240 >>FOR SURE. I DIDN'T KNOW IF 1141 00:52:28,240 --> 00:52:30,400 THERE WAS ANYTHING THAT WE AS A 1142 00:52:30,400 --> 00:52:31,560 COLLECTIVE COULD DO. 1143 00:52:31,560 --> 00:52:32,400 >>YEAH. 1144 00:52:32,400 --> 00:52:34,680 >>AND SUBMIT THAT. ANNIE, WERE 1145 00:52:34,680 --> 00:52:36,280 YOU GOING TO SAY SOMETHING? 1146 00:52:36,280 --> 00:52:38,680 >>SURE. YOU COULD -- YOU KNOW, 1147 00:52:38,680 --> 00:52:41,800 I MEAN, YOU -- YOU COULD -- AMY, 1148 00:52:41,800 --> 00:52:44,800 WHY DON'T YOU HELP ME OUT HERE. 1149 00:52:44,800 --> 00:52:48,040 WHAT WOULD BE APPROPRIATE? 1150 00:52:48,040 --> 00:52:51,080 >>YEAH. SO, JOY, HAPPY TO KEEP 1151 00:52:51,080 --> 00:52:52,800 TALKING TO YOU GUYS. 1152 00:52:52,800 --> 00:52:55,160 AS DOUG WAS ELUDING TO, THIS IS 1153 00:52:55,160 --> 00:52:56,880 A PERSISTENT ISSUE. 1154 00:52:56,880 --> 00:52:57,360 >>SURE. 1155 00:52:57,360 --> 00:52:58,800 >>AND ONE THAT WE TALKED ABOUT 1156 00:52:58,800 --> 00:53:00,800 10 YEARS AGO THAT I THINK IS -- 1157 00:53:00,800 --> 00:53:02,680 YOU KNOW, IT DOESN'T FALL 1158 00:53:02,680 --> 00:53:04,920 SQUARELY ON NCI TO FIX. THIS IS 1159 00:53:04,920 --> 00:53:06,440 SOMETHING ACROSS -- I THINK THAT 1160 00:53:06,440 --> 00:53:08,080 IS WHY WE DON'T HAVE A 1161 00:53:08,080 --> 00:53:10,040 PARTICULAR ASK OF YOU GUYS AND 1162 00:53:10,040 --> 00:53:11,240 THINK THAT REPRESENTING PATIENTS 1163 00:53:11,240 --> 00:53:12,960 IN THE DISCUSSION AND, YOU KNOW, 1164 00:53:12,960 --> 00:53:15,080 MANY ADVOCATES WORK WITH US AND 1165 00:53:15,080 --> 00:53:17,400 WITH FDA AND WORK ACROSS 1166 00:53:17,400 --> 00:53:19,200 GOVERNMENT AND WORK WITH 1167 00:53:19,200 --> 00:53:19,880 PHARMACEUTICAL COMPANIES AND WHY 1168 00:53:19,880 --> 00:53:22,840 I THINK YOU ARE IN A UNIQUE 1169 00:53:22,840 --> 00:53:23,120 POSITION. 1170 00:53:23,120 --> 00:53:26,240 YOU CAN HELP TO CONNECT THE DOTS 1171 00:53:26,240 --> 00:53:28,760 ACROSS -- YOU KNOW, MORE THAN 1172 00:53:28,760 --> 00:53:30,880 JUST MORE THAN ONE INSTITUTE OR 1173 00:53:30,880 --> 00:53:32,880 AGENCY, WHICH IS -- WHICH IS 1174 00:53:32,880 --> 00:53:34,440 WHAT WILL BE REQUIRED HERE. IT 1175 00:53:34,440 --> 00:53:36,920 IS A SYSTEMS ISSUE; RIGHT? 1176 00:53:36,920 --> 00:53:40,920 IT IS NOT -- WE TODAY WANTED TO 1177 00:53:40,920 --> 00:53:42,880 LET YOU KNOW HOW IT WAS 1178 00:53:42,880 --> 00:53:44,040 IMPACTING OUR CLINICAL TRIALS 1179 00:53:44,040 --> 00:53:46,280 AND LET YOU KNOW WHAT WE WERE 1180 00:53:46,280 --> 00:53:48,200 HEARING AND WE DON'T HAVE A 1181 00:53:48,200 --> 00:53:50,000 PARTICULAR ASK OF THE ADVOCACY 1182 00:53:50,000 --> 00:53:52,680 COMMUNITY THAT IS SPECIFIC TO 1183 00:53:52,680 --> 00:53:52,840 NC. 1184 00:53:52,840 --> 00:53:53,040 BY : 1185 00:53:53,040 --> 00:53:54,760 >>IF I COULD COMMENT AND IF I 1186 00:53:54,760 --> 00:53:57,360 STEP OUT OF BOUNDS, PLEASE STOP 1187 00:53:57,360 --> 00:53:57,880 ME 1188 00:53:57,880 --> 00:54:00,280 BUT, YOU KNOW, IN THIS BODY OF 1189 00:54:00,280 --> 00:54:03,520 WORK, YOU KNOW, WE ARE -- BEING 1190 00:54:03,520 --> 00:54:06,320 SPECIAL GOVERNMENT EMPLOYEES, WE 1191 00:54:06,320 --> 00:54:08,280 CANNOT, YOU KNOW, LOBBY THE 1192 00:54:08,280 --> 00:54:11,920 GOVERNMENT AND IN ITS OFFICIAL 1193 00:54:11,920 --> 00:54:12,160 CAPACITY. 1194 00:54:12,160 --> 00:54:13,120 THERE ARE PROFESSIONAL 1195 00:54:13,120 --> 00:54:14,800 ORGANIZATIONS AND ADVOCACY 1196 00:54:14,800 --> 00:54:17,800 ORGANIZATIONS THAT HAVE BEEN 1197 00:54:17,800 --> 00:54:20,280 INVOLVED IN DIFFERENT ASPECTS OF 1198 00:54:20,280 --> 00:54:22,440 ADDRESSING THE DRUG SHORTAGE AT 1199 00:54:22,440 --> 00:54:23,440 DIFFERENT LEVELS. 1200 00:54:23,440 --> 00:54:26,520 AND, YOU KNOW, WE CAN -- YOU 1201 00:54:26,520 --> 00:54:28,160 KNOW, WE CAN PERHAPS OFFLINE AND 1202 00:54:28,160 --> 00:54:30,560 OUTSIDE OF THE MEETING WE CAN 1203 00:54:30,560 --> 00:54:32,280 KIND OF CONNECT EVERYBODY WITH 1204 00:54:32,280 --> 00:54:37,200 OPPORTUNITIES INCLUDING A MAJOR 1205 00:54:37,200 --> 00:54:39,440 ONCOLOGY MEDICAL GROUP WHO HAS A 1206 00:54:39,440 --> 00:54:42,640 PAGE -- YOU KNOW, AN ACTION PAGE 1207 00:54:42,640 --> 00:54:44,160 AND THINGS TO DO. 1208 00:54:44,160 --> 00:54:46,440 ONE THING I WOULD LIKE TO POINT 1209 00:54:46,440 --> 00:54:48,920 OUT FROM THE PATIENT AND 1210 00:54:48,920 --> 00:54:51,680 RESEARCH ADVOCATE, YOU KNOW, 1211 00:54:51,680 --> 00:54:52,760 PERSPECTIVE HERE. WE HAVE TWO 1212 00:54:52,760 --> 00:54:54,360 THINGS KIND OF THAT WE HAVE TO 1213 00:54:54,360 --> 00:54:55,080 KEEP IN MIND. 1214 00:54:55,080 --> 00:54:57,200 THERE IS A CRISIS THAT WE 1215 00:54:57,200 --> 00:54:58,720 BELIEVE IS -- WHICH I'M HEARING 1216 00:54:58,720 --> 00:55:01,800 IS GOING TO BE A MATTER OF 6 TO 1217 00:55:01,800 --> 00:55:02,120 8 MONTHS. 1218 00:55:02,120 --> 00:55:03,160 YOU KNOW? 1219 00:55:03,160 --> 00:55:07,400 IT IS, YOU KNOW, A SHORT-TERM 1220 00:55:07,400 --> 00:55:09,440 CRISIS. TO SOMEBODY GETTING 1221 00:55:09,440 --> 00:55:11,160 CHEMOTHERAPY, THAT MIGHT BE, YOU 1222 00:55:11,160 --> 00:55:13,400 KNOW, THEIR PROGNOSIS. IT IS 1223 00:55:13,400 --> 00:55:16,240 NOT A SHORT-TERM CRISIS BUT IS 1224 00:55:16,240 --> 00:55:17,240 IMMEDIATE AND IS MORE URGENT 1225 00:55:17,240 --> 00:55:20,240 THAN THAT. YOU KNOW, ONCE THE 1226 00:55:20,240 --> 00:55:23,200 OUTRAGE KIND OF SUBSIDES FROM 1227 00:55:23,200 --> 00:55:26,920 THIS -- WHEN THIS CRISIS, WE 1228 00:55:26,920 --> 00:55:29,160 KIND OF GET PASSED IT, WE NEED 1229 00:55:29,160 --> 00:55:31,280 TO REALLY KEEP THE FEET TO THE 1230 00:55:31,280 --> 00:55:33,840 FIRE ON LONG-TERM SOLUTIONS. 1231 00:55:33,840 --> 00:55:36,280 SO, THAT OUR CLINICAL TRIAL AT 1232 00:55:36,280 --> 00:55:38,840 NCI ARE NOT ENDANGERED AS WELL 1233 00:55:38,840 --> 00:55:40,840 AS, YOU KNOW, PATIENTS. 1234 00:55:40,840 --> 00:55:43,320 I THANK YOU, DR. LOWY, FOR 1235 00:55:43,320 --> 00:55:44,920 SHOWING THE -- YOU KNOW, THE 1236 00:55:44,920 --> 00:55:46,880 IMPACT OF THE SHORTAGE ON THE 1237 00:55:46,880 --> 00:55:48,320 RESEARCH THAT IS HAPPENING IN 1238 00:55:48,320 --> 00:55:50,040 THE OPEN CLINICAL TRIALS THAT I 1239 00:55:50,040 --> 00:55:51,800 THINK IS THAT -- I DON'T KNOW 1240 00:55:51,800 --> 00:55:53,920 THAT EVERYBODY HAS THAT 1241 00:55:53,920 --> 00:55:54,480 INFORMATION QUITE YET. 1242 00:55:54,480 --> 00:55:56,960 AND YES. WE SHOULD BE RIOTING 1243 00:55:56,960 --> 00:55:58,600 IN THE STREETS. 1244 00:55:58,600 --> 00:56:01,560 BUT, NOT UNDER THIS HAT. 1245 00:56:01,560 --> 00:56:01,880 OKAY. 1246 00:56:01,880 --> 00:56:03,360 >>I WASN'T IMPLYING THAT. 1247 00:56:03,360 --> 00:56:03,840 >>YEAH. 1248 00:56:03,840 --> 00:56:05,520 >>I WAS ASKING IS THERE 1249 00:56:05,520 --> 00:56:07,440 SOMETHING WE COULD -- IS IT A 1250 00:56:07,440 --> 00:56:09,480 STATEMENT VERSUS LOBBY? IS 1251 00:56:09,480 --> 00:56:10,840 THERE DIFFERENT WAYS? 1252 00:56:10,840 --> 00:56:13,200 WE CAN TALK ABOUT IT LATER BUT 1253 00:56:13,200 --> 00:56:16,400 WANTED TO POSE THE QUESTION. 1254 00:56:16,400 --> 00:56:17,800 >>YEAH HELPFUL. 1255 00:56:17,800 --> 00:56:19,480 >>VICKY, DID YOU HAVE SOMETHING 1256 00:56:19,480 --> 00:56:20,080 TO ADD? 1257 00:56:20,080 --> 00:56:25,840 >>I DID. TO AMY'S POINT, I 1258 00:56:25,840 --> 00:56:27,760 [AUDIO BREAKING UP]. 1259 00:56:27,760 --> 00:56:31,240 WITH SOME OF OUR SPECIALIZED 1260 00:56:31,240 --> 00:56:33,760 BUSINESS SCHOOL COLLEAGUES IN 1261 00:56:33,760 --> 00:56:35,120 STRATEGY. I BELIEVE THAT THERE 1262 00:56:35,120 --> 00:56:38,200 WAS ACTUALLY A PRETTY MAJOR 1263 00:56:38,200 --> 00:56:41,520 SHIFT IN THE ORGANIZATION OF THE 1264 00:56:41,520 --> 00:56:43,680 PHARMACEUTICAL COMPANIES AROUND 1265 00:56:43,680 --> 00:56:45,520 GENERICS ABOUT FIFTEEN YEARS 1266 00:56:45,520 --> 00:56:45,720 AGO. 1267 00:56:45,720 --> 00:56:48,560 I'M NOT A SPECIALIST IN THIS 1268 00:56:48,560 --> 00:56:52,320 AREA AND CONSULTING WITH WHAT 1269 00:56:52,320 --> 00:56:54,200 HAPPENED GLOBALLY IN THE 1270 00:56:54,200 --> 00:56:57,160 INDUSTRY THAT LED TO THE 1271 00:56:57,160 --> 00:56:59,560 NARROWING OF THE APERTURE WHAT 1272 00:56:59,560 --> 00:57:00,920 HAPPENS WITH GENERIC DRUG 1273 00:57:00,920 --> 00:57:02,080 MANUFACTURING THAT PROBABLY 1274 00:57:02,080 --> 00:57:04,560 WOULD BE VERY INFORMATIVE TO 1275 00:57:04,560 --> 00:57:08,000 UNDERSTAND WHAT THE POLICY 1276 00:57:08,000 --> 00:57:10,360 SOLUTIONS MIGHT BE. 1277 00:57:10,360 --> 00:57:13,800 >>THANK YOU, VICKY. THAT IS 1278 00:57:13,800 --> 00:57:15,920 VERY HELPFUL. MARTY, YOUR HAND 1279 00:57:15,920 --> 00:57:16,640 IS UP? 1280 00:57:16,640 --> 00:57:18,720 >>YES, IT IS. 1281 00:57:18,720 --> 00:57:21,600 THANK YOU, DR. LOWY, FOR A 1282 00:57:21,600 --> 00:57:24,280 REALLY THOROUGH PRESENTATION. I 1283 00:57:24,280 --> 00:57:24,880 APPRECIATED THAT. 1284 00:57:24,880 --> 00:57:27,120 MY QUESTION HAS TO DO WITH THE 1285 00:57:27,120 --> 00:57:29,280 GOAL -- ONE OF THE GOALS OF THE 1286 00:57:29,280 --> 00:57:31,840 CANCER MOONSHOT THAT IS TO 1287 00:57:31,840 --> 00:57:33,200 OVERCOME HEALTH DISPARITIES THAT 1288 00:57:33,200 --> 00:57:35,240 IS A BIG ISSUE FOR ME. 1289 00:57:35,240 --> 00:57:37,320 THE EXAMPLE I WOULD LIKE TO USE 1290 00:57:37,320 --> 00:57:40,960 IS WE KNOW THAT BLACK MEN DIE OF 1291 00:57:40,960 --> 00:57:43,800 PROSTATE CANCER AT MORE THAN 1292 00:57:43,800 --> 00:57:47,160 TWICE THE RATE OF THE REST OF 1293 00:57:47,160 --> 00:57:47,520 THE POPULATION. 1294 00:57:47,520 --> 00:57:50,840 IN MY VIEW, THAT IS NOT 1295 00:57:50,840 --> 00:57:52,760 NECESSARILY A RESEARCH ISSUE BUT 1296 00:57:52,760 --> 00:57:54,760 HEALTH DELIVERY ISSUE. 1297 00:57:54,760 --> 00:57:56,720 WE KNOW WHEN BLACK MEN GET 1298 00:57:56,720 --> 00:57:58,560 TREATMENT, FOR EXAMPLE, THROUGH 1299 00:57:58,560 --> 00:58:00,960 THE VA WHERE THEY HAVE EQUAL 1300 00:58:00,960 --> 00:58:02,560 ACCESS TO CARE AND EQUAL 1301 00:58:02,560 --> 00:58:05,760 OPPORTUNITY TO PARTICIPATE IN 1302 00:58:05,760 --> 00:58:06,520 CLINICAL TRIALS. 1303 00:58:06,520 --> 00:58:09,080 COST BARRIERS ARE REMOVED, ET 1304 00:58:09,080 --> 00:58:12,000 CETERA, ET CETERA. 1305 00:58:12,000 --> 00:58:14,200 OUTCOMES FOR BLACK MEN AND WHITE 1306 00:58:14,200 --> 00:58:16,000 WOMEN ARE THE SAME AND REALIZE 1307 00:58:16,000 --> 00:58:19,880 IT IS NOT PRIMARY PURPOSE OF THE 1308 00:58:19,880 --> 00:58:23,600 NCI TO CHANGE THE WHOLE ECONOMIC 1309 00:58:23,600 --> 00:58:26,640 STRUCTURE AND HEALTH CARE 1310 00:58:26,640 --> 00:58:27,520 DELIVERY STRUCTURE IN THE 1311 00:58:27,520 --> 00:58:29,200 COUNTRY AND WONDERING IF THINGS 1312 00:58:29,200 --> 00:58:32,000 THAT NCI CAN DO OR WE CAN DO TO 1313 00:58:32,000 --> 00:58:34,360 HELP MOVE FORWARD WITH 1314 00:58:34,360 --> 00:58:35,280 ELIMINATING SOME OF THESE -- 1315 00:58:35,280 --> 00:58:37,160 SOME OF THE BARRIERS AND 1316 00:58:37,160 --> 00:58:41,160 OVERCOMING SOME OF THE 1317 00:58:41,160 --> 00:58:42,160 HEALTHCARE DISPARITIES. 1318 00:58:42,160 --> 00:58:47,000 >>SO, MARTY, THIS IS NOT AN NCI 1319 00:58:47,000 --> 00:58:48,280 POSITION, OKAY? 1320 00:58:48,280 --> 00:58:52,040 WHAT I AM GOING TO SAY. 1321 00:58:52,040 --> 00:58:55,720 BUT A BIG ADVANTAGE OF THE 1322 00:58:55,720 --> 00:58:59,320 CANCER MOONSHOT IS THAT GOAL BUT 1323 00:58:59,320 --> 00:59:04,000 A COMPLEMENTARY PART OF IT IS 1324 00:59:04,000 --> 00:59:06,560 WHAT THE BIDEN ADMINISTRATION 1325 00:59:06,560 --> 00:59:10,640 CALLS AN ALL OF GOVERNMENT 1326 00:59:10,640 --> 00:59:11,280 APPROACH. 1327 00:59:11,280 --> 00:59:14,440 SO, AND, YOU KNOW, FOR BETTER OR 1328 00:59:14,440 --> 00:59:18,960 WORSE, CANCER IS PREDOMINANTLY A 1329 00:59:18,960 --> 00:59:22,400 DISEASE OF OLDER PEOPLE, WHICH 1330 00:59:22,400 --> 00:59:26,760 MEANS THAT MEDICARE HAS A 1331 00:59:26,760 --> 00:59:29,560 DISPROPORTIONATE INFLUENCE AND 1332 00:59:29,560 --> 00:59:32,640 IMPACT ON WHAT ENDS UP GETTING 1333 00:59:32,640 --> 00:59:37,200 REIMBURSED AND HOW IT ENDS UP 1334 00:59:37,200 --> 00:59:38,720 GETTING REIMBURSED, ET CETERA. 1335 00:59:38,720 --> 00:59:44,400 SO, IT WOULD SEEM TO ME THAT 1336 00:59:44,400 --> 00:59:46,240 WHATEVER -- IF THERE ARE, IF YOU 1337 00:59:46,240 --> 00:59:52,360 WILL, ACCESS ISSUES STRUCTURAL 1338 00:59:52,360 --> 00:59:58,400 ISSUES THAT THE GOVERNMENT IN 1339 00:59:58,400 --> 01:00:01,000 PRINCIPLE IS POISED TO TRY TO 1340 01:00:01,000 --> 01:00:04,040 IMPROVE THE SITUATION REGARDLESS 1341 01:00:04,040 --> 01:00:05,440 WHAT AGENCY YOU ARE IN, ABOUT 1342 01:00:05,440 --> 01:00:11,120 YOU WHEN IT COMES TO POLICY, YOU 1343 01:00:11,120 --> 01:00:15,080 KNOW, CMS CAN'T RECOMMEND THINGS 1344 01:00:15,080 --> 01:00:16,920 THAT ARE NOT APPROVED BUT CAN DO 1345 01:00:16,920 --> 01:00:23,880 -- THEY PROBABLY HAVE A FAIR 1346 01:00:23,880 --> 01:00:27,480 AMOUNT OF LATITUDE WITH STANDARD 1347 01:00:27,480 --> 01:00:37,200 OF CARE AND HOW TO APPLY IT. 1348 01:00:37,200 --> 01:00:47,440 >>THANK YOU. 1349 01:00:49,240 --> 01:00:52,920 >>-- 1350 01:00:52,920 --> 01:00:56,520 >>IF WE CAN MOVE ONL TO ANOTHER 1351 01:00:56,520 --> 01:00:58,000 TOPIC WILL TRIALS INCLUDE 1352 01:00:58,000 --> 01:01:00,800 CHILDREN WITH CANCER? 1353 01:01:00,800 --> 01:01:06,600 >>YES, I HAVE -- 1354 01:01:06,600 --> 01:01:08,040 >>I DIDN'T MENTION THAT. 1355 01:01:08,040 --> 01:01:12,880 >>SORRY MATCH TRIAL HAD A 1356 01:01:12,880 --> 01:01:15,240 SEPARATE TRIAL THAT IS PEDIATRIC 1357 01:01:15,240 --> 01:01:19,480 MATCH AND MY UNDERSTANDING IS 1358 01:01:19,480 --> 01:01:22,840 COME BOW MATCH WILL BE PRETTY 1359 01:01:22,840 --> 01:01:26,120 MUCH FOR OLD COMERS. 1360 01:01:26,120 --> 01:01:29,520 >>JACK HOLD US YESTERDAY IN 1361 01:01:29,520 --> 01:01:30,760 ATLANTA THERE WAS -- I 1362 01:01:30,760 --> 01:01:33,640 APPRECIATE YOU STANDING UP FOR 1363 01:01:33,640 --> 01:01:36,080 KIDS AND DIDN'T KNOW WHAT TO SAY 1364 01:01:36,080 --> 01:01:37,720 AND ALREADY HEARD THE BLUSH. 1365 01:01:37,720 --> 01:01:39,600 >>YOU HAD INSIDE INFORMATION. 1366 01:01:39,600 --> 01:01:45,040 >>YOU HAD THE BLUSH. THAT IS 1367 01:01:45,040 --> 01:01:46,040 FANTASTIC. 1368 01:01:46,040 --> 01:01:47,680 I THINK IT IS A REALLY. 1369 01:01:47,680 --> 01:01:51,840 >>LET ME SAY THAT VICKY 1370 01:01:51,840 --> 01:01:54,880 REMINDED ME WE WORK CLOSELY ON 1371 01:01:54,880 --> 01:02:01,880 FDA ON THESE TRIALS AND JEFF IS 1372 01:02:01,880 --> 01:02:12,160 PART OF THIS -- 1373 01:02:19,760 --> 01:02:22,120 >>THAT IS BETTER FOR PATIENTS 1374 01:02:22,120 --> 01:02:23,720 AND FOR RARE CANCERS THAT DON'T 1375 01:02:23,720 --> 01:02:25,840 HAVE A LOT OF, YOU KNOW, BIG 1376 01:02:25,840 --> 01:02:26,880 TRIALS GOING ON. 1377 01:02:26,880 --> 01:02:27,400 >>YEAH. 1378 01:02:27,400 --> 01:02:30,440 >>I MEAN, THIS IS LIKE -- 1379 01:02:30,440 --> 01:02:32,400 >>ANOTHER FEATURE OF THE MATCH 1380 01:02:32,400 --> 01:02:37,160 TRIAL WAS THAT IF THERE WAS A 1381 01:02:37,160 --> 01:02:40,880 POSITIVE SIGNAL THAT WAS 1382 01:02:40,880 --> 01:02:44,200 PREDETERMINED PERCENT OF 1383 01:02:44,200 --> 01:02:50,720 RESPONSES THAT YOU COULD EXPAND 1384 01:02:50,720 --> 01:02:51,280 THE ARM. 1385 01:02:51,280 --> 01:02:51,760 >>OH. 1386 01:02:51,760 --> 01:02:55,320 >>YOU DIDN'T HAVE TO MAKE A NEW 1387 01:02:55,320 --> 01:02:55,720 TRIAL. 1388 01:02:55,720 --> 01:02:58,880 >>EXPANSION OF THE ARM WAS 1389 01:02:58,880 --> 01:02:59,760 SEMIAUTOMATIC AND MEANT THAT YOU 1390 01:02:59,760 --> 01:03:02,240 -- IT WAS ANOTHER WAY TRYING TO 1391 01:03:02,240 --> 01:03:12,720 STREAMLINE THINGS. OKAY? 1392 01:03:13,000 --> 01:03:14,960 >>ABSOLUTELY. WHEN WE THINK 1393 01:03:14,960 --> 01:03:18,080 HOW MUCH IT COSTS TO ADMINISTER 1394 01:03:18,080 --> 01:03:22,240 A TRIAL I'M EXCITED TO HAVE 1395 01:03:22,240 --> 01:03:23,000 CONVERSATION WITH THEM AS WELL. 1396 01:03:23,000 --> 01:03:25,800 >>I WAS GOING TO SAY HEARING 1397 01:03:25,800 --> 01:03:28,200 FROM HER ABOUT THE INNOVATION 1398 01:03:28,200 --> 01:03:29,440 CENTER WILL BE VERY INTERESTING 1399 01:03:29,440 --> 01:03:36,720 FOR YOU. OKAY? 1400 01:03:36,720 --> 01:03:40,640 >>ANYONE ELSE HAVE THOUGHTS OR 1401 01:03:40,640 --> 01:03:41,160 QUESTIONS? 1402 01:03:41,160 --> 01:03:45,160 >>YOU GO BACK TO YOUR EARLIER 1403 01:03:45,160 --> 01:03:46,800 PRESENTATION AROUND REDUCING 1404 01:03:46,800 --> 01:03:51,320 MORTALITY BY 50% IN THE NEXT 25 1405 01:03:51,320 --> 01:03:53,800 YEARS BEING CANCER MOONSHOTS 1406 01:03:53,800 --> 01:03:56,240 GOAL. THERE IS A NUANCE; RIGHT? 1407 01:03:56,240 --> 01:03:59,640 YOU ARE NOT SAYING WE WILL CURE 1408 01:03:59,640 --> 01:04:02,200 CANCER BUT REDUCE CANCER 1409 01:04:02,200 --> 01:04:04,440 MORTALITY RATE AND SOME CANCER 1410 01:04:04,440 --> 01:04:08,240 CAN BE CURED AND OTHERS ARE 1411 01:04:08,240 --> 01:04:10,400 NONCURABLE CANCER CAN BECOME 1412 01:04:10,400 --> 01:04:11,760 MORE CONIC IF YOU WOULD AND IF 1413 01:04:11,760 --> 01:04:15,480 YOU CAN COMMENT ON THAT AND ONE 1414 01:04:15,480 --> 01:04:19,560 RELATED ALSO TO THAT RATE OF 1415 01:04:19,560 --> 01:04:20,920 DECLINE OF DAYS TODAY I THINK 1416 01:04:20,920 --> 01:04:23,880 YOU MENTIONED WAS 2.3% THAT YOU 1417 01:04:23,880 --> 01:04:31,600 WANT TO GO TO 2.7% TO ACHIEVE A 1418 01:04:31,600 --> 01:04:35,080 50% RATE IS THERE TIMELINE FOR 1419 01:04:35,080 --> 01:04:41,000 URGENCY GOING 2.TLOO HE TO 2.7% 1420 01:04:41,000 --> 01:04:43,480 THAT WILL DECLINE? 1421 01:04:43,480 --> 01:04:46,560 >>DR. SHIELS WILL BE TALKING 1422 01:04:46,560 --> 01:04:53,600 AFTER ME, YOU KNOW, IS THE 1423 01:04:53,600 --> 01:04:56,960 EXP 1424 01:04:56,960 --> 01:04:57,200 EXPERT. 1425 01:04:57,200 --> 01:04:59,600 THE LONGER YOU ARE A 2.3, SAY 1426 01:04:59,600 --> 01:05:02,080 YOU ARE 2.3 FOR FIRST IT ENTO 15 1427 01:05:02,080 --> 01:05:04,840 YEARS AND DOING 2.7 FOR THE NEXT 1428 01:05:04,840 --> 01:05:08,920 10 OR 15 YEARS WON'T ACHIEVE IT. 1429 01:05:08,920 --> 01:05:12,080 YOU WILL NEED TO DO THREE. YOU 1430 01:05:12,080 --> 01:05:13,800 KNOW, OR SOMETHING LIKE THAT. 1431 01:05:13,800 --> 01:05:17,520 SO, THE SOONER THAT YOU CAN GET 1432 01:05:17,520 --> 01:05:25,120 TO 2.7, THE EASIER, IF YOU WILL, 1433 01:05:25,120 --> 01:05:26,920 IT WOULD BE. 1434 01:05:26,920 --> 01:05:30,120 BUT ONE OF THE GOALS OF THE 1435 01:05:30,120 --> 01:05:32,240 CANCER MOONSHOT IS WHAT 1436 01:05:32,240 --> 01:05:34,480 PRESIDENT BIDEN REFERS TO AS 1437 01:05:34,480 --> 01:05:38,240 QUOTE END CANCER AS WE KNOW IT 1438 01:05:38,240 --> 01:05:39,600 FOR ALL. 1439 01:05:39,600 --> 01:05:43,040 OUR INTERPRETATION IS THAT WE 1440 01:05:43,040 --> 01:05:50,000 ARE -- THIS MEANS THAT WE NEED 1441 01:05:50,000 --> 01:05:56,760 TO DO FOR CANCERS WHERE THERE 1442 01:05:56,760 --> 01:05:59,000 HASN'T BEEN MUCH ADVANCE FOR 1443 01:05:59,000 --> 01:06:02,160 EXAMPLE FOR PANCREATIC CANCER OR 1444 01:06:02,160 --> 01:06:05,320 GLEO BLASTOMAS OR RARE PEDIATRIC 1445 01:06:05,320 --> 01:06:08,400 CANCER WHERE'S WE HAVEN'T BEEN 1446 01:06:08,400 --> 01:06:10,720 ABLE TO REALLY CHANGE THE 1447 01:06:10,720 --> 01:06:12,240 OUTLOOK. WE HAVE TO BE ABLE TO 1448 01:06:12,240 --> 01:06:13,920 DO THAT AND YOU ARE NOT -- 1449 01:06:13,920 --> 01:06:16,000 ENDING CANCER AS WE KNOW IT 1450 01:06:16,000 --> 01:06:17,080 DOESN'T MEAN THAT NOBODY WILL 1451 01:06:17,080 --> 01:06:19,360 GET CANCER. 1452 01:06:19,360 --> 01:06:22,840 HOPEFULLY IT MEANS THAT EVERYONE 1453 01:06:22,840 --> 01:06:27,360 WHO GETS CANCER HAS THE 1454 01:06:27,360 --> 01:06:28,520 POSSIBILITY OF AN INTERVENTION 1455 01:06:28,520 --> 01:06:31,960 THAT IS REALLY GOING TO BENEFIT 1456 01:06:31,960 --> 01:06:37,200 THEM. THAT THEY ARE -- THEIR 1457 01:06:37,200 --> 01:06:38,240 OUTLOOK WILL BE BETTER EVEN FOR 1458 01:06:38,240 --> 01:06:40,400 THOSE CANCERS WHERE WE HAVEN'T 1459 01:06:40,400 --> 01:06:44,080 MADE THAT KIND OF PROGRESS TO 1460 01:06:44,080 --> 01:06:49,200 DATE. OKAY? 1461 01:06:49,200 --> 01:06:52,240 I WILL GIVE YOU A EXAMPLE I'M 1462 01:06:52,240 --> 01:06:53,360 PERSONALLY EXCITED ABOUT THAT IS 1463 01:06:53,360 --> 01:06:58,080 THE RAS INHIBITORS THAT ARE NOW 1464 01:06:58,080 --> 01:07:01,240 ENTERING EARLY-PHASE TRIALS FOR 1465 01:07:01,240 --> 01:07:03,000 PANCREATIC CANCER. 1466 01:07:03,000 --> 01:07:05,720 10 YEARS AGO, RAS, WHICH IS 1467 01:07:05,720 --> 01:07:08,400 MUTATED IN LOTS OF CANCERS AND 1468 01:07:08,400 --> 01:07:16,200 ESPECIALLY IN PANCREATIC CANCER 1469 01:07:16,200 --> 01:07:19,320 WAS FELT TO BE AN UNDRUGGABLE 1470 01:07:19,320 --> 01:07:22,800 PROTEIN. ADVANCES LED TO FDA 1471 01:07:22,800 --> 01:07:26,080 APPROVAL IN TWO YEARS AGO FOR A 1472 01:07:26,080 --> 01:07:28,240 PARTICULAR RAS MUTATION COMMON 1473 01:07:28,240 --> 01:07:33,160 IN LUNG CANCER THAT IS APPROVED 1474 01:07:33,160 --> 01:07:35,680 FOR TREATMENTS OF LUNG CANCER 1475 01:07:35,680 --> 01:07:37,160 AND PARTICULAR MUTATION IS 1476 01:07:37,160 --> 01:07:40,000 UNCOMMON IN PANCREATIC CANCER 1477 01:07:40,000 --> 01:07:42,960 AND NOW ARE SEVERAL DRUG 1478 01:07:42,960 --> 01:07:46,080 COMPANIES DEVELOPING INHIBITORS 1479 01:07:46,080 --> 01:07:50,040 FOR RAS MUTATIONS COMMON IN 1480 01:07:50,040 --> 01:07:52,880 PANCREATIC CANCER THAT IN 1481 01:07:52,880 --> 01:07:53,840 PRECLINICAL STUDIES SUGGEST THAT 1482 01:07:53,840 --> 01:07:56,240 IT COULD -- THESE INHIBITORS 1483 01:07:56,240 --> 01:07:58,360 MIGHT BE HELPFUL THAT HAVE NOT 1484 01:07:58,360 --> 01:08:00,560 YET BEEN DEMONSTRATED. EARLY 1485 01:08:00,560 --> 01:08:02,240 PHASE TRIALS ARE JUST STARTING 1486 01:08:02,240 --> 01:08:04,520 AND THIS WOULD BE -- YOU KNOW, 1487 01:08:04,520 --> 01:08:07,200 THIS WOULD BE -- YOU KNOW, THIS 1488 01:08:07,200 --> 01:08:09,520 WOULD BE A POSSIBLE EXAMPLE OF 1489 01:08:09,520 --> 01:08:15,400 HOW AN AREA WHERE WE HAVE NOT 1490 01:08:15,400 --> 01:08:18,320 MADE MAJOR ADVANCES MIGHT BE 1491 01:08:18,320 --> 01:08:20,640 ABLE TO REALLY CHANGE. OKAY? 1492 01:08:20,640 --> 01:08:23,000 AND I'M NOT TRYING TO -- I MEAN, 1493 01:08:23,000 --> 01:08:25,200 IT WOULD BE GREAT. YOU KNOW, 1494 01:08:25,200 --> 01:08:29,840 FOR EXAMPLE, IF WE HAD CANCERS 1495 01:08:29,840 --> 01:08:34,240 WHERE WE COULD DO PREVENTION OR 1496 01:08:34,240 --> 01:08:36,080 SCREENING AND MENTIONED ANOTHER 1497 01:08:36,080 --> 01:08:41,320 AREA OF SCREENING WHICH IS FOR 1498 01:08:41,320 --> 01:08:43,960 ANAL CANCER AMONG HIV POSITIVE 1499 01:08:43,960 --> 01:08:46,920 PEOPLE AND A YEAR AGO A LARGE 1500 01:08:46,920 --> 01:08:49,160 MULTICENTERED TRIAL WAS 1501 01:08:49,160 --> 01:08:55,440 CONDUCTED THAT SHOWED THAT IF 1502 01:08:55,440 --> 01:09:00,240 THOSE PEOPLE HAD HIGH DISPLASIA 1503 01:09:00,240 --> 01:09:02,240 PEOPLE IN THE TRIAL THAT 1504 01:09:02,240 --> 01:09:04,840 TREATMENT OF THAT DYSPLASIA LED 1505 01:09:04,840 --> 01:09:08,120 TO DRAMATIC DECREASE IN RATE OF 1506 01:09:08,120 --> 01:09:10,240 PROGRESSION TO INVASIVE ANAL 1507 01:09:10,240 --> 01:09:12,280 CANCER. THIS IS AN AREA OF 1508 01:09:12,280 --> 01:09:13,920 SCREENING THAT IS NOT YET 1509 01:09:13,920 --> 01:09:15,920 STANDARD OF CARE. BUT, THE 1510 01:09:15,920 --> 01:09:16,960 CENTERS FOR DISEASE CONTROL IS 1511 01:09:16,960 --> 01:09:20,240 IN THE PROCESS AND THEY HAVE 1512 01:09:20,240 --> 01:09:22,200 SAID THIS EXPLICITLY OF 1513 01:09:22,200 --> 01:09:24,760 DEVELOPING GUIDELINES FOR ANAL 1514 01:09:24,760 --> 01:09:28,200 CANCER SCREENING AND THESE ARE 1515 01:09:28,200 --> 01:09:32,040 AREAS WHERE THERE IS POTENTIAL 1516 01:09:32,040 --> 01:09:35,160 FOR ADVANCES AND IS IT 1517 01:09:35,160 --> 01:09:37,440 EVERYTHING? 1518 01:09:37,440 --> 01:09:39,240 NOT YET. 1519 01:09:39,240 --> 01:09:41,600 >>YEAH. I KIND OF HAVE ON THAT 1520 01:09:41,600 --> 01:09:43,920 AND TO CANCER AS WE KNOW IT 1521 01:09:43,920 --> 01:09:47,840 BECAUSE I KIND OF SEE IT AS A 1522 01:09:47,840 --> 01:09:51,000 SLIDING SCALE. YOU KNOW, 1523 01:09:51,000 --> 01:09:53,160 WHEREVER, YOU KNOW, A PATIENT'S 1524 01:09:53,160 --> 01:09:55,680 CURRENT PROGNOSIS OUTLOOK 1525 01:09:55,680 --> 01:09:57,600 QUALITY OF LIFE WILL BE TO JUST 1526 01:09:57,600 --> 01:09:58,880 IMPROVE, YOU KNOW, ACROSS THE 1527 01:09:58,880 --> 01:10:01,840 BOARD AS BEST AS WE CAN. FOR 1528 01:10:01,840 --> 01:10:03,360 SOME PEOPLE, YOU KNOW, WE KNOW 1529 01:10:03,360 --> 01:10:04,920 THAT SOME PEOPLE HAVE REALLY 1530 01:10:04,920 --> 01:10:06,400 GREAT OUTCOMES AND FOR SOME 1531 01:10:06,400 --> 01:10:07,920 PEOPLE LIVING WITH CANCER PIECE 1532 01:10:07,920 --> 01:10:11,480 OF IT IS ACTUALLY A GOOD 1533 01:10:11,480 --> 01:10:11,840 OUTCOME. 1534 01:10:11,840 --> 01:10:15,160 IS IT -- THE NO. 1 DESIRED 1535 01:10:15,160 --> 01:10:17,400 OUTCOME? PROBABLY NOT. 1536 01:10:17,400 --> 01:10:19,440 I THINK THAT WHEN I THOUGHT I 1537 01:10:19,440 --> 01:10:21,520 WAS LIVING WITH CHRONIC CANCER, 1538 01:10:21,520 --> 01:10:23,440 IF THAT WAS ALL THAT WAS ON THE 1539 01:10:23,440 --> 01:10:26,040 TABLE FOR ME, I WANTED AS MUCH 1540 01:10:26,040 --> 01:10:27,960 AS I COULD GET; RIGHT? 1541 01:10:27,960 --> 01:10:30,200 I THINK THAT PHRASEOLOGY, I 1542 01:10:30,200 --> 01:10:33,480 THINK WHEN WE GET, YOU KNOW, SO 1543 01:10:33,480 --> 01:10:35,800 MUCH IS CURE CENTRIC. THAT HAS 1544 01:10:35,800 --> 01:10:37,320 BEEN REALLY HARD TO REACH FOR 1545 01:10:37,320 --> 01:10:39,400 PEOPLE. IF WE CAN MAKE A STEP 1546 01:10:39,400 --> 01:10:40,960 IN THE RIGHT DIRECTION AND FOCUS 1547 01:10:40,960 --> 01:10:45,600 ON OTHER THINGS, I THINK THAT, 1548 01:10:45,600 --> 01:10:49,160 YOU KNOW, PEOPLE BENEFIT IN 1549 01:10:49,160 --> 01:10:51,120 OTHER PLACES AS WELL. 1550 01:10:51,120 --> 01:10:53,440 MY TWO CENTS THERE. IT LOOKS 1551 01:10:53,440 --> 01:10:56,800 LIKE TIME WITH DR. LOWY IS -- WE 1552 01:10:56,800 --> 01:10:59,400 HAVE THREE MINUTES LEFT TO HOLD 1553 01:10:59,400 --> 01:11:02,040 THEM HERE. IF ANY -- IF ANYONE 1554 01:11:02,040 --> 01:11:05,000 HAS ANY OTHER QUESTIONS THAT WE 1555 01:11:05,000 --> 01:11:09,000 WANT TO BRING FORTH, COMMENTS? 1556 01:11:09,000 --> 01:11:10,800 >>THANK YOU, EVERYONE. 1557 01:11:10,800 --> 01:11:14,040 AT LEAST AS MUCH AS FOR YOUR 1558 01:11:14,040 --> 01:11:16,080 COMMENTS AS FOR YOUR QUESTIONS, 1559 01:11:16,080 --> 01:11:16,960 OKAY? 1560 01:11:16,960 --> 01:11:20,680 TERRIFIC SEEING EVERYONE AGAIN. 1561 01:11:20,680 --> 01:11:25,000 YOU ARE GOING -- AMY AND 1562 01:11:25,000 --> 01:11:26,360 COLLEAGUES PUT TOGETHER WITH 1563 01:11:26,360 --> 01:11:28,800 ANNIE'S PARTICIPATION. YOU 1564 01:11:28,800 --> 01:11:30,200 KNOW, WHAT IS REALLY AN 1565 01:11:30,200 --> 01:11:33,360 INTERESTING SET OF DISCUSSIONS 1566 01:11:33,360 --> 01:11:36,600 FOR YOU. 1567 01:11:36,600 --> 01:11:38,160 >>THANK YOU FOR SPENDING SO 1568 01:11:38,160 --> 01:11:40,520 MUCH TIME WITH US AND ON THIS 1569 01:11:40,520 --> 01:11:42,200 WONDERFUL DIALOGUE. WE REALLY 1570 01:11:42,200 --> 01:11:43,400 APPRECIATE IT AND ENJOY THE REST 1571 01:11:43,400 --> 01:11:46,720 OF YOUR DAY. 1572 01:11:46,720 --> 01:11:53,160 OKAY. THAT WAS REALLY GREAT. 1573 01:11:53,160 --> 01:11:56,880 I'M HAPPY TO WELCOME THE NEXT 1574 01:11:56,880 --> 01:11:58,920 SPEAKER DR. SHIELS IS SENIOR 1575 01:11:58,920 --> 01:12:04,200 INVESTIGATOR IN INFECTIONS IN 1576 01:12:04,200 --> 01:12:04,640 IMM 1577 01:12:04,640 --> 01:12:05,200 IMMUNOEPIDEMIOLOGY -- 1578 01:12:05,200 --> 01:12:07,120 EPIDEMIOLOGY AND GENETICS YOU 1579 01:12:07,120 --> 01:12:08,920 HAVE BEEN SET UP REALLY NICELY. 1580 01:12:08,920 --> 01:12:11,440 WE ARE LOOKING FORWARD TO 1581 01:12:11,440 --> 01:12:14,520 HEARING YOUR PRESENTATION ABOUT 1582 01:12:14,520 --> 01:12:15,120 YOUR WORK. 1583 01:12:15,120 --> 01:12:17,200 >>THANK YOU SO MUCH. I HAVE 1584 01:12:17,200 --> 01:12:20,280 BEEN LISTENING THE LAST 15 OR 20 1585 01:12:20,280 --> 01:12:21,160 MINUTES AND EXCITED TO PRESENT 1586 01:12:21,160 --> 01:12:23,520 TO THE GROUP. IT WILL BE NEW TO 1587 01:12:23,520 --> 01:12:27,160 ME AND THANKS FOR THE 1588 01:12:27,160 --> 01:12:27,600 INVITATION. 1589 01:12:27,600 --> 01:12:28,360 NEXT SLIDE, PLEASE. 1590 01:12:28,360 --> 01:12:31,120 >>SO, I WANTED TO START WITH AN 1591 01:12:31,120 --> 01:12:33,440 OVERVIEW OF MY PRESENTATION FOR 1592 01:12:33,440 --> 01:12:33,680 TODAY. 1593 01:12:33,680 --> 01:12:36,160 I WILL BE PRESENTING ON A 1594 01:12:36,160 --> 01:12:38,760 MANUSCRIPT THAT WE RECENTLY 1595 01:12:38,760 --> 01:12:40,440 PUBLISHED IN JOURNAL CANCER 1596 01:12:40,440 --> 01:12:40,760 DISCOVERY. 1597 01:12:40,760 --> 01:12:43,440 THIS PUBLICATION REPRESENTS A 1598 01:12:43,440 --> 01:12:46,000 COLLABORATION BETWEEN PRINCIPLE 1599 01:12:46,000 --> 01:12:48,040 INVESTIGATORS AND IN INTRA MURAL 1600 01:12:48,040 --> 01:12:50,120 PROGRAMS OF THE NATIONAL CANCER 1601 01:12:50,120 --> 01:12:51,800 INSTITUTE AND CENTER FOR CANCER 1602 01:12:51,800 --> 01:12:53,320 RESEARCH AS WELL AS MY DIVISION 1603 01:12:53,320 --> 01:12:55,840 AND DIVISION OF CANCER 1604 01:12:55,840 --> 01:12:59,400 EPIDEMIOLOGY AND GENETICS AND 1605 01:12:59,400 --> 01:13:00,680 THIS PROJECT GREW OUT OF REQUEST 1606 01:13:00,680 --> 01:13:04,480 FROM DR. LOWY TO EXAMINE 1607 01:13:04,480 --> 01:13:06,200 FEASIBILITY OF PRESIDENT BIDEN'S 1608 01:13:06,200 --> 01:13:09,560 CANCER MOONSHOT GOAL. NEXT 1609 01:13:09,560 --> 01:13:10,440 SLIDE, PLEASE. 1610 01:13:10,440 --> 01:13:13,600 AS A REVIEW, CANCER MOONSHOT 1611 01:13:13,600 --> 01:13:15,800 PROGRAM WAS LAUNCHED UNDER 1612 01:13:15,800 --> 01:13:18,040 LEADERSHIP OF THEN VICE 1613 01:13:18,040 --> 01:13:20,120 PRESIDENT JOE BIDEN IN 2016 TO 1614 01:13:20,120 --> 01:13:21,600 SPEED PROGRESS FROM CANCER 1615 01:13:21,600 --> 01:13:25,280 PREVENTION TO SURVIVORSHIP. IN 1616 01:13:25,280 --> 01:13:28,840 2016, 21ST CENTURY CURES ACT 1617 01:13:28,840 --> 01:13:32,120 DEVOTED $1.8 BILLION OVER 7 1618 01:13:32,120 --> 01:13:35,040 YEARS TO CANCER MOONSHOT-DRIVEN 1619 01:13:35,040 --> 01:13:38,280 RESEARCH AT NCI FOCUSING ON 1620 01:13:38,280 --> 01:13:39,400 ACCELERATING SCIENTIFIC 1621 01:13:39,400 --> 01:13:41,280 DISCOVERY FOSTERING GREATER 1622 01:13:41,280 --> 01:13:44,360 COLLABATION AND DATA SHARING. 1623 01:13:44,360 --> 01:13:45,440 NEXT SLIDE, PLEASE. 1624 01:13:45,440 --> 01:13:48,120 JUST ABOUT A YEAR AND A HALF AGO 1625 01:13:48,120 --> 01:13:51,200 ON FEBRUARY 2ND, 2022, PRESIDENT 1626 01:13:51,200 --> 01:13:54,280 BIDEN AND FIRST LADY DR. BIDEN 1627 01:13:54,280 --> 01:13:56,840 REIGNITED THE CANCER MOONSHOT 1628 01:13:56,840 --> 01:13:58,800 LAYING OUT TWO NEW GOALS AND 1629 01:13:58,800 --> 01:14:01,440 FIRST TO REDUCE AGE-STANDARDIZED 1630 01:14:01,440 --> 01:14:04,280 CANCER MORTALITY RATES BY AT 1631 01:14:04,280 --> 01:14:06,480 LEAST 50% OVER THE NEXT 25 YEARS 1632 01:14:06,480 --> 01:14:08,280 AND SECOND AS WE WERE DISCUSSING 1633 01:14:08,280 --> 01:14:09,640 IS TO IMPROVE EXPERIENCE OF 1634 01:14:09,640 --> 01:14:11,240 PEOPLE AND FAMILIES LIVING WITH 1635 01:14:11,240 --> 01:14:13,160 AND SURVIVING CANCER ENDING 1636 01:14:13,160 --> 01:14:17,120 QUOTE CANCER AS WE KNOW IT. 1637 01:14:17,120 --> 01:14:19,960 NEXT SLIDE, PLEASE. 1638 01:14:19,960 --> 01:14:21,360 MY PRESENTATION TODAY WILL FOCUS 1639 01:14:21,360 --> 01:14:24,240 ON THE FIRST OF THE GOALS TO 1640 01:14:24,240 --> 01:14:26,440 REDUCE AGE STANDARDIZED CANCER 1641 01:14:26,440 --> 01:14:28,920 MORTALITY RATES BY 50% OVER THE 1642 01:14:28,920 --> 01:14:30,640 NEXT 25 YEARS. 1643 01:14:30,640 --> 01:14:32,320 SPECIFICALLY IN THIS ANALYSIS, 1644 01:14:32,320 --> 01:14:35,000 WE FOCUS HONEST MEATING CANCER 1645 01:14:35,000 --> 01:14:38,760 DEATH RATES IN 2047 IF CURRENT 1646 01:14:38,760 --> 01:14:39,240 TRENDS CONTINUE. 1647 01:14:39,240 --> 01:14:41,680 WE REALLY FOCUSED ON THE 6 1648 01:14:41,680 --> 01:14:43,880 LEADING CAUSES OF CANCER DEATH 1649 01:14:43,880 --> 01:14:46,080 AS THEY CAUSE MORE THAN 50% OF 1650 01:14:46,080 --> 01:14:47,280 ALL CANCER DEATHS. 1651 01:14:47,280 --> 01:14:50,280 AND THEN IDENTIFIED SOME OF THE 1652 01:14:50,280 --> 01:14:51,800 PROMISING AND REALISTIC 1653 01:14:51,800 --> 01:14:53,360 OPPORTUNITIES TO FURTHER REDUCE 1654 01:14:53,360 --> 01:14:55,800 CANCER DEATH RATES OVER THE NEXT 1655 01:14:55,800 --> 01:14:57,880 25 YEARS. 1656 01:14:57,880 --> 01:15:00,000 NEXT SLIDE, PLEASE. 1657 01:15:00,000 --> 01:15:01,920 SO, THIS PARTICULAR EFFORT 1658 01:15:01,920 --> 01:15:03,640 FOCUSES ON SPECIFIC 1659 01:15:03,640 --> 01:15:06,000 OPPORTUNITIES TO ACHIEVE ONE OF 1660 01:15:06,000 --> 01:15:08,560 THE NEW MOONSHOT GOALS. 1661 01:15:08,560 --> 01:15:10,720 I WANTED TO EMPHASIZE LESS 1662 01:15:10,720 --> 01:15:13,040 COMMON CANCERS INCLUDING 1663 01:15:13,040 --> 01:15:14,680 PEDIATRIC CANCERS AND EXPOSURES 1664 01:15:14,680 --> 01:15:16,680 ARE IMPORTANT AND SHOULD BE 1665 01:15:16,680 --> 01:15:18,160 STUDIED AND CONTENTS OF PAPER 1666 01:15:18,160 --> 01:15:20,120 AND PRESENTATIONS ARE NOT 1667 01:15:20,120 --> 01:15:21,440 SPECIFIC RECOMMENDATIONS FOR 1668 01:15:21,440 --> 01:15:25,120 WHAT NCI OR DCG THAT IS THE 1669 01:15:25,120 --> 01:15:27,720 DIVISION I WORK IN SHOULD BE 1670 01:15:27,720 --> 01:15:28,480 PRIORITIZING. 1671 01:15:28,480 --> 01:15:29,400 NEXT SLIDE, PLEASE. 1672 01:15:29,400 --> 01:15:31,720 THE PAPER THAT WE PUBLISHED WAS 1673 01:15:31,720 --> 01:15:36,160 ACCOMPANIED BY COMMENTARY 1674 01:15:36,160 --> 01:15:40,360 WRITTEN BY DR. BURTON OELI AND 1675 01:15:40,360 --> 01:15:42,800 WHITE HOUSE MOONSHOT COORDINATOR 1676 01:15:42,800 --> 01:15:45,600 AND ELIZABETH JAVY AT JOHNS 1677 01:15:45,600 --> 01:15:47,440 HOPKINS TITLE OF COMMENTARY WAS 1678 01:15:47,440 --> 01:15:49,760 ACHIEVING THE GOALS OF THE 1679 01:15:49,760 --> 01:15:51,360 CANCER MOONSHOT REQUIRES 1680 01:15:51,360 --> 01:15:55,160 PROGRESS AGAINST ALL CANCERS AND 1681 01:15:55,160 --> 01:15:55,680 COMMENTARY HIGHLIGHTED 1682 01:15:55,680 --> 01:15:57,160 IMPORTANCE OF PROGRESS OF 1683 01:15:57,160 --> 01:16:00,760 MORTALITY ACROSS ALL CANCER 1684 01:16:00,760 --> 01:16:04,240 TYPES INCLUDING LESS COMMON 1685 01:16:04,240 --> 01:16:04,480 SITES. 1686 01:16:04,480 --> 01:16:05,560 NEXT SLIDE, PLEASE. 1687 01:16:05,560 --> 01:16:08,760 THIS WORK WAS LED BY A TEAM OF 1688 01:16:08,760 --> 01:16:11,520 RESEARCHERS SHOWN HERE AMY 1689 01:16:11,520 --> 01:16:14,920 BERINGTON AT ICR AND NEAL 1690 01:16:14,920 --> 01:16:20,880 FRIEDMAN IN DCCPS MARK SHIFMAN 1691 01:16:20,880 --> 01:16:25,440 AND JOHN SHILER AND STANLEY 1692 01:16:25,440 --> 01:16:27,520 LIPKOWITZ AND [INDISCERNIBLE] 1693 01:16:27,520 --> 01:16:29,920 WHO IS AT HARVARD. NEXT SLIDE, 1694 01:16:29,920 --> 01:16:30,160 PLEASE. 1695 01:16:30,160 --> 01:16:32,080 THIS TABLE SHOWS LEADING 1696 01:16:32,080 --> 01:16:34,640 CAUSESES OF CANCER DEATH IN YEAR 1697 01:16:34,640 --> 01:16:36,440 2019. 1698 01:16:36,440 --> 01:16:38,040 NEXT SLIDE, PLEASE. 1699 01:16:38,040 --> 01:16:41,880 >>WE FOCUS ANALYSIS ON THE 6 1700 01:16:41,880 --> 01:16:44,480 LEADING CANCER SITES IN TERMS OF 1701 01:16:44,480 --> 01:16:45,640 MORTALITY AND INCLUDING LUNG 1702 01:16:45,640 --> 01:16:47,800 CANCER THAT CAUSES NEARLY 1 OUT 1703 01:16:47,800 --> 01:16:51,520 OF 4 CANCER DEATHS IN THE UNITED 1704 01:16:51,520 --> 01:16:54,960 STATES COLORECTAL CANCER 1705 01:16:54,960 --> 01:16:58,680 PANCREATIC CANCER FEMALE BREAST 1706 01:16:58,680 --> 01:17:01,160 CANCER PROSTATE CANCER AND LIVER 1707 01:17:01,160 --> 01:17:03,960 CANCER AND THESE CAUSE 56% OF 1708 01:17:03,960 --> 01:17:06,520 DEATHS IN MEN AND 57% IN WOMEN 1709 01:17:06,520 --> 01:17:08,840 AND GOAL OUTLINED IN MOONSHOT IS 1710 01:17:08,840 --> 01:17:12,000 A NUMERIC GOAL PROGRESS AGAINST 1711 01:17:12,000 --> 01:17:14,280 MOST COMMON CANCERS THAT IS 1712 01:17:14,280 --> 01:17:18,840 REQUIRED TO REACH THIS 50% GOAL. 1713 01:17:18,840 --> 01:17:20,840 NEXT SLIDE, PLEASE. 1714 01:17:20,840 --> 01:17:22,520 THE APPROACH THAT WE USED IN 1715 01:17:22,520 --> 01:17:26,280 THIS ANALYSIS WAS TO ESTIMATE 1716 01:17:26,280 --> 01:17:29,040 TRENDS IN CANCER INCIDENCE AND 1717 01:17:29,040 --> 01:17:32,040 RELATIVE SURVIVAL AND MORTALITY 1718 01:17:32,040 --> 01:17:33,640 AND DATA CAME FROM THE SEER 1719 01:17:33,640 --> 01:17:35,120 PROGRAM THAT IS A GROUP OF 1720 01:17:35,120 --> 01:17:36,720 CANCER REGISTRIES COVERING 1721 01:17:36,720 --> 01:17:37,960 NEARLY HALF OF THE UNITED STATES 1722 01:17:37,960 --> 01:17:40,560 THAT ARE FUNDED BY NATIONAL 1723 01:17:40,560 --> 01:17:41,040 CANCER INSTITUTE. 1724 01:17:41,040 --> 01:17:43,640 AS WELL AS NATIONAL DEATH 1725 01:17:43,640 --> 01:17:44,800 CERTIFICATE DATA FROM THE 1726 01:17:44,800 --> 01:17:47,640 NATIONAL CENTER FOR HEALTH 1727 01:17:47,640 --> 01:17:49,280 STATISTICS AND WE PROJECTED 1728 01:17:49,280 --> 01:17:54,800 MORTALITY RATES FROM 20202 TO 1729 01:17:54,800 --> 01:17:58,440 20047 BASED ON RECENT TREND AND 1730 01:17:58,440 --> 01:17:59,840 CANCER RATES IDENTIFIED FOR 1731 01:17:59,840 --> 01:18:01,760 MODELS THAT PICK UP WHERE TRENDS 1732 01:18:01,760 --> 01:18:03,520 CHANGE OVER TIME. 1733 01:18:03,520 --> 01:18:04,920 PROJECTIONS THAT WE MADE ASSUME 1734 01:18:04,920 --> 01:18:06,880 THE MOST RECENT TREND WILL 1735 01:18:06,880 --> 01:18:14,560 CONTINUE FROM 2022 2047 AND 1736 01:18:14,560 --> 01:18:16,160 PROJECTIONS ARE NOT PREDICTIONS 1737 01:18:16,160 --> 01:18:18,400 WE DON'T THINK WE ARE GETTING 1738 01:18:18,400 --> 01:18:20,720 EXACT CANCER RATES FOR 2047 1739 01:18:20,720 --> 01:18:22,440 CORRECT HOWEVER IT PROVIDES 1740 01:18:22,440 --> 01:18:24,440 OVERALL PICTURE WHETHER OR NOT 1741 01:18:24,440 --> 01:18:27,160 WE ARE ON OR OFF TRACK TO MEET 1742 01:18:27,160 --> 01:18:29,840 THE MOONSHOT GOAL. NEXT SLIDE, 1743 01:18:29,840 --> 01:18:30,560 PLEASE. 1744 01:18:30,560 --> 01:18:32,000 SO, I WILL SHOW A SERIES OF 1745 01:18:32,000 --> 01:18:33,400 SLIDES THAT IS STARTING WITH 1746 01:18:33,400 --> 01:18:36,480 TOTAL CANCER AND GOING THROUGH 1747 01:18:36,480 --> 01:18:41,960 EACH OF THE 6 SITES WE 1748 01:18:41,960 --> 01:18:46,240 HIGHLIGHTED SHOWING INCIDENCE 1749 01:18:46,240 --> 01:18:49,160 RATES RELATIVE SURVIVAL AND 1750 01:18:49,160 --> 01:18:49,760 MORTALITY RATES. 1751 01:18:49,760 --> 01:18:52,480 X AXIS IS CALENDAR YEAR AND Y 1752 01:18:52,480 --> 01:18:54,600 AXIS IS AGE STANDARDIZED 1753 01:18:54,600 --> 01:18:56,280 INCIDENCE RATE. YOU CAN SEE IN 1754 01:18:56,280 --> 01:18:58,360 THE MOST RECENT TIME PERIOD THAT 1755 01:18:58,360 --> 01:19:00,640 FOR THIS CANCER TOTAL CANCER 1756 01:19:00,640 --> 01:19:04,400 STARTED IN 2012 AND WAS A .6% 1757 01:19:04,400 --> 01:19:07,680 PER YEAR DECLINE IN INCIDENCE 1758 01:19:07,680 --> 01:19:09,600 RATES RELATIVE SURVIVAL THAT IS 1759 01:19:09,600 --> 01:19:11,400 A MEASURE OF SURVIVAL IN PEOPLE 1760 01:19:11,400 --> 01:19:13,880 WITH CANCER RELATIVE TO WHAT 1761 01:19:13,880 --> 01:19:15,120 SURVIVAL WOULD BE IN GENERAL 1762 01:19:15,120 --> 01:19:16,760 POPULATION FOR SOMEBODY OF THE 1763 01:19:16,760 --> 01:19:21,440 SAME AGE, SEX, AND RACE. WE SAW 1764 01:19:21,440 --> 01:19:23,960 IMPROVED SURVIVAL 1 AND 3 YEARS 1765 01:19:23,960 --> 01:19:26,280 SURVIVAL IN MOST RECENT TIME 1766 01:19:26,280 --> 01:19:27,840 PERIOD. 1767 01:19:27,840 --> 01:19:30,080 NEXT SLIDE, PLEASE. 1768 01:19:30,080 --> 01:19:32,080 SO, CANCER MORTALITY RATES IS 1769 01:19:32,080 --> 01:19:34,200 REALLY WHAT WE ARE FOCUSING ON 1770 01:19:34,200 --> 01:19:35,440 HERE FOR MOONSHOT GOAL. 1771 01:19:35,440 --> 01:19:37,160 YOU CAN SEE HERE THAT OVER THE 1772 01:19:37,160 --> 01:19:39,680 LAST 20 YEARS THERE HAS BEEN 1773 01:19:39,680 --> 01:19:42,000 TREMENDOUS PROGRESS IN CANCER 1774 01:19:42,000 --> 01:19:42,880 MORTALITY RATE REDUCTION. 1775 01:19:42,880 --> 01:19:45,840 IN FACT, IF IN THE MOST RECENT 1776 01:19:45,840 --> 01:19:47,720 TRENDS SHOWN HERE IN THE LAST 1777 01:19:47,720 --> 01:19:50,840 FEW YEARS, RATE OF DECLINE 1778 01:19:50,840 --> 01:19:56,160 ACCELERATED TO 2.3% PER YEAR. 1779 01:19:56,160 --> 01:19:59,200 NEXT SLIDE, PLEASE. 1780 01:19:59,200 --> 01:20:02,200 IF THIS TREND CONTINUES THAT 1781 01:20:02,200 --> 01:20:03,600 WOULD TAKE A TREMENDOUS AMOUNT 1782 01:20:03,600 --> 01:20:05,720 OF WORK AND WOULD BE A HUGE 1783 01:20:05,720 --> 01:20:09,200 SUCCESS, WE WOULD SEE A 44% 1784 01:20:09,200 --> 01:20:10,960 DECLINE IN CANCER DEATH RATES 1785 01:20:10,960 --> 01:20:18,880 FROM 2022 TO 2047 THAT IS A HUGE 1786 01:20:18,880 --> 01:20:21,960 NUMBER OF CANCER DEATHS AVOIDED 1787 01:20:21,960 --> 01:20:25,920 BUT WOULD FALL SOMEWHAT SHORT OF 1788 01:20:25,920 --> 01:20:29,160 MOONSHOT GOAL OF 50% DECLINE. 1789 01:20:29,160 --> 01:20:32,280 AS DISCUSSED BEFORE WE NEED TO 1790 01:20:32,280 --> 01:20:34,880 ACCELERATE DECLINE OF 2.7% EACH 1791 01:20:34,880 --> 01:20:37,320 YEAR TO MEET THIS GOAL. NEXT 1792 01:20:37,320 --> 01:20:37,920 SLIDE, PLEASE. 1793 01:20:37,920 --> 01:20:41,040 WHEN WE OUTLINED APPROACHES TO 1794 01:20:41,040 --> 01:20:42,400 ACCELERATE PROGRESS, WE REALIZED 1795 01:20:42,400 --> 01:20:45,640 THEY SHOULD BE CANCER-TYPE 1796 01:20:45,640 --> 01:20:51,040 SPECIFIC ETIOLOGY AND PREVENTION 1797 01:20:51,040 --> 01:20:51,520 A 1798 01:20:51,520 --> 01:20:53,480 TREATMENT ALL DIFFER BY SITE AND 1799 01:20:53,480 --> 01:20:55,280 HIGHLIGHT ESTABLISHED 1800 01:20:55,280 --> 01:20:57,520 INTERVENTIONS REDUCING CANCER 1801 01:20:57,520 --> 01:21:00,680 DEATHS OVER 25 YEAR PERIOD THAT 1802 01:21:00,680 --> 01:21:02,120 DOESN'T DISCOUNT IMPORTANCE OF 1803 01:21:02,120 --> 01:21:03,400 DISCOVERY AND CONTINUED EFFORTS 1804 01:21:03,400 --> 01:21:05,920 TO DEVELOP NEW APPROACHES TO 1805 01:21:05,920 --> 01:21:08,280 PREVENT, DISCOVER AND TREAT 1806 01:21:08,280 --> 01:21:08,520 CANCER. 1807 01:21:08,520 --> 01:21:09,560 NEXT SLIDE, PLEASE. 1808 01:21:09,560 --> 01:21:12,040 I WANT TO MAKE A NOTE ABOUT 1809 01:21:12,040 --> 01:21:15,800 MODIFIABLE RISK FACTORS AND 1810 01:21:15,800 --> 01:21:16,880 CIGARETTE SMOKING OBESITY 1811 01:21:16,880 --> 01:21:18,840 PHYSICAL ACTIVITY AND ALCOHOL 1812 01:21:18,840 --> 01:21:20,840 INTAKE CONTRIBUTE TO MORTALITY 1813 01:21:20,840 --> 01:21:22,560 FOR CANCER TYPES AS WELL AS 1814 01:21:22,560 --> 01:21:24,560 OTHER CHRONIC DISEASES AND 1815 01:21:24,560 --> 01:21:26,720 PROGRESS AGAINST RISK FACTORS IS 1816 01:21:26,720 --> 01:21:28,240 CRITICALLY IMPORTANT. 1817 01:21:28,240 --> 01:21:30,320 HOWEVER, POPULATION LEVEL 1818 01:21:30,320 --> 01:21:32,280 INTERVENTIONS TO REDUCE RISK 1819 01:21:32,280 --> 01:21:34,760 FACTORS ARE CHALLENGING AND 1820 01:21:34,760 --> 01:21:36,280 ACCEPT CRIMINAL RECEIPT SMOKING 1821 01:21:36,280 --> 01:21:38,520 HERE IS CHALLENGING AND WE HAVE 1822 01:21:38,520 --> 01:21:42,080 SEEN GREAT SUCCESS FOR SMOKING. 1823 01:21:42,080 --> 01:21:43,520 NEXT SLIDE, PLEASE. 1824 01:21:43,520 --> 01:21:47,560 AS AN EXAMPLE OF THIS, I'M 1825 01:21:47,560 --> 01:21:49,720 SHOWING YOU FROM THE NATIONAL 1826 01:21:49,720 --> 01:21:52,240 CENTER FOR HEALTH STATISTICS 1827 01:21:52,240 --> 01:21:54,720 DATA ON US OBESITY PREVALENCE 1828 01:21:54,720 --> 01:21:57,560 AND ALCOHOL INDUCED DEATH RATES 1829 01:21:57,560 --> 01:21:58,920 PROXY FORALCOHOL CONSUMPTION AND 1830 01:21:58,920 --> 01:22:02,280 SEE THAT OBESITY IN THE 1831 01:22:02,280 --> 01:22:04,680 INCREASED FROM 30.5% OF 1832 01:22:04,680 --> 01:22:08,560 POPULATION IN 1999 IN 2000 TO 1833 01:22:08,560 --> 01:22:11,680 44% IN 2017 AND 2018 AND WE HAVE 1834 01:22:11,680 --> 01:22:14,480 SEEN ALSO INCREASES IN ALCOHOL 1835 01:22:14,480 --> 01:22:17,320 INDUCED DEATH RATES. 1836 01:22:17,320 --> 01:22:19,840 NEXT SLIDE, PLEASE. 1837 01:22:19,840 --> 01:22:21,960 SO, SUCCESSFUL POPULATION 1838 01:22:21,960 --> 01:22:23,760 EFFORTS TO INCREASE PHYSICAL 1839 01:22:23,760 --> 01:22:26,600 ACTIVITY DECREASE OBESITY AND 1840 01:22:26,600 --> 01:22:28,040 ALCOHOL CONSUMPTION WOULD LOWER 1841 01:22:28,040 --> 01:22:29,720 DEATH RATES FROM CANCER AND 1842 01:22:29,720 --> 01:22:31,240 CHRONIC DISEASES THAT ARE REALLY 1843 01:22:31,240 --> 01:22:32,920 IMPORTANT AND AS I SHOWED YOU 1844 01:22:32,920 --> 01:22:34,920 THESE EXPOSURES ARE HEADED IN 1845 01:22:34,920 --> 01:22:36,240 THE WRONG DIRECTION THAT WILL 1846 01:22:36,240 --> 01:22:40,120 LIKELY TAKE LONGER THAN 25 YEAR 1847 01:22:40,120 --> 01:22:41,560 TIMEFRAME TO REVERSE CURRENT 1848 01:22:41,560 --> 01:22:43,360 TRENDS AND OBSERVE IMPACTS AT 1849 01:22:43,360 --> 01:22:46,600 THE POPULATION LEVEL. 1850 01:22:46,600 --> 01:22:49,400 NEXT SLIDE, PLEASE. 1851 01:22:49,400 --> 01:22:52,000 SGLT THIS ANLAL SIS AND STUDY 1852 01:22:52,000 --> 01:22:54,760 ALSO DID NOT FOCUS A LOT ON 1853 01:22:54,760 --> 01:22:56,960 CANCER TREATMENTS AND SORRY WE 1854 01:22:56,960 --> 01:22:58,560 ONLY FOCUS ON TREATMENTS WITH 1855 01:22:58,560 --> 01:23:01,160 LARGE SURVIVAL BENEFITS FOR 1856 01:23:01,160 --> 01:23:03,960 SUBSTANTIAL FRACTION OF CANCER 1857 01:23:03,960 --> 01:23:05,160 PATIENTS AND DIDN'T FOCUS ON 1858 01:23:05,160 --> 01:23:07,800 TREATMENTS WITH LIMITED SURVIVAL 1859 01:23:07,800 --> 01:23:08,880 BENEFITS THOUGH THEY ARE 1860 01:23:08,880 --> 01:23:10,680 TREMENDOUS WILL I IMPORTANT, OF 1861 01:23:10,680 --> 01:23:12,480 COURSE, FOR INDIVIDUAL PATIENTS 1862 01:23:12,480 --> 01:23:14,760 THEY UNLIKE WILL I TO HAVE AN 1863 01:23:14,760 --> 01:23:16,360 IMPACT AT POPULATION LEVEL ON 1864 01:23:16,360 --> 01:23:19,880 CANCER MORTALITY RATES. 1865 01:23:19,880 --> 01:23:22,120 NEXT SLIDE, PLEASE. 1866 01:23:22,120 --> 01:23:27,560 I ALSO WANT TO HIGHLIGHT THE 1867 01:23:27,560 --> 01:23:28,440 IMPORTANCE OF ADDRESSING 1868 01:23:28,440 --> 01:23:30,000 DISPARITIES TO REACH THIS 1869 01:23:30,000 --> 01:23:32,480 MOONSHOT GOAL AND ARE WELL-KNOWN 1870 01:23:32,480 --> 01:23:34,600 DISPARITIES IN CANCER PREVENTION 1871 01:23:34,600 --> 01:23:36,160 EARLY DETECTION AND TREATMENT 1872 01:23:36,160 --> 01:23:38,280 AND CRITICAL THAT THESE 1873 01:23:38,280 --> 01:23:39,720 INEQUITIES BE ADDRESSED IN 1874 01:23:39,720 --> 01:23:41,000 OPPORTUNITIES THAT WERE OUTLINED 1875 01:23:41,000 --> 01:23:43,280 AND THIS FIGURE SHOWS THE 1876 01:23:43,280 --> 01:23:46,920 DIFFERENCES IN CANCER MORTALITY 1877 01:23:46,920 --> 01:23:48,400 RATES ACROSS MAJOR RACIAL/ETHNIC 1878 01:23:48,400 --> 01:23:50,200 GROUPS IN THE UNITED STATES AND 1879 01:23:50,200 --> 01:23:53,600 FOR EXAMPLE SHOWS IN BOTH MEN 1880 01:23:53,600 --> 01:23:55,560 AND WOMEN BLACK INDIVIDUALS HAVE 1881 01:23:55,560 --> 01:23:58,440 THE HIGHEST CANCER DEATH RATES 1882 01:23:58,440 --> 01:24:01,160 AND IN FAR HIGHER THAN SOME OF 1883 01:24:01,160 --> 01:24:05,160 THE OTHER GROUPS SHOWN HERE. 1884 01:24:05,160 --> 01:24:08,280 NEXT SLIDE, PLEASE. 1885 01:24:08,280 --> 01:24:12,320 SO, NOW I WILL START TO GO 1886 01:24:12,320 --> 01:24:17,200 THROUGH INDIVIDUAL CANCER TYPES 1887 01:24:17,480 --> 01:24:21,160 EXAMINED IN OUR STUDY AND -- 1888 01:24:21,160 --> 01:24:25,160 WITH 2.3% DECLINE OVER THE 1889 01:24:25,160 --> 01:24:33,080 PERIOD 2007 TO 2019 AND 1890 01:24:33,080 --> 01:24:35,200 INCREASED DRAMATICALLY AND 1891 01:24:35,200 --> 01:24:36,640 REMAINS POOR. NEXT SLIDE, 1892 01:24:36,640 --> 01:24:37,120 PLEASE. 1893 01:24:37,120 --> 01:24:39,880 WHEN WE EXAMINED CANCER 1894 01:24:39,880 --> 01:24:42,200 MORTALITY RATES FOR LUNG CANCER 1895 01:24:42,200 --> 01:24:45,120 WE SAW A STRONG DECLINE AT 4.7% 1896 01:24:45,120 --> 01:24:47,440 PER YEAR IN THE MOST RECENT TIME 1897 01:24:47,440 --> 01:24:47,920 PERIOD. 1898 01:24:47,920 --> 01:24:51,320 IF THIS DECLINE CONTINUES FOR 1899 01:24:51,320 --> 01:24:53,800 LUNG CANCER THERE WILL BE A 1900 01:24:53,800 --> 01:24:56,160 MEETING AND SURPASSING OF 50% 1901 01:24:56,160 --> 01:25:05,600 GOAL OVER THE NEXT 25 YEARS NEXT 1902 01:25:05,600 --> 01:25:05,880 SLIDE. 1903 01:25:05,880 --> 01:25:08,080 I WILL SHOW CANCER TYPE 1904 01:25:08,080 --> 01:25:09,480 POTENTIAL INTERVENTIONS 1905 01:25:09,480 --> 01:25:11,160 OPPORTUNITIES TO ACCELERATE 1906 01:25:11,160 --> 01:25:12,360 PROGRESS AND OPPORTUNITIES TO 1907 01:25:12,360 --> 01:25:15,040 PREVENT CANCER OR IN THIS CASE 1908 01:25:15,040 --> 01:25:18,520 OUTCOME BEING INCIDENCE TO 1909 01:25:18,520 --> 01:25:19,800 PREVENT INCIDENCE OF CANCER 1910 01:25:19,800 --> 01:25:21,880 REDUCING THEM AS WELL AS 1911 01:25:21,880 --> 01:25:23,480 MORTALITY AND FOR LUNG CANCER, 1912 01:25:23,480 --> 01:25:25,960 OF COURSE, IMPORTANT WAY OF 1913 01:25:25,960 --> 01:25:28,560 PREVENTING LUNG CANCER IS 1914 01:25:28,560 --> 01:25:31,480 THROUGH SMOKING CESSATION AND 1915 01:25:31,480 --> 01:25:33,680 PREVENTING INITIATION OF 1916 01:25:33,680 --> 01:25:36,600 CIGARETTE SMOKING AND NEXT 1917 01:25:36,600 --> 01:25:40,160 SLIDE, PLEASE. 1918 01:25:40,160 --> 01:25:43,120 >>SMOKING PREVALENCE IN US HAS 1919 01:25:43,120 --> 01:25:46,720 BEEN ON DECLINE FOR DEGATES AND 1920 01:25:46,720 --> 01:25:48,040 TREMENDOUS PROGRESS GETTING 1921 01:25:48,040 --> 01:25:50,320 PEOPLE TO QUIT AND PREVENTION OF 1922 01:25:50,320 --> 01:25:52,480 SMOKING IN FIRST PLACE AND IN 1923 01:25:52,480 --> 01:25:58,560 EARLY 1990S TO LATER 20 TENS 1924 01:25:58,560 --> 01:26:00,760 PREVALENCE OF INDIVIDUALS THAT 1925 01:26:00,760 --> 01:26:04,280 WERE NEVER SMOKERS INCREASED 1926 01:26:04,280 --> 01:26:10,800 FROM 50 TO 70%. 1927 01:26:10,800 --> 01:26:14,640 NEXT SLIDE, PLEASE. 1928 01:26:14,640 --> 01:26:17,040 IMPORTANT THING TO CONSIDER FOR 1929 01:26:17,040 --> 01:26:19,640 CIGARETTE SMOKING GIVING ME HOPE 1930 01:26:19,640 --> 01:26:22,760 FOR MOONSHOT GOAL FOR LUNG 1931 01:26:22,760 --> 01:26:25,600 CANCER IS RECENT YEARS HAVE NOT 1932 01:26:25,600 --> 01:26:26,920 IMPACTED LUNG CANCER RATE DEATH 1933 01:26:26,920 --> 01:26:27,320 RATES. 1934 01:26:27,320 --> 01:26:28,960 EXAMPLE OF THIS, YOU SEE THIS 1935 01:26:28,960 --> 01:26:31,840 FIGURE TO THE RIGHT. ON THE Y 1936 01:26:31,840 --> 01:26:33,760 AXIS PRESENTS NUMBER OF 1937 01:26:33,760 --> 01:26:36,160 CIGARETTES IN THE UNITED STATES 1938 01:26:36,160 --> 01:26:38,520 PER CAPITIA. 1939 01:26:38,520 --> 01:26:42,760 YOU SEE THAT NUMBER PEAKED WITH 1940 01:26:42,760 --> 01:26:44,600 1964 SURGEON GENERAL'S REPORT 1941 01:26:44,600 --> 01:26:46,640 AND NOT UNTIL SEVERAL DECADES 1942 01:26:46,640 --> 01:26:50,000 LATER THAT LUNG CANCER MORTALITY 1943 01:26:50,000 --> 01:26:51,480 RATES PEAKED SHOWING LAG BETWEEN 1944 01:26:51,480 --> 01:26:54,440 POPULATION LEVEL SMOKING AND 1945 01:26:54,440 --> 01:26:55,640 POPULATION LEVEL MORTALITY. 1946 01:26:55,640 --> 01:26:57,840 SO, MUCH OF THE PROGRESS THAT 1947 01:26:57,840 --> 01:27:01,040 HAS HAPPENED IN THE LAST COUPLE 1948 01:27:01,040 --> 01:27:02,280 DECADES AGAINST CIGARETTE 1949 01:27:02,280 --> 01:27:04,440 SMOKING HAVE NOT PLAYED OUT IN 1950 01:27:04,440 --> 01:27:07,040 THE POPULATION LEVEL LUNG CANCER 1951 01:27:07,040 --> 01:27:07,760 MORTALITY DATA. 1952 01:27:07,760 --> 01:27:11,200 THAT IS A PROMISING POINT TO ME. 1953 01:27:11,200 --> 01:27:15,800 IN ADDITION 2% OF HIGH SCHOOL 1954 01:27:15,800 --> 01:27:17,680 STUDENTS REPORTED CIGARETTE 1955 01:27:17,680 --> 01:27:20,120 SMOKING IN 2022 AND FEW 1956 01:27:20,120 --> 01:27:22,560 INDIVIDUALS INITIATING SMOKING 1957 01:27:22,560 --> 01:27:24,360 AGAIN THAT IS REALLY GREAT NEWS 1958 01:27:24,360 --> 01:27:28,080 AND FDA PROPOSED NEW TOBACCO 1959 01:27:28,080 --> 01:27:30,680 PRODUCT STANDARDS PROHIBITING 1960 01:27:30,680 --> 01:27:32,920 MENTHOL IN CIGARETTE ROOEZ 1961 01:27:32,920 --> 01:27:35,920 DEUCING NICOTINE WITH IMPACT ON 1962 01:27:35,920 --> 01:27:40,040 SMOKING CESSATION AND PREVENTING 1963 01:27:40,040 --> 01:27:41,920 INITIATION. NEXT SLIDE, PLEASE. 1964 01:27:41,920 --> 01:27:44,800 IT IS IMPORTANT TO POINT OUT 1965 01:27:44,800 --> 01:27:47,000 THOUGH THAT PREVALENCE OF 1966 01:27:47,000 --> 01:27:49,520 SMOKING IS ALL TIME LOW NOTABLE 1967 01:27:49,520 --> 01:27:52,720 DISPARITIES BY EDUCATION IN THE 1968 01:27:52,720 --> 01:27:54,360 UNITED STATES FIGURE PRESENTS 1969 01:27:54,360 --> 01:27:57,160 DATA FROM CDC AND THOSE WITH 1970 01:27:57,160 --> 01:28:00,480 GRADUATE DEGREE PREVALENCE OF 1971 01:28:00,480 --> 01:28:03,480 SMOKING 3.5% THOSE WITHOUT HIGH 1972 01:28:03,480 --> 01:28:05,680 SCHOOL DIPLOMA HAVE HIGHER 1973 01:28:05,680 --> 01:28:12,120 SMOKING PREVALENCE AT 21.5%. 1974 01:28:12,120 --> 01:28:13,360 NEXT SLIDE, PLEASE. 1975 01:28:13,360 --> 01:28:16,160 IT IS IMPORTANT TO NOTE SMOKING 1976 01:28:16,160 --> 01:28:17,960 AND PREVENTING SMOKING WILL HAVE 1977 01:28:17,960 --> 01:28:20,440 IMPACT ON MANY CANCER TYPES AND 1978 01:28:20,440 --> 01:28:22,920 MANY OTHER DISEASES SMOKING IS 1979 01:28:22,920 --> 01:28:25,840 KNOWN TO CAUSE MANY CANCERS 1980 01:28:25,840 --> 01:28:28,480 SHOWN HERE PROGRESS AGAINST 1981 01:28:28,480 --> 01:28:31,760 SMOKING COULD HAVE A BROAD 1982 01:28:31,760 --> 01:28:35,440 IMPACT ON CANCER RATES. 1983 01:28:35,440 --> 01:28:36,280 NEXT SLIDE, PLEASE. 1984 01:28:36,280 --> 01:28:38,560 I WOULD LIKE TO TALK ABOUT 1985 01:28:38,560 --> 01:28:41,080 INTERVENTIONS TO PREVENT LUNG 1986 01:28:41,080 --> 01:28:42,520 CANCER MORTALITY AMONG THOSE 1987 01:28:42,520 --> 01:28:43,760 WITH LUNG CANCER AND ONE 1988 01:28:43,760 --> 01:28:45,560 OPPORTUNITY IS TO INCREASE 1989 01:28:45,560 --> 01:28:51,160 ACCESS TO LOW DOSE CT SCANS FOR 1990 01:28:51,160 --> 01:28:55,680 SCREENING AND EARLY DETECTION OF 1991 01:28:55,680 --> 01:28:59,680 LUNG CANCER, NEXT SLIDE, PLEASE. 1992 01:28:59,680 --> 01:29:01,560 TRIALS HAVE SHOWN HIGH RISK 1993 01:29:01,560 --> 01:29:03,840 POPULATIONS FOR LUNG CANCER 1994 01:29:03,840 --> 01:29:08,280 REDUT MORTALITY BY 20% AND CDC 1995 01:29:08,280 --> 01:29:11,280 SCHEMATIC SHOWS 7 OUT OF 8 1996 01:29:11,280 --> 01:29:12,600 ADULTS MEETING SCREENING 1997 01:29:12,600 --> 01:29:16,200 CRITERIA. SORRY 1 OF 8 ADULTS 1998 01:29:16,200 --> 01:29:17,800 MEETING SCREENING CRITERIA 1999 01:29:17,800 --> 01:29:19,360 REPORTED RECOMMENDED SCREENING 2000 01:29:19,360 --> 01:29:21,960 AND 7 OUT OF 8 DID NOT AND YOU 2001 01:29:21,960 --> 01:29:23,960 SEE CRITERIA FOR SCREENING 2002 01:29:23,960 --> 01:29:25,400 PROGRAMS ON RIGHT BASED ON AGE 2003 01:29:25,400 --> 01:29:28,280 AND SMOKING HISTORY. NEXT 2004 01:29:28,280 --> 01:29:29,120 SLIDE, PLEASE. 2005 01:29:29,120 --> 01:29:33,160 THERE IS TREMENDOUS POTENTIAL 2006 01:29:33,160 --> 01:29:35,200 FOR EXPANDING ACCESS TO LOW DOSE 2007 01:29:35,200 --> 01:29:37,040 CONSIDER. T SCANS SCREENING 2008 01:29:37,040 --> 01:29:39,600 LUNG CANCER REDUCING MORTALITY 2009 01:29:39,600 --> 01:29:41,440 FROM LUNG CANCER AND IMPORTANT 2010 01:29:41,440 --> 01:29:43,080 TO POINT OUT THOUGH THERE ARE 2011 01:29:43,080 --> 01:29:45,520 LARGE DISPARITIES IN ACCESS TO 2012 01:29:45,520 --> 01:29:48,000 LOW DOSE CT SCREENING CENTERS IN 2013 01:29:48,000 --> 01:29:50,160 THIS STUDY THAT SHOWED AT COUNTY 2014 01:29:50,160 --> 01:29:51,800 LEVEL WHERE THE SCREENING 2015 01:29:51,800 --> 01:29:53,640 CENTERS ARE LOCATED IN THE 2016 01:29:53,640 --> 01:29:55,480 STATES OF MISSOURI AND ILLINOIS 2017 01:29:55,480 --> 01:29:58,080 THAT IS THE BLACK DOTS ON MAPS 2018 01:29:58,080 --> 01:30:00,520 AND AT THE COUNTY LEVEL THE 2019 01:30:00,520 --> 01:30:02,000 COLORS INDICATE THAT THERE IS 2020 01:30:02,000 --> 01:30:07,080 PERCENTAGE OF RESIDENTS OF AGE 2021 01:30:07,400 --> 01:30:09,120 5579 WITH ACCESS TO SCREENING 2022 01:30:09,120 --> 01:30:11,640 CENTER WITHIN 30 MILES AND SEE 2023 01:30:11,640 --> 01:30:14,120 THAT THERE ARE LARGE PARTS OF 2024 01:30:14,120 --> 01:30:15,840 THE STATE WHERE 0% THAT IS RED 2025 01:30:15,840 --> 01:30:19,920 THAT HAVE ACCESS TO A LOW-DOSE 2026 01:30:19,920 --> 01:30:23,920 CD SCAN SCREENING CENTER WITHIN 2027 01:30:23,920 --> 01:30:26,320 30 MILES HIGHLIGHT DISPARITIES 2028 01:30:26,320 --> 01:30:28,440 AND ACCESS TO SCREENING MODALITY 2029 01:30:28,440 --> 01:30:31,760 AND NEXT SLIDE, PLEASE. 2030 01:30:31,760 --> 01:30:36,200 FINALLY, THERE IS OPPORTUNITIES 2031 01:30:36,200 --> 01:30:38,760 TO PREVENT MORTALITY DUE TO LUNG 2032 01:30:38,760 --> 01:30:42,040 CANCER REDUCING DISPARITIES AND 2033 01:30:42,040 --> 01:30:45,840 ACCESS TO EFFECTIVE TREATMENTS. 2034 01:30:45,840 --> 01:30:52,080 NEXT SLIDE, PLEASE NONSMALL CELL 2035 01:30:52,080 --> 01:30:54,040 LUNG CANCER TREATMENTS AND THOSE 2036 01:30:54,040 --> 01:31:00,120 IN THE US ARE OF THIS CELL TYPE. 2037 01:31:00,120 --> 01:31:02,880 TARGETED THERAPIES HAVE RESULTED 2038 01:31:02,880 --> 01:31:06,560 IN POPULATION LEVEL DECLINES IN 2039 01:31:06,560 --> 01:31:08,920 LUNG CANCER MORTALITY. 2040 01:31:08,920 --> 01:31:10,160 NEXT SLIDE, PLEASE. 2041 01:31:10,160 --> 01:31:13,880 THIS STUDY DEMONSTRATED THIS 2042 01:31:13,880 --> 01:31:19,040 POINT BY COMPARING TRENDS AND 2043 01:31:19,040 --> 01:31:22,320 INCIDENT RATES TO TRENDS IN 2044 01:31:22,320 --> 01:31:25,920 MORTALITY RATES SHOWN IN RED FOR 2045 01:31:25,920 --> 01:31:28,520 MEN AND WOMEN. 2046 01:31:28,520 --> 01:31:30,320 THIS STUDY SHOWED WHEN 2047 01:31:30,320 --> 01:31:35,080 THERAPIES WERE INTRODUCED THERE 2048 01:31:35,080 --> 01:31:38,200 WAS ACCELERATION IN DECLINE IN 2049 01:31:38,200 --> 01:31:39,720 MORTALITY WHEN THERE WASN'T 2050 01:31:39,720 --> 01:31:41,120 ACCELERATION IN INCIDENCE THAT 2051 01:31:41,120 --> 01:31:44,440 WAS INDIRECT WAY OF SHOWING THE 2052 01:31:44,440 --> 01:31:47,280 IMPACT OF TREATMENT ON 2053 01:31:47,280 --> 01:31:50,680 POPULATION LEVEL MORTALITY 2054 01:31:50,680 --> 01:31:50,920 RATES. 2055 01:31:50,920 --> 01:31:53,960 NEXT SLIDE, PLEASE. 2056 01:31:53,960 --> 01:31:57,040 IT IS IMPORTANT TO NOTE EXPANDED 2057 01:31:57,040 --> 01:31:58,680 ACCESS TO EFFECTIVE TREATMENTS 2058 01:31:58,680 --> 01:32:02,720 IS NEEDED TO MAXIMIZE BENEFITS 2059 01:32:02,720 --> 01:32:04,920 OF TREATMENT MODALITIES. 2060 01:32:04,920 --> 01:32:06,240 NEXT SLIDE, PLEASE. 2061 01:32:06,240 --> 01:32:13,920 SECOND LEADING CAUSE OF CANCER 2062 01:32:13,920 --> 01:32:17,920 -- 2.4% PER YEAR IN RECENT YEARS 2063 01:32:17,920 --> 01:32:19,640 AND WHILE NO BENEFIT AND 2064 01:32:19,640 --> 01:32:21,840 INCREASES IN SURVIVAL OVER THE 2065 01:32:21,840 --> 01:32:25,040 SAME TIME PERIOD. 2066 01:32:25,040 --> 01:32:28,920 NEXT SLIDE, PLEASE. 2067 01:32:28,920 --> 01:32:31,880 MORTALITY RATES COLORECTAL 2068 01:32:31,880 --> 01:32:35,600 CANCER DECLINED 2% PER YEAR 2069 01:32:35,600 --> 01:32:43,520 BETWEEN 2019 AND 2010 AND IF 2070 01:32:43,520 --> 01:32:45,440 THIS CONTINUES IN GOAL OR 50% 2071 01:32:45,440 --> 01:32:47,560 DECLINE AND THERE ARE SEVERAL 2072 01:32:47,560 --> 01:32:50,400 OPPORTUNITIES TO ACCELERATE 2073 01:32:50,400 --> 01:32:52,880 DECLINES IN COLORECTAL CANCER 2074 01:32:52,880 --> 01:32:54,240 THOUGH THAT ALL ARE INVOLVED 2075 01:32:54,240 --> 01:32:58,040 AROUND SCREENING THAT IS FOR 2076 01:32:58,040 --> 01:33:00,280 COLORECTAL CANCER PREVENTION OF 2077 01:33:00,280 --> 01:33:01,560 POLYPS BEFORE THEY BECOME 2078 01:33:01,560 --> 01:33:03,280 CANCERS AS WELL AS EARLY 2079 01:33:03,280 --> 01:33:05,160 DETECTION. 2080 01:33:05,160 --> 01:33:08,040 NEXT SLIDE, PLEASE. 2081 01:33:08,040 --> 01:33:12,400 USPSTF GUIDELINES FOR COLORECTAL 2082 01:33:12,400 --> 01:33:13,360 CANCER SCREENING OFFER A NUMBER 2083 01:33:13,360 --> 01:33:15,960 OF TYPES OF SCREENING TO BE USED 2084 01:33:15,960 --> 01:33:19,160 TO SCREEN FOR COLORECTAL CANCER 2085 01:33:19,160 --> 01:33:23,360 AT OUTLINED HERE FOR INDIVIDUALS 2086 01:33:23,360 --> 01:33:27,480 AGE 45 TO 75. NEXT SLIDE, 2087 01:33:27,480 --> 01:33:29,240 PLEASE. 2088 01:33:29,240 --> 01:33:31,640 DATA SHOWS HOW WELL SCREENING 2089 01:33:31,640 --> 01:33:36,480 FOR COLORECTAL CANCER WORKS. 2090 01:33:36,480 --> 01:33:38,960 NON-INVASIVE METHODS INCLUDE 2091 01:33:38,960 --> 01:33:41,520 FECAL BLOOD TEST AND FECAL 2092 01:33:41,520 --> 01:33:43,600 IMMUNOCHEMICAL TEST THAT REDUCE 2093 01:33:43,600 --> 01:33:46,240 MORTALITIES BETWEEN 9 AND 22%. 2094 01:33:46,240 --> 01:33:48,160 WHILE DIRECT VISUALIZATION 2095 01:33:48,160 --> 01:33:51,960 METHODS ARE MORE INVASIVE 2096 01:33:51,960 --> 01:33:56,280 METHODS PREVENTING POLYP REMOVAL 2097 01:33:56,280 --> 01:34:00,760 REDUCE MORTALITY 68% AND 26% 2098 01:34:00,760 --> 01:34:04,440 WITH SCREENING WITH FLEXIBLE 2099 01:34:04,440 --> 01:34:07,360 SIGMOIDOSCOPY EVERY THREE TO 5 2100 01:34:07,360 --> 01:34:07,600 YEARS. 2101 01:34:07,600 --> 01:34:08,880 NEXT SLIDE, PLEASE. 2102 01:34:08,880 --> 01:34:11,880 THERE IS ROOM FOR IMPROVEMENT 2103 01:34:11,880 --> 01:34:14,240 WITH UPTAKE OF COLORECTAL 2104 01:34:14,240 --> 01:34:16,240 SCREENING AND DATA SHOWS 2105 01:34:16,240 --> 01:34:19,600 PERCENTAGE OF ADULTS AGE 50 TO 2106 01:34:19,600 --> 01:34:21,520 75 THAT ARE UP TO DATE WITH 2107 01:34:21,520 --> 01:34:23,280 SCREENING AND LOOKING AT CIRCLES 2108 01:34:23,280 --> 01:34:25,320 AT BOT OWE M THAT ARE AGE 2109 01:34:25,320 --> 01:34:28,960 STRATIFIED YOU SEE ABOUT 62% OF 2110 01:34:28,960 --> 01:34:32,680 50 TO 64 YEAR OLDS IN 2018 AND 2111 01:34:32,680 --> 01:34:36,480 7% OF 65 TO 75 YEAR OLDS WERE UP 2112 01:34:36,480 --> 01:34:38,440 TO DATE WITH COLORECTAL 2113 01:34:38,440 --> 01:34:42,640 SCREENING AND NUMBERS FOR 2114 01:34:42,640 --> 01:34:45,480 COLONOSCOPY WERE 56% IN YOUNGER 2115 01:34:45,480 --> 01:34:48,520 AGE GROUP AND 71% IN OLDER AGE 2116 01:34:48,520 --> 01:34:50,280 GROUP THERE IS ROOM FOR 2117 01:34:50,280 --> 01:34:53,160 IMPROVEMENT WITH SCREENING IN 2118 01:34:53,160 --> 01:34:55,040 COLORECTAL CANCER IN YOUNGER AGE 2119 01:34:55,040 --> 01:34:58,160 GROUP OF 50 TO 64 AND 2120 01:34:58,160 --> 01:34:59,280 RECOMMENDED SCREENING STARTS AT 2121 01:34:59,280 --> 01:35:02,920 AGE 45 NOW. NEXT SLIDE, PLEASE. 2122 01:35:02,920 --> 01:35:05,640 FOR THOSE OPTING FOR 2123 01:35:05,640 --> 01:35:06,320 NON-INVASIVE SCREENING 2124 01:35:06,320 --> 01:35:08,280 TECHNIQUES IS CRITICALLY 2125 01:35:08,280 --> 01:35:10,440 IMPORTANT THAT POSITIVE RESULTS 2126 01:35:10,440 --> 01:35:13,040 BE FOLLOWED UCH AND THAT POLYP 2127 01:35:13,040 --> 01:35:15,400 REMOVAL OCCURS IF POLYPS ARE 2128 01:35:15,400 --> 01:35:18,800 PRESENT AND WHAT THIS SLIDE IS 2129 01:35:18,800 --> 01:35:21,080 SHOWING IS PERCENT OF 2130 01:35:21,080 --> 01:35:22,680 INDIVIDUALS WITH POSITIVE SCREEN 2131 01:35:22,680 --> 01:35:24,360 FOLLOWING UP WITH DIAGNOSTIC 2132 01:35:24,360 --> 01:35:28,560 EVALUATION AND LETTERS EFGH 2133 01:35:28,560 --> 01:35:31,360 INDICATE SCREENING CENTERS IN 2134 01:35:31,360 --> 01:35:34,720 THE STUDY AND ACROSS CENTERS 2135 01:35:34,720 --> 01:35:37,160 BETWEEN 46 AND 81% OF 2136 01:35:37,160 --> 01:35:39,960 INDIVIDUALS SCREENING POSITIVE 2137 01:35:39,960 --> 01:35:44,280 FROM LOW NON-INVASIVE TESTS 2138 01:35:44,280 --> 01:35:48,480 FOLLOWED UP TO ACTUALLY GET 2139 01:35:48,480 --> 01:35:49,480 DIAGNOSTIC EVALUATION AND GET 2140 01:35:49,480 --> 01:35:53,120 POLYPS REMOVED IF THEY WERE 2141 01:35:53,120 --> 01:35:53,640 PRESENT. 2142 01:35:53,640 --> 01:35:55,720 NEXT SLIDE, PLEASE. 2143 01:35:55,720 --> 01:35:57,000 PANCREATIC CANCER IS THIRD 2144 01:35:57,000 --> 01:35:58,720 LEADING CAUSE OF CANCER DEATH IN 2145 01:35:58,720 --> 01:36:02,760 THE UNITED STATES. 2146 01:36:02,760 --> 01:36:05,440 UNFORTUNA 2147 01:36:05,440 --> 01:36:08,360 UNFORTUNATELY INCIDENCE RATES 2148 01:36:08,360 --> 01:36:11,080 IMPROVE AND 1 YEAR SURVIVAL IN 2149 01:36:11,080 --> 01:36:14,640 MOST RECENT YEAR WAS BELOW 40% 2150 01:36:14,640 --> 01:36:15,240 STILL. 2151 01:36:15,240 --> 01:36:19,160 NEXT SLIDE, PLEASE. 2152 01:36:19,160 --> 01:36:19,880 UNFORTUNATELY MORTALITY RATES 2153 01:36:19,880 --> 01:36:23,720 ARE HEADED IN THE WRONG 2154 01:36:23,720 --> 01:36:24,280 DIRECTION. 2155 01:36:24,280 --> 01:36:29,200 NEXT SLIDE, PLEASE PAN CREATIC 2156 01:36:29,200 --> 01:36:31,880 CANCER DETECTION AND PREVENTION 2157 01:36:31,880 --> 01:36:34,320 IS CHALLENGING MODIFIABLE RISK 2158 01:36:34,320 --> 01:36:37,960 FACTORS CAUSE ONLY ABOUT 1 IN 4 2159 01:36:37,960 --> 01:36:40,840 CASES OF PANCREATIC CANCER AND 2160 01:36:40,840 --> 01:36:42,200 DIFFICULT TO DETECT AT EARLY 2161 01:36:42,200 --> 01:36:45,160 STAGE. SURGERY OF EARLY STAGE 2162 01:36:45,160 --> 01:36:46,560 PANCREATIC CANCER IS ONLY 2163 01:36:46,560 --> 01:36:47,880 CURATIVE TREATMENT. AS YOU CAN 2164 01:36:47,880 --> 01:36:51,080 SEE FROM THIS BAR GRAPH OF STAGE 2165 01:36:51,080 --> 01:36:54,240 DIAGNOSIS ONLY 10 TO 20% OF 2166 01:36:54,240 --> 01:36:55,960 PATIENTS ARE DIAGNOSED AT 2167 01:36:55,960 --> 01:36:59,400 LOCALIZED OR EARLY STAGE. 2168 01:36:59,400 --> 01:37:05,600 NEXT SLIDE, PLEASE. 2169 01:37:05,600 --> 01:37:07,840 AS DR. LOWY MENTIONED DISCUSSING 2170 01:37:07,840 --> 01:37:13,920 ASKING QUESTIONS PRIOR TO TALK 2171 01:37:13,920 --> 01:37:16,000 POTENTIAL PROMISE AND TREATMENT 2172 01:37:16,000 --> 01:37:19,560 IS DEVELOPMENT OF NEW MUTANT 2173 01:37:19,560 --> 01:37:20,280 KRAS INHIBITORS. 2174 01:37:20,280 --> 01:37:22,520 NEXT SLIDE, PLEASE. 2175 01:37:22,520 --> 01:37:25,960 MUTANT KRAS IS DRIVER MUTATION 2176 01:37:25,960 --> 01:37:29,520 IN 90% PAN CREATTIC CANCERS 2177 01:37:29,520 --> 01:37:31,320 INHIBITORS FOR THESE MUTATIONS 2178 01:37:31,320 --> 01:37:35,200 ARE UNDER ACTIVE DEVELOPMENT 2179 01:37:35,200 --> 01:37:36,160 TREATMENT HOLDS GREATEST PROMISE 2180 01:37:36,160 --> 01:37:38,160 INCREASING SURVIVAL OF 2181 01:37:38,160 --> 01:37:39,520 SUBSTANTIAL FRACTION OF 2182 01:37:39,520 --> 01:37:41,160 PANCREATIC CANCER PATIENTS IN 2183 01:37:41,160 --> 01:37:43,600 THE FUTURE. 2184 01:37:43,600 --> 01:37:47,000 NEXT SLIDE, PLEASE BREAST CANCER 2185 01:37:47,000 --> 01:37:48,640 INCIDENTS HAS INCREASED SLIGHTLY 2186 01:37:48,640 --> 01:37:51,160 OVER THE LAST 15 YEARS. 2187 01:37:51,160 --> 01:37:55,160 AND SURVIVAL HAS INCREASED 2188 01:37:55,160 --> 01:37:58,440 SOMEWHAT AND IS QUITE HIGH FOR 2189 01:37:58,440 --> 01:38:01,040 ONE YEAR SURVIVAL OR ALL 2190 01:38:01,040 --> 01:38:04,440 CATEGORIES OF SURVIVAL THAT IS 2191 01:38:04,440 --> 01:38:06,920 QUITE HIGH NEXT SLIDE, PLEASE. 2192 01:38:06,920 --> 01:38:08,320 MORTALITY RATES FOR BREAST 2193 01:38:08,320 --> 01:38:11,240 CANCER DECLINED 1.2% IN RECENT 2194 01:38:11,240 --> 01:38:11,880 TIME PERIOD. 2195 01:38:11,880 --> 01:38:15,920 AGAIN, TELLING US THAT WE NEED 2196 01:38:15,920 --> 01:38:16,920 TO ACCELERATE PROGRESS AGAINST 2197 01:38:16,920 --> 01:38:20,920 BREAST CANCER MORTALITY. 2198 01:38:20,920 --> 01:38:24,160 NEXT SLIDE, PLEASE. 2199 01:38:24,160 --> 01:38:29,160 IN TERMS OF PREVENTING BREAST 2200 01:38:29,160 --> 01:38:30,320 CANCER OPPORTUNITY IS TO 2201 01:38:30,320 --> 01:38:32,680 EVALUATE EFFICACY OF LOW-DOSE 2202 01:38:32,680 --> 01:38:35,720 HORMONE THERAPIES AND IMPROVE 2203 01:38:35,720 --> 01:38:36,800 RISK STRATIFICATION. NEXT 2204 01:38:36,800 --> 01:38:38,080 SLIDE, PLEASE. 2205 01:38:38,080 --> 01:38:41,160 HORMONE THERAPY REDUCES BREAST 2206 01:38:41,160 --> 01:38:42,880 CANCER IN HIGH-RISK WOMEN AND 2207 01:38:42,880 --> 01:38:46,440 HAS BEEN SHOWN TO REDUCE RISK OF 2208 01:38:46,440 --> 01:38:49,160 ER POSITIVE BREAST CANCER BY 2209 01:38:49,160 --> 01:38:53,320 BETWEEN 50 TO 65% WHILE ER 2210 01:38:53,320 --> 01:38:54,480 NEGATIVE BREAST CANCERS ARE 2211 01:38:54,480 --> 01:38:57,720 KNOWN TO BE MORE FATAL ER 2212 01:38:57,720 --> 01:39:00,080 POSITIVE BREAST CANCERS YOU CAN 2213 01:39:00,080 --> 01:39:02,480 SEE ON THE LEFT CAUSE ACTUALLY 2214 01:39:02,480 --> 01:39:04,600 MORE THAN 50% OF ALL BREAST 2215 01:39:04,600 --> 01:39:06,560 CANCER DEATHS INCLUDING IN 2216 01:39:06,560 --> 01:39:09,160 YOUNGER WOMEN. THERE ARE ABOUT 2217 01:39:09,160 --> 01:39:10,760 10 MILLION WOMEN WHO ARE 2218 01:39:10,760 --> 01:39:13,120 ELIGIBLE FOR HORMONE THERAPIES 2219 01:39:13,120 --> 01:39:15,240 AND LESS THAN 10% RECEIVE THEM. 2220 01:39:15,240 --> 01:39:17,600 LOTS HAS TO DO WITH 2221 01:39:17,600 --> 01:39:18,560 SIDE-EFFECTS. 2222 01:39:18,560 --> 01:39:20,320 MEDICATIONS WITH FEWER SIDE 2223 01:39:20,320 --> 01:39:21,640 EFFECTS AND RISK STRATIFICATION 2224 01:39:21,640 --> 01:39:24,560 TO IDENTIFY WOMEN WHO WOULD 2225 01:39:24,560 --> 01:39:26,400 BENEFIT MOST FROM MEDICATIONS 2226 01:39:26,400 --> 01:39:30,400 MAY IMPROVE RISK BENEFIT OF 2227 01:39:30,400 --> 01:39:33,160 HORMONAL THERAPIES. 2228 01:39:33,160 --> 01:39:34,840 NEXT SLIDE, PLEASE. 2229 01:39:34,840 --> 01:39:38,040 THERE IS DATA YOU THAT 2230 01:39:38,040 --> 01:39:41,160 INCREASING PHYSICAL ACTIVITY 2231 01:39:41,160 --> 01:39:44,160 DECREASING OBESY IN BREAST 2232 01:39:44,160 --> 01:39:45,960 CANCER SURVIVORS CAN INCREASE 2233 01:39:45,960 --> 01:39:48,000 RISK MORTALITY AND POST 2234 01:39:48,000 --> 01:39:49,000 DIAGNOSIS COULD PLAY ROLE FOR 2235 01:39:49,000 --> 01:39:53,960 BREAST CANCER MORTALITY 2236 01:39:53,960 --> 01:39:54,240 PREVENTION. 2237 01:39:54,240 --> 01:40:00,040 NEXT SLIDE, PLEASE SCREENING IS 2238 01:40:00,040 --> 01:40:02,520 IMPORTANT TOOL FOR BREAST CANCER 2239 01:40:02,520 --> 01:40:05,200 PREVENTION AND UPTAKE AMONG 2240 01:40:05,200 --> 01:40:06,480 UNDERSERVED POPULATIONS WOULD 2241 01:40:06,480 --> 01:40:08,440 REDUCE BREAST CANCER MORTALITY. 2242 01:40:08,440 --> 01:40:11,320 NEXT SLIDE, PLEASE. 2243 01:40:11,320 --> 01:40:14,600 WE KNOW FROM STUDIES MAMMOGRAPH 2244 01:40:14,600 --> 01:40:17,200 REDUCES BREAST CANCER MORTALITY 2245 01:40:17,200 --> 01:40:19,080 FROM 10 TO 30% AND ARE 2246 01:40:19,080 --> 01:40:21,000 DISPARITIES IN ACCESS AND DATA 2247 01:40:21,000 --> 01:40:24,920 FROM MM AND MWR REPORT SHOW FOR 2248 01:40:24,920 --> 01:40:26,560 EXAMPLE WOMEN THAT ARE UNINSURED 2249 01:40:26,560 --> 01:40:28,600 AND WOMEN WITH LESS THAN A HIGH 2250 01:40:28,600 --> 01:40:31,840 SCHOOL EDUCATION AND THOSE WHO 2251 01:40:31,840 --> 01:40:35,400 LIVE IN AREAS FAR BELOW POVERTY 2252 01:40:35,400 --> 01:40:39,080 THRESHOLD ARE FAR LESS LIKELY TO 2253 01:40:39,080 --> 01:40:41,000 RECEIVE A MAMMOGRAM. NEXT 2254 01:40:41,000 --> 01:40:42,200 SLIDE, PLEASE. 2255 01:40:42,200 --> 01:40:44,640 FINALLY, THERE ARE OPPORTUNITIES 2256 01:40:44,640 --> 01:40:46,880 IN TREATMENT FOR BREAST CANCER 2257 01:40:46,880 --> 01:40:49,720 INCLUDING INCREASE IN UPTAKE 2258 01:40:49,720 --> 01:40:51,680 ADHERENCE TO HORMONE AND 2259 01:40:51,680 --> 01:40:53,920 CHEMOTHERAPY. 2260 01:40:53,920 --> 01:41:04,200 NEXT SLIDE, PLEASE. 2261 01:41:04,200 --> 01:41:06,920 -- THERE ARE DOCUMENTED 2262 01:41:06,920 --> 01:41:09,200 DISPARITIES AND ACCESS IN 2263 01:41:09,200 --> 01:41:10,640 TIMELINESS IN TREATMENT AND 2264 01:41:10,640 --> 01:41:13,920 EFFORTS INCREASING UPTAKE AND 2265 01:41:13,920 --> 01:41:15,160 ADHERENCE SHOULD DECREASE BREAST 2266 01:41:15,160 --> 01:41:18,240 CANCER MORTALITY. NEXTLE SLIDE, 2267 01:41:18,240 --> 01:41:19,600 PLEASE. 2268 01:41:19,600 --> 01:41:21,080 PROSTATE CANCER HAS COMPLICATED 2269 01:41:21,080 --> 01:41:22,800 PATTERNS THAT ARE IN THE MOST 2270 01:41:22,800 --> 01:41:25,560 RECENT THAT IS FROM 2014 TO 2271 01:41:25,560 --> 01:41:28,360 2019, I SHOULD SAY INCIDENT 2272 01:41:28,360 --> 01:41:30,480 RATES OF PROSTATE CANCER 2273 01:41:30,480 --> 01:41:31,480 INCREASED THAT IS UNCLEAR 2274 01:41:31,480 --> 01:41:33,600 WHETHER OR NOT IT IS RELATED TO 2275 01:41:33,600 --> 01:41:35,720 CHANGES IN PSA TESTING 2276 01:41:35,720 --> 01:41:37,360 GUIDELINES SURVIVAL REMAINS 2277 01:41:37,360 --> 01:41:39,840 QUITE HIGH. 2278 01:41:39,840 --> 01:41:43,960 NEXT SLIDE, PLEASE. 2279 01:41:43,960 --> 01:41:45,440 MORTALITY RATES AFTER VERY 2280 01:41:45,440 --> 01:41:47,320 STRONG DECLINES HAVE FLATTENED 2281 01:41:47,320 --> 01:41:50,040 OUT IN RECENT YEARS BETWEEN 2013 2282 01:41:50,040 --> 01:41:53,480 TO 2019 AND WAS NONSTATISTICALLY 2283 01:41:53,480 --> 01:41:56,200 SIGNIFICANT DECLINE IN PROSTATE 2284 01:41:56,200 --> 01:41:58,800 CANCER MORTALITY RATES. 2285 01:41:58,800 --> 01:42:00,320 NEXT SLIDE, PLEASE. 2286 01:42:00,320 --> 01:42:03,280 AS I SAID, SOME CHANGES IN 2287 01:42:03,280 --> 01:42:04,720 INCIDENTS MAY BE RELATED TO 2288 01:42:04,720 --> 01:42:07,560 GUIDELINES FOR PSA TESTING. IN 2289 01:42:07,560 --> 01:42:11,320 2012, USPSTF RECOMMENDED AGAINST 2290 01:42:11,320 --> 01:42:13,200 SCREENING FOR PROSTATE CANCER 2291 01:42:13,200 --> 01:42:14,720 AND SWITCHED OPINION TO SHARED 2292 01:42:14,720 --> 01:42:21,040 DECISION MAKING IN 2018 STUD JIZ 2293 01:42:21,040 --> 01:42:25,240 HAVE SHOWN INCREASES IN 2294 01:42:25,240 --> 01:42:28,560 METASTATIC PROSTATE CANCER 2295 01:42:28,560 --> 01:42:31,520 DIAGNOSIS SINCE 1220 AND ALSO 2296 01:42:31,520 --> 01:42:33,120 LOCALIZED REGIONAL DISEASE SINCE 2297 01:42:33,120 --> 01:42:35,720 2014 CAUSE IS UNCLEAR AND SHIFT 2298 01:42:35,720 --> 01:42:38,320 AWAY FROM SCREENING IS RELATED 2299 01:42:38,320 --> 01:42:41,000 INCREASE IN MORE AGGRESSIVE 2300 01:42:41,000 --> 01:42:42,720 PROSTATE CANCERS RISK 2301 01:42:42,720 --> 01:42:43,920 STRATIFICATION OF SENSITIVE AND 2302 01:42:43,920 --> 01:42:46,240 SPECIFIC TASKS FOR HIGH-RISK 2303 01:42:46,240 --> 01:42:48,200 DISEASE COULD IMPROVE RISK FOR 2304 01:42:48,200 --> 01:42:51,920 BENEFIT FOR PSA TESTING. 2305 01:42:51,920 --> 01:42:53,480 NEXT SLIDE, PLEASE. 2306 01:42:53,480 --> 01:42:56,880 ANOTHER -- SO, EVALUATING RISK 2307 01:42:56,880 --> 01:42:58,960 STRATIFIED PSA SCREENING 2308 01:42:58,960 --> 01:43:01,200 IMPROVING DIAGNOSTIC TESTING 2309 01:43:01,200 --> 01:43:03,800 COULD REDUCE MORTALITY FROM 2310 01:43:03,800 --> 01:43:05,640 PROSTATE CANCER AS WE JUST 2311 01:43:05,640 --> 01:43:06,120 DESCRIBED. 2312 01:43:06,120 --> 01:43:07,840 NEXT SLIDE, PLEASE. 2313 01:43:07,840 --> 01:43:09,920 EVALUATING STRATEGIES TO FURTHER 2314 01:43:09,920 --> 01:43:12,240 REDUCE OVERTREATMENT AND REDUCE 2315 01:43:12,240 --> 01:43:14,120 DISPARITIES FOR TREATMENT AND 2316 01:43:14,120 --> 01:43:17,160 PROSTATE CANCER COULD REDUCE 2317 01:43:17,160 --> 01:43:17,760 MORTALITY. 2318 01:43:17,760 --> 01:43:19,040 NEXT SLIDE, PLEASE. 2319 01:43:19,040 --> 01:43:23,240 FINAL CANCER THAT WE FOCUSED ON 2320 01:43:23,240 --> 01:43:25,320 WAS LIVER AND INTRAHEPATIC BILE 2321 01:43:25,320 --> 01:43:28,360 DUCT CANCERS AND INCIDENTS AFTER 2322 01:43:28,360 --> 01:43:30,960 YEARS OF INCREASE STARTED TO 2323 01:43:30,960 --> 01:43:33,200 DECLINE STARTING IN 2015 AND 2324 01:43:33,200 --> 01:43:34,760 SURVIVAL FOR 3 AND 5 YEAR 2325 01:43:34,760 --> 01:43:36,880 SURVIVAL IMPROVED ALSO OVER THIS 2326 01:43:36,880 --> 01:43:39,040 TIME PERIOD AND SURVIVAL REMAINS 2327 01:43:39,040 --> 01:43:42,120 QUITE POOR. 2328 01:43:42,120 --> 01:43:45,160 NEXT SLIDE, PLEASE. 2329 01:43:45,160 --> 01:43:49,360 BETWEEN 2016 AND 2019, 2330 01:43:49,360 --> 01:43:50,680 NONSIGNIFICANT DECLINE IN LIVER 2331 01:43:50,680 --> 01:43:54,000 CANCER MORTALITY. AGAIN, AFTER 2332 01:43:54,000 --> 01:43:56,240 YEARS OF INCREASES IN MORTALITY 2333 01:43:56,240 --> 01:43:58,520 DUE TO LIVER CANCER. 2334 01:43:58,520 --> 01:43:59,640 NEXT SLIDE, PLEASE. 2335 01:43:59,640 --> 01:44:02,320 I WANT TO POINT OUT THAT IF YOU 2336 01:44:02,320 --> 01:44:03,880 ONLY CONSIDER LIVER CANCER THAT 2337 01:44:03,880 --> 01:44:05,200 IS MAJORITY OF THE CASES IN THE 2338 01:44:05,200 --> 01:44:08,320 GROUP THAT I SHOWED YOU, THERE 2339 01:44:08,320 --> 01:44:12,600 IS ACTUALLY SIGNIFICANT DECLINE 2340 01:44:12,600 --> 01:44:15,720 OF 1.8% A YEAR IN LIVER CANCER 2341 01:44:15,720 --> 01:44:18,040 MORTALITY THAT GIVES HOPE WE ARE 2342 01:44:18,040 --> 01:44:19,280 HEADED IN RIGHT DIRECTION WITH 2343 01:44:19,280 --> 01:44:22,520 LIVER CANCER DEATHS. 2344 01:44:22,520 --> 01:44:23,840 NEXT SLIDE, PLEASE. 2345 01:44:23,840 --> 01:44:25,920 ONE OPPORTUNITY FOR REDUCING 2346 01:44:25,920 --> 01:44:27,880 LIVER CANCER MORTALITY IS 2347 01:44:27,880 --> 01:44:31,400 REDUCING INCIDENCE THROUGH 2348 01:44:31,400 --> 01:44:35,200 INCREASING UPTAKE OF HBV AND HCV 2349 01:44:35,200 --> 01:44:37,560 TREATMENTS DECREASING SMOKING 2350 01:44:37,560 --> 01:44:38,040 PREVALENCE. 2351 01:44:38,040 --> 01:44:39,840 NEXT SLIDE, PLEASE. 2352 01:44:39,840 --> 01:44:43,200 LIVER CANCER IS INTERESTING IN 2353 01:44:43,200 --> 01:44:46,040 THAT IT HAS MANY DIFFERENT MAJOR 2354 01:44:46,040 --> 01:44:48,960 CAUSES AND ESTIMATED EXCESS BODY 2355 01:44:48,960 --> 01:44:52,280 WEIGHT CAUSES 1/3 OF LIVER 2356 01:44:52,280 --> 01:44:55,560 CANCERS ALCOHOL INTAKE 20%. 2357 01:44:55,560 --> 01:44:58,680 SMOKING IS 22% AND HEPATITIS B 2358 01:44:58,680 --> 01:45:01,040 VIRUS IN US IS 7% AND ABOUT 2359 01:45:01,040 --> 01:45:04,880 BETWEEN 1.5 AND 2.4 MILLION 2360 01:45:04,880 --> 01:45:09,440 PEOPLE WITH HEPATITIS B IN US 2361 01:45:09,440 --> 01:45:11,960 AND HEPATITIS C VIRUS 21% OF 2362 01:45:11,960 --> 01:45:14,040 LIVER CANCERS AND AGAIN FRACTION 2363 01:45:14,040 --> 01:45:17,200 OR NUMBER OF PEOPLE IN THE US 2364 01:45:17,200 --> 01:45:19,560 WITH CHRONIC HEPATITIS C VIRUS 2365 01:45:19,560 --> 01:45:22,960 IS BETWEEN 2.5 AND 4.7 MILLION. 2366 01:45:22,960 --> 01:45:25,160 NEXT SLIDE, PLEASE. 2367 01:45:25,160 --> 01:45:28,800 AGAIN EMPHASIZING IMPORTANCE 2368 01:45:28,800 --> 01:45:30,600 MAKING PROGRESS OF EXCESS BODY 2369 01:45:30,600 --> 01:45:32,760 WEIGHT AND ALCOHOL INTAKE AND 2370 01:45:32,760 --> 01:45:34,320 ESPECIALLY WITH LIVER CANCER. I 2371 01:45:34,320 --> 01:45:38,000 WILL FOCUS ON HEPATITIS B AND C 2372 01:45:38,000 --> 01:45:41,040 HERE. NEXT SLIDE, PLEASE. 2373 01:45:41,040 --> 01:45:45,040 NEXT SLIDE AGAIN, PLEASE. 2374 01:45:45,040 --> 01:45:47,280 SO, FOR HEPATITIS B VIRUS, THERE 2375 01:45:47,280 --> 01:45:49,680 IS INFANT VACCINATION IN US 2376 01:45:49,680 --> 01:45:51,280 STARTING IN 1991. 2377 01:45:51,280 --> 01:45:53,160 THERE IS TREATMENTS THOUGH THEY 2378 01:45:53,160 --> 01:45:57,000 ARE NOT CURATIVE FOR CHRONIC HBV 2379 01:45:57,000 --> 01:46:00,120 THAT DO REDUCE LIVER CANCER 2380 01:46:00,120 --> 01:46:01,880 RATES. HEPATITIS C VIRUS THERE 2381 01:46:01,880 --> 01:46:06,880 IS NO VACCINATION. HOWEVER, 2382 01:46:06,880 --> 01:46:07,560 DIRECT ACTING ANTIVIRAL AGENTS 2383 01:46:07,560 --> 01:46:11,520 ARE INTRODUCED IN 2014 AND ARE 2384 01:46:11,520 --> 01:46:13,840 CURATIVE INCREASED HBV AND HCV 2385 01:46:13,840 --> 01:46:15,560 TESTING IN TREATMENT ARE NEEDED 2386 01:46:15,560 --> 01:46:18,440 AND COULD MAKE A BIG IMPACT ON 2387 01:46:18,440 --> 01:46:20,320 LIVER CANCER INCIDENTS AND 2388 01:46:20,320 --> 01:46:22,040 MORTALITY AND HOWEVER LIKE WITH 2389 01:46:22,040 --> 01:46:23,680 MANY INTERVENTIONS THAT I HAVE 2390 01:46:23,680 --> 01:46:27,640 SHOWN YOU TODAY, DIRECT ACTING 2391 01:46:27,640 --> 01:46:30,120 ANTIVIRAL AGENTS THERE ARE HUGE 2392 01:46:30,120 --> 01:46:33,200 DISPARITIES AND ACCESS TO DRUGS 2393 01:46:33,200 --> 01:46:37,200 FOR TREATING CHRONIC HCV AND AGE 2394 01:46:37,200 --> 01:46:38,720 STRATIFIED FIGURE SHOWS 2395 01:46:38,720 --> 01:46:41,200 PERCENTAGE OF THOSE WITH HCV 2396 01:46:41,200 --> 01:46:42,720 INITIATING THESE TREATMENTS AND 2397 01:46:42,720 --> 01:46:44,200 HAS SHOWN THAT FRACTION OF 2398 01:46:44,200 --> 01:46:47,520 INDIVIDUALS WITH PRIVATE 2399 01:46:47,520 --> 01:46:49,120 INSURANCE WHO RECEIVE THESE 2400 01:46:49,120 --> 01:46:50,480 TREATMENTS IS MUCH HIGHER THAN 2401 01:46:50,480 --> 01:46:51,640 THOSE WITH MEDICAID. 2402 01:46:51,640 --> 01:46:53,560 IN ADDITION, I WANT TO POINT OUT 2403 01:46:53,560 --> 01:46:57,200 IN THE FIGURE THAT IN BEST CASE 2404 01:46:57,200 --> 01:46:59,720 SCENARIO 50 TO 59 YEAR OLDS WITH 2405 01:46:59,720 --> 01:47:01,760 PRIVATE INSURANCE, 40% OF 2406 01:47:01,760 --> 01:47:03,080 INDIVIDUALS WERE RECEIVING THIS 2407 01:47:03,080 --> 01:47:04,920 TREATMENT AND IS REALLY 2408 01:47:04,920 --> 01:47:06,360 OPPORTUNITY TO EXPAND ACCESS. 2409 01:47:06,360 --> 01:47:07,680 NEXT SLIDE, PLEASE. 2410 01:47:07,680 --> 01:47:09,920 I ALSO WANT TO POINT OUT THAT WE 2411 01:47:09,920 --> 01:47:12,560 THINK THAT WE ARE STARTING TO 2412 01:47:12,560 --> 01:47:15,200 SEE BENEFITS OF HCV TREATMENT 2413 01:47:15,200 --> 01:47:17,000 AND HBV TREATMENT ON LIVER 2414 01:47:17,000 --> 01:47:21,800 CANCER INCIDENTS BECAUSE OF A 2415 01:47:21,800 --> 01:47:25,560 SHARP DECLINE IN INTEREST SINCE 2416 01:47:25,560 --> 01:47:27,400 2019 NEXT SLIDE, PLEASE. 2417 01:47:27,400 --> 01:47:29,680 IN TERMS OF PREVENTING DEATHS 2418 01:47:29,680 --> 01:47:31,600 AMONGST THOSE WITH LIVER CANCER, 2419 01:47:31,600 --> 01:47:33,680 THERE IS NO POPULATION-BASED 2420 01:47:33,680 --> 01:47:35,760 SCREENING. 2421 01:47:35,760 --> 01:47:39,840 NEXT SLIDE, PLEASE. 2422 01:47:39,840 --> 01:47:42,560 BUT, SURVEILLANCE OF PEOPLE WITH 2423 01:47:42,560 --> 01:47:45,840 SOROSIS WHICH IS A CONDITION OF 2424 01:47:45,840 --> 01:47:50,000 THE LIVER THAT PRECEDES 80% OF 2425 01:47:50,000 --> 01:47:52,720 LIVER CANCERS IS RECOMMENDED 2426 01:47:52,720 --> 01:47:54,640 INCLUDING ULTRA SOUND WITH OR 2427 01:47:54,640 --> 01:47:56,320 WITHOUT ALPHA PROTEIN 2428 01:47:56,320 --> 01:47:57,840 MEASUREMENTS ASSOCIATED WITH 2429 01:47:57,840 --> 01:48:00,880 INCREASED ODDS OF HAVING 2430 01:48:00,880 --> 01:48:02,240 TRANSLATE ELIGIBLE TUMOR AND 2431 01:48:02,240 --> 01:48:06,320 IMPORTANT TO KNOW THAT 69% OF 2432 01:48:06,320 --> 01:48:10,320 INDIVIDUALS IN THE US WITH 2433 01:48:10,320 --> 01:48:15,160 SOROSIS ARE URN AWARE OF THEIR 2434 01:48:15,160 --> 01:48:17,600 DIAGNOSIS. 2435 01:48:17,600 --> 01:48:20,320 NEXT SLIDE, PLEASE. 2436 01:48:20,320 --> 01:48:22,000 NEXT LEADING CAUSES OF CANCER 2437 01:48:22,000 --> 01:48:25,800 DEATH ARE LISTED HERE. NEXT 9 2438 01:48:25,800 --> 01:48:30,080 AND THE APC LISTED HERE IS AN 2439 01:48:30,080 --> 01:48:31,080 ACRONYM FOR ANNUAL PERCENT 2440 01:48:31,080 --> 01:48:32,720 CHANGED AND WHAT IS ANNUAL 2441 01:48:32,720 --> 01:48:34,240 REDUCTION OR INCREASE IN 2442 01:48:34,240 --> 01:48:36,120 MORTALITY RATES FOR CANCERS THAT 2443 01:48:36,120 --> 01:48:39,360 YOU CAN SEE THAT FOR LEUKEMIA 2444 01:48:39,360 --> 01:48:44,320 AND NON-HODGE KINES LYMPHOMA 2445 01:48:44,320 --> 01:48:47,440 URINARY BLADDER ESOPHAGUS AND 2446 01:48:47,440 --> 01:48:51,200 KIDNEY OVARY MYELOMA UTERINE 2447 01:48:51,200 --> 01:48:52,640 CORPUS WE NEED EXCITATORY 2448 01:48:52,640 --> 01:48:55,400 PROGRESS AND FOR BRAIN TUMORS 2449 01:48:55,400 --> 01:48:57,200 AND CENTRAL NERVOUS SYSTEM 2450 01:48:57,200 --> 01:48:58,760 TUMORS RATES HAVE NOT DECLINED 2451 01:48:58,760 --> 01:49:01,840 SIGNIFICANTLY AND FOR CANCERS OF 2452 01:49:01,840 --> 01:49:04,400 UTERIN CORPUS DEATH RATES HAVE 2453 01:49:04,400 --> 01:49:07,000 ACTUALLY INCREASED OVER TIME. 2454 01:49:07,000 --> 01:49:08,320 NEXT SLIDE, PLEASE. 2455 01:49:08,320 --> 01:49:11,480 I WANT TO EMPHASIZE PROGRESS IN 2456 01:49:11,480 --> 01:49:14,200 PREVENTION EARLY DETECTION AND 2457 01:49:14,200 --> 01:49:16,040 TREATMENT OF THESE AND LESS 2458 01:49:16,040 --> 01:49:19,480 CANCERS IS CRITICALLY IMPORTANT. 2459 01:49:19,480 --> 01:49:23,040 NEXT SLIDE, PLEASE. 2460 01:49:23,040 --> 01:49:25,160 LIMITATIONS OF STUDY THERE IS A 2461 01:49:25,160 --> 01:49:27,840 NUMBER OF THEM PROJECTIONS RELY 2462 01:49:27,840 --> 01:49:29,680 ON ASSUMPTION THAT CHAFKS WILL 2463 01:49:29,680 --> 01:49:31,960 CONTINUE WITH SAME RATE 2464 01:49:31,960 --> 01:49:33,600 FACTORING RELATIVE IMPORTANCE OF 2465 01:49:33,600 --> 01:49:35,040 EXPOSURES PREVENTION AND 2466 01:49:35,040 --> 01:49:36,960 TREATMENT AND PROJECTIONS MAY BE 2467 01:49:36,960 --> 01:49:39,680 TOO OPTIMISTIC IF FOR EXAMPLE 2468 01:49:39,680 --> 01:49:41,280 PREVALENCE OF OVERWEIGHT AND 2469 01:49:41,280 --> 01:49:43,920 OBESITY ACCELERATED IN COMING 2470 01:49:43,920 --> 01:49:45,880 YEARS AND WANT TO POINT OUT THAT 2471 01:49:45,880 --> 01:49:48,880 50% DECLINE IN AGE ADJUSTED 2472 01:49:48,880 --> 01:49:50,280 MORTALITY RATES DOESN'T 2473 01:49:50,280 --> 01:49:51,840 CORRESPOND TO SIMILAR DECLINE IN 2474 01:49:51,840 --> 01:49:54,200 NUMBER OF CANCER DEATHS DUE TO 2475 01:49:54,200 --> 01:49:56,960 AGING US POPULATION AND THIS 50% 2476 01:49:56,960 --> 01:49:59,280 DECLINE IN THE AGE ADJUSTED 2477 01:49:59,280 --> 01:50:01,560 MORTALITY RATE WOULD RESULT IN 2478 01:50:01,560 --> 01:50:04,280 DECLINE FROM 608,000 CANCER 2479 01:50:04,280 --> 01:50:11,640 DEATHS IN YEAR 2022 TO 573,000 2480 01:50:11,640 --> 01:50:14,480 CANCER DEATHS IN YEAR 2047 AND 2481 01:50:14,480 --> 01:50:15,880 IMPORTANT TO REMEMBER STAYING 2482 01:50:15,880 --> 01:50:18,160 WHERE WE ARE IN TERMS OF CANCER 2483 01:50:18,160 --> 01:50:21,080 DEATH RATES THERE IS INCREASE OF 2484 01:50:21,080 --> 01:50:29,720 300,000 CANCER DEATH RATES BY 2485 01:50:29,720 --> 01:50:31,560 2047. 2486 01:50:31,560 --> 01:50:32,880 ACCELERATED PROGRESS WILL BE 2487 01:50:32,880 --> 01:50:35,200 NEED TODAY REACH MOONSHOT GOAL 2488 01:50:35,200 --> 01:50:37,560 OF A 50% REDUCTION OF CANCER 2489 01:50:37,560 --> 01:50:40,760 MORTALITY RATES BY 2047 AND IN 2490 01:50:40,760 --> 01:50:43,560 ADDITION CONTINUED INNOVATION 2491 01:50:43,560 --> 01:50:44,480 SUBSTANTIAL PROGRESS TOWARDS 2492 01:50:44,480 --> 01:50:46,960 THIS GOAL COULD BE ACCOMPLISHED 2493 01:50:46,960 --> 01:50:48,800 BY INCREASING USE OF WHAT IS 2494 01:50:48,800 --> 01:50:50,680 ALREADY KNOWN TO PREVENT DETECT 2495 01:50:50,680 --> 01:50:53,320 AND TREATMENT COMMON CANCERS AND 2496 01:50:53,320 --> 01:50:56,320 ADDRESSING UNDERUTILIZATION OF 2497 01:50:56,320 --> 01:50:58,240 DISPARITIES ACCESS TO PREVENTION 2498 01:50:58,240 --> 01:51:00,120 MUST PLAY A CENTRAL ROLE. NEXT 2499 01:51:00,120 --> 01:51:01,160 SLIDE, PLEASE. 2500 01:51:01,160 --> 01:51:03,880 ACKNOWLEDGING CO-AUTHORS. THIS 2501 01:51:03,880 --> 01:51:05,360 WAS TRULY A TEAM EFFORT IN HOW 2502 01:51:05,360 --> 01:51:07,200 WE DID THIS ANALYSIS AND PUT 2503 01:51:07,200 --> 01:51:09,240 TOGETHER THIS STUDY AS WELL AS 2504 01:51:09,240 --> 01:51:10,920 CONTENT EXPERTS THAT REVIEWED 2505 01:51:10,920 --> 01:51:13,120 OUR PAPER PRIOR TO PUBLICATION. 2506 01:51:13,120 --> 01:51:15,640 AND THANK YOU FOR YOUR 2507 01:51:15,640 --> 01:51:16,480 ATTENTION. 2508 01:51:16,480 --> 01:51:27,040 I'M HAPPY TO ANSWER QUESTIONS. 2509 01:51:29,000 --> 01:51:30,880 I AM ALL WRAPPED UP IF WE WANT 2510 01:51:30,880 --> 01:51:33,120 TO STOP SHARING SO I CAN SEE 2511 01:51:33,120 --> 01:51:35,280 EVERYONE. 2512 01:51:35,280 --> 01:51:37,760 THERE WE GO. 2513 01:51:37,760 --> 01:51:39,840 SHOULD I -- IS IT OKAY IF I CALL 2514 01:51:39,840 --> 01:51:44,720 ON PEOPLE TO ANSWER QUESTIONS? 2515 01:51:44,720 --> 01:51:48,600 I WILL DO IT. KRISTEN, SORRY I 2516 01:51:48,600 --> 01:51:50,480 DON'T KNOW ANYBODY'S TITLES. IF 2517 01:51:50,480 --> 01:51:51,800 YOU DON'T MIND FIRST NAMES THAT 2518 01:51:51,800 --> 01:51:53,240 IS WHAT I CAN SEE. 2519 01:51:53,240 --> 01:51:54,840 >>NO PROBLEM. 2520 01:51:54,840 --> 01:51:56,520 >>ANNIE MIGHT HAVE TECHNICAL 2521 01:51:56,520 --> 01:51:56,880 DIFFICULTIES. 2522 01:51:56,880 --> 01:51:58,560 I DON'T SEE HER. NO YOU THAT WE 2523 01:51:58,560 --> 01:52:00,360 HAVE EVERYBODY'S FACE UP, I 2524 01:52:00,360 --> 01:52:01,040 DON'T SEE HER. 2525 01:52:01,040 --> 01:52:02,760 THANKS FOR JUMPING IN. 2526 01:52:02,760 --> 01:52:05,720 >>SURE. GO AHEAD WITH YOUR 2527 01:52:05,720 --> 01:52:06,000 QUESTION. 2528 01:52:06,000 --> 01:52:08,360 >>THANK YOU. KRISTEN WITH 2529 01:52:08,360 --> 01:52:09,960 LONGEVITY FOUNDATION AND THIS IS 2530 01:52:09,960 --> 01:52:11,560 A LONG SPECIFIC QUESTION AND I 2531 01:52:11,560 --> 01:52:13,520 KIND OF KNOW THE ANSWER BUT WHEN 2532 01:52:13,520 --> 01:52:16,080 LOOKING AT RISK FACTORS ARE YOU 2533 01:52:16,080 --> 01:52:18,680 CONSIDER AT ALL OR IS ON RADAR I 2534 01:52:18,680 --> 01:52:21,200 DON'T KNOW DATA IS THERE 2535 01:52:21,200 --> 01:52:23,600 ENVIRONMENTAL FACTORS THAT, YOU 2536 01:52:23,600 --> 01:52:26,080 KNOW, FOREST FIRE SMOKE OR RADON 2537 01:52:26,080 --> 01:52:28,440 OR BURN PIT OR OTHER THINGS THAT 2538 01:52:28,440 --> 01:52:30,360 I DON'T -- I DON'T THINK THAT 2539 01:52:30,360 --> 01:52:32,520 THERE IS HARD DATA YET TO MAKE 2540 01:52:32,520 --> 01:52:35,320 THE CORRELATION BUT IS THAT 2541 01:52:35,320 --> 01:52:37,000 ANYTHING YOU ARE ALL CONSIDERING 2542 01:52:37,000 --> 01:52:38,920 OR THAT IS BEING CONSIDERED? 2543 01:52:38,920 --> 01:52:41,160 >>WE DON'T REALLY -- WE REALLY 2544 01:52:41,160 --> 01:52:43,640 FOCUSED ON MAJOR RISK FACTORS 2545 01:52:43,640 --> 01:52:45,160 AND MAJOR SCREENING STRATEGIES 2546 01:52:45,160 --> 01:52:46,800 AND TREATMENT AND THINGS THAT 2547 01:52:46,800 --> 01:52:48,400 WILL HAVE REALLY BIG EFFECTS AND 2548 01:52:48,400 --> 01:52:50,360 WHILE ALL OF THOSE ARE REALLY 2549 01:52:50,360 --> 01:52:53,160 IMPORTANT RISK FACTORS FOR LUNG 2550 01:52:53,160 --> 01:52:55,640 CANCER, THEY DON'T COME CLOSE TO 2551 01:52:55,640 --> 01:52:58,040 RISK ASSOCIATED AT A POPULATION 2552 01:52:58,040 --> 01:52:59,560 LEVEL WITH CIGARETTE SMOKING AND 2553 01:52:59,560 --> 01:53:02,760 WE FOCUSED REALLY ON CIGARETTE 2554 01:53:02,760 --> 01:53:04,920 SMOKING AND LOTS OF THOSE 2555 01:53:04,920 --> 01:53:06,440 PARTICULARLY THE FOREST FIRE 2556 01:53:06,440 --> 01:53:08,160 QUESTIONS AND IT REALLY IS HARD 2557 01:53:08,160 --> 01:53:09,920 TO QUANTIFY IN THE MOMENT. 2558 01:53:09,920 --> 01:53:12,120 OF COURSE, ALL OF THOSE THINGS 2559 01:53:12,120 --> 01:53:12,720 ARE REALLY IMPORTANT. 2560 01:53:12,720 --> 01:53:16,280 WE FOCUSED REALLY ON MAJOR RISK 2561 01:53:16,280 --> 01:53:16,760 FACTORS HERE. 2562 01:53:16,760 --> 01:53:18,760 >>JUST LIKE -- I KNOW. IT IS 2563 01:53:18,760 --> 01:53:20,400 KIND OF I ASSUME THAT WAS THE 2564 01:53:20,400 --> 01:53:22,440 ANSWER AND I HAVE COLLEAGUES IN 2565 01:53:22,440 --> 01:53:23,800 CALIFORNIA THAT ARE NOT EXCITED 2566 01:53:23,800 --> 01:53:25,720 BUT KIND OF EXCITED THAT THE 2567 01:53:25,720 --> 01:53:28,440 EAST COAST WAS EXPERIENCING SOME 2568 01:53:28,440 --> 01:53:31,000 AIR QUALITY ISSUES THAT IS MAYBE 2569 01:53:31,000 --> 01:53:32,800 HIGHER ON THE RADAR FOR, YOU 2570 01:53:32,800 --> 01:53:35,080 KNOW, CHANGES IN THE FUTURE. 2571 01:53:35,080 --> 01:53:36,680 >> THAT IS GREAT. OF COURSE. 2572 01:53:36,680 --> 01:53:37,160 >>THANK YOU. 2573 01:53:37,160 --> 01:53:39,040 >>THANK YOU FOR THE QUESTION. 2574 01:53:39,040 --> 01:53:41,360 >>SORRY I DROPPED OFF, FOLKS. 2575 01:53:41,360 --> 01:53:44,520 I HAD AN INTERNET HICCUP HERE. 2576 01:53:44,520 --> 01:53:46,680 NICOLE, SEE YOUR HAND IS RAISED. 2577 01:53:46,680 --> 01:53:49,280 >>YES. HI, ANNIE. WELCOME 2578 01:53:49,280 --> 01:53:49,480 BACK. 2579 01:53:49,480 --> 01:53:51,680 I HAD A COUPLE QUESTIONS. 2580 01:53:51,680 --> 01:53:52,120 >>SURE. 2581 01:53:52,120 --> 01:53:54,520 >>FIRST ONE I THINK FOLLOWS UP 2582 01:53:54,520 --> 01:53:56,120 ON WHAT KRISTEN WAS TALKING 2583 01:53:56,120 --> 01:53:58,040 ABOUT WITH ENVIRONMENTAL FACTORS 2584 01:53:58,040 --> 01:54:00,480 AND YOU TALKING ABOUT SMOKING 2585 01:54:00,480 --> 01:54:02,560 CESSATION AS BEING A MAJOR FOCUS 2586 01:54:02,560 --> 01:54:03,680 FOR LUNG CANCER. 2587 01:54:03,680 --> 01:54:07,680 DO WE KNOW WHAT THE 2588 01:54:07,680 --> 01:54:09,720 IMPLICATIONS WILL BE OF THE 2589 01:54:09,720 --> 01:54:11,680 ECIGARETTES OR VAPING THAT, YOU 2590 01:54:11,680 --> 01:54:13,560 KNOW, MORE YOUNG ADULTS ARE 2591 01:54:13,560 --> 01:54:14,720 DOING NOW? 2592 01:54:14,720 --> 01:54:17,120 AND HOW THAT WOULD CONTRIBUTE TO 2593 01:54:17,120 --> 01:54:18,920 CANCER? IF THERE SHOULD BE SOME 2594 01:54:18,920 --> 01:54:21,360 OPPORTUNITY THERE TO TRY TO 2595 01:54:21,360 --> 01:54:23,400 REDUCE AS WELL THAT AREA? 2596 01:54:23,400 --> 01:54:25,560 >>YEAH. I DON'T THINK -- 2597 01:54:25,560 --> 01:54:27,920 AGAIN, I DON'T THINK THAT DATA 2598 01:54:27,920 --> 01:54:30,400 IS QUITE THERE YET. 2599 01:54:30,400 --> 01:54:31,520 UNFORTUNATELY, WITH STUDYING 2600 01:54:31,520 --> 01:54:33,200 CANCER AS ALL OF YOU KNOW, IT 2601 01:54:33,200 --> 01:54:35,200 OFTEN TAKES MANY, MANY YEARS TO 2602 01:54:35,200 --> 01:54:36,440 SEE IN EFFECT. 2603 01:54:36,440 --> 01:54:39,600 I DON'T THINK DATA FOR THOSE 2604 01:54:39,600 --> 01:54:40,680 PRODUCTS ARE QUITE THERE YET. 2605 01:54:40,680 --> 01:54:43,840 I THINK IT IS UNLIKELY THAT THEY 2606 01:54:43,840 --> 01:54:45,560 ARE AT THE SAME LEVEL AS 2607 01:54:45,560 --> 01:54:48,880 CIGARETTE SMOKING JUST BASED ON 2608 01:54:48,880 --> 01:54:52,040 THE FACT THAT YOU ARE INHALING A 2609 01:54:52,040 --> 01:54:54,160 BURNING PRODUCT INTO YOUR LUNGS 2610 01:54:54,160 --> 01:55:01,240 OPPOSED TO SOME OTHER PRODUCUCT 2611 01:55:01,240 --> 01:55:03,240 AND DATA IS NOT THERE YET AND WE 2612 01:55:03,240 --> 01:55:05,000 CAN'T SAY MUCH ABOUT THEM AND 2613 01:55:05,000 --> 01:55:06,080 INTERESTING QUESTION TOO. IT IS 2614 01:55:06,080 --> 01:55:09,400 POSSIBLE THAT INCREASED USE TO 2615 01:55:09,400 --> 01:55:12,120 SOME NONCOMBUSTIBLE PRODUCTS IS 2616 01:55:12,120 --> 01:55:14,360 DECREASING USE OF TRADITIONAL 2617 01:55:14,360 --> 01:55:17,080 CIGARETTES THAT IS SORT OF AN 2618 01:55:17,080 --> 01:55:19,280 INTERESTING POPULATION LEVEL 2619 01:55:19,280 --> 01:55:20,920 QUESTION ABOUT WHAT IS THE NET 2620 01:55:20,920 --> 01:55:22,520 HARM VERSUS BENEFIT. 2621 01:55:22,520 --> 01:55:26,280 I HAPPENED -- MY HUSBAND IS AN 2622 01:55:26,280 --> 01:55:28,160 EPIDEMIOLOGISTS IN CENTER FOR 2623 01:55:28,160 --> 01:55:29,760 TOBACCO PRODUCTS AND FDA AND 2624 01:55:29,760 --> 01:55:31,160 WHAT THEY ARE CONSTANT WILL I 2625 01:55:31,160 --> 01:55:33,000 TRYING OR STRUGGLING WITH AND 2626 01:55:33,000 --> 01:55:34,080 TRYING TO UNDERSTAND HOW THESE 2627 01:55:34,080 --> 01:55:36,600 KIND OF PRODUCTS AS ONE GOES UP 2628 01:55:36,600 --> 01:55:38,800 AND ONE GOES DOWN WHAT NET HARM 2629 01:55:38,800 --> 01:55:40,840 OR BENEFIT IS OF USE OF 2630 01:55:40,840 --> 01:55:41,120 PRODUCTS. 2631 01:55:41,120 --> 01:55:43,280 >>UH-HUH. YEAH. IT WILL BE 2632 01:55:43,280 --> 01:55:44,400 INTERESTING WHEN WE KNOW MORE 2633 01:55:44,400 --> 01:55:47,760 AND HAVE MORE DATA, LONGER TERM 2634 01:55:47,760 --> 01:55:47,960 DATA. 2635 01:55:47,960 --> 01:55:48,600 >>YEAH. 2636 01:55:48,600 --> 01:55:51,680 >>OTHER QUESTION I HAD WAS 2637 01:55:51,680 --> 01:55:53,960 AROUND MET AFT ACYST. 2638 01:55:53,960 --> 01:55:55,320 IT WASN'T MENTIONED AND THERE IS 2639 01:55:55,320 --> 01:55:56,880 AN OPPORTUNITY THERE AND YOU 2640 01:55:56,880 --> 01:56:01,840 KNOW MOST DEATHS FROM CANCER ARE 2641 01:56:01,840 --> 01:56:05,160 FROM MET AFT CYST AND NOT FROM 2642 01:56:05,160 --> 01:56:07,720 PRIMARY TUMOR ITSELF AND IS 2643 01:56:07,720 --> 01:56:09,200 THERE OPPORTUNITY THERE FOR 2644 01:56:09,200 --> 01:56:10,400 INCREASED SCREENING? 2645 01:56:10,400 --> 01:56:12,960 WE HAVE ACTUALLY TREATMENTS THAT 2646 01:56:12,960 --> 01:56:15,840 COULD BENEFIT PATIENTS IF MET 2647 01:56:15,840 --> 01:56:19,240 AFT AKRIZ ARE DETECTED EARLIER 2648 01:56:19,240 --> 01:56:20,880 AND IS THERE DISCUSSION ABOUT 2649 01:56:20,880 --> 01:56:23,040 THAT MAKING THIS IMPACT? 2650 01:56:23,040 --> 01:56:24,120 >>REALLY INTERESTING QUESTION 2651 01:56:24,120 --> 01:56:25,680 AND OUTSIDE OF MY AREA OF 2652 01:56:25,680 --> 01:56:27,960 EXPERTISE AND I WILL TELL YOU I 2653 01:56:27,960 --> 01:56:29,120 HAVE GIVEN THIS PRESENTATION 2654 01:56:29,120 --> 01:56:30,880 MANY TIMES AND NOBODY HAS ASKED 2655 01:56:30,880 --> 01:56:31,240 ME THAT. 2656 01:56:31,240 --> 01:56:33,120 I WILL WRITE IT DOWN AND LOOK 2657 01:56:33,120 --> 01:56:33,720 MORE INTO IT. 2658 01:56:33,720 --> 01:56:35,640 I THIS I IT IS A REALLY 2659 01:56:35,640 --> 01:56:36,240 IMPORTANT QUESTION. 2660 01:56:36,240 --> 01:56:39,520 I WILL TELL YOU MY EXPERTISE IS 2661 01:56:39,520 --> 01:56:40,800 IN SURVEILLANCE RESEARCH. 2662 01:56:40,800 --> 01:56:43,240 I -- YOU KNOW, THAT IS WHAT I -- 2663 01:56:43,240 --> 01:56:46,320 THAT IS WHAT MY SCIENCE IS ON 2664 01:56:46,320 --> 01:56:48,640 UNFORTUNATELY CANCER REGISTRIES 2665 01:56:48,640 --> 01:56:50,560 DON'T -- THEY COLLECT MET 2666 01:56:50,560 --> 01:56:52,200 AFTCIES AT DIAGNOSIS. 2667 01:56:52,200 --> 01:56:53,720 THEY DON'T -- THERE IS NOT 2668 01:56:53,720 --> 01:56:56,160 FOLLOW UP FOR -- DATA IS NOT 2669 01:56:56,160 --> 01:56:57,480 COLLECTED THAT REOCCURRENCE DATA 2670 01:56:57,480 --> 01:56:59,920 IS NOT COLLECTED AND IS A MAJOR 2671 01:56:59,920 --> 01:57:01,560 GAP THAT WE CAN'T SEE WHAT IS 2672 01:57:01,560 --> 01:57:03,240 HAPPENING THERE AT A POPULATION 2673 01:57:03,240 --> 01:57:05,240 LEVEL THAT IS A MAJOR LIMITATION 2674 01:57:05,240 --> 01:57:07,760 OF OUR SURVEILLANCE SYSTEM. 2675 01:57:07,760 --> 01:57:09,200 >>ALL RIGHT. THANK YOU. 2676 01:57:09,200 --> 01:57:11,800 >>THANK YOU, NICOLE. MARTY, I 2677 01:57:11,800 --> 01:57:13,560 SEE YOUR HAND IS UP. 2678 01:57:13,560 --> 01:57:16,520 >>YES. THANK YOU. 2679 01:57:16,520 --> 01:57:20,800 SO, MY AREA OF KNOWLEDGE IS 2680 01:57:20,800 --> 01:57:24,600 PROSTATE CANCER AND QUESTION 2681 01:57:24,600 --> 01:57:27,000 APPLIES TO BROAD RANGE OF 2682 01:57:27,000 --> 01:57:28,040 CANCERS MENTIONED CESSATION OF 2683 01:57:28,040 --> 01:57:29,560 SMOKING REDUCING ALCOHOL AND 2684 01:57:29,560 --> 01:57:31,360 COUPLE OF FACTORS ARE IMPORTANT 2685 01:57:31,360 --> 01:57:33,280 BY, YOU KNOW, REDUCING BAD 2686 01:57:33,280 --> 01:57:35,400 THINGS THAT WE PUT IN OUR BODIES 2687 01:57:35,400 --> 01:57:37,360 AND ON MORE POSITIVE NOTE I READ 2688 01:57:37,360 --> 01:57:39,440 A LOT OF STUDIES THAT SHOWED 2689 01:57:39,440 --> 01:57:42,440 THAT A HEALTHY DIET AND EXERCISE 2690 01:57:42,440 --> 01:57:44,000 PROGRAM AND THAT KIND OF THING 2691 01:57:44,000 --> 01:57:47,280 ACTUALLY HAS A DOCUMENTED 2692 01:57:47,280 --> 01:57:49,760 PREVENTIVE BENEFIT IN TERMS OF 2693 01:57:49,760 --> 01:57:51,800 PROSTATE CANCER THAT ADVANCES. 2694 01:57:51,800 --> 01:57:53,840 IS THAT TOO TANGENTIAL? 2695 01:57:53,840 --> 01:57:55,440 IS THAT SOMETHING YOU ARE 2696 01:57:55,440 --> 01:57:57,680 LOOKING AT? 2697 01:57:57,680 --> 01:58:00,320 >>WE CONSIDERED THAT KIND OF 2698 01:58:00,320 --> 01:58:02,280 LIKE THE POSITIVE SPIN AND 2699 01:58:02,280 --> 01:58:03,800 PHYSICAL ACTIVITY AND HEALTHY 2700 01:58:03,800 --> 01:58:06,960 DIET AND OPPOSITE THAT IS THE 2701 01:58:06,960 --> 01:58:07,560 OBESITY RATES. 2702 01:58:07,560 --> 01:58:09,960 WE STRUGGLED A LOT IN ANALYSIS 2703 01:58:09,960 --> 01:58:12,400 WITH HOW TO ADDRESS THOSE. 2704 01:58:12,400 --> 01:58:14,360 THEY ARE QUITE DIFFICULT TO 2705 01:58:14,360 --> 01:58:18,320 ADDRESS AT A POPULATION LEVEL. 2706 01:58:18,320 --> 01:58:19,960 THERE, YOU KNOW, THERE ARE NOT 2707 01:58:19,960 --> 01:58:22,120 -- YOU KNOW, WITH CIGARETTES 2708 01:58:22,120 --> 01:58:24,480 THERE WAS REGULATION; RIGHT? 2709 01:58:24,480 --> 01:58:27,160 BY FDA AND INDOOR SMOKING LAWS 2710 01:58:27,160 --> 01:58:30,920 AND LOTS OF THINGS THAT HAPPENED 2711 01:58:30,920 --> 01:58:33,160 WITH SMOKING THAT HELPED REDUCE 2712 01:58:33,160 --> 01:58:37,080 THE PREVALENCE OF SMOKING. 2713 01:58:37,080 --> 01:58:39,560 WITH OBESITY AND PHYSICAL 2714 01:58:39,560 --> 01:58:41,840 ACTIVITY AND HEALTHY EATING IT 2715 01:58:41,840 --> 01:58:45,520 HAS BEEN A REAL CHALLENGE AT A 2716 01:58:45,520 --> 01:58:48,560 POPULATION LEVEL TO SEE PROGRESS 2717 01:58:48,560 --> 01:58:52,560 YOU SEE UNFORTUNATELY IN OBESITY 2718 01:58:52,560 --> 01:58:54,800 RATES AND PHYSICAL RATES HAVEN'T 2719 01:58:54,800 --> 01:58:55,920 IMPROVED EITHER AND WE DIDN'T 2720 01:58:55,920 --> 01:58:57,680 WANT TO SAY THERE IS NO WAY 2721 01:58:57,680 --> 01:59:00,800 THERE COULD BE PROGRESS ON 2722 01:59:00,800 --> 01:59:01,600 FACTORS THAT ARE REALLY 2723 01:59:01,600 --> 01:59:02,040 IMPORTANT. 2724 01:59:02,040 --> 01:59:04,200 I DON'T HAVE A PARTICULAR 2725 01:59:04,200 --> 01:59:05,200 INTERVENTION TO TELL YOU WE 2726 01:59:05,200 --> 01:59:07,280 SHOULD ACCELERATE ON THIS 2727 01:59:07,280 --> 01:59:08,360 INTERVENTION TO BE ABLE TO MAKE 2728 01:59:08,360 --> 01:59:10,120 CHANGE AT A POPULATION LEVEL AND 2729 01:59:10,120 --> 01:59:11,880 REALLY HOPE THAT IT HAPPENS BUT 2730 01:59:11,880 --> 01:59:13,160 CAN'T TELL WHAT YOU IT LOOKS 2731 01:59:13,160 --> 01:59:16,200 LIKE RIGHT NOW. TO YOUR POINT 2732 01:59:16,200 --> 01:59:19,880 AT AN INDIVIDUAL LEVEL, YES. 2733 01:59:19,880 --> 01:59:20,880 PHYSICAL ACTIVITY AND HEALTHY 2734 01:59:20,880 --> 01:59:23,480 EATING MAKES A DIFFERENCE TO 2735 01:59:23,480 --> 01:59:25,560 ONE'S INDIVIDUAL RISK. 2736 01:59:25,560 --> 01:59:26,880 >>THANK YOU. 2737 01:59:26,880 --> 01:59:31,600 >>THANK YOU, MARTY. NATHANIEL? 2738 01:59:31,600 --> 01:59:33,400 >>GREAT RESEARCH AND LOVE IT 2739 01:59:33,400 --> 01:59:36,880 AND COMMENT WILL BE SHORT AND IT 2740 01:59:36,880 --> 01:59:38,360 PIGGYBACKS OFF MY PEERS COMMENTS 2741 01:59:38,360 --> 01:59:40,040 IN JUST THAT I HOPE THAT MAYBE 2742 01:59:40,040 --> 01:59:41,680 AS YOU LOOK FURTHER IN YOUR 2743 01:59:41,680 --> 01:59:44,480 RE-ENVIRONMENTAL THINGS THAT MAY 2744 01:59:44,480 --> 01:59:46,560 -- THEY MAY BE OF MORE 2745 01:59:46,560 --> 01:59:48,320 PREVALENCE THAT I KNOW IS COMING 2746 01:59:48,320 --> 01:59:50,320 UP AND SEEMS MUCH MORE 2747 01:59:50,320 --> 01:59:51,760 FREQUENTLY LATELY AS WE THINK 2748 01:59:51,760 --> 01:59:53,160 ABOUT THINGS WE HAVEN'T THOUGHT 2749 01:59:53,160 --> 01:59:53,680 ABOUT BEFORE. 2750 01:59:53,680 --> 01:59:55,960 I WOULD LIKE TO POINT OUT 2751 01:59:55,960 --> 01:59:57,160 PARTICULARLY RADON THAT I THINK 2752 01:59:57,160 --> 01:59:59,640 IS A QUANTIFIABLE THING YOU CAN 2753 01:59:59,640 --> 02:00:01,520 GET HARD DATA ON PARTICULARLY 2754 02:00:01,520 --> 02:00:03,520 IN, YOU KNOW, STATES LIKE I 2755 02:00:03,520 --> 02:00:06,160 THINK WASHINGTON, CALIFORNIA AND 2756 02:00:06,160 --> 02:00:08,520 UTAH HAVE LOWEST RATES OF 2757 02:00:08,520 --> 02:00:11,840 SMOKING BUT HAVEN'T ERADICATED 2758 02:00:11,840 --> 02:00:14,120 LUNG CANCER AND CONSEQUENTIALLY 2759 02:00:14,120 --> 02:00:17,560 HAVE HIGHEST RATES OF RADON AND 2760 02:00:17,560 --> 02:00:19,080 INTERESTING THINGS THERE IN 2761 02:00:19,080 --> 02:00:21,680 NORTHWEST REGIONS WITH RADON AND 2762 02:00:21,680 --> 02:00:23,160 ENCOURAGE THAT IN FUTURE STUDIES 2763 02:00:23,160 --> 02:00:25,160 AND REALLY WOULD LOVE TO SEE 2764 02:00:25,160 --> 02:00:26,520 STATISTICALLY THIS. I THIS I IT 2765 02:00:26,520 --> 02:00:29,160 IS A GREAT -- IT IS A GREAT 2766 02:00:29,160 --> 02:00:31,000 HEADING AND CHALLENGE YOU ARE 2767 02:00:31,000 --> 02:00:32,320 GOING ON AND IS THIS FEASIBLE 2768 02:00:32,320 --> 02:00:33,960 AND THAT IS THE QUESTION THAT WE 2769 02:00:33,960 --> 02:00:37,200 LOVE TO SEE BH THERE IS A BIG 2770 02:00:37,200 --> 02:00:39,480 GOAL REDUCING CANCER BY 50%. 2771 02:00:39,480 --> 02:00:39,800 >>RIGHT. 2772 02:00:39,800 --> 02:00:41,800 >>I APPRECIATE REALLY PUTTING 2773 02:00:41,800 --> 02:00:43,720 QUANTIFIABLE MEASURES TO IT AND 2774 02:00:43,720 --> 02:00:45,520 HOPE WE CAN CONTINUE TO EXPAND 2775 02:00:45,520 --> 02:00:45,720 THAT. 2776 02:00:45,720 --> 02:00:47,680 >>THANK YOU FOR YOUR COMMENT. 2777 02:00:47,680 --> 02:00:50,240 I AGREE THAT ENVIRONMENTAL 2778 02:00:50,240 --> 02:00:51,840 EXPOSURES ARE REALLY IMPORTANT 2779 02:00:51,840 --> 02:00:54,560 AND DIVISION I SIT IN AT NC 2780 02:00:54,560 --> 02:00:56,320 INTRA MURAL DIVISION HAS A WHOLE 2781 02:00:56,320 --> 02:00:59,280 BRANCH FOCUSED ON OCCUPATIONAL 2782 02:00:59,280 --> 02:01:03,640 AND ENVIRONMENTAL EXPOSURES 2783 02:01:03,640 --> 02:01:05,640 WATER AND AIR POLLUTION AND ALSO 2784 02:01:05,640 --> 02:01:07,120 OCCUPATIONAL EXPOSURES AND 2785 02:01:07,120 --> 02:01:09,840 RESEARCH IN AREA AND PFAS AND 2786 02:01:09,840 --> 02:01:13,760 EXPOSURE AND THINGS YOU HEAR. 2787 02:01:13,760 --> 02:01:16,160 WE AT INTRAMURAL PROGRAM AT NCI 2788 02:01:16,160 --> 02:01:20,360 IS NOT FOCUSED ON THAT OR MY 2789 02:01:20,360 --> 02:01:21,200 RESEARCH SPECIFICALLY. 2790 02:01:21,200 --> 02:01:25,280 >>THANK YOU, NATHANIEL. 2791 02:01:25,280 --> 02:01:28,480 I APOLOGIZE FOR MY WI-FI 2792 02:01:28,480 --> 02:01:29,960 DROPPING LAST FEW MINUTES OF 2793 02:01:29,960 --> 02:01:31,600 YOUR TALK IN THE LAST QUESTION. 2794 02:01:31,600 --> 02:01:33,040 I APPRECIATE SO MUCH OF WORK 2795 02:01:33,040 --> 02:01:34,520 THAT YOUR TEAM PUT INTO THIS AND 2796 02:01:34,520 --> 02:01:36,640 TO REALLY LOOK AT WHAT IT WOULD 2797 02:01:36,640 --> 02:01:38,600 TAKE TO MOVE THE NEEDLE IN THE 2798 02:01:38,600 --> 02:01:39,960 RIGHT DIRECTION HERE AS WELL AS 2799 02:01:39,960 --> 02:01:42,080 DIRECTION THAT THINGS ARE GOING. 2800 02:01:42,080 --> 02:01:44,320 AND I APPRECIATE THAT YOU ARE 2801 02:01:44,320 --> 02:01:46,160 LOOKING AT, YOU KNOW, ALSO 2802 02:01:46,160 --> 02:01:49,720 REDUCIN KRIDIENTS ALONG WITH 2803 02:01:49,720 --> 02:01:51,880 MORTALITY AND NOT FOCUSING ON 2804 02:01:51,880 --> 02:01:54,040 MORTALITY INCIDENTS IF YOU 2805 02:01:54,040 --> 02:01:55,960 REDUCE YOU REDUCE MORTALITY IN 2806 02:01:55,960 --> 02:01:57,160 LOTS OF THESE CASES AND TWO 2807 02:01:57,160 --> 02:01:59,480 QUICK QUESTIONS THAT WE DON'T 2808 02:01:59,480 --> 02:02:01,000 PROBABLY HAVE TIME FOR BOTH OF 2809 02:02:01,000 --> 02:02:01,200 THEM. 2810 02:02:01,200 --> 02:02:03,080 I WILL THROW THEM OUT THERE. 2811 02:02:03,080 --> 02:02:05,720 YOU CAN CHOOSE WHAT YOU WANT TO 2812 02:02:05,720 --> 02:02:07,560 FROM THE LAST FEW MINUTES AND 2813 02:02:07,560 --> 02:02:09,560 FIRST, YOU KNOW, IS THERE GOING 2814 02:02:09,560 --> 02:02:11,760 TO BE A FOLLOW UP STUDY TO 2815 02:02:11,760 --> 02:02:13,760 UNDERSTAND HOW WE CAN PROBABLY 2816 02:02:13,760 --> 02:02:16,840 MAKE PROGRESS AGAINST UNCOMMON 2817 02:02:16,840 --> 02:02:19,800 CANCERS AND SECOND QUESTION IS A 2818 02:02:19,800 --> 02:02:21,440 LITTLE BIT THAT WE HEAR -- I 2819 02:02:21,440 --> 02:02:23,680 HAVE HEARD IN SOME SPACES ABOUT 2820 02:02:23,680 --> 02:02:25,560 REDUCING MORTALITY BY 50 P RS IF 2821 02:02:25,560 --> 02:02:27,400 WE JUST GET STANDARD OF CARE TO 2822 02:02:27,400 --> 02:02:30,640 LIKE THE AREAS OF PERSISTENT 2823 02:02:30,640 --> 02:02:32,080 POVERTY WHERE THAT IS NOT 2824 02:02:32,080 --> 02:02:33,520 HAPPENING AND IS THERE A WAY TO 2825 02:02:33,520 --> 02:02:35,320 SHOW THAT OR PROVE IT OR DO IT 2826 02:02:35,320 --> 02:02:36,000 P. 2827 02:02:36,000 --> 02:02:36,920 AND, YOU KNOW. 2828 02:02:36,920 --> 02:02:39,880 >>YEAH. I WILL TAKE THE SECOND 2829 02:02:39,880 --> 02:02:40,200 ONE. 2830 02:02:40,200 --> 02:02:44,760 YOU PEEKED MY INTEREST THERE I'M 2831 02:02:44,760 --> 02:02:46,880 REALLY INTERESTED IN THAT. 2832 02:02:46,880 --> 02:02:48,080 NUMERICALLY, WE COULD TRY TO 2833 02:02:48,080 --> 02:02:49,200 FIGURE OUT SOME WAY OF LIKE 2834 02:02:49,200 --> 02:02:51,160 THESE ARE THE AREAS OF THE 2835 02:02:51,160 --> 02:02:53,320 COUNTRY WITH THE BEST MORTALITY 2836 02:02:53,320 --> 02:02:53,640 RATES. 2837 02:02:53,640 --> 02:02:55,480 IF EVERYBODY HAD THE BEST 2838 02:02:55,480 --> 02:02:57,640 MORTALITY RATES, WHERE WILL WE 2839 02:02:57,640 --> 02:02:58,280 BE? 2840 02:02:58,280 --> 02:02:59,760 SOMETHING OF THAT MAYBE 2841 02:02:59,760 --> 02:03:01,040 SOMETHING A LITTLE MORE NUANCED 2842 02:03:01,040 --> 02:03:02,520 IN THAT WAY AND SOMETHING THAT 2843 02:03:02,520 --> 02:03:03,960 COLLEAGUES AND I ARE THINKING 2844 02:03:03,960 --> 02:03:04,280 ABOUT. 2845 02:03:04,280 --> 02:03:08,080 AS I SHOWED AND AS YOU ARE VERY 2846 02:03:08,080 --> 02:03:09,400 AWARE AT EVERY INTERVENTION 2847 02:03:09,400 --> 02:03:11,360 POINT THERE ARE PROFOUND 2848 02:03:11,360 --> 02:03:13,840 DISPARITIES IN ALL SORTS OF 2849 02:03:13,840 --> 02:03:18,880 METRICS OF DISADVANTAGE. 2850 02:03:18,880 --> 02:03:21,080 AND IF WE COULD GET THINGS THAT 2851 02:03:21,080 --> 02:03:22,680 WORKED AND PEOPLE NOT RECEIVING 2852 02:03:22,680 --> 02:03:27,240 THEM WE COULD MAKE TREMENDOUS 2853 02:03:27,240 --> 02:03:27,480 PROGRESS. 2854 02:03:27,480 --> 02:03:29,440 >>THANK YOU SO MUCH. 2855 02:03:29,440 --> 02:03:31,440 I'M GLAD YOU ARE THINKING ABOUT 2856 02:03:31,440 --> 02:03:33,400 THAT AND THANKS SO MUCH FOR YOUR 2857 02:03:33,400 --> 02:03:36,440 WORK AND THANK COLLEAGUES FOR 2858 02:03:36,440 --> 02:03:38,120 WONDERFUL DIALOGUE AND QUESTIONS 2859 02:03:38,120 --> 02:03:40,120 AND AT THIS POINT, WE CAN HAVE 2860 02:03:40,120 --> 02:03:41,600 -- WE ARE SLATED TO HAVE A 2861 02:03:41,600 --> 02:03:44,120 BREAK. IT WAS GOING TO BE 15 2862 02:03:44,120 --> 02:03:48,080 MINUTES BUT WE ARE NOW DOWN TO 2863 02:03:48,080 --> 02:03:48,240 10. 2864 02:03:48,240 --> 02:03:50,360 SO, IF EVERYBODY -- AMY, IS IT 2865 02:03:50,360 --> 02:03:54,760 OKAY IF WE COME BACK AT 2:15? 2866 02:03:54,760 --> 02:04:00,400 >>YEAH. 2:15 SOUNDS GOOD. DR. 2867 02:04:00,400 --> 02:04:03,560 PRINDIVILLE WILL JOIN US THEN. 2868 02:04:03,560 --> 02:04:05,320 >>FANTASTIC. THANK YOU DR. 2869 02:04:05,320 --> 02:04:05,560 SHIELS. 2870 02:04:05,560 --> 02:04:10,600 >>THANK YOU. 2871 02:04:10,600 --> 02:04:12,520 >>CALLING THE MEETING BACK TO 2872 02:04:12,520 --> 02:04:16,160 ORDER. AT THIS TIME WELCOMING 2873 02:04:16,160 --> 02:04:18,600 SHEILA PRINDIVILLE. I AM SO 2874 02:04:18,600 --> 02:04:21,160 EXCITED TO HEAR YOUR OVERVIEW OF 2875 02:04:21,160 --> 02:04:23,560 CLINICAL TRIALS INNOVATION UNIT. 2876 02:04:23,560 --> 02:04:27,760 THANK YOU FOR JOINING US TODAY. 2877 02:04:27,760 --> 02:04:30,520 >>TERRIFIC. 2878 02:04:30,520 --> 02:04:33,280 THANK YOU ALL. WE CAN GO TO THE 2879 02:04:33,280 --> 02:04:34,120 NEXT SLIDE. 2880 02:04:34,120 --> 02:04:36,160 I REALLY THANK YOU FOR THE 2881 02:04:36,160 --> 02:04:38,080 OPPORTUNITY TO SPEAK WITH YOU 2882 02:04:38,080 --> 02:04:41,720 TODAY AND TO ACTUALLY GET YOUR 2883 02:04:41,720 --> 02:04:44,000 FEEDBACK AND INPUT ON THE TOP 2884 02:04:44,000 --> 02:04:46,960 CLINICAL TRIALS INNOVATION UNIT. 2885 02:04:46,960 --> 02:04:48,760 IN MY PRESENTATION TODAY THOUGH, 2886 02:04:48,760 --> 02:04:50,680 I WANT TO FIRST PROVIDE YOU WITH 2887 02:04:50,680 --> 02:04:54,560 AN OVERVIEW OF NCI'S STRATEGIC 2888 02:04:54,560 --> 02:04:56,480 VISION FOR CLINICAL TRIALS THAT 2889 02:04:56,480 --> 02:04:58,600 WILL PROVIDE CONTEXT FOR THE 2890 02:04:58,600 --> 02:04:59,840 INFORMATION THAT I WILL PRESENT 2891 02:04:59,840 --> 02:05:01,600 ON THE CLINICAL TRIALS 2892 02:05:01,600 --> 02:05:04,360 INNOVATION UNIT THAT IS A NEW 2893 02:05:04,360 --> 02:05:07,720 INITIATIVE THAT IS LAUNCHED 2894 02:05:07,720 --> 02:05:09,760 EARLIER THIS YEAR UNDER DR. 2895 02:05:09,760 --> 02:05:11,880 [INDISCERNIBLE]'S LEADERSHIP. 2896 02:05:11,880 --> 02:05:13,120 NEXT SLIDE, PLEASE. 2897 02:05:13,120 --> 02:05:16,560 MANY OF YOU REALLY KNOW AND HAVE 2898 02:05:16,560 --> 02:05:18,440 EXPERIENCED FIRSTHAND THAT MANY 2899 02:05:18,440 --> 02:05:21,480 OF OUR CANCER CLINICAL TRIALS 2900 02:05:21,480 --> 02:05:23,120 ARE COMPLEX AND EXPENSIVE 2901 02:05:23,120 --> 02:05:27,480 STUDIES THAT CAN BE SLOW AND 2902 02:05:27,480 --> 02:05:29,800 CUMBERSOME AND HAVE A SLOW 2903 02:05:29,800 --> 02:05:30,880 ACTIVATION PROCESS THAT CAN THEN 2904 02:05:30,880 --> 02:05:33,240 RESULT IN DELAYING RESULTS IN 2905 02:05:33,240 --> 02:05:36,440 GETTING THEM OUT IN A TIMELY 2906 02:05:36,440 --> 02:05:38,520 FASHION THAT IS OFTEN OVERLY 2907 02:05:38,520 --> 02:05:41,040 BURDENED DESIGNS AND INEQUITABLE 2908 02:05:41,040 --> 02:05:43,600 ACCESS TO SOME STUDIES AND OFTEN 2909 02:05:43,600 --> 02:05:44,720 DATA COLLECTION COULD BE IN 2910 02:05:44,720 --> 02:05:46,560 EXCESS OF WHAT IS ACTUALLY USED 2911 02:05:46,560 --> 02:05:48,120 AT THE END OF THE DAY AND WE 2912 02:05:48,120 --> 02:05:50,320 KNOW COLLECTIVE WILL I THAT SOME 2913 02:05:50,320 --> 02:05:52,880 AILMENTS THAT ARE EFFECTING SOME 2914 02:05:52,880 --> 02:05:54,880 TRIALS HAS RESULTED IN A MODEL 2915 02:05:54,880 --> 02:05:57,400 THAT COULD BE UNSUSTAINABLE FOR 2916 02:05:57,400 --> 02:05:59,920 THE LONG TERM. 2917 02:05:59,920 --> 02:06:01,560 NEXT SLIDE, PLEASE. 2918 02:06:01,560 --> 02:06:06,040 SO, TO ADDRESS SOME OF THE 2919 02:06:06,040 --> 02:06:08,840 CHALLENGES I JUST DESCRIBED, NCI 2920 02:06:08,840 --> 02:06:13,920 FORMED A STRATEGIC PLANNING 2921 02:06:13,920 --> 02:06:16,160 WORKING GROUP UNDEROS PISSIES 2922 02:06:16,160 --> 02:06:18,160 UNDER THE RESEARCH ADVISORY 2923 02:06:18,160 --> 02:06:19,600 COMMITTEE AND THAT COMMITTEE IS 2924 02:06:19,600 --> 02:06:22,120 KNOWN AS CTAC. YOU HAVE HEARD 2925 02:06:22,120 --> 02:06:24,520 OF THAT IN THE PAST. 2926 02:06:24,520 --> 02:06:27,080 WA WE REALLY THIS GROUP IS 2927 02:06:27,080 --> 02:06:29,840 CHALLENGED TO ASSESS NCI'S 2928 02:06:29,840 --> 02:06:32,320 STRATEGIC VISION FOR CLINICAL 2929 02:06:32,320 --> 02:06:34,200 TRIALS FOR 2030 AND BEYOND AND 2930 02:06:34,200 --> 02:06:40,720 THEY DID THAT AND DEVELOPED 15 2931 02:06:40,720 --> 02:06:41,560 RECOMMENDATIONS FOR WHICH THEY 2932 02:06:41,560 --> 02:06:43,840 FOLLOW THEMES ON THIS SLIDE AND 2933 02:06:43,840 --> 02:06:46,760 MANY ADDRESS TRIAL COMPLEXITY 2934 02:06:46,760 --> 02:06:48,480 AND DECENTRALIZING TRIALS AND 2935 02:06:48,480 --> 02:06:50,040 OPERATIONAL NEW BURDEN AND NEW 2936 02:06:50,040 --> 02:06:51,160 DATA COLLECTION APPROACHES AND 2937 02:06:51,160 --> 02:06:53,000 IF INTERESTED IN THIS I WANT TO 2938 02:06:53,000 --> 02:06:54,560 CALL THOSE OUT AND THIS IS ON 2939 02:06:54,560 --> 02:06:57,680 THE CTAC WEBSITE AND FULL LINK 2940 02:06:57,680 --> 02:06:59,720 IN THE REPORT IS HERE ON THE 2941 02:06:59,720 --> 02:07:00,280 SLIDE. 2942 02:07:00,280 --> 02:07:02,160 LISTING OUT A LOT OF DIFFERENT 2943 02:07:02,160 --> 02:07:05,280 APPROACHES THAT WE ARE ACTIVELY 2944 02:07:05,280 --> 02:07:07,160 IMPLEMENTING THIS AT NCI. 2945 02:07:07,160 --> 02:07:08,800 NEXT SLIDE, PLEASE. 2946 02:07:08,800 --> 02:07:10,400 BUT, THE STRATEGIC VISION THAT 2947 02:07:10,400 --> 02:07:13,640 THE WORKING GROUP AND NCI CAME 2948 02:07:13,640 --> 02:07:16,120 TO REALLY IS TO FOCUS ON 2949 02:07:16,120 --> 02:07:18,640 DEVELOPING FLEXIBLE FASTER AND 2950 02:07:18,640 --> 02:07:21,600 SIMPLER AND LESS EXPENSIVE HIGH 2951 02:07:21,600 --> 02:07:24,440 IMPACT CLINICAL TRIALS THAT 2952 02:07:24,440 --> 02:07:25,960 SEAMLESSLY INTEGRATE IN CLINICAL 2953 02:07:25,960 --> 02:07:27,240 PRACTICE AND SOME 2954 02:07:27,240 --> 02:07:28,200 RECOMMENDATIONS OUT OF THAT 2955 02:07:28,200 --> 02:07:30,120 REPORT THAT ARE KEY IS THAT WE 2956 02:07:30,120 --> 02:07:32,720 NEED TO STREAMLINE PROCESSES FOR 2957 02:07:32,720 --> 02:07:34,560 TRIAL DESIGN AND EXECUTION. 2958 02:07:34,560 --> 02:07:38,080 FOCUS ON THE ESSENTIAL ENDPOINTS 2959 02:07:38,080 --> 02:07:40,600 AND DECREASE REGULATORY HURDLES 2960 02:07:40,600 --> 02:07:42,920 AND ARE -- AND ARE BROADENED 2961 02:07:42,920 --> 02:07:46,560 TRIAL ACCESS AND INCREASE 2962 02:07:46,560 --> 02:07:50,760 EFFICIENCY OF DATA COLLECTION. 2963 02:07:50,760 --> 02:07:53,280 NEXT SLIDE. EXAMPLES OF 2964 02:07:53,280 --> 02:07:55,920 ACTIVITY NCI THAT HAS LAUNCHED 2965 02:07:55,920 --> 02:07:59,600 TOWARDS ACHIEVING THIS VISION 2966 02:07:59,600 --> 02:08:03,680 ARE LISTED ON THE SLIDE. LAST 2967 02:08:03,680 --> 02:08:04,520 MEETING [INDISCERNIBLE] CAME AND 2968 02:08:04,520 --> 02:08:06,440 TALKED TO YOU ABOUT EFFORTS 2969 02:08:06,440 --> 02:08:09,760 CREATING STANDARDS FOR LIMITING 2970 02:08:09,760 --> 02:08:11,640 DATA COLLECTION AND IMD EXEMPT 2971 02:08:11,640 --> 02:08:12,760 TRIALS AND WE TALK YOU TO ABOUT 2972 02:08:12,760 --> 02:08:15,080 THE FACT WE ARE ADOPTING LOCAL 2973 02:08:15,080 --> 02:08:17,120 AND REMOTE STUDY PROCEDURES THAT 2974 02:08:17,120 --> 02:08:19,040 WE PUT IN PLACE DURING THE 2975 02:08:19,040 --> 02:08:22,840 PANDEMIC AND WE ARE MAKING SOME 2976 02:08:22,840 --> 02:08:24,720 OF THOSE PERMANENT AS MUCH AS 2977 02:08:24,720 --> 02:08:26,520 POSSIBLE TO PROMOTE 2978 02:08:26,520 --> 02:08:28,720 DECENTRALIZED TRIALS AND 2979 02:08:28,720 --> 02:08:30,080 BRINGING TRIALS TO MEET PATIENTS 2980 02:08:30,080 --> 02:08:32,280 WHERE THEY ARE AND WORKING ON 2981 02:08:32,280 --> 02:08:33,680 EFFORTS TO INCREASE PATIENT 2982 02:08:33,680 --> 02:08:36,280 ACCESS TO TRIALS INCLUDING 2983 02:08:36,280 --> 02:08:37,120 BROADENING PATIENT ELIGIBILITY 2984 02:08:37,120 --> 02:08:43,880 AND PROGRAM TO CONNECT 2985 02:08:43,880 --> 02:08:46,000 UNDER-REPRESENTED POPULATION 2986 02:08:46,000 --> 02:08:48,760 TRIALS PARTICULARLY NCNN AND 2987 02:08:48,760 --> 02:08:50,800 [INDISCERNIBLE] TRIALS AND 2988 02:08:50,800 --> 02:08:52,400 ACTIONS DR. DORIS SPOKE TO YOU 2989 02:08:52,400 --> 02:08:54,400 ABOUT AT LAST MEETING WE ARE 2990 02:08:54,400 --> 02:08:56,960 ACTIVELY WORKING ON IMPLEMENTING 2991 02:08:56,960 --> 02:08:59,040 AND, YOU KNOW, THEY ARE REALLY 2992 02:08:59,040 --> 02:09:00,720 IMPORTANT TO MODERNIZING 2993 02:09:00,720 --> 02:09:04,400 CLINICAL TRIALS SYSTEM AND DR. 2994 02:09:04,400 --> 02:09:06,760 BURTON ELLI WHEN ARRIVED SHH IS 2995 02:09:06,760 --> 02:09:08,480 HE CHALLENGE THE US TO THINK 2996 02:09:08,480 --> 02:09:09,680 OUTSIDE OF THE BOX ABOUT 2997 02:09:09,680 --> 02:09:11,640 ADDITIONAL ACTIONS THAT COULD BE 2998 02:09:11,640 --> 02:09:13,920 TAKEN TO HELP TRANSFORM AND 2999 02:09:13,920 --> 02:09:17,960 MODERNIZE OUR CLINICAL TRIALS 3000 02:09:17,960 --> 02:09:18,200 SYSTEM. 3001 02:09:18,200 --> 02:09:20,160 AND SO SOMETHING THAT HAS COME 3002 02:09:20,160 --> 02:09:22,480 OUT OF THAT IS LAUNCHING OF 3003 02:09:22,480 --> 02:09:24,480 CLINICAL TRIALS INNOVATION UNIT. 3004 02:09:24,480 --> 02:09:27,640 THE NEED FOR THIS IS REALLY THAT 3005 02:09:27,640 --> 02:09:29,960 WE FELT THAT TO RADICALLY 3006 02:09:29,960 --> 02:09:31,920 TRANSFORM HOW CLINICAL TRIALS 3007 02:09:31,920 --> 02:09:34,400 ARE CONDUCTED, WE NEEDED A NEW 3008 02:09:34,400 --> 02:09:35,080 PLATFORM TO DO THAT. 3009 02:09:35,080 --> 02:09:39,840 WE WANTED TO BE ABLE TO RAPIDLY 3010 02:09:39,840 --> 02:09:43,920 IDENTIFY AND TEST MOST 3011 02:09:43,920 --> 02:09:45,520 INNOVATIVE APPROACHES AND DIDN'T 3012 02:09:45,520 --> 02:09:47,280 WANT TO CAUSE DISRUPTION TO 3013 02:09:47,280 --> 02:09:49,200 CURRENT SYSTEM AND PROCESSES 3014 02:09:49,200 --> 02:09:53,480 BUILDING CROWN JEWELS OF SYSTEM 3015 02:09:53,480 --> 02:09:54,840 NCTN AND N CORE AND WANTED THAT 3016 02:09:54,840 --> 02:09:56,680 TO BE ABLE TO CONTINUE ON AND 3017 02:09:56,680 --> 02:09:58,480 MAKE CHANGES THAT I ALREADY 3018 02:09:58,480 --> 02:10:00,000 DESCRIBED AND MAKE SURE THAT 3019 02:10:00,000 --> 02:10:02,040 TRIALS THAT WERE UNDERWAY WERE 3020 02:10:02,040 --> 02:10:03,840 NOT DISRUPTED AND WE THOUGHT 3021 02:10:03,840 --> 02:10:06,120 THAT CLINICAL TRIALS INNOVATION 3022 02:10:06,120 --> 02:10:08,080 UNIT MAY BE A PLATFORM TO HELP 3023 02:10:08,080 --> 02:10:10,720 US TRY MORE RADICALLY OR 3024 02:10:10,720 --> 02:10:13,560 INNOVATIVE ACTIONS. 3025 02:10:13,560 --> 02:10:15,720 NEXT SLIDE, PLEASE. 3026 02:10:15,720 --> 02:10:18,360 SO, THE OVERARCHING GOALS OF 3027 02:10:18,360 --> 02:10:21,320 CLINICAL TRIALS INNOVATION IS TO 3028 02:10:21,320 --> 02:10:22,840 REDUCE COMPLEXITY THROUGH NEW 3029 02:10:22,840 --> 02:10:24,560 MODELS OF SCIENTIFIC 3030 02:10:24,560 --> 02:10:25,760 PARTNERSHIPS AND COLLABORATIONS 3031 02:10:25,760 --> 02:10:28,720 FOR INNOVATIVE SCIENCE AND 3032 02:10:28,720 --> 02:10:30,360 PROMOTE EQUITABLE CLINICAL 3033 02:10:30,360 --> 02:10:31,000 TRIALS PARTICIPATION AND 3034 02:10:31,000 --> 02:10:33,040 COMPLEMENT THE NATIONAL CANCER 3035 02:10:33,040 --> 02:10:34,760 PLAN AND CANCER MOONSHOTS GOALS 3036 02:10:34,760 --> 02:10:36,720 TO WORK WITH PARTNERS IN 3037 02:10:36,720 --> 02:10:38,840 GOVERNMENT INDUSTRY AND ADVOCACY 3038 02:10:38,840 --> 02:10:41,280 AND OTHER ORGANIZATIONS TO 3039 02:10:41,280 --> 02:10:44,600 MODERNIZE TRIALS AND MOST 3040 02:10:44,600 --> 02:10:46,640 IMPORTANTLY TO BRING RESULTS TO 3041 02:10:46,640 --> 02:10:49,320 PATIENTS FASTER. 3042 02:10:49,320 --> 02:10:50,920 NEXT SLIDE, PLEASE. 3043 02:10:50,920 --> 02:10:55,360 JUST EXACTLY WHAT IS CTIU? 3044 02:10:55,360 --> 02:10:57,400 INTERAGENCY PLATFORM AND FORUM 3045 02:10:57,400 --> 02:10:59,920 FOR WHICH WE BRING TOGETHER THE 3046 02:10:59,920 --> 02:11:04,480 NCI FDA AND EXTRAMURAL CLINICAL 3047 02:11:04,480 --> 02:11:06,120 RESEARCH COMMUNITY TO ADVANCE 3048 02:11:06,120 --> 02:11:08,120 CLINICAL CARE AND EQUITABLE 3049 02:11:08,120 --> 02:11:10,360 TRIALS PARTICIPATION THROUGH 3050 02:11:10,360 --> 02:11:12,560 INNOVATIVE SCIENCE, TRIAL 3051 02:11:12,560 --> 02:11:15,080 DESIGNS, AND OPERATIONAL 3052 02:11:15,080 --> 02:11:15,400 EFFICIENCIES. 3053 02:11:15,400 --> 02:11:17,600 WE ENVISION THIS ONLY FOR A FEW 3054 02:11:17,600 --> 02:11:20,360 HIGH PRIORITY CLINICAL RESEARCH 3055 02:11:20,360 --> 02:11:21,960 STUDIES A YEAR; RIGHT? 3056 02:11:21,960 --> 02:11:24,720 ALL OTHER STUDIES WE DON'T WANT 3057 02:11:24,720 --> 02:11:27,280 TO DISRUPT BUT WILL TRY 3058 02:11:27,280 --> 02:11:29,360 POTENTIALLY NEW NOVEL WAYS TO DO 3059 02:11:29,360 --> 02:11:33,960 THINGS FOR A FEW STUDIES ON A 3060 02:11:33,960 --> 02:11:34,440 [INDISCERNIBLE] BASIS. 3061 02:11:34,440 --> 02:11:36,080 NEXT SLIDE. 3062 02:11:36,080 --> 02:11:38,520 SO, THE -- YOU KNOW, THE THING 3063 02:11:38,520 --> 02:11:40,000 THAT IS REALLY UNIQUE ABOUT THIS 3064 02:11:40,000 --> 02:11:43,120 IS THAT WE ARE TRYING TO BRING 3065 02:11:43,120 --> 02:11:47,720 CRITICAL LEADERSHIP OF OUR 3066 02:11:47,720 --> 02:11:49,080 SYSTEMS TOGETHER AT THE EARLIEST 3067 02:11:49,080 --> 02:11:51,520 POINT IN THE DEVELOPMENT OF A 3068 02:11:51,520 --> 02:11:53,720 TRIAL ALL TO THE SAME TABLE THAT 3069 02:11:53,720 --> 02:11:56,360 WOULD INCLUDE REPRESENTATIVES OF 3070 02:11:56,360 --> 02:11:59,600 FDA WHO COULD PROVIDE US 3071 02:11:59,600 --> 02:12:00,720 HIGH-LEVEL REGULATORY INPUT 3072 02:12:00,720 --> 02:12:02,360 ABOUT DESIGNS OF TRIALS THAT 3073 02:12:02,360 --> 02:12:04,920 COULD BE INNOVATED AND NCI THAT 3074 02:12:04,920 --> 02:12:08,200 WOULD PROVIDE IMPACT ABOUT IDEAS 3075 02:12:08,200 --> 02:12:10,840 AND FEASIBILITY AND EXTRAMURAL 3076 02:12:10,840 --> 02:12:12,680 COMMUNITY, RESEARCH COMMUNITY AS 3077 02:12:12,680 --> 02:12:13,560 WELL. 3078 02:12:13,560 --> 02:12:15,920 THAT PARTICULARLY I HAVE -- MY 3079 02:12:15,920 --> 02:12:17,160 NEXT SLIDE WILL DESCRIBE THAT. 3080 02:12:17,160 --> 02:12:19,040 I WANT TO POINT OUT THAT THERE 3081 02:12:19,040 --> 02:12:21,600 ARE TWO KEY PEOPLE THAT ARE 3082 02:12:21,600 --> 02:12:24,240 INCLUDING MYSELF AND I CODIRECT 3083 02:12:24,240 --> 02:12:27,320 THIS WITH MICHAEL MORRIS WHO IS 3084 02:12:27,320 --> 02:12:29,520 A MEDICAL ONKOLGS WHO HAS COME 3085 02:12:29,520 --> 02:12:34,080 TO NCI FROM MEMORIAL SLOAN 3086 02:12:34,080 --> 02:12:35,160 KETERRING ON INTERAGENCY 3087 02:12:35,160 --> 02:12:37,120 AGREEMENT AND WILL WORK WITH US 3088 02:12:37,120 --> 02:12:39,800 AND SPECIAL ADVISOR TO DR. 3089 02:12:39,800 --> 02:12:41,800 BURTON ELLI AS WELL AND TOGETHER 3090 02:12:41,800 --> 02:12:43,600 WE ARE WORKING TO LAUNCH THIS 3091 02:12:43,600 --> 02:12:47,600 UNIT AND FACILITATE IT WITH 3092 02:12:47,600 --> 02:12:48,440 COORDINATOR IRIS CASTRO. 3093 02:12:48,440 --> 02:12:50,320 NEXT SLIDE, PLEASE. 3094 02:12:50,320 --> 02:12:54,040 THE EXTRAMURAL COMMUNITY 3095 02:12:54,040 --> 02:12:56,440 PARTNERS AS YOU ALL KNOW INCLUDE 3096 02:12:56,440 --> 02:13:00,560 NCTN AND INL VEST GATORS AND 3097 02:13:00,560 --> 02:13:02,520 LEADERSHIP THERE AND COMMUNITY 3098 02:13:02,520 --> 02:13:04,600 ONCOLOGY AND N CORE AND INDUSTRY 3099 02:13:04,600 --> 02:13:05,920 IS IMPORTANT COMPONENT OF ALL 3100 02:13:05,920 --> 02:13:08,960 THIS AND ADVOCACY AND REASON I 3101 02:13:08,960 --> 02:13:13,360 HAVE NCTN IN BLUE IS AS WE HAVE 3102 02:13:13,360 --> 02:13:15,280 STARTED TO LAUNCH THIS IN OUR 3103 02:13:15,280 --> 02:13:17,440 INITIAL PILOT PHASE HERE WE ARE 3104 02:13:17,440 --> 02:13:20,440 WORKING CLOSELY WITH NCTN. 3105 02:13:20,440 --> 02:13:23,120 WE HAVE NOT YET BROADENED OUR 3106 02:13:23,120 --> 02:13:24,840 PARTNERS AND N CORE INDUSTRY AND 3107 02:13:24,840 --> 02:13:27,560 FULLY WITH ADVOCACY AND ADVOCACY 3108 02:13:27,560 --> 02:13:28,920 OF COURSE IS AN IMPORTANT PART 3109 02:13:28,920 --> 02:13:30,680 OF ANY RESEARCH THAT WE DO. 3110 02:13:30,680 --> 02:13:32,440 WE HAVE ACTUALLY STARTED THIS 3111 02:13:32,440 --> 02:13:34,320 OUT WITH NCTN. 3112 02:13:34,320 --> 02:13:37,120 WE -- BASED ON OUR EXPERIENCE AS 3113 02:13:37,120 --> 02:13:39,280 WE LEARN AND FINE TUNE THINGS AS 3114 02:13:39,280 --> 02:13:41,160 WE EXPECT TO BE BRINGING IN N 3115 02:13:41,160 --> 02:13:45,320 CORE INDUSTRY AND FULLY BRINGING 3116 02:13:45,320 --> 02:13:48,120 ADVOCACY INTO THIS PROGRAM. 3117 02:13:48,120 --> 02:13:50,200 NEXT SLIDE, PLEASE. 3118 02:13:50,200 --> 02:13:52,320 WHAT DO WE ENVISION DELIVERABLES 3119 02:13:52,320 --> 02:13:53,440 FOR THIS WOULD BE? 3120 02:13:53,440 --> 02:13:55,920 WE ARE TRYING TO DEVELOP 3121 02:13:55,920 --> 02:13:57,480 IMPACTFUL AND TRANSFORMATIVE 3122 02:13:57,480 --> 02:13:59,080 THAT COULD BE THERAPEUTIC 3123 02:13:59,080 --> 02:14:01,680 AGENTS, PREVENTIVE STRATEGIES OR 3124 02:14:01,680 --> 02:14:03,080 IMAGING AND BIOLOGICAL MARKERS 3125 02:14:03,080 --> 02:14:06,800 AND WANT TO PRODUCE HIGH-IXPACT 3126 02:14:06,800 --> 02:14:08,640 ACTIONABLE RESULTS, STREAMLINED 3127 02:14:08,640 --> 02:14:10,200 TRIAL DESIGNS AND DATA 3128 02:14:10,200 --> 02:14:11,480 COLLECTIONS AND ARE TYPES OF 3129 02:14:11,480 --> 02:14:15,000 THINGS TO BE RAPIDLY CONDUCTING 3130 02:14:15,000 --> 02:14:17,080 INNOVATIVE STUDIES IN OUR 3131 02:14:17,080 --> 02:14:18,520 EXISTING NCI NETWORKS THAT IS 3132 02:14:18,520 --> 02:14:19,920 IMPORTANT TO POINT OUT THAT WE 3133 02:14:19,920 --> 02:14:22,880 ARE NOT FORMING A NEW NETWORK 3134 02:14:22,880 --> 02:14:24,520 AND WAY OF BRINGING PEOPLE 3135 02:14:24,520 --> 02:14:26,920 TOGETHER TO SELECT A FEW HIGH 3136 02:14:26,920 --> 02:14:29,040 PRIORITY TRIALS TO BE CONDUCTED 3137 02:14:29,040 --> 02:14:31,080 WITHIN NETWORK AND NO NEW 3138 02:14:31,080 --> 02:14:32,720 INFRASTRUCTURE AND WOULD BE TO 3139 02:14:32,720 --> 02:14:36,320 LAUNCH TRIALS WITHIN NCTN OR N 3140 02:14:36,320 --> 02:14:39,680 CORE OR OTHER EXISTING NETWORKS. 3141 02:14:39,680 --> 02:14:41,880 NEXT SLIDE, PLEASE. 3142 02:14:41,880 --> 02:14:43,920 WHAT TYPES OF STUDIES ARE WE 3143 02:14:43,920 --> 02:14:44,720 LOOKING AT? 3144 02:14:44,720 --> 02:14:46,520 WHAT IS TRULY INNOVATIVE? 3145 02:14:46,520 --> 02:14:48,720 THIS IS THE BIG QUESTION. WHAT 3146 02:14:48,720 --> 02:14:51,960 IS A REALLY INNOVATIVE STUDY; 3147 02:14:51,960 --> 02:14:52,360 RIGHT? 3148 02:14:52,360 --> 02:14:55,200 BIG PART OF WHAT OUR DISCUSSIONS 3149 02:14:55,200 --> 02:14:56,920 ARE AS WE LAUNCH THIS AMONGST 3150 02:14:56,920 --> 02:14:58,520 GROUPS PART OF THIS IS WE ARE 3151 02:14:58,520 --> 02:15:00,640 TRYING TO REALLY DEFINE WHAT 3152 02:15:00,640 --> 02:15:03,080 MAKES AN INNOVATIVE STUDY AND WE 3153 02:15:03,080 --> 02:15:04,840 ARE THINKING THESE ARE STUDIES 3154 02:15:04,840 --> 02:15:06,840 THAT WOULD BREAK THE MOLD DOING 3155 02:15:06,840 --> 02:15:08,040 THINGS DIFFERENTLY AND NOT JUST 3156 02:15:08,040 --> 02:15:10,680 -- WE WANT INTERVENTIONS THAT 3157 02:15:10,680 --> 02:15:13,320 WOULD NOT JUST BE NOT 3158 02:15:13,320 --> 02:15:14,320 INCREMENTALLY ALTERING STANDARDS 3159 02:15:14,320 --> 02:15:16,120 OF CARE AND WANT SOMETHING THAT 3160 02:15:16,120 --> 02:15:17,800 WOULD BE BOLD AND ACTUALLY 3161 02:15:17,800 --> 02:15:20,760 MAKING A CHANGE AND COULD BE 3162 02:15:20,760 --> 02:15:22,400 BIOMARKERS DRAMATICALLY 3163 02:15:22,400 --> 02:15:23,320 SHORTENING TRIALEND POINTS AND 3164 02:15:23,320 --> 02:15:24,720 WOULD HAVE TO BE THINGS OF 3165 02:15:24,720 --> 02:15:27,600 COURSE THAT ARE FULL WILL I 3166 02:15:27,600 --> 02:15:29,120 VALIDATED EXPECT OCCURRING IN 3167 02:15:29,120 --> 02:15:31,320 LATE PHASE STUDIES NOT EARLY 3168 02:15:31,320 --> 02:15:36,280 PHASE STUDIES AND LOOKING ATTIES 3169 02:15:36,280 --> 02:15:40,880 THAT COULD LOOK NOVEL WAYS TRIAL 3170 02:15:40,880 --> 02:15:42,080 OPERATIONS AND NEW WAYS TO 3171 02:15:42,080 --> 02:15:44,720 EXTRACT DATA FOR EXAMPLE FROM 3172 02:15:44,720 --> 02:15:46,000 ELECTRONIC HEALTH REPORTS AND 3173 02:15:46,000 --> 02:15:49,840 THINGS THAT ARE NOVEL WAYS OF 3174 02:15:49,840 --> 02:15:50,480 COLLABORATING AMONGST VARIOUS 3175 02:15:50,480 --> 02:15:52,720 ENL TITTIES AND STAKEHOLDERS AND 3176 02:15:52,720 --> 02:15:55,560 BUILT INTO ALL THIS IS WE ARE 3177 02:15:55,560 --> 02:15:56,440 ANTICIPATING WE WANT TRIALS TO 3178 02:15:56,440 --> 02:15:58,720 BE LAUNCHED RAPIDLY AND QUICKLY 3179 02:15:58,720 --> 02:16:00,520 SO THERE WOULD BE NOT -- THERE 3180 02:16:00,520 --> 02:16:03,480 WOULD BE RAPID EVALUATION 3181 02:16:03,480 --> 02:16:05,800 APPROVAL AND ACTIVATION SUCH 3182 02:16:05,800 --> 02:16:07,120 THAT THINGS WOULD HOPEFULLY BE 3183 02:16:07,120 --> 02:16:09,240 FROM THE TIME ONSET TO LAUNCH, 3184 02:16:09,240 --> 02:16:13,040 YOU KNOW, IN LESS THAN A YEAR. 3185 02:16:13,040 --> 02:16:14,400 NEXT SLIDE, PLEASE. 3186 02:16:14,400 --> 02:16:16,720 SO, AN EXAMPLE FOR US AS I THINK 3187 02:16:16,720 --> 02:16:18,080 YOU HAVE HEARD ABOUT THIS IS 3188 02:16:18,080 --> 02:16:21,120 THAT, YOU KNOW, IS THIS REAL OR 3189 02:16:21,120 --> 02:16:21,560 ASPIRATIONAL? 3190 02:16:21,560 --> 02:16:23,200 CAN THIS REALLY BE DONE? 3191 02:16:23,200 --> 02:16:26,000 I THINK YOU HAVE HEARD FROM -- 3192 02:16:26,000 --> 02:16:28,720 I'M NOT SURE IF YOU HAD TO HAVE 3193 02:16:28,720 --> 02:16:29,200 THIS PRESENTED. 3194 02:16:29,200 --> 02:16:32,040 BUT, THE -- YOU KNOW, NCI 3195 02:16:32,040 --> 02:16:34,800 RECENTLY LAUNCHED A STREAMLINE 3196 02:16:34,800 --> 02:16:36,200 CLINICAL TRIAL WITH 3197 02:16:36,200 --> 02:16:40,520 COLLABORATION WITH FDA UNDER 3198 02:16:40,520 --> 02:16:42,560 SWOG THAT IS PRAGMATIC LUNG 3199 02:16:42,560 --> 02:16:45,440 STUDY AND IT IS TRYING TO 3200 02:16:45,440 --> 02:16:46,920 EVALUATE WHETHER TWO AGENTS FOR 3201 02:16:46,920 --> 02:16:49,920 WHICH WE KNOW A LOT ABOUT THEM 3202 02:16:49,920 --> 02:16:52,160 ALREADY COMBINED THERAPY THAT 3203 02:16:52,160 --> 02:16:53,760 CAN REALLY IMPROVE OVERALL 3204 02:16:53,760 --> 02:16:56,560 SURVIVAL IN PATIENTS WITH 3205 02:16:56,560 --> 02:16:58,960 ADVANCED LUNG CANCER AND 3206 02:16:58,960 --> 02:17:00,720 NONSMALL CELL LUNG CANCER. 3207 02:17:00,720 --> 02:17:01,760 WHAT IS IMPORTANT ABOUT THIS 3208 02:17:01,760 --> 02:17:03,680 TRIAL IS THAT IT REALLY IS 3209 02:17:03,680 --> 02:17:05,920 DESIGNED TO ELIMINATE POTENTIAL 3210 02:17:05,920 --> 02:17:08,680 BARRIERS TO ENROLLMENT AND 3211 02:17:08,680 --> 02:17:10,600 INCREASING DIVERSITY AND 3212 02:17:10,600 --> 02:17:12,800 ENROLLMENT IN TRIALS AND NOVEL 3213 02:17:12,800 --> 02:17:14,600 ABOUT THIS IS STREAMLINING 3214 02:17:14,600 --> 02:17:16,760 PROCESSES AND USING FOCUSED 3215 02:17:16,760 --> 02:17:19,280 ENDPOINTS AND EFFICIENT DATA 3216 02:17:19,280 --> 02:17:21,680 COLLECTION AND ANTICIPATE THIS 3217 02:17:21,680 --> 02:17:23,680 STUDY LAUNCHED AND ANTICIPATE 3218 02:17:23,680 --> 02:17:25,960 700 PARTICIPANTS ENROLLED BY 3219 02:17:25,960 --> 02:17:27,840 2025 AND THIS REALLY WAS THIS 3220 02:17:27,840 --> 02:17:30,400 IDEA THAT WE ARE COMING TOGETHER 3221 02:17:30,400 --> 02:17:32,040 HAVING A PRAGMATIC TRIAL AND 3222 02:17:32,040 --> 02:17:34,080 COLLECTING ONLY KEY ESSENTIAL 3223 02:17:34,080 --> 02:17:35,560 ENDPOINTS THAT ARE NEEDED AND 3224 02:17:35,560 --> 02:17:41,400 THIS TRIAL WAS LAUVE LAUNCH THE 3225 02:17:41,400 --> 02:17:42,800 VERY SHORT PERIOD OF TIME 3226 02:17:42,800 --> 02:17:45,200 ROUGHLY 6 MONTHS TO IDEA AT TIME 3227 02:17:45,200 --> 02:17:47,520 IT WAS REALLY LAUNCH THE AND 3228 02:17:47,520 --> 02:17:51,440 FACILITATED HAVING KEY PARTNERS 3229 02:17:51,440 --> 02:17:53,280 AT TABLE AS THIS TRIAL WAS 3230 02:17:53,280 --> 02:17:53,560 LAUNCHED. 3231 02:17:53,560 --> 02:17:55,480 NEXT SLIDE. ADDITIONALLY WITH 3232 02:17:55,480 --> 02:17:57,320 THIS TRIAL, NEXT SLIDE, I THINK 3233 02:17:57,320 --> 02:17:58,880 THERE IS A THING THAT GOES AND 3234 02:17:58,880 --> 02:18:01,280 MUST BE ANIMATED AND THANKS SO 3235 02:18:01,280 --> 02:18:02,600 MUCH. WHAT IS DIFFERENT ABOUT 3236 02:18:02,600 --> 02:18:06,280 THIS PARTICULAR TRIAL IS THAT WE 3237 02:18:06,280 --> 02:18:08,720 REALLY LIMITED FOCUSING ON 3238 02:18:08,720 --> 02:18:11,000 ESSENTIAL ENDPOINTS THAT WE KNEW 3239 02:18:11,000 --> 02:18:14,600 ABOUT THE TWO DRUGS THAT ARE 3240 02:18:14,600 --> 02:18:19,920 BEING STUDIED NO PROTOCOL 3241 02:18:19,920 --> 02:18:22,880 REQUIRING LABS OR SPECIMEN 3242 02:18:22,880 --> 02:18:24,040 COLLECTIONS AND IMPORTANTLY 3243 02:18:24,040 --> 02:18:26,240 ADVERSE EVENTS THAT ARE 3244 02:18:26,240 --> 02:18:28,960 COLLECTED ARE REALLY ALL GRADE 5 3245 02:18:28,960 --> 02:18:31,080 AND UNEXPECTED REPORTABLE GRADE 3246 02:18:31,080 --> 02:18:33,920 3 AND 4 ADVERSE EVENTS AND WHAT 3247 02:18:33,920 --> 02:18:37,560 IT DOES IS REALLY REDUCES BURDEN 3248 02:18:37,560 --> 02:18:40,600 ON STUDY SITES AS WELL AS 3249 02:18:40,600 --> 02:18:42,480 PATIENTS PARTICIPATING TO GET 3250 02:18:42,480 --> 02:18:44,600 FOCUSING ON WHAT IS KEY AND 3251 02:18:44,600 --> 02:18:47,360 CRITICAL THAT IS A VERY 3252 02:18:47,360 --> 02:18:48,000 STREAMLINED CLINICAL TRIAL. 3253 02:18:48,000 --> 02:18:49,840 THIS IS REALLY A EXAMPLE THAT 3254 02:18:49,840 --> 02:18:52,440 THIS CAN BE DONE WHEN YOU BRING 3255 02:18:52,440 --> 02:18:54,640 THE RIGHT PEOPLE TOGETHER 3256 02:18:54,640 --> 02:18:57,360 QUICKLY TO GET A TRIAL LAUNCHED. 3257 02:18:57,360 --> 02:18:58,520 IMPORTANTLY, THIS IS NOT 3258 02:18:58,520 --> 02:19:00,160 APPROPRIATE FOR EVERY TRIAL. IF 3259 02:19:00,160 --> 02:19:02,480 YOU HAD AN EARLY DRUG AND DIDN'T 3260 02:19:02,480 --> 02:19:05,440 KNOW TOXICITIES YET, YOU WOULD 3261 02:19:05,440 --> 02:19:07,320 NEED TO COLLECT MORE ADVERSE 3262 02:19:07,320 --> 02:19:09,320 EVENTS AND IN THIS SETTING, WE 3263 02:19:09,320 --> 02:19:11,200 DID KNOW REALLY WHAT IS GOING ON 3264 02:19:11,200 --> 02:19:15,960 WITH BOTH OF THE DRU DRUGS AND E 3265 02:19:15,960 --> 02:19:17,480 VERY MUCH ABLE TO STREAMLINE 3266 02:19:17,480 --> 02:19:19,360 THIS AND HOPING TO HAVE 3267 02:19:19,360 --> 02:19:20,640 ADDITIONAL TYPES OF TRIALS IN 3268 02:19:20,640 --> 02:19:22,600 THIS TYPE OF SETTING WE COULD 3269 02:19:22,600 --> 02:19:24,960 REALLY PRIORITIZE AS ONE MODEL 3270 02:19:24,960 --> 02:19:28,160 THAT MIGHTINO VATED AND TRULY 3271 02:19:28,160 --> 02:19:31,320 STREAMLINING WHAT WE COLLECT. 3272 02:19:31,320 --> 02:19:33,640 NEXT SLIDE, PLEASE. 3273 02:19:33,640 --> 02:19:36,280 SO, WHAT WE ARE ENVISIONING WHAT 3274 02:19:36,280 --> 02:19:38,240 WILL HAPPEN THAT IS ROAD MAP FOR 3275 02:19:38,240 --> 02:19:40,520 BEING IN NEW WAYS THINKING ABOUT 3276 02:19:40,520 --> 02:19:42,880 HOW TO GET TRIALS LAUNCHED 3277 02:19:42,880 --> 02:19:45,440 QUICKLY AND IN JUNE, WE HAD OUR 3278 02:19:45,440 --> 02:19:49,360 FIRST ROUND OF IDEAS THAT WERE 3279 02:19:49,360 --> 02:19:52,000 SUBMITTED AND IDEA HERE IS THAT 3280 02:19:52,000 --> 02:19:54,600 WE WANT ONE TO TWO PAGES BECAUSE 3281 02:19:54,600 --> 02:19:57,520 WE NEED TO QUICKLY MAKE A 3282 02:19:57,520 --> 02:19:57,800 DECISION. 3283 02:19:57,800 --> 02:20:00,440 AS YOU KNOW, CONCEPTS NOW ARE 3284 02:20:00,440 --> 02:20:02,120 MUCH LONGER THAN THAT AND IDEA 3285 02:20:02,120 --> 02:20:05,640 TO BE RAPID VETTING BY CTI UNIT 3286 02:20:05,640 --> 02:20:06,800 FOR SELECTION. 3287 02:20:06,800 --> 02:20:09,040 WE WOULD THEN TAKE ONE OR TWO 3288 02:20:09,040 --> 02:20:11,200 IDEAS THAT WE RAPIDLY WOULD THEN 3289 02:20:11,200 --> 02:20:14,440 DEVELOP INTO A PROTOCOL 3290 02:20:14,440 --> 02:20:15,120 COLLABORATIVELY FOR DEVELOPMENT 3291 02:20:15,120 --> 02:20:18,200 AND EXECUTION WITH NCI'S 3292 02:20:18,200 --> 02:20:18,480 NETWORK. 3293 02:20:18,480 --> 02:20:20,960 AS YOU SEE, THIS IS NOT 3294 02:20:20,960 --> 02:20:22,600 TYPICALLY WE HAVE NOW A PROCESS 3295 02:20:22,600 --> 02:20:24,640 WHERE THERE WILL BE CONCEPTS 3296 02:20:24,640 --> 02:20:26,800 THAT COME INTO OUR STEERING 3297 02:20:26,800 --> 02:20:28,720 COMMITTEES THAT THERE IS THEN 3298 02:20:28,720 --> 02:20:31,160 PROTOCOL DEVELOPMENT AND IT IS A 3299 02:20:31,160 --> 02:20:33,080 MUCH LONGER TIMELINE AND HOPING 3300 02:20:33,080 --> 02:20:35,640 BY WORKING COLLABORATIVELY FROM 3301 02:20:35,640 --> 02:20:37,880 THE GET-GO WE COULD DEMONSTRATE 3302 02:20:37,880 --> 02:20:40,240 FOR A FEW SELECT TRIALS YOU 3303 02:20:40,240 --> 02:20:44,360 COULD RAPIDLY LAUNCH THESE 3304 02:20:44,360 --> 02:20:44,600 TRIALS. 3305 02:20:44,600 --> 02:20:45,880 NEXT SLIDE, PLEASE. 3306 02:20:45,880 --> 02:20:48,240 SO, WHERE ARE WE GOING TO GET 3307 02:20:48,240 --> 02:20:48,760 IDEAS? 3308 02:20:48,760 --> 02:20:51,760 WHAT HAVE WE DONE IN THIS VERY 3309 02:20:51,760 --> 02:20:52,920 EARLY PILOT PHASE? 3310 02:20:52,920 --> 02:20:54,640 SO, WHAT I HAVE MENTIONED IS 3311 02:20:54,640 --> 02:20:56,280 THAT FOR THE FIRST ROUND THAT WE 3312 02:20:56,280 --> 02:21:01,000 HAVE LIMITED IT TO JUST NCTN. 3313 02:21:01,000 --> 02:21:03,200 GOAL IS TO MAKE THIS MORE 3314 02:21:03,200 --> 02:21:04,720 BROADLY FOR FUTURE ROUNDS AND 3315 02:21:04,720 --> 02:21:07,120 FIRST ROUND WE TOOK IDEAS FROM 3316 02:21:07,120 --> 02:21:10,360 NCTN MEMBERS AS WELL AS INDUSTRY 3317 02:21:10,360 --> 02:21:12,640 PARTNERS WITH NCTN THAT WERE 3318 02:21:12,640 --> 02:21:14,520 ABLE TO WORK WITHIN THEIR GROUPS 3319 02:21:14,520 --> 02:21:17,720 AND SUBMIT IDEAS TO CTI UNIT ALL 3320 02:21:17,720 --> 02:21:19,680 OF WHICH AS YOU SEE IS VERY 3321 02:21:19,680 --> 02:21:21,200 EARLY ON AND WE GOT THE FIRST 3322 02:21:21,200 --> 02:21:24,600 ROUND OF IDEAS FROM THE NCTN. 3323 02:21:24,600 --> 02:21:27,200 EACH GROUP WAS LIMITED TO GIVING 3324 02:21:27,200 --> 02:21:29,280 US APPROXIMATELY THREE TO FOUR 3325 02:21:29,280 --> 02:21:32,240 IDEAS AND GROUP IS GOING TO COME 3326 02:21:32,240 --> 02:21:34,760 TOGETHER AND RAPIDLY LOOK AT 3327 02:21:34,760 --> 02:21:36,640 IDEAS AND DECIDE AND IN PART 3328 02:21:36,640 --> 02:21:38,240 SELECT ONE THAT WE HOPE THAT IS 3329 02:21:38,240 --> 02:21:39,920 BY THE END OF JULY THAT WE 3330 02:21:39,920 --> 02:21:41,240 ACTUALLY WOULD BE ABLE TO SAY 3331 02:21:41,240 --> 02:21:44,160 THIS IS THE TRIAL THAT WE MIGHT 3332 02:21:44,160 --> 02:21:46,240 TAKE AND DEVELOP INTO A -- INTO 3333 02:21:46,240 --> 02:21:47,960 A PROTOCOL. 3334 02:21:47,960 --> 02:21:49,840 SO, IT IS RIGHT NOW THAT WE HAVE 3335 02:21:49,840 --> 02:21:52,720 LIMITED IT TO THE NCTN. 3336 02:21:52,720 --> 02:21:54,120 WE HOPE THAT WE WILL EXPAND UPON 3337 02:21:54,120 --> 02:21:57,320 THIS BASED ON WHAT WE LEARNED IN 3338 02:21:57,320 --> 02:21:59,040 THIS VERY INITIAL PHASE. 3339 02:21:59,040 --> 02:22:01,960 AS YOU KNOW, ADVOCATES ARE 3340 02:22:01,960 --> 02:22:04,600 INVOLVED IN NCTN GROUPS WHEN 3341 02:22:04,600 --> 02:22:06,280 VETTING IDEAS THAT WE WILL HAVE 3342 02:22:06,280 --> 02:22:08,400 AT OUR TABLE AND WHEN COMING TO 3343 02:22:08,400 --> 02:22:10,240 MAKE A DECISION ON THIS -- WHAT 3344 02:22:10,240 --> 02:22:12,320 TRIAL WE THINK COULD BE MOVED 3345 02:22:12,320 --> 02:22:14,160 FORWARD AND LAUNCHED WITH US. 3346 02:22:14,160 --> 02:22:16,120 WE WILL HAVE AN ADVOCATE AND 3347 02:22:16,120 --> 02:22:18,760 LIKELY ONE NOT ENGAGE THE WITH 3348 02:22:18,760 --> 02:22:20,120 NCTN AND AT TABLE TO TELL US 3349 02:22:20,120 --> 02:22:23,600 WHICH TRIALS THEY THINK WOULD 3350 02:22:23,600 --> 02:22:27,080 BEST BE LAUNCHED IN THIS 3351 02:22:27,080 --> 02:22:27,400 PROCESS. 3352 02:22:27,400 --> 02:22:28,920 NEXT SLIDE, PLEASE. 3353 02:22:28,920 --> 02:22:31,360 SO, IN SUMMARY HERE, YOU KNOW, 3354 02:22:31,360 --> 02:22:35,120 WHAT WE ARE ENVISIONING CLINICAL 3355 02:22:35,120 --> 02:22:36,480 TRIALS TO BE COLLABORATION 3356 02:22:36,480 --> 02:22:40,160 BETWEEN NCI AND FDA AS I 3357 02:22:40,160 --> 02:22:41,800 MENTIONED THAT ARE EXTRAMURAL 3358 02:22:41,800 --> 02:22:43,760 PARTNERS THAT WE HOPE THAT WE 3359 02:22:43,760 --> 02:22:46,320 WILL SELECT A FEW HIGH PRIORITY 3360 02:22:46,320 --> 02:22:48,720 STUDIES WITH NOVEL OR DIFFERENT 3361 02:22:48,720 --> 02:22:49,920 STUDY DESIGNS AND THINGS FOR 3362 02:22:49,920 --> 02:22:52,600 OPERATIONAL PROCEDURES TO HELP 3363 02:22:52,600 --> 02:22:54,080 US WITH CLINICAL TESTING TO 3364 02:22:54,080 --> 02:22:56,640 DELIVER NEW APPROACHES FOR 3365 02:22:56,640 --> 02:22:57,280 DIAGNOSIS TREATMENT AND 3366 02:22:57,280 --> 02:22:58,840 PREVENTION OF CANCER. 3367 02:22:58,840 --> 02:23:00,840 WE HOPE WE WILL GET THESE IDEAS 3368 02:23:00,840 --> 02:23:03,200 MORE BROADLY THAN JUST FROM THE 3369 02:23:03,200 --> 02:23:05,520 NCTN AS WE GO FORWARD. 3370 02:23:05,520 --> 02:23:07,880 WE KNOW THEY ARE IDEAS FOR OTHER 3371 02:23:07,880 --> 02:23:09,760 NOVEL THINGS THAT COULD BE DONE 3372 02:23:09,760 --> 02:23:13,280 FROM INDUSTRY PARTNERS AS WELL 3373 02:23:13,280 --> 02:23:16,720 AS NCOR AND COMMUNITY ONCOLOGY 3374 02:23:16,720 --> 02:23:18,960 UNIT AND OTHER FOUNDATIONS AND 3375 02:23:18,960 --> 02:23:20,760 ADVOCACY GROUPS AND NOW WE HAVE 3376 02:23:20,760 --> 02:23:24,280 BEEN FOCUSING ON NCTN THAT IS 3377 02:23:24,280 --> 02:23:27,600 INITIAL PILOT AS WE ROLL THIS 3378 02:23:27,600 --> 02:23:32,040 OUT TO SEE WHAT IDEAS WE GET AND 3379 02:23:32,040 --> 02:23:34,920 RAPIDLY USE IDEAS OF DIFFERENT 3380 02:23:34,920 --> 02:23:36,640 WAYS OF REVIEWING AND LAUNCHING 3381 02:23:36,640 --> 02:23:38,120 A TRIAL AND WITH THAT, THIS IS 3382 02:23:38,120 --> 02:23:39,880 SORT OF AS I MENTIONED WE ARE 3383 02:23:39,880 --> 02:23:42,360 VERY EARLY ON IN THIS PROCESS 3384 02:23:42,360 --> 02:23:44,160 THAT WAS JUST LAUNCHED AT END OF 3385 02:23:44,160 --> 02:23:46,640 FEBRUARY THAT HAS BEEN MOVING 3386 02:23:46,640 --> 02:23:48,280 VERY, VERY QUICKLY AND DELIGHTED 3387 02:23:48,280 --> 02:23:49,640 WE HAVE THE OPPORTUNITY TO TALK 3388 02:23:49,640 --> 02:23:51,760 WITH YOU HERE TODAY TO START TO 3389 02:23:51,760 --> 02:23:53,600 GET YOUR THOUGHTS AND FEEDBACK 3390 02:23:53,600 --> 02:23:55,440 ON THIS. AND WE CAN TALK 3391 02:23:55,440 --> 02:23:56,800 THROUGH WAYS IN WHICH WE WILL BE 3392 02:23:56,800 --> 02:23:58,920 -- AS THIS EVOLVES, I'M SURE I 3393 02:23:58,920 --> 02:24:00,840 WILL BE BACK TALKING WITH YOU AS 3394 02:24:00,840 --> 02:24:04,080 WE GAIN MORE EXPERIENCE WITH 3395 02:24:04,080 --> 02:24:05,160 THIS PROGRAM. 3396 02:24:05,160 --> 02:24:08,440 WITH THAT, WE CAN TAKE -- THAT 3397 02:24:08,440 --> 02:24:10,120 IS MY LAST SLIDE AND OTHER THAN 3398 02:24:10,120 --> 02:24:11,920 I WANT TO GIVE MUCH APPRECIATION 3399 02:24:11,920 --> 02:24:18,280 FOR LEADERSHIP FROM DR. BERT AGO 3400 02:24:18,280 --> 02:24:19,440 NOELI FOR US THINKING OUTSIDE OF 3401 02:24:19,440 --> 02:24:21,640 THE BOX AND COMING UP LAUNCHING 3402 02:24:21,640 --> 02:24:24,320 NEW WAYS TO DO THINGS FASTER 3403 02:24:24,320 --> 02:24:26,600 WHILE NOT DISRUPTING SYSTEM AND 3404 02:24:26,600 --> 02:24:29,000 NCI COLLEAGUES AND COLLEAGUES AT 3405 02:24:29,000 --> 02:24:31,840 FDA ONCOLOGY CENTER OF 3406 02:24:31,840 --> 02:24:33,040 EXCELLENCE AND EXTRAMURAL 3407 02:24:33,040 --> 02:24:33,280 PARTNERS. 3408 02:24:33,280 --> 02:24:35,000 IF YOU HAVE QUESTIONS, FEEL 3409 02:24:35,000 --> 02:24:36,560 FREE TO CONTACT ME. 3410 02:24:36,560 --> 02:24:38,800 OF COURSE, YOU CAN CONTACT THIS 3411 02:24:38,800 --> 02:24:39,880 E-MAIL ADDRESS HERE. 3412 02:24:39,880 --> 02:24:42,000 WE HAVE A SPECIFIC E-MAIL BOX 3413 02:24:42,000 --> 02:24:44,480 THAT IS SET UP FOR THE NCI 3414 02:24:44,480 --> 02:24:46,920 CLINICAL TRIALS INNOVATION UNIT 3415 02:24:46,920 --> 02:24:48,360 AND E-MAIL IS HERE ON THIS 3416 02:24:48,360 --> 02:24:48,840 SLIDE. 3417 02:24:48,840 --> 02:24:53,880 SO, WITH THAT, I THINK I WILL 3418 02:24:53,880 --> 02:24:54,120 PAUSE. 3419 02:24:54,120 --> 02:24:57,600 I WILL OPEN IT UP TO QUESTIONS. 3420 02:24:57,600 --> 02:25:00,920 AND I GUESS WE WILL GO FROM 3421 02:25:00,920 --> 02:25:01,160 THERE. 3422 02:25:01,160 --> 02:25:02,080 >>THANK YOU SO MUCH. 3423 02:25:02,080 --> 02:25:03,960 >>OKAY. TERRIFIC. HI. 3424 02:25:03,960 --> 02:25:08,440 >>IT IS OKAY. THANK YOU SO 3425 02:25:08,440 --> 02:25:10,480 MUCH DR. PRINDIVILLE FOR 3426 02:25:10,480 --> 02:25:12,040 EXCITING PRESENTATION ABOUT 3427 02:25:12,040 --> 02:25:13,960 EARLY DAYS THAT I BET MUST BE 3428 02:25:13,960 --> 02:25:15,520 VERY EXCITING TO SEE THOSE -- 3429 02:25:15,520 --> 02:25:17,800 THE FIRST SET OF PROPOSALS COME 3430 02:25:17,800 --> 02:25:18,120 THROUGH. 3431 02:25:18,120 --> 02:25:21,280 I'M SO HAPPY THAT THEY ARE MUCH 3432 02:25:21,280 --> 02:25:23,960 SHORTER THAN CLINICAL TRIAL 3433 02:25:23,960 --> 02:25:24,240 CONCEPTS. 3434 02:25:24,240 --> 02:25:27,600 I -- AND DR. DERTIA DID SHARE 3435 02:25:27,600 --> 02:25:30,200 WITH US A LITTLE BIT OF 3436 02:25:30,200 --> 02:25:31,800 PRAGMATIC LUNG CANCER AT OUR 3437 02:25:31,800 --> 02:25:32,920 LAST MEETING AND WE TALKED 3438 02:25:32,920 --> 02:25:37,880 THROUGH A LOT OF, YOU KNOW, THE 3439 02:25:37,880 --> 02:25:39,920 LOWERING BURDEN OF REPORTING 3440 02:25:39,920 --> 02:25:41,520 EVEN WITH ADVERSE EVENTS THAT HE 3441 02:25:41,520 --> 02:25:44,680 GOT US TO A GREAT COMFORT LEVEL 3442 02:25:44,680 --> 02:25:44,880 THERE. 3443 02:25:44,880 --> 02:25:47,200 I'M WONDERING, YOU KNOW, AGAIN, 3444 02:25:47,200 --> 02:25:48,720 THIS IS JUST SO EXCITING. 3445 02:25:48,720 --> 02:25:52,280 HOW MANY TIMES HAVE WE SEEN HOW 3446 02:25:52,280 --> 02:25:54,240 SLOWLY CLINICAL TRIALS GO 3447 02:25:54,240 --> 02:25:55,200 THROUGH THIS PROCESS. 3448 02:25:55,200 --> 02:25:57,920 AND THEN BY THE TIME THAT IT IS 3449 02:25:57,920 --> 02:26:00,320 ACTIVATED, YOU KNOW, STANDARD OF 3450 02:26:00,320 --> 02:26:02,200 CARE MAY HAVE CHANGED AND, YOU 3451 02:26:02,200 --> 02:26:06,000 KNOW, IT IS A VERY FRUSTRATING 3452 02:26:06,000 --> 02:26:06,200 THING. 3453 02:26:06,200 --> 02:26:09,200 I SEE YOU, BOB. I HAVE A REALLY 3454 02:26:09,200 --> 02:26:11,120 QUICK QUESTION. YOU KNOW, IS 3455 02:26:11,120 --> 02:26:12,360 THERE CONSIDERATION OF HAVING 3456 02:26:12,360 --> 02:26:15,840 SOMEONE FROM NCOR ON THE INITIAL 3457 02:26:15,840 --> 02:26:18,520 -- YOU KNOW, REVIEWING THESE 3458 02:26:18,520 --> 02:26:21,960 THINGS TO JUST SEE THEY ARE 3459 02:26:21,960 --> 02:26:24,720 SCALEABLE TO RECRUITMENT AT NCOR 3460 02:26:24,720 --> 02:26:28,760 SITES TO BROADEN? 3461 02:26:28,760 --> 02:26:29,160 >>YEAH. 3462 02:26:29,160 --> 02:26:30,080 >>OKAY. 3463 02:26:30,080 --> 02:26:35,000 >>SEVERAL NCTN GROUPS ARE NCOR 3464 02:26:35,000 --> 02:26:36,000 SITES AND MENTIONING ONCE FIRST 3465 02:26:36,000 --> 02:26:38,720 WE LOOK AT THE IDEA AND WILL GET 3466 02:26:38,720 --> 02:26:40,760 MORE FULLY DEVELOPED PROPOSALS 3467 02:26:40,760 --> 02:26:42,440 BEFORE THINGS ARE TAKEN INTO 3468 02:26:42,440 --> 02:26:44,760 FULL PROTOCOL AND WILL OF COURSE 3469 02:26:44,760 --> 02:26:48,080 HAVE ADVOCACY INPUT AS WELL AS 3470 02:26:48,080 --> 02:26:49,960 NCOR AND COMMUNITY ONCOLOGY 3471 02:26:49,960 --> 02:26:52,080 INPUT INTO THOSE TRIALS AND YOU 3472 02:26:52,080 --> 02:26:53,800 ALSO ARE PROBABLY WELL AWARE 3473 02:26:53,800 --> 02:26:57,960 THAT AS IDEAS COME OUT OF NCTN 3474 02:26:57,960 --> 02:27:00,240 AND DISEASE COMMITTEES THERE IS 3475 02:27:00,240 --> 02:27:01,960 INPUT FROM EACH AND ALL GROUPS 3476 02:27:01,960 --> 02:27:05,360 DO THOSE THINGS AS WELL AS TO 3477 02:27:05,360 --> 02:27:07,040 WHAT IS FEASIBLE IN 3478 02:27:07,040 --> 02:27:07,400 ORGANIZATIONS. 3479 02:27:07,400 --> 02:27:07,680 >>YES. 3480 02:27:07,680 --> 02:27:09,280 >>OF COURSE, THAT IS DEFINITELY 3481 02:27:09,280 --> 02:27:12,680 THE PLAN AND IDEA THAT GETS -- 3482 02:27:12,680 --> 02:27:13,800 WE GET FURTHER DEVELOPED. 3483 02:27:13,800 --> 02:27:15,880 >>THAT IS FANTASTIC. 3484 02:27:15,880 --> 02:27:17,600 BOB, YOU HAD A QUESTION? 3485 02:27:17,600 --> 02:27:19,960 >>I WAS JUST GOING TO ASK ARE 3486 02:27:19,960 --> 02:27:22,120 YOU HOPING THIS WOULD BE A WAY 3487 02:27:22,120 --> 02:27:26,680 TO PILOT TEST WAYS TO MAKE ALL 3488 02:27:26,680 --> 02:27:30,880 CLINICAL TRIALS MORE EXPEDIENT? 3489 02:27:30,880 --> 02:27:34,240 >>YES. THAT WOULD MAKE IT 3490 02:27:34,240 --> 02:27:36,760 INNOVATIVE. FOR EXAMPLE LONG 3491 02:27:36,760 --> 02:27:37,960 PRAGMATIC AND GOT LAUNCH THE IN 3492 02:27:37,960 --> 02:27:42,080 SOME WAYS AND WE DID THINGS IN A 3493 02:27:42,080 --> 02:27:44,000 VERY EXPEDITETIVE FASHION THAT 3494 02:27:44,000 --> 02:27:46,080 YOU CAN'T DO IT FOR EVERY TRIAL 3495 02:27:46,080 --> 02:27:47,600 AND DOING THAT FOR A COUPLE 3496 02:27:47,600 --> 02:27:48,440 TRIALS YOU CAN SHOW SOMETHING 3497 02:27:48,440 --> 02:27:50,640 COULD BE DONE AND YOU CAN SAY, 3498 02:27:50,640 --> 02:27:52,120 HEY, FOR THE RIGHT KIND OF 3499 02:27:52,120 --> 02:27:53,840 TRIAL; RIGHT? 3500 02:27:53,840 --> 02:27:55,600 YOU CAN CERTAINLY STREAMLINE 3501 02:27:55,600 --> 02:27:57,280 WHAT YOU COLLECT; RIGHT? 3502 02:27:57,280 --> 02:27:59,080 YOU CAN DO CERTAIN THINGS LIKE 3503 02:27:59,080 --> 02:28:01,120 WE ARE DOING WITH PRAGMATIC 3504 02:28:01,120 --> 02:28:02,560 TRIALS AND IF YOU DO THAT AFTER 3505 02:28:02,560 --> 02:28:04,040 A COUPLE TRIALS AND SHOW THE WAY 3506 02:28:04,040 --> 02:28:07,000 IT WORKS, YOU WILL SAY, HEY, 3507 02:28:07,000 --> 02:28:09,720 THAT MAY NOT BE SO INNOVATIVE 3508 02:28:09,720 --> 02:28:11,480 ANYMORE. WE KNOW HOW TO DO THIS 3509 02:28:11,480 --> 02:28:13,400 AND CAN INCORPORATE ACTIVITIES 3510 02:28:13,400 --> 02:28:15,920 INTO REGULAR WAY THAT WE DO 3511 02:28:15,920 --> 02:28:16,240 TRIALS. 3512 02:28:16,240 --> 02:28:18,160 IF SOMETHING IS NOVEL THAT WE 3513 02:28:18,160 --> 02:28:20,880 FIND AND TEST AROUND WAYS YOU 3514 02:28:20,880 --> 02:28:23,040 COLLECT DATA OR PULL IT OUT OF 3515 02:28:23,040 --> 02:28:24,760 HR THAT HELPS YOU DO SOMETHING 3516 02:28:24,760 --> 02:28:27,680 IN A TRIAL, OF COURSE, WE WOULD 3517 02:28:27,680 --> 02:28:28,920 THEN HOPE TO LAUNCH AND MAKE 3518 02:28:28,920 --> 02:28:32,720 THAT OR GET ADOPTED AS PART OF 3519 02:28:32,720 --> 02:28:35,880 OUR REGULAR CLINICAL TRIALS 3520 02:28:35,880 --> 02:28:37,200 WORKSTREAM. 3521 02:28:37,200 --> 02:28:40,560 YES. THAT IS INDEED THE IDEA 3522 02:28:40,560 --> 02:28:43,520 TAKING A LITTLE MORE RISK AND 3523 02:28:43,520 --> 02:28:45,120 TRYING THINGS OUT AND PUSHING 3524 02:28:45,120 --> 02:28:46,960 THE ENVELOPE ON THINGS, WHICH 3525 02:28:46,960 --> 02:28:48,680 YOU CAN'T DO FOR EVERY TRIAL AND 3526 02:28:48,680 --> 02:28:50,480 YOU PROBABLY ALL -- I THINK YOU 3527 02:28:50,480 --> 02:28:51,600 HEARD AND IF YOU HAVEN'T AND 3528 02:28:51,600 --> 02:28:53,400 MUST HAVE BEEN DISCUSSED AT YOUR 3529 02:28:53,400 --> 02:28:55,960 MEETINGS AND DISCUSSED A LOT 3530 02:28:55,960 --> 02:28:57,440 ABOUT BURDENS ON OUR WORKFORCE. 3531 02:28:57,440 --> 02:28:59,280 WE -- I HAVE A -- I HAVE A LOT 3532 02:28:59,280 --> 02:29:01,680 OF THE WORK THAT WE DO COMES 3533 02:29:01,680 --> 02:29:05,680 FROM LOTS OF REALLY DEDICATED 3534 02:29:05,680 --> 02:29:07,280 PEOPLE OFTEN UNDER RESOURCE AND 3535 02:29:07,280 --> 02:29:10,640 STAFF. WE CAN ONLY PUSH FOR MY 3536 02:29:10,640 --> 02:29:12,360 RESEARCH FOR A FEW TRIALS 3537 02:29:12,360 --> 02:29:14,440 WITHOUT BREAKING OUR SYSTEM. 3538 02:29:14,440 --> 02:29:17,760 >>THANK YOU FOR THAT QUESTION, 3539 02:29:17,760 --> 02:29:18,320 BOB. 3540 02:29:18,320 --> 02:29:20,800 YOU KNOW, DR. PRINDIVILLE, I 3541 02:29:20,800 --> 02:29:22,960 CAN'T SAY HOW EXCITING THIS IS 3542 02:29:22,960 --> 02:29:26,200 BECAUSE, YOU KNOW, WE KNOW HOW 3543 02:29:26,200 --> 02:29:29,520 EXPENSIVE ADMINISTRATION IS OF A 3544 02:29:29,520 --> 02:29:31,400 CLINICAL TRIAL AND I NEVER KNEW 3545 02:29:31,400 --> 02:29:32,920 THIS UNTIL LAST SUMMER. 3546 02:29:32,920 --> 02:29:35,320 FINDING WAYS TO MAKE TRIALS 3547 02:29:35,320 --> 02:29:37,240 ADAPTIVE AND KEEP WHAT WORKS 3548 02:29:37,240 --> 02:29:38,880 AND, YOU KNOW, ONLY REPLACING 3549 02:29:38,880 --> 02:29:39,720 WHAT YOU NEED. 3550 02:29:39,720 --> 02:29:42,520 IT IS LIKE IF I HAVE A FLAT 3551 02:29:42,520 --> 02:29:44,640 TIRE, I DON'T REPLACE THE WHOLE 3552 02:29:44,640 --> 02:29:45,800 CAR BUT CHANGE THE TIRE. 3553 02:29:45,800 --> 02:29:48,200 YOU KNOW, IF WE CAN FIND A WAY 3554 02:29:48,200 --> 02:29:50,880 TO MAKE OUR CLINICAL TRIALS MORE 3555 02:29:50,880 --> 02:29:52,960 NIMBLE, THAT IS A VERY 3556 02:29:52,960 --> 02:29:55,080 SIMPLISTIC VIEW. YOU KNOW, SO 3557 02:29:55,080 --> 02:29:57,440 MANY TIMES SO MUCH EFFORT GOES 3558 02:29:57,440 --> 02:30:00,680 INTO THIS LARGE-SCALE DESIGN 3559 02:30:00,680 --> 02:30:02,800 ESPECIALLY WITH PHASE 2 AND 3 3560 02:30:02,800 --> 02:30:04,880 TRIALS AND THEN, YOU KNOW, IT IS 3561 02:30:04,880 --> 02:30:06,960 ALREADY OUTDATED. 3562 02:30:06,960 --> 02:30:11,360 I'M VERY EXCITED ABOUT THESE 3563 02:30:11,360 --> 02:30:11,640 EFFORTS. 3564 02:30:11,640 --> 02:30:12,600 ANYONE -- SORRY. 3565 02:30:12,600 --> 02:30:15,240 >>SORRY THE SECOND ONE AND 3566 02:30:15,240 --> 02:30:16,920 IMPORTANT THING THAT GETS TO 3567 02:30:16,920 --> 02:30:18,600 WHAT BOB WAS SAYING IS, YOU 3568 02:30:18,600 --> 02:30:20,640 KNOW, WE ARE TRYING -- THIS IS 3569 02:30:20,640 --> 02:30:22,160 ANOTHER AVENUE THAT WE ARE 3570 02:30:22,160 --> 02:30:24,080 TAKING IN ADDITION TO ALL OF THE 3571 02:30:24,080 --> 02:30:25,720 THINGS THAT WE POINTED OUT. YOU 3572 02:30:25,720 --> 02:30:27,480 KNOW, THAT IS WHY -- YOU KNOW, 3573 02:30:27,480 --> 02:30:30,200 AS YOU HAVE BEEN HEARING ABOUT 3574 02:30:30,200 --> 02:30:31,680 BECAUSE -- THIS IS TAKING A 3575 02:30:31,680 --> 02:30:33,600 LITTLE MORE RISK TO TRY TO PUSH 3576 02:30:33,600 --> 02:30:35,640 A FEW THINGS FORWARD TO SEE WHAT 3577 02:30:35,640 --> 02:30:39,600 WE CAN DO INNOVATIVELY WITH OUR 3578 02:30:39,600 --> 02:30:39,840 SYSTEM. 3579 02:30:39,840 --> 02:30:41,920 >>THAT IS FANTASTIC. 3580 02:30:41,920 --> 02:30:43,720 NICOLE, YOU HAVE A QUESTION? 3581 02:30:43,720 --> 02:30:46,480 >>THANK YOU. I THINK THIS IS 3582 02:30:46,480 --> 02:30:48,360 FANTASTIC. REALLY IT IS 3583 02:30:48,360 --> 02:30:50,120 EXCITING TO SEE THAT YOU ARE 3584 02:30:50,120 --> 02:30:52,520 BRINGING IN NEW PERSPECTIVES ON 3585 02:30:52,520 --> 02:30:55,800 HOW CLINICAL TRIALS COULD BE RUN 3586 02:30:55,800 --> 02:30:57,760 AND MAYBE RUN MORE EFFECTIVELY. 3587 02:30:57,760 --> 02:31:00,400 I DON'T KNOW WHAT IS MEANT BY -- 3588 02:31:00,400 --> 02:31:02,760 YOU MENTIONED THAT YOU WANT 3589 02:31:02,760 --> 02:31:04,520 INNOVATION BUT IT DOESN'T -- IT 3590 02:31:04,520 --> 02:31:08,080 IS NOT TOO DISRUPTIVE OF CURRENT 3591 02:31:08,080 --> 02:31:08,440 PROCESSES. 3592 02:31:08,440 --> 02:31:09,760 SO, ONE QUESTION THAT I HAD IN 3593 02:31:09,760 --> 02:31:12,760 MY MIND AS I WAS THINKING 3594 02:31:12,760 --> 02:31:15,360 THROUGH THIS IS, YOU KNOW, WHAT 3595 02:31:15,360 --> 02:31:17,360 IS -- WOULD SOMETHING -- WOULD A 3596 02:31:17,360 --> 02:31:18,520 TRIAL BE CONSIDERED APPROPRIATE 3597 02:31:18,520 --> 02:31:22,800 FOR THIS IF THEY WANTED TO USE 3598 02:31:22,800 --> 02:31:24,360 EXTERNAL CONTROLS OR REAL-WORLD 3599 02:31:24,360 --> 02:31:25,600 DATA, FOR INSTANCE? 3600 02:31:25,600 --> 02:31:27,520 THERE IS LOTS OF INTEREST IN 3601 02:31:27,520 --> 02:31:31,080 THAT. I KNOW THAT FDA HAD 3602 02:31:31,080 --> 02:31:33,160 GUIDANCE OF USE OF REAL WORLD 3603 02:31:33,160 --> 02:31:35,000 DATA IN CLINICAL TRIALS THAT IS 3604 02:31:35,000 --> 02:31:37,200 NOT AS COMMONLY SEEN OR COMMONLY 3605 02:31:37,200 --> 02:31:39,320 AS ACCEPTED AND WONDERING IF IT 3606 02:31:39,320 --> 02:31:42,880 IS AN INNOVATIVE APPROACH. 3607 02:31:42,880 --> 02:31:45,120 >>YEAH. YES. DIFFERENT WAYS 3608 02:31:45,120 --> 02:31:47,600 COLLECTING DATA AND/OR LOOKING 3609 02:31:47,600 --> 02:31:50,000 AT THINGS CERTAINLY COULD BE 3610 02:31:50,000 --> 02:31:51,680 CONSIDERED TO BE DONE. OF 3611 02:31:51,680 --> 02:31:54,360 COURSE, YOU KNOW, IF IT DEPENDS 3612 02:31:54,360 --> 02:31:56,120 WHAT THE BASIC TRIAL DESIGN IS, 3613 02:31:56,120 --> 02:31:57,920 YOU KNOW, AND WHAT WOULD BE 3614 02:31:57,920 --> 02:32:00,720 ACKRECHTED AND OBVIOUSLY IF 3615 02:32:00,720 --> 02:32:02,840 SOMETHING IS DONE UNDER IND OR 3616 02:32:02,840 --> 02:32:04,760 NOT AND YES. WE ARE OPEN TO 3617 02:32:04,760 --> 02:32:07,360 NOVEL WAYS OF LOOKING AND 3618 02:32:07,360 --> 02:32:08,600 COLLECTING DATA AND/OR REALLY 3619 02:32:08,600 --> 02:32:10,400 WHAT YOU ARE TALKING ABOUT IS 3620 02:32:10,400 --> 02:32:12,200 TRIAL DESIGNS. 3621 02:32:12,200 --> 02:32:12,760 RIGHT? 3622 02:32:12,760 --> 02:32:13,120 SO. 3623 02:32:13,120 --> 02:32:13,360 >>YES. 3624 02:32:13,360 --> 02:32:13,840 >>OKAY. 3625 02:32:13,840 --> 02:32:16,240 >>I THINK WE WILL -- ONE THING 3626 02:32:16,240 --> 02:32:17,880 WE REALLY HOPE TO AS WE GET OUR 3627 02:32:17,880 --> 02:32:20,040 FIRST ROUND OF IDEAS AND LOOK AT 3628 02:32:20,040 --> 02:32:23,720 THIS, I THINK IT WILL HELP US 3629 02:32:23,720 --> 02:32:25,400 SORT OF COMMUNICATE IN EXPANDING 3630 02:32:25,400 --> 02:32:27,360 WHAT OUR -- YOU KNOW, WHAT ARE 3631 02:32:27,360 --> 02:32:29,360 DIFFERENT TYPES OF THINGS THAT 3632 02:32:29,360 --> 02:32:31,960 WE ARE CONSIDERING; RIGHT? 3633 02:32:31,960 --> 02:32:33,960 WE HAVE NOW BEEN PRETTY WIDE 3634 02:32:33,960 --> 02:32:36,680 OPEN IN TERMS OF NOVEL TRIAL 3635 02:32:36,680 --> 02:32:37,560 DESIGNS. 3636 02:32:37,560 --> 02:32:39,840 AS WELL AS CONSIDERING DIFFERENT 3637 02:32:39,840 --> 02:32:41,440 WAYS OF COLLECTING DATA AND 3638 02:32:41,440 --> 02:32:44,720 DOESN'T HAVE TO JUST BE A NOVEL 3639 02:32:44,720 --> 02:32:46,120 AND SCIENTIFIC QUESTION THAT 3640 02:32:46,120 --> 02:32:47,360 COULD BE REALLY SOMETHING FOR 3641 02:32:47,360 --> 02:32:50,280 WHICH THERE IS A NOVEL WAY THAT 3642 02:32:50,280 --> 02:32:52,280 IS THAT OPERATIONALLY WE DO 3643 02:32:52,280 --> 02:32:53,880 SOMETHING THAT ULTIMATELY MAY 3644 02:32:53,880 --> 02:32:56,760 HAVE AN IMPACT ON OUR SYSTEM. 3645 02:32:56,760 --> 02:33:05,920 >>GREAT. THANK YOU. 3646 02:33:05,920 --> 02:33:10,000 >>SO, AS WE BECOME MORE NIMBLE 3647 02:33:10,000 --> 02:33:11,920 INCORPORATING NOVEL TRIAL 3648 02:33:11,920 --> 02:33:13,960 DESIGNS IT IS A 3649 02:33:13,960 --> 02:33:15,880 COMMENT/QUESTION, I GUESS. HOW 3650 02:33:15,880 --> 02:33:16,800 CAN ENSURE AND CONTINUE TO 3651 02:33:16,800 --> 02:33:20,880 SIGNAL AND CONTINUE TO BE 3652 02:33:20,880 --> 02:33:23,440 PATIENT-CENTRIC; RIGHT? 3653 02:33:23,440 --> 02:33:28,560 ONE DESIGN OF PRAGMATICA 3654 02:33:28,560 --> 02:33:31,880 ELIMINATES COLLECTION OF 3655 02:33:31,880 --> 02:33:34,120 PATIENT-REPORTED OUTCOMES THAT 3656 02:33:34,120 --> 02:33:35,120 PATIENTS MAY FEEL IS IMPORTANT 3657 02:33:35,120 --> 02:33:36,720 AND TRADE OF BALANCE TO CONTINUE 3658 02:33:36,720 --> 02:33:38,600 TO ACHIEVE TO CONTINUE TO SIGNAL 3659 02:33:38,600 --> 02:33:40,720 WE ARE STILL GOING TO CONTINUE 3660 02:33:40,720 --> 02:33:43,760 TO BE PATIENT-CENTRIC AS WE 3661 02:33:43,760 --> 02:33:45,240 INTRODUCE URGENCY. 3662 02:33:45,240 --> 02:33:48,280 >>YES. I AGREE WITH YOU. I 3663 02:33:48,280 --> 02:33:51,200 THINK THERE IS A VERY IMPORTANT 3664 02:33:51,200 --> 02:33:53,400 BALANCE BETWEEN, YOU KNOW, 3665 02:33:53,400 --> 02:33:55,440 COLLECTING AND BEING 3666 02:33:55,440 --> 02:33:57,800 PATIENT-CENTRIC AND PARTICULARLY 3667 02:33:57,800 --> 02:33:58,400 PATIENT-REPORTED OUTCOMES. 3668 02:33:58,400 --> 02:34:00,080 THERE IS NO REASON WE CAN'T 3669 02:34:00,080 --> 02:34:01,440 COLLECT THE IMPORTANT ONES IN 3670 02:34:01,440 --> 02:34:02,480 THE TRIALS. 3671 02:34:02,480 --> 02:34:03,920 RIGHT? 3672 02:34:03,920 --> 02:34:06,040 THIS IS NOT NECESSARILY 3673 02:34:06,040 --> 02:34:08,560 LIMITING. IT IN MANY WAYS 3674 02:34:08,560 --> 02:34:09,960 DEPENDS ON THE TRIAL DESIGN AND 3675 02:34:09,960 --> 02:34:12,120 WHAT TRIAL IS AND DEPENDING ON 3676 02:34:12,120 --> 02:34:13,960 STUDY QUESTION AND 3677 02:34:13,960 --> 02:34:15,440 PATIENT-REPORTED OUTCOMES COULD 3678 02:34:15,440 --> 02:34:16,760 BE MOST IMPORTANT PART OF A 3679 02:34:16,760 --> 02:34:18,840 TRIAL IF LOOKING AT CERTAIN 3680 02:34:18,840 --> 02:34:21,440 TYPES OF DISEASES AND/OR AGENTS 3681 02:34:21,440 --> 02:34:23,480 WITH SIGNIFICANT TOXICITY FOR 3682 02:34:23,480 --> 02:34:23,840 PATIENTS. 3683 02:34:23,840 --> 02:34:26,880 I THINK IT IS VERY MUCH A TRIAL 3684 02:34:26,880 --> 02:34:29,040 BY TRIAL BASIS IN MAKING SURE 3685 02:34:29,040 --> 02:34:31,240 THAT IT GETS INCORPORATED INTO 3686 02:34:31,240 --> 02:34:33,720 THE RIGHT SETTING AND WHAT THE 3687 02:34:33,720 --> 02:34:35,200 STUDY QUESTION IS. 3688 02:34:35,200 --> 02:34:37,680 BECAUSE IT IS DEFINITELY NOT 3689 02:34:37,680 --> 02:34:39,880 INTENT TO NOT COLLECT PATIENT 3690 02:34:39,880 --> 02:34:41,520 REPORTED OUTCOMES ARE INCREDIBLY 3691 02:34:41,520 --> 02:34:43,920 IMPORTANT COMPONENT WHAT WE DO 3692 02:34:43,920 --> 02:34:47,240 AND IS A MATTER OF IN WHAT 3693 02:34:47,240 --> 02:34:49,240 SETTING AND TRIAL THAT MIGHT NOT 3694 02:34:49,240 --> 02:34:53,080 BE -- THAT IS SORT OF MY 3695 02:34:53,080 --> 02:34:54,240 THINKING ON THAT. 3696 02:34:54,240 --> 02:35:04,160 >>I THINK ANNIE IS ON MUTE. 3697 02:35:04,160 --> 02:35:05,800 >>THERE WE GO. THANK YOU FOR 3698 02:35:05,800 --> 02:35:07,000 THE QUESTION AND RESPONSE. 3699 02:35:07,000 --> 02:35:09,680 IT IS SOMETHING THAT WE TALKED A 3700 02:35:09,680 --> 02:35:13,760 BIT ABOUT WITH DR. DORSO AS 3701 02:35:13,760 --> 02:35:15,280 WELL. IT IS SOMETHING OF 3702 02:35:15,280 --> 02:35:15,840 CONCERN TO US. 3703 02:35:15,840 --> 02:35:17,680 I SEE WE ARE A LITTLE OVER TIME 3704 02:35:17,680 --> 02:35:19,320 AND IF THERE IS A PRESSING 3705 02:35:19,320 --> 02:35:21,520 QUESTION, WE WANT TO MAKE SURE 3706 02:35:21,520 --> 02:35:22,360 IT GETS ANSWERED. 3707 02:35:22,360 --> 02:35:26,560 IT LOOKS LIKE WE ARE ALL CLEAR. 3708 02:35:26,560 --> 02:35:29,920 SO S 3709 02:35:29,920 --> 02:35:36,440 SO, THANK YOU FOR SPENDING TIME 3710 02:35:36,440 --> 02:35:41,720 ON THAT AND WE HOPE TO HEAR 3711 02:35:41,720 --> 02:35:43,640 FUTURE MEETINGS AND THANK YOU 3712 02:35:43,640 --> 02:35:44,800 FOR TIME TO REPORT. 3713 02:35:44,800 --> 02:35:45,640 >>THANK YOU. 3714 02:35:45,640 --> 02:35:48,120 >>THANK YOU. 3715 02:35:48,120 --> 02:35:51,040 >>SO, NOW I GUESS THIS IS THE 3716 02:35:51,040 --> 02:35:55,760 MAIN EVENT HERE THAT IS HEARING 3717 02:35:55,760 --> 02:35:59,560 LEGISLATIVE UPDATE FROM HOLLY 3718 02:35:59,560 --> 02:36:02,000 GIBBONS DEPUTY DIRECTOR FROM NCI 3719 02:36:02,000 --> 02:36:06,040 AND INVITE YOU NOW TO DELIVER 3720 02:36:06,040 --> 02:36:07,800 YOUR LEGISLATIVE UPDATE. 3721 02:36:07,800 --> 02:36:09,160 >> THANK YOU SO MUCH AND FOR 3722 02:36:09,160 --> 02:36:10,720 HAVING ME TODAY. 3723 02:36:10,720 --> 02:36:12,560 STARTING WITH RECENT DEBT LIMIT 3724 02:36:12,560 --> 02:36:14,360 AND BUDGET DEAL AND GO AHEAD AND 3725 02:36:14,360 --> 02:36:15,840 ADVANCE TO THE NEXT SLIDE. 3726 02:36:15,840 --> 02:36:20,160 LY SHARE UPDATES ON ONGOING 3727 02:36:20,160 --> 02:36:22,920 FY2024 APPROPRIATIONS PROCESS 3728 02:36:22,920 --> 02:36:25,560 AND HOUSE VERSUS SENATE 3729 02:36:25,560 --> 02:36:28,000 CONGRESSIONAL BRIEFINGS AND 3730 02:36:28,000 --> 02:36:30,000 LOOKING TO EARLY FALL AND 3731 02:36:30,000 --> 02:36:31,560 ACTIVITIES WE ARE EXPECTING AND 3732 02:36:31,560 --> 02:36:32,920 NEXT SLIDE, PLEASE. 3733 02:36:32,920 --> 02:36:37,600 WANTING TO SHARE A BRIEF RECAP 3734 02:36:37,600 --> 02:36:40,200 WHERE CONGRESS AND 3735 02:36:40,200 --> 02:36:41,480 ADMINISTRATION ENDED UP. 3736 02:36:41,480 --> 02:36:44,680 WE AVOIDED REACHING THE DEBT 3737 02:36:44,680 --> 02:36:47,560 LIMIT AND DR. LOWY MENTIONED 3738 02:36:47,560 --> 02:36:49,080 AGREEMENT REACHED DEBT CEILING 3739 02:36:49,080 --> 02:36:51,240 TO JANUARY 2025 AND AGREEMENT 3740 02:36:51,240 --> 02:36:54,800 WAS PART OF LARGER FISCAL 3741 02:36:54,800 --> 02:37:03,840 RESPONSIBILITY ACT OR FRI AND 3742 02:37:03,840 --> 02:37:07,360 PASSED ON HOUSE AND JUNE THIRD 2 3743 02:37:07,360 --> 02:37:10,400 DAYS AHEAD OF DEFAULT DATE ON 3744 02:37:10,400 --> 02:37:13,200 JUNE FIFTH. NEXT SLIDE, PLEASE. 3745 02:37:13,200 --> 02:37:14,600 SHARING NATIONAL JOURNAL SLIDE 3746 02:37:14,600 --> 02:37:16,400 FOR REFERENCE AND WELCOME TO 3747 02:37:16,400 --> 02:37:20,440 COME BACK TO IT IN ALL DETAILS 3748 02:37:20,440 --> 02:37:23,520 AND WANTED TO COVER HOW 3749 02:37:23,520 --> 02:37:25,280 AGREEMENTS PART OF THE BILL 3750 02:37:25,280 --> 02:37:27,680 EFFECT NCI AND OTHER FEDERAL 3751 02:37:27,680 --> 02:37:29,120 AGENCIES AND AGREEMENT INCLUDES 3752 02:37:29,120 --> 02:37:32,520 TWO YEARS SPENDING CAPS AS DR. 3753 02:37:32,520 --> 02:37:34,640 LOWY REFERENCED ALLOWING DEFENSE 3754 02:37:34,640 --> 02:37:36,760 FUNDING TO INCREASE BY 3% THAT 3755 02:37:36,760 --> 02:37:39,400 IS AMOUNT REQUESTED IN 3756 02:37:39,400 --> 02:37:42,320 PRESIDENT'S BUDGET PROTECTING 3757 02:37:42,320 --> 02:37:44,000 VETERAN'S HEALTH CARE SPENDING 3758 02:37:44,000 --> 02:37:47,000 CAPPING FY2024 NONDEFENSE 3759 02:37:47,000 --> 02:37:49,000 DISCRETIONARY SPENDING IN FY23 3760 02:37:49,000 --> 02:37:51,800 LEVELS AND POINTING OUT 3761 02:37:51,800 --> 02:37:55,160 NONDEFENSE DISCRETIONARY 3762 02:37:55,160 --> 02:37:58,040 SPENDING IS WHERE NCI AND 3763 02:37:58,040 --> 02:37:59,880 [INDISCERNIBLE] -- 1% INCREASE 3764 02:37:59,880 --> 02:38:04,160 AND WOULD ALSO RESCIND ABOUT 30 3765 02:38:04,160 --> 02:38:07,360 BILLION DOLLARS OF UNOBLIGATED 3766 02:38:07,360 --> 02:38:09,360 COVID RELIEF FUND AND RESCIND 3767 02:38:09,360 --> 02:38:12,400 $20 BILLION OF IRS DATA 3768 02:38:12,400 --> 02:38:13,960 ALLOCATED THROUGH INFLATION 3769 02:38:13,960 --> 02:38:17,080 REDUCTION ACT AND IS A STICK IF 3770 02:38:17,080 --> 02:38:18,800 CONGRESS DOESN'T PASS ALL 12 3771 02:38:18,800 --> 02:38:20,760 SPEVENDING BILLS BY JANUARY 1ST 3772 02:38:20,760 --> 02:38:23,080 THAT IMPOSES IMMEDIATE 1% 3773 02:38:23,080 --> 02:38:24,640 OVERALL CUT THAT IS PERMANENT IF 3774 02:38:24,640 --> 02:38:28,520 WORK IS NOT DONE BY END OF 3775 02:38:28,520 --> 02:38:32,560 APRIL. NEXT SLIDE, PLEASE. 3776 02:38:32,560 --> 02:38:35,520 THAT IS JUNE THIRD EARLIER THIS 3777 02:38:35,520 --> 02:38:37,880 MONTH AND LOTS HAPPENS IN TWO 3778 02:38:37,880 --> 02:38:39,320 WEEKS SINCE THEN AND 3779 02:38:39,320 --> 02:38:40,720 RESPONSIBILITY ACT GROUP OF 3780 02:38:40,720 --> 02:38:43,320 11GOP MEMBERS DERAILED HOUSE 3781 02:38:43,320 --> 02:38:45,440 PROCEDURAL PROCESSES BLOCKING A 3782 02:38:45,440 --> 02:38:47,760 RULE TO BRING UP UNRELATED BILLS 3783 02:38:47,760 --> 02:38:51,520 THAT ARE UNCONTROE VER SHAL FOR 3784 02:38:51,520 --> 02:38:53,360 GOP MEMBERS AND SHUT DOWN 3785 02:38:53,360 --> 02:38:54,760 EFFECTIVELY HOUSE ACTIVITIES FOR 3786 02:38:54,760 --> 02:38:56,040 SEVERAL DAYS AND GOAL WAS TO 3787 02:38:56,040 --> 02:38:58,560 SEND A MESSAGE THAT BUDGET 3788 02:38:58,560 --> 02:38:59,400 AGREEMENT DIDN'T GO FAR ENOUGH 3789 02:38:59,400 --> 02:39:01,360 AND THEY WANTED TO CONTINUE TO 3790 02:39:01,360 --> 02:39:03,680 PUSH FOR A MORE CONSERVATIVE 3791 02:39:03,680 --> 02:39:05,000 APPROACH TO FEDERAL SPENDING 3792 02:39:05,000 --> 02:39:07,920 THAT IS A PRESSURE THEY OR SMALL 3793 02:39:07,920 --> 02:39:10,320 COALITION OF MEMBERS CAN IMPOSE 3794 02:39:10,320 --> 02:39:12,720 BASED ON FACT THAT THERE IS A 3795 02:39:12,720 --> 02:39:16,760 SLIM MAJORITY IN THE HOUSE AND 3796 02:39:16,760 --> 02:39:19,160 222GOP MEMBERS IN THE HOUSE AND 3797 02:39:19,160 --> 02:39:21,360 MAGIC NUMBER TO PASS ANY PIECE 3798 02:39:21,360 --> 02:39:24,120 OF LEGISLATION IS 2018 AND 3799 02:39:24,120 --> 02:39:26,160 SPEAKER CAN LOSE ONLY FOUR 3800 02:39:26,160 --> 02:39:26,720 VOTES. 3801 02:39:26,720 --> 02:39:29,240 SPEAKER MCCARTHY AND LEADERSHIP 3802 02:39:29,240 --> 02:39:32,440 TEAM EMERGED MULTIPLE TIMES -- 3803 02:39:32,440 --> 02:39:33,680 BRINGING LEGISLATION TO THE 3804 02:39:33,680 --> 02:39:36,280 FLOOR AND RE-DEFINING FISCAL 3805 02:39:36,280 --> 02:39:39,280 RESPONSIBILITY ACT FUNDING 3806 02:39:39,280 --> 02:39:40,840 LEVELS AS CEILINGS NOT FLOORS 3807 02:39:40,840 --> 02:39:42,800 AND MORE ON THAT IN NEXT SLIDE, 3808 02:39:42,800 --> 02:39:43,720 PLEASE. 3809 02:39:43,720 --> 02:39:47,120 SO, THIS IS A BIT OF A PLOT 3810 02:39:47,120 --> 02:39:49,960 TWIST MONDAY JUNE 12TH WE SEE 3811 02:39:49,960 --> 02:39:53,360 HOUSE APPROPRIATIONS CHAIR AND 3812 02:39:53,360 --> 02:39:56,760 HOUSE WILL MARK FY24 SPENDING 3813 02:39:56,760 --> 02:39:59,440 BILLS TO FY22 TOP LEVEL FUNDING 3814 02:39:59,440 --> 02:40:04,080 AMOUNT THAT IS $119 BILLION LESS 3815 02:40:04,080 --> 02:40:08,000 THAN FY23 THAN AMOUNTS 3816 02:40:08,000 --> 02:40:08,960 NEGOTIATED IN FISCAL 3817 02:40:08,960 --> 02:40:11,640 RESPONSIBILITY ACT. FY22 LEVEL 3818 02:40:11,640 --> 02:40:12,840 IS ESSENTIALLY LEVEL THAT HOUSE 3819 02:40:12,840 --> 02:40:16,720 GOP ORIGINALLY RALLIED AROUND IF 3820 02:40:16,720 --> 02:40:18,680 HEADED INTO THE DEBT CEILING 3821 02:40:18,680 --> 02:40:20,520 NEGOTIATIONS AND SENATE AND 3822 02:40:20,520 --> 02:40:23,080 CONTRAST WILL WRITE BILLS TO 3823 02:40:23,080 --> 02:40:25,360 FY23 LEVELS AS AGREED TO IN 3824 02:40:25,360 --> 02:40:26,640 BUDGET DEAL. 3825 02:40:26,640 --> 02:40:27,960 THIS SETS UP WHAT WE EXPECT TO 3826 02:40:27,960 --> 02:40:30,760 BE A BIT OF A COLLISION COURSE 3827 02:40:30,760 --> 02:40:32,760 BETWEEN TWO CHAMBERS AND HOUSE 3828 02:40:32,760 --> 02:40:36,880 AND SENATE TYPICAL DON'T PROPOSE 3829 02:40:36,880 --> 02:40:39,240 THE SAME NUMBERS CONFERENCE 3830 02:40:39,240 --> 02:40:41,360 PROCESS TO ECONCRIME THE TWO 3831 02:40:41,360 --> 02:40:43,360 BILLS AND THIS IS A BIG 3832 02:40:43,360 --> 02:40:47,480 DIFFERENCE THAT WILL MAKE FOR A 3833 02:40:47,480 --> 02:40:48,520 REALLY CHALLENGING SEPTEMBER 3834 02:40:48,520 --> 02:40:50,080 THROUGH DECEMBER OR POTENTIALLY 3835 02:40:50,080 --> 02:40:52,720 INTO APRIL AND WILL SEE HERE IN 3836 02:40:52,720 --> 02:40:55,800 CLIP THAT CHAIR GRANGER 3837 02:40:55,800 --> 02:40:58,560 REITERATED BUDGET DEAL SET A 3838 02:40:58,560 --> 02:41:01,440 CEILING FOR FY24 BILLS AND 3839 02:41:01,440 --> 02:41:05,600 CONTINUE SO SEE REPORTED IN PAST 3840 02:41:05,600 --> 02:41:08,800 WEEK OR SO LAST WEEK AFTER HER 3841 02:41:08,800 --> 02:41:11,840 ANNOUNCEMENT AS FULL HOUSE 3842 02:41:11,840 --> 02:41:14,000 APPROPRIATIONS COMMITTEE 3843 02:41:14,000 --> 02:41:16,320 APPROXIMATELY 60 MEMBERS IN THE 3844 02:41:16,320 --> 02:41:20,000 HOUSE GATHERED FOR MARKUP OF 3845 02:41:20,000 --> 02:41:21,680 AGRICULTURAL FDA BILL AND 3846 02:41:21,680 --> 02:41:24,440 MARYLAND IN UPPER RIGHT VOICED 3847 02:41:24,440 --> 02:41:26,840 CONCERNS ABOUT APPROACH AND 3848 02:41:26,840 --> 02:41:29,240 CONGRESSMAN HOYER IS FORMER 3849 02:41:29,240 --> 02:41:31,960 HOUSE MAJORITY LEADER RETURNING 3850 02:41:31,960 --> 02:41:34,840 TO APPROPRIATIONS COMMITTEE AND 3851 02:41:34,840 --> 02:41:36,200 118TH CONGRESS EMPHASIZED 3852 02:41:36,200 --> 02:41:38,000 EXTREME DISAPPOINTMENT AND WHAT 3853 02:41:38,000 --> 02:41:41,800 HE SEES AS GOP COLLEAGUES GOING 3854 02:41:41,800 --> 02:41:44,480 BACK TO FISCAL RESPONSIBILITY 3855 02:41:44,480 --> 02:41:47,640 ACT AND WANTED TO MAKE A COMMENT 3856 02:41:47,640 --> 02:41:49,560 ON CHAIR GRANGER'S STATEMENT 3857 02:41:49,560 --> 02:41:52,360 LAST WEEK ELUDED TO DECLINE 115 3858 02:41:52,360 --> 02:41:54,240 ABOUTLE IN UNSENT FUNDS AND WERE 3859 02:41:54,240 --> 02:41:56,520 NO DETAILS YET ON WHAT -- FROM 3860 02:41:56,520 --> 02:41:58,960 WHERE FUNDS WOULD BE RESCINDED 3861 02:41:58,960 --> 02:42:01,960 THAT COULD HELP CLOSE THAT $119 3862 02:42:01,960 --> 02:42:03,400 BILLION GAP BETWEEN THE 3863 02:42:03,400 --> 02:42:05,240 POTENTIAL HOUSE AND SENATE 3864 02:42:05,240 --> 02:42:07,320 LEVELS. 3865 02:42:07,320 --> 02:42:09,000 NEXT SLIDE, PLEASE. 3866 02:42:09,000 --> 02:42:11,320 SO, I WANTED TO JUST SUMMARIZE 3867 02:42:11,320 --> 02:42:13,520 HERE THIS IS WHERE WE ARE 3868 02:42:13,520 --> 02:42:16,760 HEADING INTO FY2024 3869 02:42:16,760 --> 02:42:22,000 APPROPRIATIONS NEGOTIATIONS AND 3870 02:42:22,000 --> 02:42:25,120 SENATE BILLS AND HOUSE BILLS TO 3871 02:42:25,120 --> 02:42:27,280 FY22 LEVELS AND PROTECTING 3872 02:42:27,280 --> 02:42:29,080 DEFENSE AND VETERANS AND NOTING 3873 02:42:29,080 --> 02:42:32,280 LABOR HHS BILL IS ABOUT A $60 3874 02:42:32,280 --> 02:42:34,400 BILLION DIFFERENCE BETWEEN FY23 3875 02:42:34,400 --> 02:42:36,960 AND FY22 AND FINALLY STILL 3876 02:42:36,960 --> 02:42:41,400 WAITING TO LEARN MORE ABOUT WHAT 3877 02:42:41,400 --> 02:42:43,600 $115 BILLION PLAN FOR RECISIONS 3878 02:42:43,600 --> 02:42:46,120 WOULD BE TO MAKE IT HARD TO 3879 02:42:46,120 --> 02:42:47,040 PREDICT WAREHOUSE WILL LAND. 3880 02:42:47,040 --> 02:42:48,680 NEXT SLIDE, PLEASE. 3881 02:42:48,680 --> 02:42:50,520 THIS TABLE IS JUST A REMINDER 3882 02:42:50,520 --> 02:42:52,440 WHERE WE ARE AS WE WAIT TO SEE 3883 02:42:52,440 --> 02:42:54,960 THOSE HOUSE AND SENATE PROPOSALS 3884 02:42:54,960 --> 02:42:58,520 AND IT OUTLINES FY23 ENACTED 3885 02:42:58,520 --> 02:42:59,880 FUNDING AND PRESIDENT'S BUDGET 3886 02:42:59,880 --> 02:43:02,160 REQUEST FOR FY24 AND WE EXPECT 3887 02:43:02,160 --> 02:43:04,520 TO LEARN MORE ABOUT THAT IN 3888 02:43:04,520 --> 02:43:06,800 COMING WEEKS FOR ALL REASONS WE 3889 02:43:06,800 --> 02:43:08,080 JUST DISCUSSED NUMBERS IN HOUSE 3890 02:43:08,080 --> 02:43:10,400 AND SENATE THAT WILL LOOK 3891 02:43:10,400 --> 02:43:12,280 DIFFERENT FOR THESE AGENCIES 3892 02:43:12,280 --> 02:43:13,920 VERY LIKELY AND SO FAR IN TERMS 3893 02:43:13,920 --> 02:43:16,760 OF COMMITTEE ACTIVITY IN THE 3894 02:43:16,760 --> 02:43:19,200 HOUSE HOMELAND SECURITY AND 3895 02:43:19,200 --> 02:43:20,360 LEGISLATIVE BRANCH FULL 3896 02:43:20,360 --> 02:43:22,560 COMMITTEE MARKUPS ARE TODAY AND 3897 02:43:22,560 --> 02:43:24,880 DEFENSE BILL AND ENERGY AND 3898 02:43:24,880 --> 02:43:26,280 WATER BILL WILL BE MARKED 3899 02:43:26,280 --> 02:43:28,960 TOMORROW AND AGRICULTURE AND FDA 3900 02:43:28,960 --> 02:43:31,760 AS WELL AS MILITARY CONSTRUCTION 3901 02:43:31,760 --> 02:43:35,520 FDA WERE MARKED IN THE HOUSE AND 3902 02:43:35,520 --> 02:43:38,680 LABOR HHS HASN'T MARKED UP YET 3903 02:43:38,680 --> 02:43:40,440 AND BEGINNING THIS WEEK FULL 3904 02:43:40,440 --> 02:43:41,520 COMMITTEE MARKUP WITH 3905 02:43:41,520 --> 02:43:45,600 CONSTRUCTION VA BILL AND 3906 02:43:45,600 --> 02:43:48,360 AGRICULTURE FDA BILL SCHEDULED 3907 02:43:48,360 --> 02:43:50,480 FOR TOMORROW AND COMMITTEES ARE 3908 02:43:50,480 --> 02:43:52,120 PLANNING TO CONSIDER 3909 02:43:52,120 --> 02:43:54,240 SUB-COMMITTEE ALLOCATIONS FOR 3910 02:43:54,240 --> 02:43:56,160 ALL 12 BILLS TOMORROW AND THOSE 3911 02:43:56,160 --> 02:43:58,160 LEVELS HAVE YET TO BE RELEASED 3912 02:43:58,160 --> 02:44:02,080 AND THIS MORNING REPORTING WAS 3913 02:44:02,080 --> 02:44:07,480 INDICATING SENATOR SUSAN COLLINS 3914 02:44:07,480 --> 02:44:09,840 WAS WAITING TO RECEIVE SEVERAL 3915 02:44:09,840 --> 02:44:10,320 SUB-COMMITTEE NUMBERS. 3916 02:44:10,320 --> 02:44:11,960 NEXT SLIDE, PLEASE. 3917 02:44:11,960 --> 02:44:14,000 THIS GRAPH IS A QUICK LOOK AT 3918 02:44:14,000 --> 02:44:16,320 TRENDS OVER TIME AND AGAIN IS 3919 02:44:16,320 --> 02:44:19,720 STILL UNCLEAR WHETHER IT WILL BE 3920 02:44:19,720 --> 02:44:21,520 FEASIBLE TO MEET THE PRESIDENT'S 3921 02:44:21,520 --> 02:44:23,800 REQUEST IN A CHALLENGING BUDGET 3922 02:44:23,800 --> 02:44:24,200 YEAR. 3923 02:44:24,200 --> 02:44:25,600 NEXT SLIDE, PLEASE. 3924 02:44:25,600 --> 02:44:27,800 I DID WANT TO HIGHLIGHT THAT WE 3925 02:44:27,800 --> 02:44:30,880 HAD NIH BUDGET HEARING IN EARLY 3926 02:44:30,880 --> 02:44:33,720 MAY WITH SENATE LABOR HHS 3927 02:44:33,720 --> 02:44:36,040 APPROPRIATIONS SUB-COMMITTEE AND 3928 02:44:36,040 --> 02:44:39,120 DR. LOWY HERE REPRESENTED NCI 3929 02:44:39,120 --> 02:44:42,120 SHAKING HANDS WITH COMMITTEE 3930 02:44:42,120 --> 02:44:46,720 SHARE AND RANKING MEMBER SENATOR 3931 02:44:46,720 --> 02:44:48,320 SHELLY FROM WEST VIRGINIA ON THE 3932 02:44:48,320 --> 02:44:51,160 RIGHT AND DR. LOWY JOINED ACTING 3933 02:44:51,160 --> 02:44:54,360 DIRECTOR AT NIH DR. LARRY TABAK 3934 02:44:54,360 --> 02:44:56,640 AND SEVERAL DIRECTORS OF THE 3935 02:44:56,640 --> 02:44:58,840 HEARING IT WAS BIPARTISAN AND 3936 02:44:58,840 --> 02:45:01,320 GENERALLY SUPPORTIVE EMPHASIZING 3937 02:45:01,320 --> 02:45:04,080 IMPORTANCE OF INVESTMENTS OF 3938 02:45:04,080 --> 02:45:05,840 BIOMEDICAL RESEARCH AT NIH AND 3939 02:45:05,840 --> 02:45:07,800 HOUSE SIDE THEY CHOSE NO THE TO 3940 02:45:07,800 --> 02:45:10,840 HAVE A STANDALONE NIH BUDGET 3941 02:45:10,840 --> 02:45:14,280 HEARING THIS YEAR AND DR. TABAK 3942 02:45:14,280 --> 02:45:16,920 JOINED CDC LEADERSHIP AND 3943 02:45:16,920 --> 02:45:18,600 PREPAREDNESS AND RESPONSE 3944 02:45:18,600 --> 02:45:20,120 LEADERSHIP TO TESTIFY AT HOUSE 3945 02:45:20,120 --> 02:45:22,320 LABOR HHS SUB-COMMITTEE HEARING 3946 02:45:22,320 --> 02:45:25,480 FOCUSED ON MANAGEMENT OF COVID 3947 02:45:25,480 --> 02:45:26,960 PUBLIC HEALTH EMERGENCY. 3948 02:45:26,960 --> 02:45:28,040 NEXT SLIDE, PLEASE. 3949 02:45:28,040 --> 02:45:30,680 I WANTED TO TAKE A VERY BRIEF 3950 02:45:30,680 --> 02:45:33,480 BREAK FROM BUDGET AND 3951 02:45:33,480 --> 02:45:35,000 APPROPRIATIONS SHARING 3952 02:45:35,000 --> 02:45:37,040 CONGRESSIONAL ACTIVITY THAT NCI 3953 02:45:37,040 --> 02:45:38,640 COLLEAGUES PARTICIPATED IN 3954 02:45:38,640 --> 02:45:40,840 RECENTLY AND ON LEFT WE HAVE AMY 3955 02:45:40,840 --> 02:45:44,720 WHO LEADS NCI'S COMPARATIVE 3956 02:45:44,720 --> 02:45:46,080 ONCOLOGY PROGRAM STUDYING 3957 02:45:46,080 --> 02:45:48,720 APPROACHES TO TREAT CANCERS 3958 02:45:48,720 --> 02:45:50,200 OCCURRING NATURALLY IN PET DOGS 3959 02:45:50,200 --> 02:45:53,200 AND IN HUMANS AND WHY SHE IS 3960 02:45:53,200 --> 02:45:56,720 HOLDING CUTE PUPPY THERE AND ON 3961 02:45:56,720 --> 02:45:59,280 RIGHT STAN LIP CO WITS WHO IS AT 3962 02:45:59,280 --> 02:46:02,000 NCI'S INTRAMURAL CENTER FOR 3963 02:46:02,000 --> 02:46:03,320 CANCER RESEARCH AND MAKING 3964 02:46:03,320 --> 02:46:05,600 REGULAR REMINDER TO GROUP AND IF 3965 02:46:05,600 --> 02:46:07,360 ANY ORGANIZATIONS ARE HOSTING 3966 02:46:07,360 --> 02:46:08,040 BRIEFINGS WHERE YOU THINK IT 3967 02:46:08,040 --> 02:46:11,200 MIGHT BE HELPFUL TO HAVE NCI 3968 02:46:11,200 --> 02:46:12,440 RESEARCH UPDATE DON'T HESITATE 3969 02:46:12,440 --> 02:46:15,360 TO REACH OUT. WE ARE HAPPY TO 3970 02:46:15,360 --> 02:46:16,200 HELP FACILITATE THAT. 3971 02:46:16,200 --> 02:46:17,800 NEXT SLIDE, PLEASE. 3972 02:46:17,800 --> 02:46:21,920 SO, COMING UP, APPROPRIATIONS 3973 02:46:21,920 --> 02:46:23,960 ARE NOT ONLY MUST PASS BILLS 3974 02:46:23,960 --> 02:46:25,600 WITH SEPTEMBER DEADLINE. THERE 3975 02:46:25,600 --> 02:46:32,320 ARE FDA USER FREE PROVISIONS FOR 3976 02:46:32,320 --> 02:46:35,360 ANIMAL DRUGS THAT EXPIRE 3977 02:46:35,360 --> 02:46:38,000 SEPTEMBER 30TH AS WELL AND ALL 3978 02:46:38,000 --> 02:46:42,200 HAS YARDS PREPAREDNESS ACT 3979 02:46:42,200 --> 02:46:44,440 EXPIRES SEPTEMBER 30TH AND -- 3980 02:46:44,440 --> 02:46:47,120 BOTH ARE MARKING UP RESPECTIVE 3981 02:46:47,120 --> 02:46:49,080 NDA PROPOSALS TODAY AND IF TIME 3982 02:46:49,080 --> 02:46:51,760 TO SPARE WE WILL SEE THERE IS A 3983 02:46:51,760 --> 02:46:52,720 RUNNING LIST OF POSSIBLE 3984 02:46:52,720 --> 02:46:56,720 COMPETING PRIORITIES INCLUDING 3985 02:46:56,720 --> 02:46:59,440 OVERSITE ACTIVITY AND DRUG 3986 02:46:59,440 --> 02:46:59,960 PRICING LEGISLATION. 3987 02:46:59,960 --> 02:47:01,240 NEXT SLIDE, PLEASE. 3988 02:47:01,240 --> 02:47:04,000 WRAPPING UP WHERE I OFTEN DO 3989 02:47:04,000 --> 02:47:06,040 WITH A QUICK LOOK AT 3990 02:47:06,040 --> 02:47:07,440 CONGRESSIONAL CALENDAR. WE HAVE 3991 02:47:07,440 --> 02:47:10,200 102 DAYS ON CALENDAR UNTIL END 3992 02:47:10,200 --> 02:47:12,080 OF THE FISCAL YEAR AND 25 OF 3993 02:47:12,080 --> 02:47:14,000 THOSE ARE DATES WHEN BOTH HOUSE 3994 02:47:14,000 --> 02:47:16,720 AND SENATE ARE IN SESSION. 3995 02:47:16,720 --> 02:47:19,240 THE NEXT NCRA MEETING IS 3996 02:47:19,240 --> 02:47:21,280 CURRENTLY SCHEDULED FOR 3997 02:47:21,280 --> 02:47:22,080 WEDNESDAY, OCTOBER 4TH. 3998 02:47:22,080 --> 02:47:24,320 IF THERE IS NOT A GOVERNMENT 3999 02:47:24,320 --> 02:47:25,640 SHUTDOWN AND WE ARE ABLE TO MEET 4000 02:47:25,640 --> 02:47:28,040 ON THAT DATE AS PLAN THE WE WILL 4001 02:47:28,040 --> 02:47:30,720 HAVE LOTS TO CATCH UP ON 4002 02:47:30,720 --> 02:47:32,280 ACTIVITIES OVER THE SUMMER. 4003 02:47:32,280 --> 02:47:34,600 NEXT SLIDE, I AM HAPPY TO TAKE 4004 02:47:34,600 --> 02:47:36,320 QUESTIONS IF WE HAVE TIME AND WE 4005 02:47:36,320 --> 02:47:38,160 ARE RUNNING UP AGAINST THE 4006 02:47:38,160 --> 02:47:40,920 DEADLINE. YOU HAVE MY E-MAIL. 4007 02:47:40,920 --> 02:47:42,400 PLEASE FEEL FREE TO REACH OUT IF 4008 02:47:42,400 --> 02:47:44,160 THAT WOULD BE HELPFUL. 4009 02:47:44,160 --> 02:47:44,600 THANK YOU. 4010 02:47:44,600 --> 02:47:48,760 >>THANK YOU SO MUCH, HOLLY. 4011 02:47:48,760 --> 02:47:51,120 IT IS ALWAYS JUST SO EYE-OPENING 4012 02:47:51,120 --> 02:47:54,800 TO GET THE UPDATE AND WORK THAT 4013 02:47:54,800 --> 02:47:58,640 YOU AND YOUR STAFF HAVE TO KEEP 4014 02:47:58,640 --> 02:48:00,680 UP WITH EVERYTHING. 4015 02:48:00,680 --> 02:48:05,560 SO, ARE WE LOOKING, YOU KNOW, AT 4016 02:48:05,560 --> 02:48:08,760 CONTINUING RESOLUTIONS IN THE 4017 02:48:08,760 --> 02:48:09,400 FUTURE? 4018 02:48:09,400 --> 02:48:12,760 WHAT IS YOUR SENSE OF WHAT THE 4019 02:48:12,760 --> 02:48:14,760 FUTURE MIGHT HOLD? 4020 02:48:14,760 --> 02:48:15,960 >>ALMOST CERTAIN UNTIL SOMETIME 4021 02:48:15,960 --> 02:48:18,720 LATER IN THE FALL. YOU KNOW, I 4022 02:48:18,720 --> 02:48:20,760 THINK THEY WILL TRY TO GET AS 4023 02:48:20,760 --> 02:48:22,920 MUCH DONE ON HAMMERING OUT 4024 02:48:22,920 --> 02:48:24,720 INDIVIDUAL BILLS BETWEEN NOW AND 4025 02:48:24,720 --> 02:48:26,120 END OF SEPTEMBER. I DON'T KNOW 4026 02:48:26,120 --> 02:48:28,560 THEY WILL BE ABLE TO MAKE THAT 4027 02:48:28,560 --> 02:48:33,840 DEADLINE THAT USUALLE DOESN'T 4028 02:48:33,840 --> 02:48:37,320 HAPPEN AND HATE TO MAKE HARD 4029 02:48:37,320 --> 02:48:38,520 PREDICTIONS THERE IS VERY THAT 4030 02:48:38,520 --> 02:48:39,960 DEADLINE OF JANUARY 1ST AND THAT 4031 02:48:39,960 --> 02:48:42,720 STICK I MENTIONED EARLIER ON. 4032 02:48:42,720 --> 02:48:44,360 I THINK THAT WILL PLAY A ROLE IN 4033 02:48:44,360 --> 02:48:46,840 THE NEXT DATE THEY ARE WORKING 4034 02:48:46,840 --> 02:48:47,120 TOWARDS. 4035 02:48:47,120 --> 02:48:49,200 I THINK SHUTDOWNS ARE VERY HARD 4036 02:48:49,200 --> 02:48:50,560 TO PREDICT. 4037 02:48:50,560 --> 02:48:52,640 WITH A TWIST OF THE HOUSE NOW 4038 02:48:52,640 --> 02:48:55,080 TURNING BACK TO FY22 LEVELS AND 4039 02:48:55,080 --> 02:48:58,800 IT IS GOING TO MAKE IT MORE 4040 02:48:58,800 --> 02:49:00,560 DIFFICULT FOR THEM TO CONFERENCE 4041 02:49:00,560 --> 02:49:01,840 AND MUCH MORE DIFFICULT. 4042 02:49:01,840 --> 02:49:04,200 WE ARE SEEING LOTS OF POLITICAL 4043 02:49:04,200 --> 02:49:05,800 AND BUDGET REPORTERS THAT HAVE 4044 02:49:05,800 --> 02:49:08,040 BEEN IN THE FIELD FOR A LONG 4045 02:49:08,040 --> 02:49:09,280 TIME STARTING TO SPECULATE NOW 4046 02:49:09,280 --> 02:49:11,720 ABOUT THE POTENTIAL FOR A 4047 02:49:11,720 --> 02:49:11,960 SHUTDOWN. 4048 02:49:11,960 --> 02:49:13,720 I'M NOT GOING TO CERTAINLY MAKE 4049 02:49:13,720 --> 02:49:16,200 HARD PREDICTIONS THERE. 4050 02:49:16,200 --> 02:49:18,560 I HOPE TO REALLY SEE YOU ON 4051 02:49:18,560 --> 02:49:20,160 OCTOBER 4TH. 4052 02:49:20,160 --> 02:49:22,600 >>FINGERS CROSSED AND FURTHER 4053 02:49:22,600 --> 02:49:24,520 QUESTION IF NO ONE ELSE HAS ANY 4054 02:49:24,520 --> 02:49:24,800 QUESTIONS. 4055 02:49:24,800 --> 02:49:25,200 >>SURE. 4056 02:49:25,200 --> 02:49:28,360 >>I SAW YOU TOUCH UPON IT IN 4057 02:49:28,360 --> 02:49:30,400 WRITTEN RHO RT THAT WE RECEIVED. 4058 02:49:30,400 --> 02:49:32,960 >>UH-HUH. 4059 02:49:32,960 --> 02:49:35,200 >>WE ARE HEARING DEAR COLLEAGUE 4060 02:49:35,200 --> 02:49:36,280 LETTERS CIRCULATING ON DRUG 4061 02:49:36,280 --> 02:49:39,600 SHORTAGE AND IS THERE 4062 02:49:39,600 --> 02:49:42,080 TRACTIONING ON ANYTHING OR IS IT 4063 02:49:42,080 --> 02:49:43,600 UNLIKELY THAT SOMETHING WILL 4064 02:49:43,600 --> 02:49:44,320 HAPPEN THIS SUMMER? 4065 02:49:44,320 --> 02:49:47,760 >> THERE IS A LOT OF INTEREST 4066 02:49:47,760 --> 02:49:49,480 THAT I HAVE SEEN SEVERAL DEAR 4067 02:49:49,480 --> 02:49:51,240 COLLEAGUES AND COUPLE OF 4068 02:49:51,240 --> 02:49:52,520 HEARINGS ONE EARLIER IN THE 4069 02:49:52,520 --> 02:49:56,760 SPRING AND ONE RECENTLY EARLIER 4070 02:49:56,760 --> 02:49:59,600 IN MAY A FEW DIFFERENT PROPOSALS 4071 02:49:59,600 --> 02:50:04,720 ARE ADDRESSING PIECES AND 4072 02:50:04,720 --> 02:50:07,360 POTENTIAL SOLUTIONS NOTHING THAT 4073 02:50:07,360 --> 02:50:09,040 LOOKED COMPREHENSIVE THAT FOLKS 4074 02:50:09,040 --> 02:50:10,680 HAVE RALLIED AROUND AND 4075 02:50:10,680 --> 02:50:12,200 CHALLENGE WILL BE LIST THAT I 4076 02:50:12,200 --> 02:50:16,400 SHOWED YOU AT END OF COMPETING 4077 02:50:16,400 --> 02:50:18,320 PRIORITIES AND ARE THERE ANY 4078 02:50:18,320 --> 02:50:20,400 PROVISIONS THAT MIGHT BE TACKED 4079 02:50:20,400 --> 02:50:23,040 TO OTHER LEGISLATION 4080 02:50:23,040 --> 02:50:24,600 POTENTIALLY. I THINK AS DR. 4081 02:50:24,600 --> 02:50:28,880 LOWY ELUDED TO EARLIER IT IS A 4082 02:50:28,880 --> 02:50:33,120 MUCH BROADER SYSTEMS CHALLENGE 4083 02:50:33,120 --> 02:50:36,240 THAT WHILE LEGISLATION HELPS 4084 02:50:36,240 --> 02:50:37,520 ADDRESS SOME PIECES MIGHT NOT 4085 02:50:37,520 --> 02:50:39,800 SOLVE ENTIRE ISSUE AND WE ARE 4086 02:50:39,800 --> 02:50:41,720 KEEPING AN EYE ON IT THOUGH. 4087 02:50:41,720 --> 02:50:44,720 >>THANK YOU SO MUCH. ANYBODY 4088 02:50:44,720 --> 02:50:50,520 HAVE QUESTIONS OR COMMENTS? 4089 02:50:50,520 --> 02:50:54,520 WE STILL HAVE OUR -- 4090 02:50:54,520 --> 02:50:57,960 SEEING NONE THANKS FOR PROVIDING 4091 02:50:57,960 --> 02:50:58,840 COMPREHENSIVIZE TO UNDERSTAND 4092 02:50:58,840 --> 02:51:00,360 OVERVIEW WHAT IS GOING ON. 4093 02:51:00,360 --> 02:51:00,760 >>THANK YOU. 4094 02:51:00,760 --> 02:51:03,320 >>LOOK FORWARD TO SEEING YOU 4095 02:51:03,320 --> 02:51:05,920 AGAIN NEXT TIME IF WE SEE EACH 4096 02:51:05,920 --> 02:51:07,000 OTHER NEXT TIME. 4097 02:51:07,000 --> 02:51:08,560 >>IF YOU HAVE FOLLOW-UP 4098 02:51:08,560 --> 02:51:11,120 QUESTIONS OR LOOKING AT WRITTEN 4099 02:51:11,120 --> 02:51:13,240 UPDATE FEEL FREE TO REACH OUT. 4100 02:51:13,240 --> 02:51:14,040 HAPPY TO FOLLOW UP. 4101 02:51:14,040 --> 02:51:19,280 >>THANKS SO MUCH. 4102 02:51:19,280 --> 02:51:22,080 OKAY. I THINK WE ARE DOWN TO A 4103 02:51:22,080 --> 02:51:23,440 LITTLE BOARD BUSINESS AMY UNLESS 4104 02:51:23,440 --> 02:51:24,720 YOU HAVE SOMETHING ELSE FOR NOW. 4105 02:51:24,720 --> 02:51:26,640 >>THAT IS IT. HOME STRETCH. 4106 02:51:26,640 --> 02:51:29,480 >>OKAY. LAST THING ON THE 4107 02:51:29,480 --> 02:51:32,160 AGENDA IS APPROVING SUMMARY OF 4108 02:51:32,160 --> 02:51:35,720 LAST MEETING 8 EIGHTH NCRA 4109 02:51:35,720 --> 02:51:37,480 MEETING BACK IN MARCH WAS IT 4110 02:51:37,480 --> 02:51:39,880 MARCH? MY GOSH. IT WAS MARCH. 4111 02:51:39,880 --> 02:51:40,600 >>YUP. 4112 02:51:40,600 --> 02:51:45,120 >>IF I CAN HAVE SOMEONE MOVE TO 4113 02:51:45,120 --> 02:51:46,160 APPROVE THOSE. 4114 02:51:46,160 --> 02:51:47,040 >>SO MOVED. 4115 02:51:47,040 --> 02:51:48,960 >>OKAY. SECOND? 4116 02:51:48,960 --> 02:51:49,480 >> SECOND. 4117 02:51:49,480 --> 02:51:51,640 >>EXCELLENT. THANKS SO MUCH. 4118 02:51:51,640 --> 02:51:53,520 WE HAVE A MOTION TO APPROVE THE 4119 02:51:53,520 --> 02:51:55,120 MEETING SUMMARY AND ALL THOSE 4120 02:51:55,120 --> 02:51:57,920 WHO ARE IN FAVOR SAY AYE OR PUT 4121 02:51:57,920 --> 02:52:00,200 IT IN THE CHAT OR RAISE A HAND. 4122 02:52:00,200 --> 02:52:00,560 >>AYE. 4123 02:52:00,560 --> 02:52:01,200 >>AYE. 4124 02:52:01,200 --> 02:52:01,480 >>AYE. 4125 02:52:01,480 --> 02:52:06,160 >>ANY OPPOSED? OKAY. SEEING 4126 02:52:06,160 --> 02:52:06,920 NONE. 4127 02:52:06,920 --> 02:52:09,600 THE SUMMARY FROM LAST MEETING IS 4128 02:52:09,600 --> 02:52:11,200 APPROVED AND FINALIZED. 4129 02:52:11,200 --> 02:52:14,000 SO, I GUESS THAT IS IT. AMY, 4130 02:52:14,000 --> 02:52:15,120 UNLESS YOU HAVE SOMETHING ELSE? 4131 02:52:15,120 --> 02:52:17,560 >>NO. THAT IS -- NO. THAT IS 4132 02:52:17,560 --> 02:52:19,640 THE LAST ITEM. I DO AS ALWAYS 4133 02:52:19,640 --> 02:52:22,680 WANT TO THANK YOU FOR YOUR TIME. 4134 02:52:22,680 --> 02:52:23,480 I THOUGHT THAT THE DISCUSSION 4135 02:52:23,480 --> 02:52:30,080 WAS REALLY, REALLY AWESOME TODAY 4136 02:52:30,080 --> 02:52:34,000 AND HELPFUL TO NCI AND CANCER 4137 02:52:34,000 --> 02:52:35,240 PATIENTS YOU REPRESENT AND 4138 02:52:35,240 --> 02:52:38,880 ISSUES WE TALKED ABOUT AFTER DR. 4139 02:52:38,880 --> 02:52:41,640 LOWY'S UPDATE AND DR. SHIELS 4140 02:52:41,640 --> 02:52:44,240 UPDATE AND CTU WE COVERED THE 4141 02:52:44,240 --> 02:52:47,200 GAMUT THAT WAS HELPFUL AND 4142 02:52:47,200 --> 02:52:48,320 CONSTRUCTIVE FEEDBACK THROUGHOUT 4143 02:52:48,320 --> 02:52:50,600 AND THANKS FOR TIME AND 4144 02:52:50,600 --> 02:52:52,720 ATTENTION AND FOR BEING SO 4145 02:52:52,720 --> 02:52:53,040 THOUGHTFUL. 4146 02:52:53,040 --> 02:52:56,040 I WANT TO THANK THE ADVOCACY 4147 02:52:56,040 --> 02:52:58,200 OFFICE STAFF AND MANY WHOM YOU 4148 02:52:58,200 --> 02:52:59,400 WORK WITH INDIVIDUALLY THAT DOES 4149 02:52:59,400 --> 02:53:02,040 LOTS OF WORK GETTING US HERE TO 4150 02:53:02,040 --> 02:53:04,720 THIS DAY TO MAKE SURE WE HAVE 4151 02:53:04,720 --> 02:53:06,200 CONTENT SET UP FOR A GREAT 4152 02:53:06,200 --> 02:53:08,000 DISCUSSION AND THEY DO A 4153 02:53:08,000 --> 02:53:09,200 TERRIFIC JOB THAT I APPRECIATE 4154 02:53:09,200 --> 02:53:16,200 AS WELL AND NEXT MEETING IS IN 4155 02:53:16,200 --> 02:53:16,480 OCTOBER. 4156 02:53:16,480 --> 02:53:19,200 WE ARE LOOKING AT THAT NOW AND 4157 02:53:19,200 --> 02:53:21,240 WILL SEND OUT DETAILS FOR WHAT 4158 02:53:21,240 --> 02:53:24,720 WE HAVE PLANNED IN THE VERY NEAR 4159 02:53:24,720 --> 02:53:24,960 FUTURE. 4160 02:53:24,960 --> 02:53:27,960 STAY TUNED. GIVING EVERYBODY 4161 02:53:27,960 --> 02:53:30,520 LOTS OF ADVANCED NOTICE WHAT WE 4162 02:53:30,520 --> 02:53:32,280 ARE UP TO IN OCTOBER STAY TUNED. 4163 02:53:32,280 --> 02:53:33,880 TURNING IT TO YOU TO CLOSE THE 4164 02:53:33,880 --> 02:53:35,680 MEETING AND THANKS FOR TIME 4165 02:53:35,680 --> 02:53:36,760 TODAY AND LOOK FORWARD TO 4166 02:53:36,760 --> 02:53:38,920 TALKING WITH ALL OF YOU WELL 4167 02:53:38,920 --> 02:53:39,320 BEFORE OCTOBER. 4168 02:53:39,320 --> 02:53:41,840 >>THANK YOU TO AMY AND VINCENT 4169 02:53:41,840 --> 02:53:43,400 AND WHOLE TEAM FOR PULLING THIS 4170 02:53:43,400 --> 02:53:44,640 MEETING TOGETHER. I THANK 4171 02:53:44,640 --> 02:53:46,920 EVERYONE FOR THE WONDERFUL 4172 02:53:46,920 --> 02:53:48,720 DIALOGUES AND PERSPECTIVES THAT 4173 02:53:48,720 --> 02:53:51,760 EVEN ADDS IS REALLY AMAZING AND 4174 02:53:51,760 --> 02:53:54,400 LOVE HOW WE ARE ALL COMING AT 4175 02:53:54,400 --> 02:53:55,800 THIS AT DIFFERENT PERSPECTIVES 4176 02:53:55,800 --> 02:53:57,880 AND PASSION THAT WE BRING TO 4177 02:53:57,880 --> 02:53:58,240 THIS. 4178 02:53:58,240 --> 02:53:59,960 SO, I GUESS UNTIL WE SEE YOU 4179 02:53:59,960 --> 02:54:02,960 NEXT TIME, WE ARE ALL DONE! 4180 02:54:02,960 --> 02:54:04,080 MEETING IS ADJOURNED. 4181 02:54:04,080 --> 02:54:05,760 >> THANK YOU, GUYS. 4182 02:54:05,760 --> 02:54:06,360 >>THANK YOU. 4183 02:54:06,360 --> 02:54:10,000 >>BYE, EVERYONE. 4184 02:54:10,000 --> 02:54:20,040 >>