1 00:00:04,904 --> 00:00:06,606 MY NAME IS AMY WILLIAMS, 2 00:00:06,673 --> 00:00:07,941 DIRECTOR OF THE ADVOCACY OFFICE. 3 00:00:08,007 --> 00:00:09,109 I KNOW ALL OF YOU GUYS KNOW 4 00:00:09,175 --> 00:00:09,342 THAT. 5 00:00:09,409 --> 00:00:12,178 BUT I WANTED TO WELCOME YOU TO 6 00:00:12,245 --> 00:00:15,782 THE 91ST MEETING OF THE NCRA. 7 00:00:15,849 --> 00:00:16,883 AS ALWAYS WE ARE VERY HAPPY TO 8 00:00:16,950 --> 00:00:17,417 HAVE YOU HERE. 9 00:00:17,484 --> 00:00:21,054 WE ALSO HAVE SEVERAL BOARD 10 00:00:21,121 --> 00:00:22,589 MEMBERS JOINING US VIRTUALLY FOR 11 00:00:22,655 --> 00:00:26,192 VARIOUS REASONS, SO WELCOME. 12 00:00:26,259 --> 00:00:27,494 I'M GOING TO TURN IT OVER TO 13 00:00:27,560 --> 00:00:28,928 ANNIE IN JUST A MINUTE TO GET US 14 00:00:28,995 --> 00:00:30,230 STARTED BUT I DID WANT TO THANK 15 00:00:30,296 --> 00:00:32,098 YOU AND THE ADVOCACY OFFICE 16 00:00:32,165 --> 00:00:34,934 STAFF FOR THE WORK THAT YOU'VE 17 00:00:35,001 --> 00:00:36,269 DONE IN PUTTING THIS MEET 18 00:00:36,336 --> 00:00:36,803 TOGETHER HERE. 19 00:00:36,870 --> 00:00:39,439 I THINK WE HAVE SOME REALLY 20 00:00:39,506 --> 00:00:41,408 TERRIFIC CONTENT TO WALK THROUGH 21 00:00:41,474 --> 00:00:41,941 AND DISCUSS TODAY. 22 00:00:42,008 --> 00:00:45,745 WE ARE JOINED BY OUR NEW 23 00:00:45,812 --> 00:00:48,715 DIRECTOR, DR. RATHNELL. 24 00:00:48,782 --> 00:00:52,218 WE'RE ALSO GOING TO HAVE A 25 00:00:52,285 --> 00:00:55,722 DISCUSSION ABOUT -- WE'LL HAVE A 26 00:00:55,789 --> 00:00:56,923 LEG UPDATE AS ALWAYS AND AFTER 27 00:00:56,990 --> 00:00:58,458 LUNCH WE'LL BE TALKING A LITTLE 28 00:00:58,525 --> 00:01:00,860 BIT ABOUT THE NATIONAL CANCER 29 00:01:00,927 --> 00:01:04,264 PLAN. 30 00:01:04,330 --> 00:01:08,067 AS WELL AS AN UPDATE ON THE AI 31 00:01:08,134 --> 00:01:09,169 EFFORT. 32 00:01:09,235 --> 00:01:11,037 SO A PRETTY FULL AND TIMELY 33 00:01:11,104 --> 00:01:13,339 AGENDA FOR US. 34 00:01:13,406 --> 00:01:14,407 AGAIN IT'S NICE TO SEE YOUR 35 00:01:14,474 --> 00:01:14,641 FACES. 36 00:01:14,707 --> 00:01:16,843 I KNOW YOU GUYS WEAR MANY HATS 37 00:01:16,910 --> 00:01:18,144 AND DO A VARIETY OF DIFFERENT 38 00:01:18,211 --> 00:01:20,113 THINGS ON BEHALF OF CANCER 39 00:01:20,180 --> 00:01:20,680 PATIENTS. 40 00:01:20,747 --> 00:01:24,250 IT'S ALWAYS GREAT TO HAVE YOU 41 00:01:24,317 --> 00:01:27,454 HERE [INAUDIBLE]. 42 00:01:27,520 --> 00:01:30,156 >> THANK YOU, AMY. 43 00:01:30,223 --> 00:01:31,591 FOR ALL YOUR HARD WORK IN 44 00:01:31,658 --> 00:01:34,327 GETTING THIS MEETING PULLED 45 00:01:34,394 --> 00:01:35,662 TOGETHER. 46 00:01:35,728 --> 00:01:39,599 TO MY COLLEAGUES ON THE BOARD, I 47 00:01:39,666 --> 00:01:41,768 THANK YOU FOR YOUR EFFORTS TO BE 48 00:01:41,835 --> 00:01:43,837 HERE AND I WELCOME AS WELL OUR 49 00:01:43,903 --> 00:01:45,805 COLLEAGUES ONLINE. 50 00:01:45,872 --> 00:01:47,240 SO TO CALL THE MEETING TO ORDER, 51 00:01:47,307 --> 00:01:50,210 I NEED TO READ THE OPENING 52 00:01:50,276 --> 00:01:50,877 STATEMENT. 53 00:01:50,944 --> 00:01:52,712 AS COMMITTEE MEMBERS, I WANT TO 54 00:01:52,779 --> 00:01:54,481 REMIND YOU THAT YOU MUST ABSENT 55 00:01:54,547 --> 00:01:56,216 YOURSELF DURING SPECIFIC 56 00:01:56,282 --> 00:01:57,517 DISCUSSIONS WHENEVER YOUR 57 00:01:57,584 --> 00:01:59,185 PARTICIPATION AND DELIBERATION 58 00:01:59,252 --> 00:02:00,353 ON A PARTICULAR PRODUCT, 59 00:02:00,420 --> 00:02:02,121 PROGRAM, OR OTHER SPECIFIC 60 00:02:02,188 --> 00:02:03,323 MATTER WOULD CONSTITUTE A 61 00:02:03,389 --> 00:02:04,958 CONFLICT OF INTEREST OR CREATE 62 00:02:05,024 --> 00:02:06,159 THE APPEARANCE OF ONE. 63 00:02:06,226 --> 00:02:07,927 IT IS INCUMBENT UPON YOU TO 64 00:02:07,994 --> 00:02:09,896 ADVISE THE EXECUTIVE SECRETARY 65 00:02:09,963 --> 00:02:11,531 AND ABSTAIN FROM ANY 66 00:02:11,598 --> 00:02:12,599 PARTICIPATION AND DISCUSSION OR 67 00:02:12,665 --> 00:02:14,133 ACTION REGARDING THAT MATTER. 68 00:02:14,200 --> 00:02:16,436 IN LIGHT OF THE CURRENT POLICIES 69 00:02:16,503 --> 00:02:18,171 GOVERNING CONFLICT OF INTEREST 70 00:02:18,238 --> 00:02:20,173 BASED ON FINANCIAL HOLDING OF 71 00:02:20,240 --> 00:02:22,442 SPECIAL GOVERNMENT EMPLOYEES, 72 00:02:22,509 --> 00:02:23,543 WHICH INCLUDE ALL THE MEMBERS OF 73 00:02:23,610 --> 00:02:25,378 THIS COMMITTEE, WE MUST DEPEND 74 00:02:25,445 --> 00:02:27,580 ON YOU TO VOLUNTARILY ABSENT 75 00:02:27,647 --> 00:02:29,148 YOURSELF DURING ANY AND ALL 76 00:02:29,215 --> 00:02:31,317 DISCUSSION OF MATTERS THAT WOULD 77 00:02:31,384 --> 00:02:32,318 CONCEIVABLY IMPACT THE STATUS OF 78 00:02:32,385 --> 00:02:32,952 THOSE HOLDINGS. 79 00:02:33,019 --> 00:02:35,021 WE TRUST YOUR JUDGMENT IN THESE 80 00:02:35,088 --> 00:02:35,855 INSTANCES. 81 00:02:35,922 --> 00:02:37,557 BY LAW, A QUORUM OF BOARD 82 00:02:37,624 --> 00:02:38,758 MEMBERS IS REQUIRED FOR EACH 83 00:02:38,825 --> 00:02:39,959 INSTANCE IN WHICH A VOTE OCCURS 84 00:02:40,026 --> 00:02:40,860 IN AN OPEN SESSION. 85 00:02:40,927 --> 00:02:42,795 DURING THIS MEETING, A MINIMUM 86 00:02:42,862 --> 00:02:44,330 OF EIGHT APPOINTED MEMBERS MUST 87 00:02:44,397 --> 00:02:46,432 BE PRESENT TO VOICE THEIR VOTES. 88 00:02:46,499 --> 00:02:48,868 NEW MEMBERS WHO ARE NOT CURRENT 89 00:02:48,935 --> 00:02:51,104 MEMBERS OF ANOTHER NCI ADVISORY 90 00:02:51,170 --> 00:02:52,205 BOARD ARE NOT VOTING UNTIL THEY 91 00:02:52,272 --> 00:02:53,940 HAVE BEEN CLEARED BY THE NCI 92 00:02:54,007 --> 00:02:55,275 ETHICS OFFICE AND OFFICE OF 93 00:02:55,341 --> 00:02:55,842 HUMAN RESOURCES. 94 00:02:55,909 --> 00:02:57,577 NOW THE PUBLIC COMMENT 95 00:02:57,644 --> 00:02:58,111 STATEMENT. 96 00:02:58,177 --> 00:02:58,878 MEMBERS OF THE PUBLIC WHO MAY 97 00:02:58,945 --> 00:03:00,847 WISH TO EXPRESS VIEWS REGARDING 98 00:03:00,914 --> 00:03:02,715 ANY ITEMS DISCUSSED DURING THIS 99 00:03:02,782 --> 00:03:05,985 MEETING MAY DO SO BY WRITING AMY 100 00:03:06,052 --> 00:03:08,288 WILLIAMS, EXECUTIVE SECRETARY, 101 00:03:08,354 --> 00:03:09,756 WITHIN 10 DAYS OF THE MEETING. 102 00:03:09,822 --> 00:03:11,124 STATEMENTS BY MEMBERS OF THE 103 00:03:11,190 --> 00:03:12,992 PUBLIC WILL RECEIVE CAREFUL 104 00:03:13,059 --> 00:03:13,326 CONSIDERATION. 105 00:03:13,393 --> 00:03:15,395 JUST WANT TO REMIND THE BOARD TO 106 00:03:15,461 --> 00:03:20,099 NOT ONLY TURN ON THE MICS BUT 107 00:03:20,166 --> 00:03:21,501 TUL TOWARDS YOU SO YOUR REMARKS 108 00:03:21,568 --> 00:03:22,835 CAN BE RECORDED FOR THE MINUTES 109 00:03:22,902 --> 00:03:24,804 LATER ON. 110 00:03:24,871 --> 00:03:33,179 BEFORE WE WELCOME DR. RATHMELL, 111 00:03:33,246 --> 00:03:34,447 I WOULD LIKE TO HAVE THE BOARD 112 00:03:34,514 --> 00:03:35,181 INTRODUCE THEMSELVES. 113 00:03:35,248 --> 00:03:36,816 WE'RE JUST ASKING FOR A VERY 114 00:03:36,883 --> 00:03:39,018 QUICK YOUR NAME, YOUR 115 00:03:39,085 --> 00:03:40,753 ORGANIZATION, CANCER AREA, AND 116 00:03:40,820 --> 00:03:41,854 WHERE YOU'RE FROM. 117 00:03:41,921 --> 00:03:44,257 SO IF WE CAN START ON THIS END 118 00:03:44,324 --> 00:03:46,793 WITH NATHANIEL. 119 00:03:46,859 --> 00:03:48,094 >> PLEASED TO MEET YOU. 120 00:03:48,161 --> 00:03:49,829 GOOD TO SEE EVERYONE ELSE. 121 00:03:49,896 --> 00:03:55,435 I'M NATHANIEL FERRE, HUNTSMAN 122 00:03:55,501 --> 00:03:57,704 CANCER INSTITUTE, UNIVERSITY OF 123 00:03:57,770 --> 00:03:57,971 UTAH. 124 00:03:58,037 --> 00:04:08,548 >> I'M -- PROSTATE CANCER. 125 00:04:10,750 --> 00:04:14,487 [INAUDIBLE] 126 00:04:14,554 --> 00:04:15,922 >> HAPPY TO BE HERE. 127 00:04:15,989 --> 00:04:21,494 MY NAME IS NICOLE WILLMARTH, 128 00:04:21,561 --> 00:04:23,529 CHIEF MISSION OFFICER FOR THE 129 00:04:23,596 --> 00:04:25,064 AMERICAN BRAIN TUMOR 130 00:04:25,131 --> 00:04:26,265 ASSOCIATION, I'M IN CHICAGO, 131 00:04:26,332 --> 00:04:27,800 REALLY DEDICATE MY TIME TO 132 00:04:27,867 --> 00:04:29,969 WORKING ON RESEARCH TO SUPPORT 133 00:04:30,036 --> 00:04:33,506 PATIENTS AND THEIR FAMILIES. 134 00:04:33,573 --> 00:04:40,013 >> I'M KEVIN STEMBERGER FROM 135 00:04:40,079 --> 00:04:43,750 FARMINGTON HILLS, MICHIGAN. 136 00:04:43,816 --> 00:04:48,888 ADVOCACY WORK -- SCIENTIFIC SI 137 00:04:48,955 --> 00:04:59,465 SIDE -- [INAUDIBLE] PLEASURE. 138 00:05:03,903 --> 00:05:07,674 >> -- HERE AT NCI -- NEW YORK. 139 00:05:07,740 --> 00:05:14,847 >> HI, KRISTEN SANTIAGO. 140 00:05:14,914 --> 00:05:25,558 LUNPERSONALLY I HAD KIDNEY CANCR 141 00:06:07,366 --> 00:06:09,202 >> GOOD MORNING, MY NAME IS LEE 142 00:06:09,268 --> 00:06:09,602 JONES. 143 00:06:09,669 --> 00:06:12,705 I HAVE A CAREER IN THE FEDERAL 144 00:06:12,772 --> 00:06:15,541 GOVERNMENT. 145 00:06:15,608 --> 00:06:18,277 I'M A STAGE IV COLON CANCER 146 00:06:18,344 --> 00:06:18,711 SURVIVOR. 147 00:06:18,778 --> 00:06:20,113 THIS MONTH IT'S 20 YEARS SINCE I 148 00:06:20,179 --> 00:06:21,447 WAS DIAGNOSED. 149 00:06:21,514 --> 00:06:23,783 AND I DO WORK WITH A NUMBER OF 150 00:06:23,850 --> 00:06:27,053 ORGANIZATIONS INCLUDING NCI SSH 151 00:06:27,120 --> 00:06:30,289 IRB WHICH I'M MISSING A MEETING 152 00:06:30,356 --> 00:06:40,466 TODAY. 153 00:07:10,396 --> 00:07:12,331 >> BRITTANY, COULD YOU INTRODUCE 154 00:07:12,398 --> 00:07:13,900 YOURSELF, PLEASE? 155 00:07:13,966 --> 00:07:15,802 >> HI. 156 00:07:15,868 --> 00:07:19,739 I'M BRITTANY MCKELVEY. 157 00:07:19,806 --> 00:07:23,242 CHILDHOOD CANCER SURVIVOR, I'M A 158 00:07:23,309 --> 00:07:24,577 DIRECTOR OF REGULATORY AFFAIRS 159 00:07:24,644 --> 00:07:26,312 AT FRIENDS OF CANCER RESEARCH, 160 00:07:26,379 --> 00:07:28,848 SO I CANNOT BE THERE IN PERSON 161 00:07:28,915 --> 00:07:31,350 AS WE HAVE A NEW ADDITION, MY 162 00:07:31,417 --> 00:07:33,019 1 MONTH OLD AUBREY WHO'S JOINING 163 00:07:33,085 --> 00:07:34,487 US TODAY AS WELL. 164 00:07:34,554 --> 00:07:38,224 >> CONGRATULATIONS. 165 00:07:38,291 --> 00:07:39,425 NEXT TIME WE WANT TO SEE 166 00:07:39,492 --> 00:07:42,395 PICTURES. 167 00:07:42,461 --> 00:07:44,997 ADMISSION REQUIRED. 168 00:07:45,064 --> 00:07:47,633 SO THANK YOU ALL FOR THE 169 00:07:47,700 --> 00:07:49,302 INTRODUCTIONS AND NOW IT IS MY 170 00:07:49,368 --> 00:07:51,337 HONOR AND PLEASURE TO INTRODUCE 171 00:07:51,404 --> 00:07:58,878 OUR NEW DIRECTOR OF NCI, DR. KIM 172 00:07:58,945 --> 00:08:00,112 RATHMELL, 17TH DIRECTOR OF NCI 173 00:08:00,179 --> 00:08:01,747 WHO'S JUST RECENTLY SWORN IN AND 174 00:08:01,814 --> 00:08:04,917 WE ARE SO PRIVILEGED TO HAVE HER 175 00:08:04,984 --> 00:08:06,552 PRESENT THE REPORT. 176 00:08:06,619 --> 00:08:09,488 SHE PREVIOUSLY WAS AT VANDERBILT 177 00:08:09,555 --> 00:08:10,289 UNIVERSITY MEDICAL CENTER, AND 178 00:08:10,356 --> 00:08:11,357 CHAIR OF THE DEPARTMENT OF 179 00:08:11,424 --> 00:08:14,327 MEDICINE AND HAS DONE A LOT OF 180 00:08:14,393 --> 00:08:18,164 BENCH RESEARCH AS WELL AS SEEING 181 00:08:18,231 --> 00:08:19,465 CLIENTS SPECIFICALLY WITH KIDNEY 182 00:08:19,532 --> 00:08:21,300 CANCERS. 183 00:08:21,367 --> 00:08:23,836 SO WE ARE VERY EXCITED TO 184 00:08:23,903 --> 00:08:28,174 WELCOME HER. 185 00:08:28,241 --> 00:08:29,041 AND THANK YOU SO MUCH. 186 00:08:29,108 --> 00:08:29,709 >> GREAT. 187 00:08:29,775 --> 00:08:30,810 I'M GLAD TO BE HERE. 188 00:08:30,877 --> 00:08:32,111 FIRST A MIC CHECK, YOU CAN HEAR 189 00:08:32,178 --> 00:08:33,746 ME ALL RIGHT IN THE ROOM? 190 00:08:33,813 --> 00:08:34,981 LET ME KNOW ONLINE IF THAT'S NOT 191 00:08:35,047 --> 00:08:36,716 COMING THROUGH. 192 00:08:36,782 --> 00:08:38,217 SO IT'S MY PLEASURE TO BE HERE, 193 00:08:38,284 --> 00:08:38,985 THANK YOU VERY MUCH FOR THE 194 00:08:39,051 --> 00:08:39,452 INVITATION. 195 00:08:39,518 --> 00:08:41,287 I AM VERY MUCH LOOKING FORWARD 196 00:08:41,354 --> 00:08:44,957 TO TODAY. 197 00:08:45,024 --> 00:08:47,093 GETTING TO HEAR THE DISCUSSIONS. 198 00:08:47,159 --> 00:08:48,294 YOU DO HAVE A GREAT PROGRAM. 199 00:08:48,361 --> 00:08:50,062 I AM STILL LEARNING, I'VE BEEN 200 00:08:50,129 --> 00:08:52,465 HERE NOW 2 1/2 MONTHS. 201 00:08:52,531 --> 00:08:53,666 KEY TODAY, I JUST LEARNED THAT 202 00:08:53,733 --> 00:08:54,967 THERE'S A STARBUCKS IN THIS 203 00:08:55,034 --> 00:08:55,835 BUILDING. 204 00:08:55,902 --> 00:08:57,336 [LAUGHTER] 205 00:08:57,403 --> 00:08:58,237 SO -- BIT BY BIT. 206 00:08:58,304 --> 00:09:00,673 BUT REALLY -- I'LL BE LISTENING 207 00:09:00,740 --> 00:09:01,674 AND LEARNING ALONG WITH YOU ALL 208 00:09:01,741 --> 00:09:02,842 TODAY. 209 00:09:02,909 --> 00:09:04,310 I AM LOOKING FORWARD TO SPENDING 210 00:09:04,377 --> 00:09:05,912 THE DAY, I WILL BE WITH YOU AT 211 00:09:05,978 --> 00:09:07,013 LUNCH, WOULD LOVE TO JUST REALLY 212 00:09:07,079 --> 00:09:10,182 GET TO KNOW YOU, AND WE'LL HAVE 213 00:09:10,249 --> 00:09:10,950 A GO. 214 00:09:11,017 --> 00:09:13,352 SO THE TOPICS OF TODAY ARE, 215 00:09:13,419 --> 00:09:15,021 FIRST, I'LL GIVE YOU JUST A 216 00:09:15,087 --> 00:09:16,322 BRIEF INTRODUCTION TO ME SO THAT 217 00:09:16,389 --> 00:09:17,723 YOU CAN GET TO KNOW WHERE I COME 218 00:09:17,790 --> 00:09:19,592 FROM AND HOW I'LL LIKELY BE 219 00:09:19,659 --> 00:09:21,327 APPROACHING THINGS. 220 00:09:21,394 --> 00:09:24,630 AND THEN WE'LL ALSO -- THE TOPIC 221 00:09:24,697 --> 00:09:25,932 OF THE DAY SINCE I'VE BEEN HERE, 222 00:09:25,998 --> 00:09:28,434 AT LEAST, HAS BEEN BUDGET, AND 223 00:09:28,501 --> 00:09:31,270 SO WE'LL TALK ABOUT BUDGET, AND 224 00:09:31,337 --> 00:09:32,371 THEN GET SOME RESEARCH 225 00:09:32,438 --> 00:09:34,907 HIGHLIGHTS, JUST SO YOU HAVE 226 00:09:34,974 --> 00:09:35,975 SOME -- THERE'S SO MANY GOOD 227 00:09:36,042 --> 00:09:38,611 STORIES TO TELL AND WE'LL HEAR 228 00:09:38,678 --> 00:09:39,712 MORE TODAY BUT THESE ARE JUST 229 00:09:39,779 --> 00:09:41,681 SOME GOOD ONES TO WORK WITH. 230 00:09:41,747 --> 00:09:42,648 SO WHO AM I? 231 00:09:42,715 --> 00:09:45,751 YOU HEARD THAT I'VE MOST 232 00:09:45,818 --> 00:09:46,819 RECENTLY COME FROM VANDERBILT 233 00:09:46,886 --> 00:09:47,720 WHERE I CHAIRED THE DEPARTMENT 234 00:09:47,787 --> 00:09:50,189 OF ME MEDICINE. 235 00:09:50,256 --> 00:09:51,257 I HAVE 20 YEARS OF EXPERIENCE AS 236 00:09:51,324 --> 00:09:52,792 A SCIENTIST, KIDNEY CANCER HAS 237 00:09:52,858 --> 00:09:53,960 BEEN MY FOCUS AREA IN THE 238 00:09:54,026 --> 00:09:54,527 LABORATORY AS WELL AS IN THE 239 00:09:54,593 --> 00:09:54,760 CLINIC. 240 00:09:54,827 --> 00:09:57,029 I'VE BEEN A CLINICIAN, I'VE RUN 241 00:09:57,096 --> 00:10:00,933 CLINICAL TRIALS, AND -- SORRY, I 242 00:10:01,000 --> 00:10:01,500 DIDN'T REALIZE THERE WAS 243 00:10:01,567 --> 00:10:05,638 SOMETHING ON THERE. 244 00:10:05,705 --> 00:10:08,908 AND ALSO EDUCATED SCORES OF 245 00:10:08,975 --> 00:10:10,676 GRADUATE STUDENTS AND LED 246 00:10:10,743 --> 00:10:11,210 TRAINING PROGRAMS. 247 00:10:11,277 --> 00:10:13,646 ALL OF THAT LED ME INTO WANTING 248 00:10:13,713 --> 00:10:15,481 TO PUT IT ALL TOGETHER, 249 00:10:15,548 --> 00:10:17,116 ADMINISTRATION, THAT'S WHAT I 250 00:10:17,183 --> 00:10:18,584 DID AT VANDY. 251 00:10:18,651 --> 00:10:19,952 SO MUCH SO THAT I ACTUALLY SPENT 252 00:10:20,019 --> 00:10:25,658 A LITTLE TIME LEARNING ABOUT THE 253 00:10:25,725 --> 00:10:26,993 OPERATION, MEANING I WENT BACK 254 00:10:27,059 --> 00:10:28,627 TO SCHOOL, GOT A MASTER'S DEGREE 255 00:10:28,694 --> 00:10:30,129 IN HEALTHCARE ADMINISTRATION IN 256 00:10:30,196 --> 00:10:31,564 2021, GRADUATING IN 2022. 257 00:10:31,630 --> 00:10:33,399 SO WITH THAT BACKGROUND COMING 258 00:10:33,466 --> 00:10:36,268 TO THE NCI HAS BEEN JUST A 259 00:10:36,335 --> 00:10:37,937 THRILL. 260 00:10:38,004 --> 00:10:40,773 THIS IS THE BIGGEST CONGLOMERATE 261 00:10:40,840 --> 00:10:42,975 OF ALL OF THOSE PARTS: SCIENCE, 262 00:10:43,042 --> 00:10:44,777 CLINICAL CARE, EDUCATION, AND A 263 00:10:44,844 --> 00:10:46,245 NATIONAL STAGE TO MAKE A 264 00:10:46,312 --> 00:10:49,048 DIFFERENCE AS YOU ALL KNOW. 265 00:10:49,115 --> 00:10:50,616 SO I HAVE REALLY ENJOYED BEING 266 00:10:50,683 --> 00:10:50,816 HERE. 267 00:10:50,883 --> 00:10:53,219 I'LL TALK ABOUT SOME OF MY ROLES 268 00:10:53,285 --> 00:10:54,754 IN ADVOCACY A LITTLE LATER AND 269 00:10:54,820 --> 00:10:55,721 THOSE OF WHO YOU ARE MEETING ME 270 00:10:55,788 --> 00:10:57,923 IN THE ROOM, I'M 6 FEET TALL, I 271 00:10:57,990 --> 00:10:58,991 PLAYED BASKETBALL GROWING UP, MY 272 00:10:59,058 --> 00:11:00,559 KIDS ARE TALLER THAN ME, THEY 273 00:11:00,626 --> 00:11:02,294 PLAYED BASKETBALL, I'VE WATCHED 274 00:11:02,361 --> 00:11:03,996 BASKETBALL, I SPENT 12 YEARS ON 275 00:11:04,063 --> 00:11:06,665 THE FACULTY AT UNC CHAPEL HILL, 276 00:11:06,732 --> 00:11:07,433 GO TAR HEELS! 277 00:11:07,500 --> 00:11:09,502 BUT MY DAUGHTER GOES TO DUKE, SO 278 00:11:09,568 --> 00:11:14,206 GO DEVILS, WE LIKE BASKETBALL. 279 00:11:14,273 --> 00:11:15,975 SO I TEND TO USE BASKETBALL A 280 00:11:16,042 --> 00:11:17,710 LOT IN MY ANALOGIES, I LIKE TO 281 00:11:17,777 --> 00:11:19,612 THINK ABOUT TEAM WORK AND DRILLS 282 00:11:19,678 --> 00:11:22,748 AND BEING THERE TO CATCH THE 283 00:11:22,815 --> 00:11:23,983 PASS AND BASKETBALL JUST HAS A 284 00:11:24,050 --> 00:11:26,052 GOOD ANALOGY FOR EVERYTHING. 285 00:11:26,118 --> 00:11:27,019 THINGS THAT I VALUE. 286 00:11:27,086 --> 00:11:31,424 I REALLY VALUE COMMUNICATION, 287 00:11:31,490 --> 00:11:33,793 LISTENING, THAT'S WHAT I'LL BE 288 00:11:33,859 --> 00:11:36,095 DOING HERE MAYBE MORE THAN 289 00:11:36,162 --> 00:11:37,063 TALKING. 290 00:11:37,129 --> 00:11:38,397 BUT OPEN COMMUNICATION AND BEING 291 00:11:38,464 --> 00:11:39,598 AS TRANSPARENT AS POSSIBLE, I 292 00:11:39,665 --> 00:11:41,434 REALLY BELIEVE IN HONESTY. 293 00:11:41,500 --> 00:11:43,736 I MENTIONED TEAM WORK. 294 00:11:43,803 --> 00:11:45,171 I'VE BEEN A PART OF TEAM 295 00:11:45,237 --> 00:11:47,006 SCIENCE, I'VE BEEN A PART OF 296 00:11:47,073 --> 00:11:48,974 TEAM CLINICALLY AND PART OF 297 00:11:49,041 --> 00:11:50,176 TEAMS OPERATIONALLY, AND FOUND 298 00:11:50,242 --> 00:11:51,310 THAT THAT'S WHERE THE POWER IS, 299 00:11:51,377 --> 00:11:54,647 IS GETTING DIFFERENT PEOPLE IN 300 00:11:54,713 --> 00:11:56,148 THE ROOM, THE TEAM CAN'T WORK IF 301 00:11:56,215 --> 00:11:59,785 YOU DON'T HAVE THE CENTER, POWER 302 00:11:59,852 --> 00:12:00,853 FORWARD, AND A BACKUP TEAM TO 303 00:12:00,920 --> 00:12:01,620 COME IN WHEN THE PLAY CHANGES 304 00:12:01,687 --> 00:12:03,022 AND YOU HAVE TO BE UP AGAINST A 305 00:12:03,089 --> 00:12:03,556 DIFFERENT COMPONENT. 306 00:12:03,622 --> 00:12:05,224 SO IS HAVING ALL OF THOSE PEOPLE 307 00:12:05,291 --> 00:12:06,192 TOGETHER ON THE TEAM MAKES ALL 308 00:12:06,258 --> 00:12:07,960 THE DIFFERENCE. 309 00:12:08,027 --> 00:12:10,062 THEN FINALLY, I REALLY LIKE 310 00:12:10,129 --> 00:12:12,331 DIGGING INTO A COMPLEX PROBLEM. 311 00:12:12,398 --> 00:12:13,666 AND THAT'S THE KIND OF SCIENCE 312 00:12:13,732 --> 00:12:14,300 THAT I DO. 313 00:12:14,366 --> 00:12:16,135 I'M A MOLECULAR BIOLOGIST AND I 314 00:12:16,202 --> 00:12:17,403 LIKE TO FIGURE OUT A PATHWAY, 315 00:12:17,470 --> 00:12:18,471 THAT'S WHAT I LIKE DO WHETHER 316 00:12:18,537 --> 00:12:19,638 I'M SITTING DOWN WITH A PATIENT 317 00:12:19,705 --> 00:12:20,506 AND TRYING TO FIGURE OUT WHAT 318 00:12:20,573 --> 00:12:22,608 WE'RE GOING TO DO WITH A 319 00:12:22,675 --> 00:12:23,809 COMPLICATED SET OF SYMPTOMS. 320 00:12:23,876 --> 00:12:26,278 THAT'S WHAT I LIKE TO DO IN AN 321 00:12:26,345 --> 00:12:26,879 ORGANIZATION. 322 00:12:26,946 --> 00:12:29,181 THAT'S WHY THE BUDGET SITUATION 323 00:12:29,248 --> 00:12:32,318 IS KIND OF FUN, SO -- NOT THAT 324 00:12:32,384 --> 00:12:33,519 FUN BUT I THOUGHT THAT WAS A 325 00:12:33,586 --> 00:12:34,453 GOOD JOKE. 326 00:12:34,520 --> 00:12:39,258 BUT I DO LIKE -- OKAY, SO THAT'S 327 00:12:39,325 --> 00:12:47,433 ME. 328 00:12:47,500 --> 00:12:48,834 BUT I THOUGHT I WOULD TELL YOU A 329 00:12:48,901 --> 00:12:49,835 STORY ABOUT A PARTICULAR 330 00:12:49,902 --> 00:12:51,137 PATIENT, I'VE HAD HUNDREDS OF 331 00:12:51,203 --> 00:12:52,238 PATIENTS WHO HAVE REALLY 332 00:12:52,304 --> 00:12:53,339 COMPELLING STORIES AND YOU ALL 333 00:12:53,405 --> 00:12:54,974 KNOW THAT, BUT I HAD ONE WHO 334 00:12:55,040 --> 00:12:56,509 CHANGED ME PROFESSIONALLY AND 335 00:12:56,575 --> 00:12:59,578 CHANGED ME PERSONALLY, AND SO -- 336 00:12:59,645 --> 00:13:02,948 AND HIS STORY IS ONE THAT REALLY 337 00:13:03,015 --> 00:13:05,251 HELPS FOR A LOT OF DIFFERENT 338 00:13:05,317 --> 00:13:06,252 CONVERSATIONS. 339 00:13:06,318 --> 00:13:07,720 SO HIS IS ONE THAT I REALLY LIKE 340 00:13:07,786 --> 00:13:08,420 TO TELL. 341 00:13:08,487 --> 00:13:09,522 SO SOME OF YOU IN THE ROOM MAY 342 00:13:09,588 --> 00:13:13,025 HAVE HEARD THIS, BUT HE'S A 343 00:13:13,092 --> 00:13:15,060 YOUNG MAN THAT I MET IN MY 344 00:13:15,127 --> 00:13:17,062 CLINIC WHEN I'D BEEN RUNNING A 345 00:13:17,129 --> 00:13:18,063 KIDNEY CANCER CLINIC, WHICH WAS 346 00:13:18,130 --> 00:13:20,166 NOT THAT POPULAR IN THE EARLY 347 00:13:20,232 --> 00:13:22,101 2000s. 348 00:13:22,168 --> 00:13:23,702 BUT I'VE BEEN DOING THAT FOR 349 00:13:23,769 --> 00:13:28,107 FIVE OR SIX YEARS, AND HAVE AN 350 00:13:28,174 --> 00:13:30,075 18-YEAR-OLD, BLACK MAN AND HIS 351 00:13:30,142 --> 00:13:30,843 MOM SHOW UP. 352 00:13:30,910 --> 00:13:32,478 SO, YOU KNOW, A KID WHO'S IN MY 353 00:13:32,545 --> 00:13:34,813 CLINIC. 354 00:13:34,880 --> 00:13:37,616 AND HE HAD A SURGERY ABOUT A 355 00:13:37,683 --> 00:13:40,819 MONTH BEFORE, HAD A LARGE KIDNEY 356 00:13:40,886 --> 00:13:42,021 MASS, EVIDENCE OF METASTATIC 357 00:13:42,087 --> 00:13:43,689 DISEASE, THE WOUND WASN'T MALING 358 00:13:43,756 --> 00:13:49,461 HEALING SO HE WAS SENT UP TO THE 359 00:13:49,528 --> 00:13:49,862 UNIVERSITY. 360 00:13:49,929 --> 00:13:51,997 SO HE HAD TRADITIONAL RENAL CELL 361 00:13:52,064 --> 00:13:52,665 CARCINOMA AND WE NEEDED TO 362 00:13:52,731 --> 00:13:55,467 FIGURE OUT THIS WOUND. 363 00:13:55,534 --> 00:13:58,771 FORTUNATELY, WE RAN THIS FOCUSED 364 00:13:58,837 --> 00:13:59,838 KIDNEY CANCER CLINIC AND KNEW 365 00:13:59,905 --> 00:14:02,775 RIGHT AWAY THAT AN 18-YEAR-OLD 366 00:14:02,841 --> 00:14:05,211 AFRICAN AMERICAN MAN WHO, BY THE 367 00:14:05,277 --> 00:14:07,179 WAY, HIS FATHER DIED OF HIV FROM 368 00:14:07,246 --> 00:14:09,014 A BLOOD TRANSFUSION FOR HIS 369 00:14:09,081 --> 00:14:10,149 SICKLE CELL DISEASE, MEANS THAT 370 00:14:10,216 --> 00:14:13,552 HE HAS TO GO -- IN THE TEXTBOOK, 371 00:14:13,619 --> 00:14:14,853 THERE'S THIS INCREDIBLY RARE 372 00:14:14,920 --> 00:14:17,556 TYPE OF TUMOR CALLED RENAL 373 00:14:17,623 --> 00:14:18,824 MEDULLARY CARCINOMA THAT ONLY 374 00:14:18,891 --> 00:14:22,261 OCCURS IN YOUNG PEOPLE WITH 375 00:14:22,328 --> 00:14:25,431 SICKLE CELL -- I HAD NEVER SEEN 376 00:14:25,497 --> 00:14:26,298 THIS BEFORE. 377 00:14:26,365 --> 00:14:27,933 AS ONE OF THE FEW CARD CARRYING 378 00:14:28,000 --> 00:14:30,803 KIDNEY CANCER DOCTORS I IN 379 00:14:30,869 --> 00:14:31,770 AMERICA, I HAD ONLY READ ABOUT 380 00:14:31,837 --> 00:14:32,338 THIS DISEASE. 381 00:14:32,404 --> 00:14:34,340 SO THIS WAS MY INTRODUCTION. 382 00:14:34,406 --> 00:14:37,042 AND WHAT I HAD READ ABOUT THIS 383 00:14:37,109 --> 00:14:38,010 DISEASE WAS THAT THERE WAS 384 00:14:38,077 --> 00:14:42,715 ALMOST NO LITERATURE, AND THEY 385 00:14:42,781 --> 00:14:44,016 USUALLY LIVED FOR ABOUT THREE 386 00:14:44,083 --> 00:14:45,017 MONTHS AFTER DIAGNOSIS. 387 00:14:45,084 --> 00:14:48,454 AND SO WE WERE A MONTH IN, AND 388 00:14:48,520 --> 00:14:51,090 OUT OF SOME DESPERATION, MADE A 389 00:14:51,156 --> 00:14:53,225 LOT OF PHONE CALLS, WE CAME UP 390 00:14:53,292 --> 00:14:56,395 WITH TREATMENT PLAN WHICH WAS 391 00:14:56,462 --> 00:14:58,797 USING A CHEMOTHERAPY REGIMEN 392 00:14:58,864 --> 00:14:59,765 DESIGNED AROUND BLADDER CANCER 393 00:14:59,832 --> 00:15:01,100 BECAUSE WE NEEDED TO OFFER HIM 394 00:15:01,166 --> 00:15:03,402 SOMETHING JUST FOR SYMPTOM 395 00:15:03,469 --> 00:15:06,572 CONTROL AND HIS TUMOR RESPONDED. 396 00:15:06,639 --> 00:15:09,074 IT SHRANK, ALL OF HIS ME STATIC 397 00:15:09,141 --> 00:15:09,642 DISEASE SHRANK. 398 00:15:09,708 --> 00:15:12,444 HE STARTED TO LOOK A LITTLE BIT 399 00:15:12,511 --> 00:15:13,779 BETTER. 400 00:15:13,846 --> 00:15:15,080 BUT OF COURSE IT DIDN'T LAST. 401 00:15:15,147 --> 00:15:16,749 HE LIVED ABOUT A YEAR, THOUGH, 402 00:15:16,815 --> 00:15:18,550 WHICH WAS DRAMATICALLY MORE THAN 403 00:15:18,617 --> 00:15:22,187 WHAT WE HAD EXPECTED AND WHAT 404 00:15:22,254 --> 00:15:25,257 THE COMMUNITY THAT I WAS TALKING 405 00:15:25,324 --> 00:15:26,558 TO OF THE KIDNEY CANCER WORLD 406 00:15:26,625 --> 00:15:27,793 HAD REALLY SEEN BEFORE. 407 00:15:27,860 --> 00:15:29,962 AT THE END OF HIS LIFE, HE WAS 408 00:15:30,029 --> 00:15:31,597 IN HOSPICE AND I HAPPENED -- HE 409 00:15:31,664 --> 00:15:35,868 LIVED ABOUT TWO HOURS AWAY FROM 410 00:15:35,934 --> 00:15:36,835 OUR MEDICAL CENTER. 411 00:15:36,902 --> 00:15:37,836 I HAPPENED TO BE DRIVING ACROSS 412 00:15:37,903 --> 00:15:40,472 THE STATE WITH MY KIDS WHEN HIS 413 00:15:40,539 --> 00:15:42,308 MOM CALLED WITH SOME SYMPTOM AND 414 00:15:42,374 --> 00:15:44,743 ASKED ME TO COME OUT TO -- WELL, 415 00:15:44,810 --> 00:15:46,345 ASKED ME FOR ADVICE, BUT I WAS 416 00:15:46,412 --> 00:15:48,113 WITHIN AN HOUR OF THEIR HOUSE 417 00:15:48,180 --> 00:15:49,882 AND SO OFFERED TO STOP BY AND SO 418 00:15:49,948 --> 00:15:53,085 I WENT OUT, YOU KNOW, GOT 419 00:15:53,152 --> 00:15:54,787 DIRECTIONS, DOWN A GRAVEL ROAD, 420 00:15:54,853 --> 00:15:56,755 THIS IS BEFORE I USED A LOT OF 421 00:15:56,822 --> 00:15:58,190 GPS, PARKED MY KIDS ON THE FRONT 422 00:15:58,257 --> 00:15:59,825 STEP AND WENT IN TO A HOUSE THAT 423 00:15:59,892 --> 00:16:01,226 YOU SHOULD NEVER HAVE TO SEE, 424 00:16:01,293 --> 00:16:01,927 RIGHT? 425 00:16:01,994 --> 00:16:03,095 SINGLE MOM, DYING KID IN THE 426 00:16:03,162 --> 00:16:05,731 LIVING ROOM, AND WE TALKED ABOUT 427 00:16:05,798 --> 00:16:08,467 THE SYMPTOMS, AND THEN SHE SAT 428 00:16:08,534 --> 00:16:10,536 AT HER KITCHEN TABLE WITH ME AND 429 00:16:10,602 --> 00:16:12,071 JUST UNLOADED ON HOW EVERYTHING 430 00:16:12,137 --> 00:16:12,504 WAS SO UNFAIR. 431 00:16:12,571 --> 00:16:13,839 YOU KNOW, IT'S UNFAIR THAT HE 432 00:16:13,906 --> 00:16:16,008 HAD HAD THIS CANCER, IT WAS 433 00:16:16,075 --> 00:16:19,278 UNFAIR THAT IT TOOK A LONG TIME 434 00:16:19,345 --> 00:16:21,680 TO GET TAKEN SERIOUSLY BECAUSE 435 00:16:21,747 --> 00:16:23,349 HE'S 18 YEARS OLD, 17, YOU KNOW, 436 00:16:23,415 --> 00:16:24,750 WHO LISTENS TO THEM WHEN THEY 437 00:16:24,817 --> 00:16:26,752 COMPLAIN ABOUT ABDOMINAL PAIN? 438 00:16:26,819 --> 00:16:27,720 BECAUSE HE HAD TO DO THIS 439 00:16:27,786 --> 00:16:29,788 WITHOUT A DAD, BECAUSE HE HAD TO 440 00:16:29,855 --> 00:16:32,424 DO THIS WITH, YOU KNOW -- YOU 441 00:16:32,491 --> 00:16:33,992 KNOW, GROWING UP IN POVERTY, AND 442 00:16:34,059 --> 00:16:35,461 BECAUSE HE WAS A KID WITH TALENT 443 00:16:35,527 --> 00:16:38,364 WHO NEVER GOT TO EXPLORE THAT. 444 00:16:38,430 --> 00:16:40,199 SO SHE SAID, YOU KNOW, YOU CAN'T 445 00:16:40,265 --> 00:16:41,934 JUST TREAT HIM AND THEN BE DONE, 446 00:16:42,000 --> 00:16:44,336 LIKE THERE HAS TO BE MORE. 447 00:16:44,403 --> 00:16:49,908 AND SO I DON'T KNOW -- I WROTE A 448 00:16:49,975 --> 00:16:52,211 PAPER AND BY THEN A COUPLE OF 449 00:16:52,277 --> 00:16:52,978 OTHER -- ONE PERSON AT OHIO 450 00:16:53,045 --> 00:16:54,413 STATE HAD TREATED SOMEONE ELSE 451 00:16:54,480 --> 00:16:56,815 WITH THE SAME REGIMEN, ALSO 452 00:16:56,882 --> 00:16:58,884 LIVED A YEAR, SO WROTE A PAPER, 453 00:16:58,951 --> 00:17:01,854 ABOUT TWO OR THREE PEOPLE. 454 00:17:01,920 --> 00:17:07,459 AND WE POSTED IT ON TWITTER. 455 00:17:07,526 --> 00:17:08,861 SO TO MAKE THE STORY GO A LITTLE 456 00:17:08,927 --> 00:17:11,063 BIT FASTER, WE POSTED IT ON 457 00:17:11,130 --> 00:17:11,897 TWITTER, THAT STARTED THE 458 00:17:11,964 --> 00:17:13,232 COMMUNITY TALKING A LITTLE BIT, 459 00:17:13,298 --> 00:17:18,804 AND WE MET A REALLY POWERFUL 460 00:17:18,871 --> 00:17:25,811 ADVOCATE, CORA COUCONNOR, A MAD 461 00:17:25,878 --> 00:17:26,879 RELATIVE SISTER OF A YOUNG MAN 462 00:17:26,945 --> 00:17:28,747 WHO IS STILL ALIVE TODAY, BY THE 463 00:17:28,814 --> 00:17:32,584 WAY, WITH YOU BUT HE WAS THE ONN 464 00:17:32,651 --> 00:17:35,587 SHE FOUND HAD LIVED WITH RENAL 465 00:17:35,654 --> 00:17:36,855 MEDULLARY CARCINOMA AND COULDN'T 466 00:17:36,922 --> 00:17:38,023 BELIEVE THIS WAS POSSIBLE. 467 00:17:38,090 --> 00:17:41,860 SO SHE INTRODUCED US TO AN 468 00:17:41,927 --> 00:17:43,295 ADVOCATE IN HOUSTON AND THEY GOT 469 00:17:43,362 --> 00:17:45,364 THE FEW OF US THAT THERE WERE 470 00:17:45,431 --> 00:17:46,799 SPEAKING THE LAJ WAJ OF THE 471 00:17:46,865 --> 00:17:48,534 RENAL MEDULLARY CARCINOMA, WE 472 00:17:48,600 --> 00:17:50,602 GOT TOGETHER WITH A THINK TANK 473 00:17:50,669 --> 00:17:52,805 STYLE MEETING IN 2017 IN 474 00:17:52,871 --> 00:17:53,272 NASHVILLE, TENNESSEE. 475 00:17:53,338 --> 00:17:54,573 I HAD JUST MOVED TO NASHVILLE. 476 00:17:54,640 --> 00:17:55,541 WE BROUGHT TOGETHER PEOPLE FROM 477 00:17:55,607 --> 00:18:00,012 AROUND THE WORLD, BUT ALL 478 00:18:00,078 --> 00:18:00,913 INTERESTED AND TALKED ABOUT WHAT 479 00:18:00,979 --> 00:18:01,447 DID WE NEED. 480 00:18:01,513 --> 00:18:07,686 WE NEEDED JUST GUIDELINES, WE 481 00:18:07,753 --> 00:18:09,521 NEEDED EDUCATION, EDUCATIONAL 482 00:18:09,588 --> 00:18:11,523 MATERIALS PUSHED OUT TO DOCTORS 483 00:18:11,590 --> 00:18:15,360 AND PATIENTS AND WE STARTED AN 484 00:18:15,427 --> 00:18:16,862 ORGANIZATION CALLED RMC 485 00:18:16,929 --> 00:18:17,863 ALLIANCE, WHICH WAS REALLY JUST 486 00:18:17,930 --> 00:18:19,598 MEANT TO CONTINUE TO RAISE 487 00:18:19,665 --> 00:18:21,600 AWARENESS FOR THIS ULTRA-RARE 488 00:18:21,667 --> 00:18:26,004 DISEASE, WHICH TODAY HAS GRANT 489 00:18:26,071 --> 00:18:27,806 MECHANISMS, HAS FUNDING, HAS AN 490 00:18:27,873 --> 00:18:30,008 ACTIVE COMMUNITY, HAS CLINICAL 491 00:18:30,075 --> 00:18:30,876 TRIALS. 492 00:18:30,943 --> 00:18:31,977 THESE KIDS STILL AREN'T LIVING 493 00:18:32,044 --> 00:18:33,178 LONG ENOUGH BUT THEY'RE LIVING 494 00:18:33,245 --> 00:18:33,812 LONGER. 495 00:18:33,879 --> 00:18:34,713 WE UNDERSTAND THE BIOLOGY 496 00:18:34,780 --> 00:18:35,380 BETTER. 497 00:18:35,447 --> 00:18:41,820 AND IT IS A NAMED PART OF THE 498 00:18:41,887 --> 00:18:42,654 CCDI EFFORT HERE AT THE NCI SO 499 00:18:42,721 --> 00:18:44,656 IT IS NO LONGER A SURPRISE THAT 500 00:18:44,723 --> 00:18:46,792 NO ONE HAS EVER HEARD OF, IT 501 00:18:46,859 --> 00:18:47,960 SHOULD BE SOMETHING PEOPLE KNOW. 502 00:18:48,026 --> 00:18:48,927 SO THAT'S WHERE I COME FROM AND 503 00:18:48,994 --> 00:18:50,863 THAT'S WHERE I UNDERSTAND THE 504 00:18:50,929 --> 00:18:56,034 POWER IN WHAT YOU GUYS DO. 505 00:18:56,101 --> 00:18:58,136 THE IMPACT OF ADVOCACY, I KNOW 506 00:18:58,203 --> 00:19:01,073 CAN'T BE UNDERSTATED. 507 00:19:01,139 --> 00:19:02,474 SO IT'S HARD TO TRANSITION FROM 508 00:19:02,541 --> 00:19:03,675 THAT TO BUDGET. 509 00:19:03,742 --> 00:19:04,243 [LAUGHTER] 510 00:19:04,309 --> 00:19:07,212 BUT WE CAN'T DO WHAT WE DO 511 00:19:07,279 --> 00:19:10,749 WITHOUT FUNDING. 512 00:19:10,816 --> 00:19:14,520 SO YOU ALL CAN TELL THE STORY TO 513 00:19:14,586 --> 00:19:16,021 REALLY HELP US BE ABLE TO RAISE 514 00:19:16,088 --> 00:19:17,322 THE FUNDS TO DO WHAT WE DO. 515 00:19:17,389 --> 00:19:18,323 SO IT'S IMPORTANT YOU KNOW WHERE 516 00:19:18,390 --> 00:19:19,858 WE ARE SO YOU CAN SAY WHAT IT IS 517 00:19:19,925 --> 00:19:22,294 THAT WE REALLY TRULY NEED TO BE 518 00:19:22,361 --> 00:19:26,231 ABLE TO MAKE THE KIND OF 519 00:19:26,298 --> 00:19:27,099 DIFFERENCE THAT'S IMPORTANT. 520 00:19:27,165 --> 00:19:29,067 SO THIS IS WHERE WE ARE IN TERMS 521 00:19:29,134 --> 00:19:30,502 OF OUR OVERALL BUDGET PROCESS. 522 00:19:30,569 --> 00:19:34,306 IF YOU WAMP WATCH THE NEWS YOUW 523 00:19:34,373 --> 00:19:37,576 WE'VE AVERTED THREE TIMES, WE'RE 524 00:19:37,643 --> 00:19:39,778 NOW HOPEFUL THAT MARCH 22ND WILL 525 00:19:39,845 --> 00:19:41,079 BE OUR DAY THAT WE'LL HAVE A 526 00:19:41,146 --> 00:19:42,948 BUDGET THEN. 527 00:19:43,015 --> 00:19:44,016 WE'RE HALFWAY THROUGH THE YEAR. 528 00:19:44,082 --> 00:19:46,018 WE'VE BEEN LIVING WITH TH THE 529 00:19:46,084 --> 00:19:46,752 ASSUMPTION THAT WE KNOW WHAT 530 00:19:46,818 --> 00:19:47,853 WE'RE GOING TO GET BASED ON WHAT 531 00:19:47,920 --> 00:19:52,357 HWE GOT LAST YEAR, WE NEED TO BE 532 00:19:52,424 --> 00:19:53,792 CONSERVATIVE WHICH I KNOW IS NOT 533 00:19:53,859 --> 00:19:55,761 WHAT WE NEED TO DO, AND WE WILL 534 00:19:55,827 --> 00:19:57,596 MAKE ADJUSTMENTS WHEN WE GET OUR 535 00:19:57,663 --> 00:19:59,231 BUDGET. 536 00:19:59,298 --> 00:20:00,999 SO JUST TO KNOW A LITTLE BIT OF 537 00:20:01,066 --> 00:20:04,503 THE ECOSYSTEM THAT'S GOING ON IN 538 00:20:04,570 --> 00:20:06,572 THESE NEXT COUPLE OF WEEKS, WE 539 00:20:06,638 --> 00:20:11,476 ARE A PART OF LABOR HEALTH, 540 00:20:11,543 --> 00:20:12,611 RELATED AGENCIES BUT ALL OF 541 00:20:12,678 --> 00:20:14,680 THESE GROUPS NEED TO HAVE THEIR 542 00:20:14,746 --> 00:20:15,881 BUDGETS BUILT, SO WITH THE 543 00:20:15,948 --> 00:20:17,049 COMPETITIVE LANDSCAPE, THESE ARE 544 00:20:17,115 --> 00:20:20,018 OTHER IMPORTANT THINGS TOO, AND 545 00:20:20,085 --> 00:20:22,521 SO MAKING SURE THAT JUST LIKE 546 00:20:22,588 --> 00:20:23,755 RMC DOESN'T GET LOST IN THE SEA 547 00:20:23,822 --> 00:20:26,592 OF KIDNEY CANCER, THAT CANCER 548 00:20:26,658 --> 00:20:27,893 DOESN'T GET LOST IN THE SEA OF 549 00:20:27,960 --> 00:20:31,630 ALL THE OTHERS. 550 00:20:31,697 --> 00:20:33,332 SO WHAT DO WE SPEND OUR MONEY 551 00:20:33,398 --> 00:20:33,699 ON? 552 00:20:33,765 --> 00:20:35,233 WE SPEND IT ON, AS YOU KNOW, 553 00:20:35,300 --> 00:20:37,536 GRANTS THAT GO OUT TO THE 554 00:20:37,603 --> 00:20:38,070 EXTRAMURAL COMMUNITY. 555 00:20:38,136 --> 00:20:40,806 THAT'S THE BLUE -- ARE ALL 556 00:20:40,872 --> 00:20:42,441 RESEARCH GRANTS, VARIOUS TYPES. 557 00:20:42,507 --> 00:20:44,343 WE HAVE THOSE THAT FUND A SMALL 558 00:20:44,409 --> 00:20:47,779 GROUP OF INVESTIGATORS, THOSE 559 00:20:47,846 --> 00:20:50,616 THAT FUND WHOLE CENTERS, ABOUT 560 00:20:50,682 --> 00:20:53,085 THREE QUARTERS WORK THAT WAY. 561 00:20:53,151 --> 00:20:56,388 THERE'S SOME, ABOUT 7% THAT JUST 562 00:20:56,455 --> 00:20:57,990 RUN IN PLACE, KEEP THE LIGHTS 563 00:20:58,056 --> 00:21:00,158 ON, AND ABOUT 18% IS HERE, 564 00:21:00,225 --> 00:21:00,525 RIGHT? 565 00:21:00,592 --> 00:21:02,027 I'M GLAD YOU'RE HERE SO YOU GET 566 00:21:02,094 --> 00:21:06,932 TO SEE THE -- ESPECIALLY FOR 567 00:21:06,999 --> 00:21:09,668 THOSE ONLINE, THE NUMBER OF 568 00:21:09,735 --> 00:21:10,769 RESEARCHERS THAT WE HAVE HERE, 569 00:21:10,836 --> 00:21:12,771 THE CLINICAL CENTER. 570 00:21:12,838 --> 00:21:16,341 THIS IS SORT OF THE HUB OF A BIG 571 00:21:16,408 --> 00:21:22,581 ENTERPRISE. 572 00:21:22,648 --> 00:21:26,084 NOW LAST YEAR, OUR ALLOCATION 573 00:21:26,151 --> 00:21:26,652 WAS $7.3 BILLION. 574 00:21:26,718 --> 00:21:29,054 WE HAD THE PRIVILEGE, THE 575 00:21:29,121 --> 00:21:30,756 RESPONSIBILITY, TO INFORM THE 576 00:21:30,822 --> 00:21:32,357 WHITE HOUSE OF WHAT WE THINK IT 577 00:21:32,424 --> 00:21:33,625 WOULD COST TO DO THE WORK THAT 578 00:21:33,692 --> 00:21:35,394 WE'RE BEING ASKED TO DO. 579 00:21:35,460 --> 00:21:36,294 ACTUALLY NEED TO CHANGE THE 580 00:21:36,361 --> 00:21:40,632 TITLE OF THIS SLIDE BECAUSE WHAT 581 00:21:40,699 --> 00:21:42,267 SAYS WHAT IT WOULD COST TO MAKE 582 00:21:42,334 --> 00:21:43,168 MORE RAPID PROGRESS. 583 00:21:43,235 --> 00:21:43,802 THAT IS NOT TRUE. 584 00:21:43,869 --> 00:21:45,771 IF WE HAD MORE WE COULD MAKE 585 00:21:45,837 --> 00:21:46,238 MORE RAPID PROGRESS. 586 00:21:46,304 --> 00:21:48,740 THIS IS WHAT IT WOULD COST TO DO 587 00:21:48,807 --> 00:21:49,941 WHAT YOU EXPECT US TO DO. 588 00:21:50,008 --> 00:21:51,510 SO WHEN YOU RUN THE 589 00:21:51,576 --> 00:21:52,878 CALCULATIONS, SOME THINGS ARE 590 00:21:52,944 --> 00:21:54,413 JUST MORE EXPENSIVE, MORE 591 00:21:54,479 --> 00:21:55,547 CLINICAL TRIALS, THERE'S CLEARLY 592 00:21:55,614 --> 00:21:56,882 AN APPETITE TO TAKE MORE THINGS 593 00:21:56,948 --> 00:21:58,917 OUT AND GET THEM INTO PATIENTS, 594 00:21:58,984 --> 00:22:02,187 WOULD BE AN INCREASE FROM 7.3 TO 595 00:22:02,254 --> 00:22:03,288 9.9 BILLION THIS YEAR. 596 00:22:03,355 --> 00:22:05,257 THAT'S A BIG ASK IN THE WHOLE 597 00:22:05,323 --> 00:22:06,291 CLIMATE THAT WE'RE IN, THE 598 00:22:06,358 --> 00:22:07,993 PRESIDENT'S ASKED FOR 599 00:22:08,060 --> 00:22:08,894 7.8 BILLION, WE DON'T KNOW WHAT 600 00:22:08,960 --> 00:22:11,363 WE'RE GOING TO GET. 601 00:22:11,430 --> 00:22:13,999 IF THIS YEAR WE HAD GOTTEN # 602 00:22:14,066 --> 00:22:20,205 .9GOTTEN9.9 AND CONTINUE TO DO E 603 00:22:20,272 --> 00:22:21,306 THINGS WE WANT TO DO NEXT YEAR, 604 00:22:21,373 --> 00:22:23,942 IT WOULD BE $11 BILLION. 605 00:22:24,009 --> 00:22:26,111 SO WE DON'T WANT TO DO LESS. 606 00:22:26,178 --> 00:22:27,479 YOU KNOW, WE'RE DOING MORE WITH 607 00:22:27,546 --> 00:22:31,950 LESS, BUT WE DON'T WANT TO DO -- 608 00:22:32,017 --> 00:22:33,018 WE'RE JUST SAYING WHAT WOULD WE 609 00:22:33,085 --> 00:22:35,887 DO IF WE HAD -- WE WOULD BE 610 00:22:35,954 --> 00:22:42,327 REALLY FOCUSING ON -- 611 00:22:42,394 --> 00:22:42,961 REVOLUTIONIZING CLINICAL TRIALS 612 00:22:43,028 --> 00:22:45,063 AND GETTING MORE PATIENTS ACCESS 613 00:22:45,130 --> 00:22:47,599 TO CLINICAL TRIALS IN MORE 614 00:22:47,666 --> 00:22:49,234 CORNERS OF THE COUNTRY AND THE 615 00:22:49,301 --> 00:22:50,535 WORLD, CLARIFYING THE IMPACT OF 616 00:22:50,602 --> 00:22:51,703 THE ENVIRONMENT ON CANCER RISK 617 00:22:51,770 --> 00:22:54,039 IS A BIG AREA THAT'S NEW AND 618 00:22:54,106 --> 00:22:56,007 BURGEONING, WE HAVEN'T HAD A 619 00:22:56,074 --> 00:22:57,409 REAL OPPORTUNITY TO TAKE A BITE 620 00:22:57,476 --> 00:22:58,376 OUT OF AND REALLY TAKE ADVANTAGE 621 00:22:58,443 --> 00:22:59,611 OF THE POWER OF CANCER DATA. 622 00:22:59,678 --> 00:23:01,146 SOME OF THAT'S ALREADY THERE, 623 00:23:01,213 --> 00:23:02,447 PUTTING IT TOGETHER IS SUPER 624 00:23:02,514 --> 00:23:03,315 EXPENSIVE TO PUT IT UP IN THE 625 00:23:03,381 --> 00:23:07,052 CLOUD AND MAKE IT ACCESSIBLE. 626 00:23:07,119 --> 00:23:10,122 AND THEN REALLY -- I JUST WANT 627 00:23:10,188 --> 00:23:13,391 YOU TO KNOW THAT WE HAVE HAD 628 00:23:13,458 --> 00:23:14,392 GENEROUS INCREASES YEAR OVER 629 00:23:14,459 --> 00:23:18,864 YEAR, SO THE LEFT GRAPH SHOWS 630 00:23:18,930 --> 00:23:20,132 INCREASES IN OUR ALLOCATION, AND 631 00:23:20,198 --> 00:23:22,534 YOU CAN SEE EVERY YEAR UP UNTIL 632 00:23:22,601 --> 00:23:24,770 NOW, IT'S BEEN AN INCREASE, 633 00:23:24,836 --> 00:23:25,403 INCLUDING MOONSHOT MONEY THAT'S 634 00:23:25,470 --> 00:23:26,304 SHOWN IN YELLOW. 635 00:23:26,371 --> 00:23:28,306 AND WHAT WE'VE DONE WITH THAT IS 636 00:23:28,373 --> 00:23:32,444 CONTINUE TO PUSH MORE GRANT 637 00:23:32,511 --> 00:23:33,078 DOLLARS OUT THE DOOR. 638 00:23:33,145 --> 00:23:38,216 THE BLUE IS AWARDS THAT WE GIVE. 639 00:23:38,283 --> 00:23:40,018 SO THE MORE WE HAVE ALLOCATED 640 00:23:40,085 --> 00:23:42,721 THE MORE WE'RE GOING TO DO AS A 641 00:23:42,788 --> 00:23:44,556 NATION TO MAKE A BIG DIFFERENCE 642 00:23:44,623 --> 00:23:46,158 FOR CANCER. 643 00:23:46,224 --> 00:23:48,160 IF WE GET ANOTHER ALLOCATION 644 00:23:48,226 --> 00:23:51,863 JUST LIKE $7.3 BILLION AGAIN, 645 00:23:51,930 --> 00:23:54,733 THAT IS NOT STATUS QUO, THAT IS 646 00:23:54,800 --> 00:23:55,934 ACTUALLY A BIG DROP FOR US. 647 00:23:56,001 --> 00:23:57,769 IT'S A DROP BECAUSE SOME THINGS 648 00:23:57,836 --> 00:23:59,104 JUST COST MORE MONEY. 649 00:23:59,171 --> 00:24:00,772 THIS IS -- CANCER IS NOT 650 00:24:00,839 --> 00:24:01,606 DIFFERENT THAN THE REST OF THE 651 00:24:01,673 --> 00:24:02,274 WORLD. 652 00:24:02,340 --> 00:24:03,475 SALARIES GO UP. 653 00:24:03,542 --> 00:24:05,110 EXPENSES GO UP. 654 00:24:05,177 --> 00:24:08,947 EVERYTHING COSTS MORE. 655 00:24:09,014 --> 00:24:12,117 THERE ARE ABOUT $100 MILLION OF 656 00:24:12,184 --> 00:24:14,953 STANDARD INCREASES THAT ARE 657 00:24:15,020 --> 00:24:16,488 UNAVOIDABLE FOR US EVERY YEAR. 658 00:24:16,555 --> 00:24:18,256 AND IF WE WANT TO FUND THE 659 00:24:18,323 --> 00:24:19,324 GRANTS EVEN AT THE CURRENT LEVEL 660 00:24:19,391 --> 00:24:23,261 THAT WE CURRENTLY HAVE, NOT AN 661 00:24:23,328 --> 00:24:25,363 INCREASE, THAT COSTS US ANOTHER 662 00:24:25,430 --> 00:24:25,897 $250 MILLION. 663 00:24:25,964 --> 00:24:27,432 GRANTS COST MORE. 664 00:24:27,499 --> 00:24:28,867 IT JUST ADDS UP. 665 00:24:28,934 --> 00:24:32,470 SO IT'S GOING TO EAT AWAY AT 666 00:24:32,537 --> 00:24:33,438 WHAT WE'RE ABLE TO DO. 667 00:24:33,505 --> 00:24:37,609 AND WHAT WE'LL LOSE, WE'LL LOSE 668 00:24:37,676 --> 00:24:39,778 FEWER GRANTS OUT THE DOOR, FEWER 669 00:24:39,845 --> 00:24:40,445 BIG PROJECTS. 670 00:24:40,512 --> 00:24:41,980 I LOVE TRAINING AND I THINK OUR 671 00:24:42,047 --> 00:24:43,281 WORKFORCE IS ONE OF OUR MOST 672 00:24:43,348 --> 00:24:44,482 IMPORTANT ASSETS, SO CUTTING 673 00:24:44,549 --> 00:24:46,685 THOSE KINDS OF PROGRAMS WILL BE 674 00:24:46,751 --> 00:24:50,422 VERY, VERY HARD FOR ME, AND THIS 675 00:24:50,488 --> 00:24:52,390 IS AN R01 INTRAMURAL PROGRAM. 676 00:24:52,457 --> 00:24:54,759 THE YEAR WAS STARTED WITH BUDGET 677 00:24:54,826 --> 00:24:58,597 REDUCTION WITH 15% ACROSS ALL 678 00:24:58,663 --> 00:25:01,900 NON-PERSONNEL, SO THOSE HAVE 679 00:25:01,967 --> 00:25:03,635 ALREADY OCCURRED BUT WE ARE 680 00:25:03,702 --> 00:25:04,936 CURRENTLY DOING A HIRING PAUSE 681 00:25:05,003 --> 00:25:06,705 SO WE CAN REALLY LOOK AT OUR 682 00:25:06,771 --> 00:25:08,106 HIRING PRACTICES BECAUSE WE 683 00:25:08,173 --> 00:25:12,711 CAN'T AFFORD TO GROW. 684 00:25:12,777 --> 00:25:16,448 SO THIS IS WHERE WE ARE. 685 00:25:16,514 --> 00:25:17,616 IF YOU WANT TO KNOW MORE, 686 00:25:17,682 --> 00:25:18,817 THERE'S ALL KINDS OF INFORMATION 687 00:25:18,884 --> 00:25:19,384 ONLINE. 688 00:25:19,451 --> 00:25:21,353 THERE'S VIDEOS AND WE REALLY TRY 689 00:25:21,419 --> 00:25:23,488 TO MAKE IT TRANSPARENT WHERE OUR 690 00:25:23,555 --> 00:25:24,656 DOLLARS COME FROM AND WHERE THEY 691 00:25:24,723 --> 00:25:26,658 GO. 692 00:25:26,725 --> 00:25:27,893 SO JUST A COUPLE OTHER THINGS I 693 00:25:27,959 --> 00:25:30,128 WANT TO MAKE MENTION. 694 00:25:30,195 --> 00:25:32,831 ONE IS THE NATIONAL CANCER PLAN. 695 00:25:32,898 --> 00:25:35,033 THE NATIONAL CANCER PLAN WAS 696 00:25:35,100 --> 00:25:38,103 ROLLED OUT -- YOU'LL HEAR A LOT 697 00:25:38,169 --> 00:25:40,538 MORE ABOUT THIS LATER TODAY, IT 698 00:25:40,605 --> 00:25:42,574 WAS ROLLED OUT A YEAR AGO TO PUT 699 00:25:42,641 --> 00:25:43,808 A FRAMEWORK AROUND ALL OF THE 700 00:25:43,875 --> 00:25:44,976 WORK THAT WE DO. 701 00:25:45,043 --> 00:25:46,411 IT HAS EIGHT GOALS. 702 00:25:46,478 --> 00:25:48,013 THOSE GOALS ARE PREVENT CANCER, 703 00:25:48,079 --> 00:25:51,216 DETECT CANCERS EARLY, DEVELOP 704 00:25:51,283 --> 00:25:52,751 EFFECTIVE TREATMENTS, WHICH IS, 705 00:25:52,817 --> 00:25:53,852 I THINK, ONE OF THE THINGS THAT 706 00:25:53,919 --> 00:25:55,687 WE TALKED ABOUT MOST ALL OF 707 00:25:55,754 --> 00:25:56,454 THOSE COMPONENTS ARE IMPORTANT 708 00:25:56,521 --> 00:25:59,190 TO MAKE A BIG DENT, AND THEN 709 00:25:59,257 --> 00:25:59,658 DELIVER OPTIMAL CARE. 710 00:25:59,724 --> 00:26:03,561 ALL OF THAT HAPPENING USING 711 00:26:03,628 --> 00:26:06,197 DATA, ELIMINATING HEALTH 712 00:26:06,264 --> 00:26:08,266 INEQUITIES INTENTIONALLY. 713 00:26:08,333 --> 00:26:10,602 OPTIMIZING THE WORKFORCE AND 714 00:26:10,669 --> 00:26:12,637 REALLY IMPORTANT IS ENGAGING 715 00:26:12,704 --> 00:26:13,738 EVERY PERSON BECAUSE EVERYBODY 716 00:26:13,805 --> 00:26:15,373 IS IMPACTED BY CANCER. 717 00:26:15,440 --> 00:26:19,544 AND WITH THIS PLAN, WE CAN MAKE 718 00:26:19,611 --> 00:26:20,979 STRATEGIES TO MOVE FORWARD. 719 00:26:21,046 --> 00:26:22,480 BUT WE ALSO NEED A BIG GOAL. 720 00:26:22,547 --> 00:26:24,683 AND THE GOAL WAS SET FOR US BY 721 00:26:24,749 --> 00:26:25,784 THE CANCER MOONSHOT. 722 00:26:25,850 --> 00:26:27,752 SO THIS IS THE WHERE DO WE NEED 723 00:26:27,819 --> 00:26:29,721 TO GET TO AND BY WHEN, RIGHT? 724 00:26:29,788 --> 00:26:31,690 WHERE DO WE NEED TO GET TO? 725 00:26:31,756 --> 00:26:32,991 50% REDUCTION IN DEATH FROM 726 00:26:33,058 --> 00:26:34,292 CANCER IN 2047. 727 00:26:34,359 --> 00:26:36,161 IT'S ACHIEVABLE. 728 00:26:36,227 --> 00:26:37,796 IT'S HARD, AND IT WILL TAKE ALL 729 00:26:37,862 --> 00:26:39,364 OF THOSE PART OF THE NATIONAL 730 00:26:39,431 --> 00:26:40,532 CANCER PLAN TO GET THERE, AND 731 00:26:40,598 --> 00:26:43,168 WHEN YOU DO THAT, WE'LL HAVE 732 00:26:43,234 --> 00:26:45,070 CHANGED CANCER AND THE CANCER AS 733 00:26:45,136 --> 00:26:47,205 WE KNOW IT. 734 00:26:47,272 --> 00:26:48,506 ENDING CANCER AS WE KNOW IT. 735 00:26:48,573 --> 00:26:49,074 A COUPLE WINS. 736 00:26:49,140 --> 00:26:50,175 I JUST WANT TO MAKE SURE YOU 737 00:26:50,241 --> 00:26:50,608 KNOW. 738 00:26:50,675 --> 00:26:52,043 WE DIDN'T STOP DOING THINGS JUST 739 00:26:52,110 --> 00:26:53,345 BECAUSE THE BUDGET GOT TIGHT. 740 00:26:53,411 --> 00:26:54,546 THERE'S ALL KINDS OF GOOD THINGS 741 00:26:54,612 --> 00:26:59,684 TO TALK ABOUT, NEW FDA APPROVAL 742 00:26:59,751 --> 00:27:04,155 OF THERAPIES FOR -- CELLULAR 743 00:27:04,222 --> 00:27:05,790 THERAPIES IN SOLID TUMORS, 744 00:27:05,857 --> 00:27:06,358 REALLY HUGE WIN. 745 00:27:06,424 --> 00:27:07,492 I'M GOING TO TALK ABOUT A FEW 746 00:27:07,559 --> 00:27:08,193 MORE OF THESE. 747 00:27:08,259 --> 00:27:09,060 I'M NOT GOING TO RUN THROUGH 748 00:27:09,127 --> 00:27:13,498 THEM ALL. 749 00:27:13,565 --> 00:27:16,267 THIS STEMS FROM STEVE ROSENBERG, 750 00:27:16,334 --> 00:27:18,703 WHO HAS BEEN A CHAMPION OF 751 00:27:18,770 --> 00:27:20,338 CELLULAR IMMUNOTHERAPY FOR 752 00:27:20,405 --> 00:27:23,208 DECADES AND THIS HAS ALREADY 753 00:27:23,274 --> 00:27:27,679 REVOLUTIONIZED LEUKEMIA AND 754 00:27:27,746 --> 00:27:28,747 LYMPHOMA, INCLUDING NON-CANCER. 755 00:27:28,813 --> 00:27:32,384 I'M REALLY EXCITED ABOUT THIS 756 00:27:32,450 --> 00:27:35,453 TRIAL, WHICH PUTS SELF-TESTING 757 00:27:35,520 --> 00:27:36,321 INTO THE HANDS OF PATIENTS. 758 00:27:36,388 --> 00:27:38,823 REALLY USES THE NATIONAL CANCER 759 00:27:38,890 --> 00:27:41,993 PLAN COMPONENT OF ENGAGE EVERY 760 00:27:42,060 --> 00:27:43,661 PERSON, WHICH TESTING FOR 761 00:27:43,728 --> 00:27:45,063 CERVICAL CANCER IS NOT EQUALLY 762 00:27:45,130 --> 00:27:47,465 AVAILABLE TO EVERYONE, BUT IF 763 00:27:47,532 --> 00:27:49,034 TESTED, IT CAN BE A CANCER THAT 764 00:27:49,100 --> 00:27:51,503 WE CAN CONTROL AND MANAGE IT, 765 00:27:51,569 --> 00:27:52,404 ESPECIALLY WHEN CAUGHT EARLY. 766 00:27:52,470 --> 00:27:54,773 SO TESTING FOR HPV IS SOMETHING 767 00:27:54,839 --> 00:27:57,542 THAT CAN BE DONE BY ONCE SELF, 768 00:27:57,609 --> 00:27:59,277 SO THIS TEST IS A BIG 769 00:27:59,344 --> 00:28:01,579 PARTNERSHIP WITH THE FDA AND 770 00:28:01,646 --> 00:28:03,148 WITH SEVERAL BIOTECH COMPANIES 771 00:28:03,214 --> 00:28:07,052 TO TEST VARIOUS DEVICES. 772 00:28:07,118 --> 00:28:09,354 WITH BROAD COLLABORATION. 773 00:28:09,421 --> 00:28:11,656 WE'RE ALSO -- YOU'RE GOING TO 774 00:28:11,723 --> 00:28:13,625 HEAR MORE ABOUT A BIG SCREENING 775 00:28:13,691 --> 00:28:14,926 STUDY -- I THINK I'M RUNNING 776 00:28:14,993 --> 00:28:15,927 OVER SO I'M GOING TO LEAVE YOU 777 00:28:15,994 --> 00:28:17,328 TO HEAR ABOUT THAT LATER, BUT 778 00:28:17,395 --> 00:28:18,329 SCREENING IS GOING TO BE VERY 779 00:28:18,396 --> 00:28:19,297 IMPORTANT AND HAVING THAT 780 00:28:19,364 --> 00:28:20,398 OPPORTUNITY. 781 00:28:20,465 --> 00:28:25,103 THANK YOU VERY MUCH. 782 00:28:25,170 --> 00:28:26,738 ALSO -- I'M OKAY FOR TIME? 783 00:28:26,805 --> 00:28:27,605 OH, REALLY? 784 00:28:27,672 --> 00:28:29,808 IT FEELS LIKE I'M -- GOOD. 785 00:28:29,874 --> 00:28:30,341 OKAY. 786 00:28:30,408 --> 00:28:31,543 THEN I'LL SLOW DOWN, SAY ALL 787 00:28:31,609 --> 00:28:32,343 KINDS OF THINGS. 788 00:28:32,410 --> 00:28:34,245 NO. 789 00:28:34,312 --> 00:28:35,513 SO I WANT YOU TO KNOW THAT WE 790 00:28:35,580 --> 00:28:38,450 ARE REALLY TRYING TO THINK ABOUT 791 00:28:38,516 --> 00:28:40,852 INNOVATIVE WAYS TO TAKE THESE 792 00:28:40,919 --> 00:28:41,886 DISCOVERIES AND GET THEM INTO 793 00:28:41,953 --> 00:28:43,688 THE HANDS OF PATIENTS. 794 00:28:43,755 --> 00:28:45,790 THE NEW NCI VIRTUAL CLINICAL 795 00:28:45,857 --> 00:28:46,991 TRIALS OFFICE IS A PILOT THAT 796 00:28:47,058 --> 00:28:51,229 WAS REALLY BORN FROM THE 797 00:28:51,296 --> 00:28:52,363 PANDEMIC AND THE EXPERIENCE WE 798 00:28:52,430 --> 00:28:53,064 LEARNED HOW MANY THINGS YOU 799 00:28:53,131 --> 00:28:54,966 COULD REALLY DO REMOTELY AND HOW 800 00:28:55,033 --> 00:28:57,802 YOU CAN DO THINGS IN PATIENTS' 801 00:28:57,869 --> 00:28:59,270 HOMES, AND WHAT DO YOU REALLY 802 00:28:59,337 --> 00:29:00,872 NEED BOOTS ON THE GROUND AND A 803 00:29:00,939 --> 00:29:02,507 WHOLE WORK FOFS OR COULD THEY 804 00:29:02,574 --> 00:29:02,941 MEET ONLINE? 805 00:29:03,007 --> 00:29:04,576 THE VIRTUAL CLINICAL TRIALS 806 00:29:04,642 --> 00:29:05,577 OFFICE FOR A SITE THAT DOESN'T 807 00:29:05,643 --> 00:29:07,445 HAVE A TRIALS NURSE AND A DATA 808 00:29:07,512 --> 00:29:09,080 COORDINATOR AND REGULATORY -- 809 00:29:09,147 --> 00:29:11,149 THOSE PEOPLE CAN BE THERE ON -- 810 00:29:11,216 --> 00:29:13,985 THIS IS AN iPAD, YOU KNOW, 811 00:29:14,052 --> 00:29:14,652 THERE VIRTUALLY. 812 00:29:14,719 --> 00:29:16,621 SO WE HAVE SIX SITES THAT ARE 813 00:29:16,688 --> 00:29:25,797 CURRENTLY CONDUCTING THIS PILOT. 814 00:29:25,864 --> 00:29:28,199 ONE OF THE BIG INITIATIVES OF 815 00:29:28,266 --> 00:29:29,634 THE WHITE HOUSE HAS BEEN A FOCUS 816 00:29:29,701 --> 00:29:31,503 ON PEDIATRIC CANCERS, AND THAT 817 00:29:31,569 --> 00:29:33,371 HAS LED TO THE CHILDHOOD CANCER 818 00:29:33,438 --> 00:29:34,005 DATA INITIATIVE. 819 00:29:34,072 --> 00:29:36,841 A REALLY BIG EFFORT TO LINK DATA 820 00:29:36,908 --> 00:29:39,577 SOURCES SO THAT ALMOST EVERY 821 00:29:39,644 --> 00:29:41,112 PEDIATRIC CANCER IS A RARE 822 00:29:41,179 --> 00:29:41,446 TUMOR. 823 00:29:41,513 --> 00:29:44,616 WE REALLY NEED TO LEARN FROM 824 00:29:44,682 --> 00:29:46,684 THESE TUMORS TO BE ABLE TO 825 00:29:46,751 --> 00:29:48,319 UNDERSTAND ADULT DISEASE, HOW 826 00:29:48,386 --> 00:29:50,622 CANCERS COME TO BE, AND BE ABLE 827 00:29:50,688 --> 00:29:54,359 TO MAKE MORE RAPID ADVANCES IN 828 00:29:54,425 --> 00:29:57,228 THESE TUMOR TYPES, ESPECIALLY TO 829 00:29:57,295 --> 00:29:59,063 CURE CHILDREN, RIGHT? 830 00:29:59,130 --> 00:30:00,565 SO I ALREADY MENTIONED THAT 831 00:30:00,632 --> 00:30:02,066 RENAL MEDULLARY CARCINOMA WAS 832 00:30:02,133 --> 00:30:04,636 ONE OF THE LISTED PRIORITY AREAS 833 00:30:04,702 --> 00:30:06,304 TO TAKE A LOOK AT, REALLY, 834 00:30:06,371 --> 00:30:07,272 REALLY THRILLING. 835 00:30:07,338 --> 00:30:09,007 SO THIS IS MOVING FORWARD REALLY 836 00:30:09,073 --> 00:30:11,309 NICELY AND TOUCHES ON SO MANY 837 00:30:11,376 --> 00:30:12,310 PARTS OF THE NATIONAL CANCER 838 00:30:12,377 --> 00:30:17,315 PLAN. 839 00:30:17,382 --> 00:30:20,151 SO THIS IS MY LAST SLIDE JUST TO 840 00:30:20,218 --> 00:30:20,885 CLOSE. 841 00:30:20,952 --> 00:30:23,454 BUDGET OUTLOOK IS NOT IDEAL. 842 00:30:23,521 --> 00:30:25,723 WE HAVE TO THINK ABOUT 843 00:30:25,790 --> 00:30:26,791 EVERYTHING THAT WE DO IN THE 844 00:30:26,858 --> 00:30:28,493 CONTEXT OF A TIGHT BUDGET BUT AT 845 00:30:28,560 --> 00:30:29,994 THE SAME TIME, WE HAVE 846 00:30:30,061 --> 00:30:31,229 OPPORTUNITIES THAT WE'VE NEVER 847 00:30:31,296 --> 00:30:31,963 HAD EVER BEFORE. 848 00:30:32,030 --> 00:30:33,731 I MEAN, THAT'S WHAT MADE ME 849 00:30:33,798 --> 00:30:35,600 EXCITED TO COME AND TAKE A JOB 850 00:30:35,667 --> 00:30:38,636 LIKE THIS, IS THE POTENTIAL. 851 00:30:38,703 --> 00:30:40,071 THE POTENTIAL IS JUST HUGE, AND 852 00:30:40,138 --> 00:30:41,806 IF WE WORK TOGETHER ACROSS THE 853 00:30:41,873 --> 00:30:44,209 CANCER COMMUNITY, VERY MUCH -- 854 00:30:44,275 --> 00:30:46,744 THAT INCLUDES THE ADVOCACY 855 00:30:46,811 --> 00:30:48,279 COMMUNITY, WE CAN MAKE THE BEST 856 00:30:48,346 --> 00:30:50,481 DECISIONS THAT ARE AVAILABLE TO 857 00:30:50,548 --> 00:30:51,783 US AND MAKE REALLY HUGE 858 00:30:51,849 --> 00:30:52,984 PROGRESS. 859 00:30:53,051 --> 00:30:55,353 THIS ULTIMATELY WILL BENEFIT 860 00:30:55,420 --> 00:30:56,487 EVERYONE, AND SO I'M REALLY 861 00:30:56,554 --> 00:31:00,558 EXCITED TO HEAR ALL OF THE 862 00:31:00,625 --> 00:31:01,392 PRESENTATIONS TODAY TO HEAR YOUR 863 00:31:01,459 --> 00:31:02,160 THOUGHTS AND DISCUSSION AND 864 00:31:02,227 --> 00:31:03,695 REALLY JUST TO GET TO KNOW YOU. 865 00:31:03,761 --> 00:31:07,432 SO I WILL TAKE ANY QUESTIONS. 866 00:31:07,498 --> 00:31:09,200 >> THANK YOU SO MUCH, 867 00:31:09,267 --> 00:31:09,734 DR. RATHMELL. 868 00:31:09,801 --> 00:31:13,137 WE'RE JUST SO EXCITED TO HEAR, 869 00:31:13,204 --> 00:31:16,407 YOU KNOW, INTIMATELY ABOUT WHAT 870 00:31:16,474 --> 00:31:17,709 YOU'RE INVOLVED IN, WHAT YOU'RE 871 00:31:17,775 --> 00:31:20,778 CONCERNED WITH, AND WE'RE HAPPY 872 00:31:20,845 --> 00:31:23,615 TO BRING OUR PERSPECTIVE TO 873 00:31:23,681 --> 00:31:27,118 THIS, AND JUST RECOGNIZING HOW 874 00:31:27,185 --> 00:31:29,187 PAINFUL THE BUDGET SITUATION IS 875 00:31:29,254 --> 00:31:30,755 AND NOT KNOWING WHERE THINGS ARE 876 00:31:30,822 --> 00:31:33,458 GOING TO LAND. 877 00:31:33,524 --> 00:31:38,162 I'M WONDERING, YOU KNOW, THE 878 00:31:38,229 --> 00:31:38,930 PAINFUL DECISIONS THAT 879 00:31:38,997 --> 00:31:40,064 LEADERSHIP IS GOING TO HAVE TO 880 00:31:40,131 --> 00:31:43,868 MAKE, AND I THINK SOMETIMES, YOU 881 00:31:43,935 --> 00:31:47,472 KNOW, DO YOU SEE, LIKE IS 882 00:31:47,538 --> 00:31:49,340 EXTRAMURAL GOING TO HURT MORE OR 883 00:31:49,407 --> 00:31:50,642 INTRAMURAL OR IS EVERYBODY GOING 884 00:31:50,708 --> 00:31:52,710 TO HURT EQUALLY, AND JUST TO 885 00:31:52,777 --> 00:31:54,579 PIGGY BACK ON THAT THOUGHT IS, 886 00:31:54,646 --> 00:31:57,515 YOU KNOW, THERE ARE SOME -- THE 887 00:31:57,582 --> 00:32:02,220 RARER CANCERS WHERE WE'RE JUST 888 00:32:02,287 --> 00:32:03,888 SEEING STRIDES BEING MADE, 889 00:32:03,955 --> 00:32:05,723 RIGHT, AND IT SEEMS LIKE 890 00:32:05,790 --> 00:32:09,661 SOMETIMES WHEN TIMES ARE TOUGH, 891 00:32:09,727 --> 00:32:11,729 THE PEOPLE -- YOU KNOW, WHEN 892 00:32:11,796 --> 00:32:13,097 THERE'S NOT AS MUCH POPULATION 893 00:32:13,164 --> 00:32:15,033 AND SOMETHING IS RARE, THEY KIND 894 00:32:15,099 --> 00:32:18,202 OF GET FORGOTTEN, AND, YOU KNOW, 895 00:32:18,269 --> 00:32:20,071 THESE ARE THE SAME GROUPS THAT 896 00:32:20,138 --> 00:32:21,572 DON'T HAVE THE SAME BENEFIT 897 00:32:21,639 --> 00:32:22,907 FROM, YOU KNOW, ADVANCES THAT 898 00:32:22,974 --> 00:32:24,175 SOME OF THE OTHER CANCERS MAY 899 00:32:24,242 --> 00:32:25,209 HAVE, AND I DON'T WANT TO GET 900 00:32:25,276 --> 00:32:27,278 INTO THIS CANCER VERSUS THAT 901 00:32:27,345 --> 00:32:31,382 CANCER, BUT DOES MORTALITY OR, 902 00:32:31,449 --> 00:32:34,852 YOU KNOW, WHOEVER HASN'T BEEN 903 00:32:34,919 --> 00:32:36,788 FITTED, IS THAT GOING TO BE PART 904 00:32:36,854 --> 00:32:37,388 OF THE CONSIDERATION? 905 00:32:37,455 --> 00:32:39,557 >> THAT'S A REALLY COMPLICATED 906 00:32:39,624 --> 00:32:39,824 QUESTION. 907 00:32:39,891 --> 00:32:40,758 AND IT'S HARD TO SAY THAT 908 00:32:40,825 --> 00:32:43,528 EVERYONE WILL BE AFFECTED 909 00:32:43,594 --> 00:32:44,696 UNIFORMLY BECAUSE THERE WILL 910 00:32:44,762 --> 00:32:46,164 HAVE TO BE SOME HARD DECISIONS 911 00:32:46,230 --> 00:32:46,898 THAT ARE MADE. 912 00:32:46,964 --> 00:32:48,466 I MEAN, IT'S HARD TO BE HERE TWO 913 00:32:48,533 --> 00:32:49,400 MONTHS AND ALREADY SAY WE'RE 914 00:32:49,467 --> 00:32:50,601 HAVING A HIRING PAUSE, RIGHT? 915 00:32:50,668 --> 00:32:52,670 I MEAN, THAT'S -- SO THAT HITS 916 00:32:52,737 --> 00:32:53,571 THE INTRAMURAL PROGRAM. 917 00:32:53,638 --> 00:32:55,707 BUT IT HURTS THE EXTRAMURAL 918 00:32:55,773 --> 00:32:56,741 PROGRAM TOO BECAUSE THAT'S THE 919 00:32:56,808 --> 00:32:59,344 PEOPLE WHO WIN THE GRANTS FOR 920 00:32:59,410 --> 00:33:01,546 THE EXTRAMURAL PROGRAM. 921 00:33:01,612 --> 00:33:02,847 SO I THINK TO YOUR QUESTION 922 00:33:02,914 --> 00:33:05,249 ABOUT HOW WILL THIS AFFECT 923 00:33:05,316 --> 00:33:07,785 DIFFERENT TUMOR TYPES REMAINS A 924 00:33:07,852 --> 00:33:09,087 LITTLE BIT TO BE SEEN. 925 00:33:09,153 --> 00:33:11,389 IT COULD GO BOTH WAYS. 926 00:33:11,456 --> 00:33:13,791 AND IN SOME WAYS, THE BIGGER 927 00:33:13,858 --> 00:33:15,093 TUMOR TYPES HAVE A LOT OF BUFFER 928 00:33:15,159 --> 00:33:18,162 OUT THERE, THEY HAVE BIG 929 00:33:18,229 --> 00:33:20,131 FOUNDATIONS THAT HAVE -- THAT 930 00:33:20,198 --> 00:33:21,432 ARE STABLE TO SUPPORT 931 00:33:21,499 --> 00:33:22,967 RESEARCHERS THAT WILL KEEP THEM 932 00:33:23,034 --> 00:33:25,837 GOING AND IN SOME SENSES, THE 933 00:33:25,903 --> 00:33:27,672 NCI CAN BE THE ONLY RESOURCE FOR 934 00:33:27,739 --> 00:33:28,906 SOME TUMOR TYPES. 935 00:33:28,973 --> 00:33:30,942 YOU KNOW, I THINK MY FOCUS WILL 936 00:33:31,008 --> 00:33:33,578 BE ON WHERE THERE'S MOMENTUM, 937 00:33:33,644 --> 00:33:35,813 WHERE WE CAN HAVE BIG IMPACT. 938 00:33:35,880 --> 00:33:38,182 YOU KNOW, WE CAN'T PUT IT ALL IN 939 00:33:38,249 --> 00:33:39,984 ONE PLACE, WE HAVE TO KEEP A 940 00:33:40,051 --> 00:33:41,986 PRETTY GOOD BALANCE GOING. 941 00:33:42,053 --> 00:33:42,987 THAT'S I THINK WHERE THE 942 00:33:43,054 --> 00:33:43,921 NATIONAL CANCER PLAN REALLY 943 00:33:43,988 --> 00:33:45,990 HELPS, SO THAT WE CAN REALLY 944 00:33:46,057 --> 00:33:47,658 STILL -- WE CAN'T STOP DOING 945 00:33:47,725 --> 00:33:49,394 PREVENTION AND JUST FOCUS ON 946 00:33:49,460 --> 00:33:50,228 TREATMENTS. 947 00:33:50,294 --> 00:33:51,829 WE CAN'T JUST FOCUS ON SCREENING 948 00:33:51,896 --> 00:33:56,367 AND WE CAN'T FORGET ABOUT THE 949 00:33:56,434 --> 00:33:57,034 WORKFORCE, RIGHT? 950 00:33:57,101 --> 00:33:58,569 SO ALL OF THOSE PIECES HAVE TO 951 00:33:58,636 --> 00:34:02,840 BE STRONG. 952 00:34:02,907 --> 00:34:07,211 AND IT'S GOING TO BE A LITTLE 953 00:34:07,278 --> 00:34:08,413 BIT, BIT BY BIT, TO FIGURE OUT 954 00:34:08,479 --> 00:34:09,013 WHERE IT HAPPENS. 955 00:34:09,080 --> 00:34:10,047 >> THANK YOU, WE KNOW IT'S 956 00:34:10,114 --> 00:34:10,715 REALLY TOUGH. 957 00:34:10,782 --> 00:34:13,217 DOES ANYONE ELSE HAVE ANY 958 00:34:13,284 --> 00:34:17,488 COMMENTS, QUESTIONS? 959 00:34:17,555 --> 00:34:18,322 LEE? 960 00:34:18,389 --> 00:34:19,791 >> THANKS FOR ALL YOU DO, AND 961 00:34:19,857 --> 00:34:23,294 WELCOME TO THE D.C. AREA. 962 00:34:23,361 --> 00:34:25,163 I'VE LIVED HERE FOR 40 YEARS, SO 963 00:34:25,229 --> 00:34:26,264 I'VE SEEN A LOT COMING AND 964 00:34:26,330 --> 00:34:26,764 GOING. 965 00:34:26,831 --> 00:34:28,566 I HAVE A COUPLE QUESTIONS 966 00:34:28,633 --> 00:34:31,002 RELATED TO THE BUDGET, BUT ONE 967 00:34:31,068 --> 00:34:32,069 NON-BUDGET-RELATED IS EARLY 968 00:34:32,136 --> 00:34:36,674 ONSET CANCERS. 969 00:34:36,741 --> 00:34:39,710 CERTAINLY WE'RE SEEING IT IN 970 00:34:39,777 --> 00:34:40,578 COLORECTAL CANCER WHICH IS AB 971 00:34:40,645 --> 00:34:42,680 AREA I FOCUS ON BUT ALSO BREAST 972 00:34:42,747 --> 00:34:44,549 CANCER AND OTHER CANCER TYPES. 973 00:34:44,615 --> 00:34:45,483 NO ONE KNOWS WHY THAT'S 974 00:34:45,550 --> 00:34:45,750 HAPPENING. 975 00:34:45,817 --> 00:34:46,717 DO YOU HAVE ANY THOUGHTS ON THAT 976 00:34:46,784 --> 00:34:48,019 AND WHAT KIND OF INITIATIVES 977 00:34:48,085 --> 00:34:50,755 COULD THE NCI PUT IN PLACE THAT 978 00:34:50,822 --> 00:34:51,823 WOULD HELP FURTHER RESEARCH IN 979 00:34:51,889 --> 00:34:52,390 THAT AREA? 980 00:34:52,457 --> 00:34:55,827 >> I THINK THOSE KINDS OF THINGS 981 00:34:55,893 --> 00:34:56,994 ARE HELPED WHEN WE FIRST NAME 982 00:34:57,061 --> 00:35:01,899 THEM AND START TO BRING PEOPLE 983 00:35:01,966 --> 00:35:04,969 TOGETHER A LITTLE LIKE THE RMC 984 00:35:05,036 --> 00:35:05,303 STORY. 985 00:35:05,369 --> 00:35:07,405 WHEN I WAS AT VANDERBILT, WE 986 00:35:07,472 --> 00:35:09,574 RECRUITED A WOMAN FROM MD 987 00:35:09,640 --> 00:35:10,741 ANDERSON TO LEAD SOME COLON 988 00:35:10,808 --> 00:35:12,210 CANCER THINGS. 989 00:35:12,276 --> 00:35:13,711 SHE HAD THIS SECRET PASSION 990 00:35:13,778 --> 00:35:17,882 ABOUT EARLY ONSET COLORECTAL 991 00:35:17,949 --> 00:35:20,351 CANCER, AND -- IT WAS NOT SECRET 992 00:35:20,418 --> 00:35:22,720 BUT IT WASN'T THE THING IT IS 993 00:35:22,787 --> 00:35:25,122 TODAY, WHATEVER -- CATHY YANG, 994 00:35:25,189 --> 00:35:26,657 YOU GUYS KNOW, BUT SHE DIDN'T 995 00:35:26,724 --> 00:35:28,426 JUST DO IT FOR COLON CANCER. 996 00:35:28,493 --> 00:35:29,393 SHE BROUGHT TOGETHER 997 00:35:29,460 --> 00:35:31,929 INVESTIGATORS AROUND THE TABLE 998 00:35:31,996 --> 00:35:33,798 FOR SARCOMAS AND EARLY ONSET 999 00:35:33,865 --> 00:35:34,665 BREAST CANCER AND ALL THESE 1000 00:35:34,732 --> 00:35:35,733 OTHER CANCERS. 1001 00:35:35,800 --> 00:35:38,936 FIRST FOCUSING ON ISSUES THAT 1002 00:35:39,003 --> 00:35:40,037 PEOPLE JUST WEREN'T TALKING 1003 00:35:40,104 --> 00:35:41,005 ABOUT. 1004 00:35:41,072 --> 00:35:45,176 LIFESTYLE IN THAT AGE GROUP. 1005 00:35:45,243 --> 00:35:46,811 AND HOW TO EVEN HAVE SOME OF THE 1006 00:35:46,878 --> 00:35:47,678 CONVERSATIONS AROUND CANCER 1007 00:35:47,745 --> 00:35:49,647 REALLY TO SUPPORT THE PATIENTS 1008 00:35:49,714 --> 00:35:50,982 FIRST, BUT ONCE THEY'RE 1009 00:35:51,048 --> 00:35:51,616 TOGETHER, IT GAVE THE 1010 00:35:51,682 --> 00:35:53,050 OPPORTUNITY FOR RESEARCHERS TO 1011 00:35:53,117 --> 00:35:55,453 START THINKING ABOUT HOW CAN WE 1012 00:35:55,520 --> 00:35:56,654 ADDRESS LIKE WHAT MIGHT BE A 1013 00:35:56,721 --> 00:35:56,988 ROOT CAUSE. 1014 00:35:57,054 --> 00:35:59,156 SO I THINK YOU HAVE TO JUST 1015 00:35:59,223 --> 00:36:01,692 START TO, YOU KNOW, IDENTIFY AND 1016 00:36:01,759 --> 00:36:02,994 BRING CLUSTERS TOGETHER. 1017 00:36:03,060 --> 00:36:04,328 THERE ARE GRANTS THAT ARE OUT 1018 00:36:04,395 --> 00:36:06,697 THERE TODAY THAT ARE TRYING TO 1019 00:36:06,764 --> 00:36:07,265 INVESTIGATE THIS. 1020 00:36:07,331 --> 00:36:11,335 THIS IS AN INTEREST OF MORE THAN 1021 00:36:11,402 --> 00:36:13,371 JUST THE NCI, THE NIEHS I KNOW 1022 00:36:13,437 --> 00:36:16,040 IS ALSO INTERESTED. 1023 00:36:16,107 --> 00:36:17,909 SO IT'S INTERESTING HOW IT'S 1024 00:36:17,975 --> 00:36:19,544 BECOME NOW IN THE MORE PUBLIC 1025 00:36:19,610 --> 00:36:20,878 ARENA, AND I THINK THAT'S GREAT 1026 00:36:20,945 --> 00:36:24,916 BECAUSE THAT WILL BRING MORE 1027 00:36:24,982 --> 00:36:25,182 ATTENTION. 1028 00:36:25,249 --> 00:36:27,752 >> I KNOW IT IS A CANCER GRAND 1029 00:36:27,818 --> 00:36:28,586 CHALLENGE TOPIC THIS YEAR, WHICH 1030 00:36:28,653 --> 00:36:32,456 OF COURSE IS AN NCI C RUK 1031 00:36:32,523 --> 00:36:32,924 INITIATIVE. 1032 00:36:32,990 --> 00:36:35,426 I THINK TODAY MAYBE THEY'RE 1033 00:36:35,493 --> 00:36:36,761 GOING TO BE ANNOUNCING THE 1034 00:36:36,827 --> 00:36:37,428 WINNERS, TODAY OR TOMORROW? 1035 00:36:37,495 --> 00:36:39,263 >> IT'S THIS WEEK, YEAH. 1036 00:36:39,330 --> 00:36:40,932 >> THE CHALLENGES, SO THAT WILL 1037 00:36:40,998 --> 00:36:44,135 HOPEFULLY BE ONE OF THEM. 1038 00:36:44,201 --> 00:36:46,103 >> NATHANIEL. 1039 00:36:46,170 --> 00:36:47,305 >> YEAH, I APPRECIATE THE 1040 00:36:47,371 --> 00:36:47,605 THOUGHTS. 1041 00:36:47,672 --> 00:36:52,677 I WANTED TO -- IT WAS MENTIONED 1042 00:36:52,743 --> 00:36:53,844 EARLIER THE HIRING CLAUSE, AND 1043 00:36:53,911 --> 00:36:56,047 I'M WONDERING, I THINK IT'S 1044 00:36:56,113 --> 00:36:58,115 INTERESTING YOU HAVE A LOT OF 1045 00:36:58,182 --> 00:37:00,184 HEADWINDS GOING AT YOU WITH 1046 00:37:00,251 --> 00:37:03,054 THIS, AND IT MAY LEAD TO LEAKAGE 1047 00:37:03,120 --> 00:37:05,022 OF TALENT, RIGHT, INTO MORE 1048 00:37:05,089 --> 00:37:06,324 INDUSTRY ROLES THAT ARE WILLING 1049 00:37:06,390 --> 00:37:08,092 TO PAY A HIGHER PREMIUM FOR 1050 00:37:08,159 --> 00:37:10,928 TALENT. 1051 00:37:10,995 --> 00:37:15,633 AT THE SAME TIME, I'M REALLY 1052 00:37:15,700 --> 00:37:16,734 STARTING TO CONTINUE TO SEE 1053 00:37:16,801 --> 00:37:18,803 DEGRADATION OF TRUST IN THAT 1054 00:37:18,869 --> 00:37:19,837 SUBSECTION OF CANCER RESEARCH, 1055 00:37:19,904 --> 00:37:20,338 RIGHT? 1056 00:37:20,404 --> 00:37:22,873 I WONDER IF THERE IS A PLAY HERE 1057 00:37:22,940 --> 00:37:24,208 TO ALLOCATE MORE RESOURCES 1058 00:37:24,275 --> 00:37:27,578 TOWARDS TRYING TO REBUILD THE 1059 00:37:27,645 --> 00:37:29,780 PUBLIC IMAGE OF THAT 1060 00:37:29,847 --> 00:37:30,881 PUBLIC-PRIVATE KIND OF 1061 00:37:30,948 --> 00:37:32,216 RELATIONSHIP. 1062 00:37:32,283 --> 00:37:38,422 I THINK COVID UNFORTUNATELY HAD 1063 00:37:38,489 --> 00:37:40,358 MANY THINGS BE CATALYZED DURING 1064 00:37:40,424 --> 00:37:40,625 THAT. 1065 00:37:40,691 --> 00:37:41,826 WHAT ARE YOUR THOUGHTS ON THAT 1066 00:37:41,892 --> 00:37:44,028 BECAUSE IT'S HARD TO LOSE THAT 1067 00:37:44,095 --> 00:37:45,429 TALENT BUT STILL WANT TO 1068 00:37:45,496 --> 00:37:48,833 CONTINUE TO HAVE THAT IN A 1069 00:37:48,899 --> 00:37:50,835 WORKING HAPPENING FOR CANCER 1070 00:37:50,901 --> 00:37:51,102 PATIENTS. 1071 00:37:51,168 --> 00:37:53,804 >> ABSOLUTELY. 1072 00:37:53,871 --> 00:37:54,705 I'LL ADDRESS SORT OF TWO 1073 00:37:54,772 --> 00:37:55,339 QUESTIONS THERE. 1074 00:37:55,406 --> 00:37:58,275 THE BRAIN DRAIN IS A HUGE RISK. 1075 00:37:58,342 --> 00:38:01,245 IT HAS BEEN HAPPENING FOR YEARS 1076 00:38:01,312 --> 00:38:01,579 ALREADY. 1077 00:38:01,646 --> 00:38:04,749 IT REALLY ACCELERATED DURING THE 1078 00:38:04,815 --> 00:38:06,651 PANDEMIC, WHEN COMPANIES -- I 1079 00:38:06,717 --> 00:38:10,788 SAW THIS AS A CHAIR, PEOPLE 1080 00:38:10,855 --> 00:38:11,789 STARTED HIRING NOT JUST THE 1081 00:38:11,856 --> 00:38:13,557 PEOPLE YOU KNEW WERE AT RISK BUT 1082 00:38:13,624 --> 00:38:13,858 EVERYBODY. 1083 00:38:13,924 --> 00:38:15,826 THAT SLOWED DOWN A BIT 1084 00:38:15,893 --> 00:38:17,395 FORTUNATELY, BUT ANY TIME 1085 00:38:17,461 --> 00:38:18,829 THERE'S INSTABILITY, IT'S A RISK 1086 00:38:18,896 --> 00:38:22,833 THAT WE HAVE SOME DEPARTURES. 1087 00:38:22,900 --> 00:38:25,569 I THINK THE BIGGER ISSUE ON THE 1088 00:38:25,636 --> 00:38:26,704 WORKFORCE FRONT IS TO REALLY 1089 00:38:26,771 --> 00:38:28,539 INCREASE THE PIPELINE AND TO 1090 00:38:28,606 --> 00:38:30,508 MAKE SURE THAT WE HAVE LOTS OF 1091 00:38:30,574 --> 00:38:33,277 PEOPLE INTERESTED IN GOING INTO 1092 00:38:33,344 --> 00:38:36,981 CANCER RESEARCH AND IT IS 1093 00:38:37,048 --> 00:38:37,515 RETAINING TALENT. 1094 00:38:37,581 --> 00:38:39,150 I THINK INDUSTRY NEEDS GOOD 1095 00:38:39,216 --> 00:38:39,717 TALENT TOO. 1096 00:38:39,784 --> 00:38:42,219 I SUSPECT THERE WILL BE SOME 1097 00:38:42,286 --> 00:38:44,455 BACK AND FORTH AND SO THAT 1098 00:38:44,522 --> 00:38:45,289 TALENT ISN'T LOST, I DON'T 1099 00:38:45,356 --> 00:38:45,956 THINK. 1100 00:38:46,023 --> 00:38:47,391 I THINK THEY'RE JUST IN A 1101 00:38:47,458 --> 00:38:49,360 DIFFERENT GEOGRAPHIC SPACE, SO 1102 00:38:49,427 --> 00:38:51,662 THINKING ABOUT HOW WE WORK 1103 00:38:51,729 --> 00:38:53,230 TOGETHER TO THINK ABOUT THE 1104 00:38:53,297 --> 00:38:57,802 CANCER RESEARCH COMMUNITY AT 1105 00:38:57,868 --> 00:38:59,870 LARGE, I THINK WILL HELP US 1106 00:38:59,937 --> 00:39:08,612 THERE. 1107 00:39:08,679 --> 00:39:10,147 DUE TO PUBLIC TRUST, IT'S UNITED 1108 00:39:10,214 --> 00:39:12,683 SO IT REALLY IS ONE QUESTION. 1109 00:39:12,750 --> 00:39:14,218 WE DID LOSE SOME GROUND DURING 1110 00:39:14,285 --> 00:39:15,953 THE PANDEMIC, BUT WE ARE, I 1111 00:39:16,020 --> 00:39:18,155 THINK, MAKING SOME HEADWAY. 1112 00:39:18,222 --> 00:39:19,690 WE'VE BEEN REALLY PROACTIVE AT 1113 00:39:19,757 --> 00:39:21,092 TRYING TO BE COMMUNICATING 1114 00:39:21,158 --> 00:39:22,193 OPENLY IN ALL OF THE FORUMS THAT 1115 00:39:22,259 --> 00:39:23,527 ARE AVAILABLE, INCLUDING SOCIAL 1116 00:39:23,594 --> 00:39:26,897 MEDIA, BUT ALSO I'M TRYING TO 1117 00:39:26,964 --> 00:39:28,599 GET OUT IN FRONT OF AS MANY 1118 00:39:28,666 --> 00:39:29,767 PEOPLE AS I CAN AND GET OTHER 1119 00:39:29,834 --> 00:39:31,001 FOLKS OUT TO REALLY TALK ABOUT 1120 00:39:31,068 --> 00:39:36,140 WHAT WE'RE DOING, THE WINS, TO 1121 00:39:36,207 --> 00:39:40,511 HELP PEOPLE REALIZE THAT CANCER 1122 00:39:40,578 --> 00:39:41,846 HAS MADE TREMENDOUS PROGRESS. 1123 00:39:41,912 --> 00:39:43,814 ONE OF THE THINGS THAT WAS MOST 1124 00:39:43,881 --> 00:39:45,182 DISHEARTENING TO ME WHEN I WAS 1125 00:39:45,249 --> 00:39:46,350 FIRST SAYING LIKE, OH, I'M GOING 1126 00:39:46,417 --> 00:39:50,087 TO GO TO THE NCI, BE THE NCI 1127 00:39:50,154 --> 00:39:51,388 DIRECTOR, WOULD BE PEOPLE WHO 1128 00:39:51,455 --> 00:39:52,490 WOULD SAY, WELL, NOTHING 1129 00:39:52,556 --> 00:39:55,326 HAPPENED UP THERE, AND -- IN 1130 00:39:55,392 --> 00:39:56,994 YEARS, WHICH IS SO WRONG. 1131 00:39:57,061 --> 00:39:58,062 CANCER IS DIFFERENT TODAY THAN 1132 00:39:58,129 --> 00:39:58,963 IT WAS 10 YEARS AGO. 1133 00:39:59,029 --> 00:40:00,598 IT WILL BE MUCH DIFFERENT 10 1134 00:40:00,664 --> 00:40:03,467 YEARS FROM NOW, AND THERE ARE 1135 00:40:03,534 --> 00:40:06,303 CANCERS TODAY THAT ARE VERY 1136 00:40:06,370 --> 00:40:06,737 CURABLE. 1137 00:40:06,804 --> 00:40:08,372 THERE ARE CANCERS TODAY THAT ARE 1138 00:40:08,439 --> 00:40:09,940 VERY MANAGEABLE BUT 10 YEARS 1139 00:40:10,007 --> 00:40:13,911 AGO, THAT WASN'T TRUE AT ALL. 1140 00:40:13,978 --> 00:40:15,546 EVEN KIDNEY CANCER, MY OWN 1141 00:40:15,613 --> 00:40:16,947 CANCER, HAS REALLY UNDERGONE 1142 00:40:17,014 --> 00:40:19,550 THIS RADICAL CHANGE, OPENED UP 1143 00:40:19,617 --> 00:40:21,318 THE DOORS FOR MORE RADICAL 1144 00:40:21,385 --> 00:40:21,886 CHANGES. 1145 00:40:21,952 --> 00:40:23,854 AND IT'S BEEN INTERESTING AS 1146 00:40:23,921 --> 00:40:25,156 I'VE CONTINUED TO TALK TO PEOPLE 1147 00:40:25,222 --> 00:40:27,024 AND HEAR PEOPLE SAY, YOU KNOW, 1148 00:40:27,091 --> 00:40:27,792 WHAT'S YOUR EXPERIENCE WITH 1149 00:40:27,858 --> 00:40:29,460 CANCER AND THEN THEY'LL DESCRIBE 1150 00:40:29,527 --> 00:40:31,428 SOMEONE WHOSE CANCER WAS TAKEN 1151 00:40:31,495 --> 00:40:38,035 CARE OF, EASY PEE SEE, PEASY, AM 1152 00:40:38,102 --> 00:40:39,236 LIKE, YES, THAT'S THE CANCER 1153 00:40:39,303 --> 00:40:40,371 EXPERIENCE WE WANT EVERYONE TO 1154 00:40:40,437 --> 00:40:45,509 HAVE TO SO THE CANCER ISN'T 1155 00:40:45,576 --> 00:40:46,610 SCARY ANYMORE AND THAT CANCER IS 1156 00:40:46,677 --> 00:40:48,579 SOMETHING THAT WE CAN MANAGE AND 1157 00:40:48,646 --> 00:40:48,879 UNDERSTAND. 1158 00:40:48,946 --> 00:40:53,050 IT'S A HARD PROBLEM TO TACKLE, 1159 00:40:53,117 --> 00:40:53,818 IT'S A THOUSAND DIFFERENT 1160 00:40:53,884 --> 00:40:54,819 DISEASES, IT'S NOT REALLY ONE 1161 00:40:54,885 --> 00:40:56,020 AND YOU KNOW WHAT THEY'RE ASKING 1162 00:40:56,086 --> 00:40:57,988 US TO DO IS NOT JUST TO PUT A 1163 00:40:58,055 --> 00:40:59,757 MAN ON THE MOON BUT TO COLONIZE 1164 00:40:59,824 --> 00:41:01,759 A SOLAR SYSTEM WORTH OF PLANETS 1165 00:41:01,826 --> 00:41:02,726 THAT ALL HAVE DIFFERENT 1166 00:41:02,793 --> 00:41:04,128 ENVIRONMENTS BUT WE'RE UP TO THE 1167 00:41:04,195 --> 00:41:06,463 CHALLENGE AND WE'RE GETTING 1168 00:41:06,530 --> 00:41:07,998 THERE AND MAKING REALLY BIG 1169 00:41:08,065 --> 00:41:09,733 STRIDES. 1170 00:41:09,800 --> 00:41:11,702 I THINK THE OTHER PART, THIS 1171 00:41:11,769 --> 00:41:13,704 GETS BACK TO THE WORKFORCE, IS 1172 00:41:13,771 --> 00:41:14,905 THAT WE NEED TO GET THE MESSAGE 1173 00:41:14,972 --> 00:41:16,307 OUT IN YOUNGER PEOPLE. 1174 00:41:16,373 --> 00:41:19,176 AND REALLY HELPING YOUNG FOLKS 1175 00:41:19,243 --> 00:41:22,379 KNOW WHAT THERE IS IN THE CANCER 1176 00:41:22,446 --> 00:41:23,781 SPACE, WHAT THEY CAN BE A PART. 1177 00:41:23,848 --> 00:41:24,782 THIS IS PART OF THE NATIONAL 1178 00:41:24,849 --> 00:41:25,749 CANCER PLAN, EVERYBODY HAS A 1179 00:41:25,816 --> 00:41:28,953 ROLE, INCLUDING KIDS IN MIDDLE 1180 00:41:29,019 --> 00:41:31,121 SCHOOL, AND OPENING THEIR EYES 1181 00:41:31,188 --> 00:41:32,690 TO FUTURES WORKING IN THE CANCER 1182 00:41:32,756 --> 00:41:33,257 ARENA. 1183 00:41:33,324 --> 00:41:36,527 SO THAT'S THE LONG TERM IF 1184 00:41:36,594 --> 00:41:38,162 THERE'S A BRAIN DRAIN, I HOPE WE 1185 00:41:38,229 --> 00:41:41,232 JUST HAVE A BIGGER GROWTH IN THE 1186 00:41:41,298 --> 00:41:42,700 FUTURE. 1187 00:41:42,766 --> 00:41:43,434 >> THANK YOU. 1188 00:41:43,500 --> 00:41:45,870 BEFORE I RECOGNIZE VICKIE 1189 00:41:45,936 --> 00:41:47,171 ONLINE, I JUST WANTED TO PIGGY 1190 00:41:47,238 --> 00:41:49,240 BACK ON WHAT YOU SAID ABOUT, YOU 1191 00:41:49,306 --> 00:41:52,409 KNOW, THE MOONSHOT'S ROLE OF 1192 00:41:52,476 --> 00:41:53,777 ENDING CANCER AS WE KNOW IT. 1193 00:41:53,844 --> 00:41:54,979 I WONDER IF IT SHOULD HAVE 1194 00:41:55,045 --> 00:41:57,281 BEEN -- AND CANCERS AS WE KNOW 1195 00:41:57,348 --> 00:41:57,715 THEM. 1196 00:41:57,781 --> 00:41:57,948 >> YES. 1197 00:41:58,015 --> 00:42:02,853 >> CHANGE OUR PRONOUNS HERE. 1198 00:42:02,920 --> 00:42:04,722 BUT -- BECAUSE MY -- WHEN THAT 1199 00:42:04,788 --> 00:42:08,359 WAS RE-LAUNCHED, MY FIRST TALK 1200 00:42:08,425 --> 00:42:09,326 WAS ALWAYS WHAT DOES THAT MEAN, 1201 00:42:09,393 --> 00:42:10,427 WHAT DOES THAT MEAN. 1202 00:42:10,494 --> 00:42:13,831 LIKE YOU SAID, THERE'S A LOT OF 1203 00:42:13,898 --> 00:42:14,832 CANCERS WITH THE NEW 1204 00:42:14,899 --> 00:42:16,333 TECHNOLOGIES AND NEW 1205 00:42:16,400 --> 00:42:17,201 THERAPEUTICS THAT WERE 1206 00:42:17,268 --> 00:42:18,802 PREVIOUSLY DEADLY THAT ARE NOW 1207 00:42:18,869 --> 00:42:23,707 MANAGEABLE, AND I THINK THAT MAY 1208 00:42:23,774 --> 00:42:25,109 NOT BE SEEN AS A VICTORY 1209 00:42:25,175 --> 00:42:25,776 INTEREST THE GENERAL PUBLIC 1210 00:42:25,843 --> 00:42:27,878 WHERE YOU GET CANCER AND YOU 1211 00:42:27,945 --> 00:42:28,913 LIVE OR YOU'RE DEAD. 1212 00:42:28,979 --> 00:42:30,981 THERE'S THIS NEW MIDDLE GROUND 1213 00:42:31,048 --> 00:42:32,383 AND I THINK IT'S A WHOLE GROUP 1214 00:42:32,449 --> 00:42:35,653 OF INVISIBLE PEOPLE THAT IT 1215 00:42:35,719 --> 00:42:36,854 WOULD BE WORTH HIGHLIGHTING THAT 1216 00:42:36,921 --> 00:42:38,856 THIS IS PROGRESS. 1217 00:42:38,923 --> 00:42:41,025 IT MAY NOT BE THE ULTIMATE GOAL 1218 00:42:41,091 --> 00:42:42,660 BUT IT IS WAY BETTER THAN 1219 00:42:42,726 --> 00:42:43,494 INSTANT DEATH. 1220 00:42:43,560 --> 00:42:44,595 VICKIE, I SEE YOU'VE GOT YOUR 1221 00:42:44,662 --> 00:42:45,162 HAND RAISED. 1222 00:42:45,229 --> 00:42:45,696 PLEASE GO AHEAD. 1223 00:42:45,763 --> 00:42:46,096 >> THANK YOU. 1224 00:42:46,163 --> 00:42:49,967 CAN YOU HEAR ME WELL ENOUGH? 1225 00:42:50,034 --> 00:42:50,467 >> I CAN. 1226 00:42:50,534 --> 00:42:55,539 >> I APOLOGIZE FOR ASKING THIS, 1227 00:42:55,606 --> 00:42:57,074 I THINK IT'S A VERY HARD 1228 00:42:57,141 --> 00:42:58,175 QUESTION BUT IT IS RELATED TO 1229 00:42:58,242 --> 00:42:59,710 THE LABOR AND BEING ABLE TO 1230 00:42:59,777 --> 00:43:00,010 HIRE. 1231 00:43:00,077 --> 00:43:01,879 IT SEEMS LIKE THE FUTURE FOR 1232 00:43:01,946 --> 00:43:04,448 MANY OF US AND I'M COMING FROM 1233 00:43:04,515 --> 00:43:05,950 THE CHILDHOOD CANCER WORLD AND 1234 00:43:06,016 --> 00:43:07,484 I'M SO PROUD OF THE WORK WE'RE 1235 00:43:07,551 --> 00:43:08,819 DOING IN THE CHILDHOOD CANCER 1236 00:43:08,886 --> 00:43:10,688 DATA INITIATIVE, BUT I'M A 1237 00:43:10,754 --> 00:43:13,324 LITTLE WORRIED ABOUT THAT 1238 00:43:13,390 --> 00:43:16,026 MANPOWER PIECE THAT WE ARE 1239 00:43:16,093 --> 00:43:17,728 COMPETING WITH FOR 1240 00:43:17,795 --> 00:43:20,130 MATHEMATICIANS AND DATA 1241 00:43:20,197 --> 00:43:22,299 SCIENTISTS AND BIOINFORMATICS 1242 00:43:22,366 --> 00:43:25,903 SPECIALISTS WHICH REALLY, I FEEL 1243 00:43:25,970 --> 00:43:26,937 LIKE ANY PART OF GOVERNMENT HAS 1244 00:43:27,004 --> 00:43:28,238 A HARD TIME ATTRACTING THAT 1245 00:43:28,305 --> 00:43:30,774 TALENT AND IT FEELS LIKE IT HAS 1246 00:43:30,841 --> 00:43:32,977 TO BE A BIGGER EMPHASIS ON THE 1247 00:43:33,043 --> 00:43:34,945 MISSION RATHER THAN THE PAYCHECK 1248 00:43:35,012 --> 00:43:38,449 TO BE ABLE TO POPULATE THOSE 1249 00:43:38,515 --> 00:43:39,249 REALLY IMPORTANT NEEDS TO BE 1250 00:43:39,316 --> 00:43:40,050 ABLE TO MOVE FORWARD. 1251 00:43:40,117 --> 00:43:43,620 YOU HAVE A THOUGHT ABOUT THAT? 1252 00:43:43,687 --> 00:43:44,555 >> YEAH, THANK YOU FOR THAT 1253 00:43:44,621 --> 00:43:45,089 QUESTION. 1254 00:43:45,155 --> 00:43:48,592 MY ONLY THOUGHT ON THAT IS THAT 1255 00:43:48,659 --> 00:43:50,027 YOU HIT IT EXACTLY RIGHT, THAT 1256 00:43:50,094 --> 00:43:51,462 PEOPLE WITH DATA SCIENCE SKILLS 1257 00:43:51,528 --> 00:43:52,763 ARE IN THE HIGHEST DEMAND OF 1258 00:43:52,830 --> 00:43:55,632 ANYBODY IN THE COUNTRY. 1259 00:43:55,699 --> 00:43:57,601 MY KIDS ARE NOW IN THEIR 20s 1260 00:43:57,668 --> 00:43:58,802 AND HAVE CHOSEN THEIR CAREERS 1261 00:43:58,869 --> 00:44:00,371 BUT IF THEY WERE YOUNGER, I 1262 00:44:00,437 --> 00:44:01,939 WOULD HAVE SAID LEARN COMPUTER 1263 00:44:02,006 --> 00:44:03,540 SKILLS AND GO INTO DATA SCIENCE, 1264 00:44:03,607 --> 00:44:08,045 PAUSE THEREBECAUSE THERE'S SO MO 1265 00:44:08,112 --> 00:44:09,680 THERE, THAT MAKES IT VERY 1266 00:44:09,747 --> 00:44:10,347 COMPETITIVE FOR US. 1267 00:44:10,414 --> 00:44:11,782 THAT'S TRUE IN ACADEMIA AS WELL. 1268 00:44:11,849 --> 00:44:13,017 THERE ARE NOT ENOUGH OF THEM TO 1269 00:44:13,083 --> 00:44:13,417 GO AROUND. 1270 00:44:13,484 --> 00:44:15,953 BUT I THINK YOU'RE TOTALLY 1271 00:44:16,020 --> 00:44:17,588 RIGHT, THAT THE MISSION IS WHAT 1272 00:44:17,654 --> 00:44:19,023 WILL GET PEOPLE EXCITED. 1273 00:44:19,089 --> 00:44:21,658 THAT'S WHAT I'VE SEEN IN MY TIME 1274 00:44:21,725 --> 00:44:22,926 SO FAR AT NCI. 1275 00:44:22,993 --> 00:44:24,762 I'VE NEVER SEEN PEOPLE MORE 1276 00:44:24,828 --> 00:44:26,764 MISSION-DRIVEN AND REALLY 1277 00:44:26,830 --> 00:44:29,133 DEDICATED TO MAKING A HUGE 1278 00:44:29,199 --> 00:44:29,433 DIFFERENCE. 1279 00:44:29,500 --> 00:44:32,102 I THINK WE HAVE TO TEACH OUR 1280 00:44:32,169 --> 00:44:34,638 DATA SCIENTISTS AS WELL TO 1281 00:44:34,705 --> 00:44:35,806 REALIZE THAT THAT CAN BE A BIG 1282 00:44:35,873 --> 00:44:36,507 PART OF THEIR CAREER. 1283 00:44:36,573 --> 00:44:38,575 SO I HEAR YOU LOUD AND CLEAR, 1284 00:44:38,642 --> 00:44:41,311 BUT IT IS HIGH ON MY WORRY LIST 1285 00:44:41,378 --> 00:44:42,546 OF DATA SCIENTISTS. 1286 00:44:42,613 --> 00:44:44,314 >> IT IS TRUE, BOTH MY SON AND 1287 00:44:44,381 --> 00:44:47,951 DAUGHDAUGHTER-IN-LAW ARE PH.D. 1288 00:44:48,018 --> 00:44:48,719 MATHEMATICIAN DATA SCIENTISTS 1289 00:44:48,786 --> 00:44:51,321 AND THEY LEFT ACADEMIA AND IT'S 1290 00:44:51,388 --> 00:44:54,324 GOING TO BE TOUGH. 1291 00:44:54,391 --> 00:44:54,958 >> YEAH. 1292 00:44:55,025 --> 00:44:56,727 IT WILL ALSO TAKE US LEARNING 1293 00:44:56,794 --> 00:45:01,031 HOW TO PARTNER WITH THOSE 1294 00:45:01,098 --> 00:45:02,032 COMPANIES THAT HAVE THE TALENT 1295 00:45:02,099 --> 00:45:03,567 AND HELPING THEM WANT TO BE PART 1296 00:45:03,634 --> 00:45:06,670 OF THE MISSION AS WELL. 1297 00:45:06,737 --> 00:45:08,005 >> BOB, YOU HAD A QUESTION? 1298 00:45:08,072 --> 00:45:08,939 >> SURE, A QUICK ONE. 1299 00:45:09,006 --> 00:45:10,274 NOW THAT YOU'VE BEEN HERE 2 1/2 1300 00:45:10,340 --> 00:45:12,142 MONTHS OR SO, WHAT'S BEEN YOUR 1301 00:45:12,209 --> 00:45:13,811 BIGGEST SURPRISE? 1302 00:45:13,877 --> 00:45:15,212 >> OH! 1303 00:45:15,279 --> 00:45:16,313 THAT'S GOOD. 1304 00:45:16,380 --> 00:45:18,382 MY BIGGEST SURPRISE. 1305 00:45:18,449 --> 00:45:19,917 UM, BUT THERE ARE NOT VERY MANY 1306 00:45:19,983 --> 00:45:21,351 COFFEE SHOPS ON THIS REALLY HUGE 1307 00:45:21,418 --> 00:45:22,252 CAMPUS. 1308 00:45:22,319 --> 00:45:22,753 [LAUGHTER] 1309 00:45:22,820 --> 00:45:24,088 THAT'S PROBABLY MY BIGGEST 1310 00:45:24,154 --> 00:45:25,289 SURPRISE, BUT NOW I'VE FOUND 1311 00:45:25,355 --> 00:45:26,723 ANOTHER ONE SO THAT'S GOOD. 1312 00:45:26,790 --> 00:45:28,292 YOU KNOW, I THINK WHAT I WAS 1313 00:45:28,358 --> 00:45:30,694 JUST SAYING ABOUT THE MISSION OF 1314 00:45:30,761 --> 00:45:33,230 THE PLACE, I THINK I KNEW THAT, 1315 00:45:33,297 --> 00:45:35,432 BUT I -- AND I CAME FROM, YOU 1316 00:45:35,499 --> 00:45:37,167 KNOW, ACADEMIC MEDICAL -- WE 1317 00:45:37,234 --> 00:45:40,037 THOUGHT WE WERE MISSION-DRIVEN? 1318 00:45:40,104 --> 00:45:43,006 IT IS A LOGSCALE DIFFERENT HERE. 1319 00:45:43,073 --> 00:45:44,541 AND I LOVE THE WAY THAT IT 1320 00:45:44,608 --> 00:45:45,742 PERMEATES, IT'S NOT JUST THE 1321 00:45:45,809 --> 00:45:46,777 SCIENTISTS AND THE DOCTORS WHO 1322 00:45:46,844 --> 00:45:48,278 ARE MISSION-DRIVEN. 1323 00:45:48,345 --> 00:45:49,480 IT'S EVERYBODY. 1324 00:45:49,546 --> 00:45:51,348 IT'S LITERALLY EVERYONE THAT I 1325 00:45:51,415 --> 00:45:54,218 TALK TO WHO WORKS HERE. 1326 00:45:54,284 --> 00:45:56,553 THEY KNOW THEY'RE AT THE NCI OR 1327 00:45:56,620 --> 00:45:58,589 THE NIH, YOU KNOW, AND I RODE 1328 00:45:58,655 --> 00:46:00,591 THE BUS THIS MORNING BECAUSE I 1329 00:46:00,657 --> 00:46:02,593 HIT MY -- MY KNEE IS NOT GOOD 1330 00:46:02,659 --> 00:46:05,629 TODAY, AND THE BUS DRIVER WAS 1331 00:46:05,696 --> 00:46:06,730 TALKING ABOUT SHE HEARD THAT I 1332 00:46:06,797 --> 00:46:08,398 WAS AT THE NCI AND SHE WANTED TO 1333 00:46:08,465 --> 00:46:09,733 TALK ABOUT WHAT WE WERE DOING IN 1334 00:46:09,800 --> 00:46:10,033 CANCER. 1335 00:46:10,100 --> 00:46:12,002 I MEAN, PEOPLE HERE ARE 1336 00:46:12,069 --> 00:46:12,703 REALLY -- THEY'RE ALL IN. 1337 00:46:12,769 --> 00:46:18,609 I LOVE IT. 1338 00:46:18,675 --> 00:46:19,643 >> I HAVE A QUESTION ABOUT 1339 00:46:19,710 --> 00:46:21,645 SOMETHING THAT YOU DIDN'T COVER, 1340 00:46:21,712 --> 00:46:22,679 BUT WE'RE HEARING THAT THE BOARD 1341 00:46:22,746 --> 00:46:24,648 OF SCIENTIFIC ADVISERS HAVE A 1342 00:46:24,715 --> 00:46:26,383 NEW WORKING GROUP ON COMMUNITY 1343 00:46:26,450 --> 00:46:28,085 CANCER CARE RESEARCH AND EQUITY. 1344 00:46:28,152 --> 00:46:30,787 CAN YOU TALK A LITTLE BIT ABOUT 1345 00:46:30,854 --> 00:46:32,456 THE ANTICIPATED DELIVERABLES 1346 00:46:32,523 --> 00:46:32,656 AND -- 1347 00:46:32,723 --> 00:46:33,891 >> YEAH, ABSOLUTELY. 1348 00:46:33,957 --> 00:46:34,791 THAT'S ONE OF THE THINGS I'M 1349 00:46:34,858 --> 00:46:35,759 EXCITED ABOUT BECAUSE I'VE ONLY 1350 00:46:35,826 --> 00:46:36,860 BEEN HERE 2 1/2 MONTHS SO I 1351 00:46:36,927 --> 00:46:38,595 HAVEN'T DONE THAT MANY THINGS. 1352 00:46:38,662 --> 00:46:41,465 AND STARTING A WORKING GROUP IS 1353 00:46:41,532 --> 00:46:43,133 JUST MORE ABOUT GETTING 1354 00:46:43,200 --> 00:46:46,403 INFORMATION. 1355 00:46:46,470 --> 00:46:49,573 SO -- SO THIS CAME FROM MANY 1356 00:46:49,640 --> 00:46:51,909 CONVERSATIONS THAT I HAD IN 1357 00:46:51,975 --> 00:46:53,777 EARLY WEEKS WHERE PEOPLE TALKED 1358 00:46:53,844 --> 00:46:54,978 ABOUT WHAT ARE WE DOING OR HOW 1359 00:46:55,045 --> 00:46:59,483 CAN WE GET CLINICAL TRIALS OR -- 1360 00:46:59,550 --> 00:47:01,885 INTO RURAL AMERICA OR INTO 1361 00:47:01,952 --> 00:47:04,087 UNDERSERVED PARTS OF THE UNITED 1362 00:47:04,154 --> 00:47:06,256 STATES OR HOW DO WE ADDRESS THE 1363 00:47:06,323 --> 00:47:08,392 GROSS HEALTH INEQUITIES. 1364 00:47:08,458 --> 00:47:09,793 IN SOME CANCERS -- THERE WAS A 1365 00:47:09,860 --> 00:47:11,328 REPORT RECENTLY ON SOME CANCERS 1366 00:47:11,395 --> 00:47:13,530 SHOWING THAT THE DEATH RATES IN 1367 00:47:13,597 --> 00:47:14,731 THE SAME CANCER IN NASHVILLE 1368 00:47:14,798 --> 00:47:15,499 COMPARED TO THE SURROUNDING 1369 00:47:15,566 --> 00:47:16,934 AREA, WHICH IS MY HOME, AND I 1370 00:47:17,000 --> 00:47:18,302 FELT RESPONSIBLE FOR ALL OF 1371 00:47:18,368 --> 00:47:21,672 THOSE PEOPLE IN THE GREATER MID 1372 00:47:21,738 --> 00:47:23,106 SOUTH AROUND NASHVILLE, BUT IT'S 1373 00:47:23,173 --> 00:47:24,208 VERY DIFFERENT. 1374 00:47:24,274 --> 00:47:25,976 SO THAT'S NOT RIGHT. 1375 00:47:26,043 --> 00:47:28,412 THE TOOLS ARE THERE TO BE ABLE 1376 00:47:28,478 --> 00:47:30,681 TO TAKE BETTER CARE OF PATIENTS 1377 00:47:30,747 --> 00:47:31,248 THAN THAT. 1378 00:47:31,315 --> 00:47:33,350 SO AS WE LOOKED AROUND AT WHAT 1379 00:47:33,417 --> 00:47:35,085 WERE OPTIONS AND WHAT HAD BEEN 1380 00:47:35,152 --> 00:47:36,286 DONE BEFORE, WHAT HAD BEEN 1381 00:47:36,353 --> 00:47:37,654 TRIED, WE REALIZED WE DIDN'T 1382 00:47:37,721 --> 00:47:38,655 HAVE ENOUGH INFORMATION. 1383 00:47:38,722 --> 00:47:40,857 AND SO THIS IS A WORKING GROUP. 1384 00:47:40,924 --> 00:47:46,196 IT IS BEING CO-CHAIRED BY THE 1385 00:47:46,263 --> 00:47:47,898 AMERIAMERICAN CANCER SEW SOAT BE 1386 00:47:47,965 --> 00:47:50,734 AMERICAN CANCER SOCIETY BECAUSE 1387 00:47:50,801 --> 00:47:52,603 THEY HAVE GRASSROOTS 1388 00:47:52,669 --> 00:47:56,873 RELATIONSHIP WITH THE COMMUNITY, 1389 00:47:56,940 --> 00:48:02,346 AND RAY OSIBIGARIAN WHO IS WITH 1390 00:48:02,412 --> 00:48:04,881 NCORP AND BSA LEADER, SO THE TWO 1391 00:48:04,948 --> 00:48:05,983 OF THEM ALREADY REPRESENT A LOT 1392 00:48:06,049 --> 00:48:07,618 OF WHAT WE THOUGHT WE KNEW 1393 00:48:07,684 --> 00:48:08,719 ALREADY, BUT THERE'S A LOT MORE, 1394 00:48:08,785 --> 00:48:10,921 SO THE REST OF THE COMMITTEE IS 1395 00:48:10,988 --> 00:48:12,923 THERE TO TRY TO SUPPORT REALLY 1396 00:48:12,990 --> 00:48:14,124 LOOKING AT WHAT ALL THE 1397 00:48:14,191 --> 00:48:16,026 RESOURCES ARE, WHAT CAN WE DO 1398 00:48:16,093 --> 00:48:18,128 WITH EXISTING RESOURCES BECAUSE 1399 00:48:18,195 --> 00:48:20,264 WE'RE RESOURCE-LIMITED AT THE 1400 00:48:20,330 --> 00:48:21,465 MOMENT, BUT WHAT COULD WE DO IF 1401 00:48:21,531 --> 00:48:23,100 WE HAD THE RIGHT RESOURCES, AND 1402 00:48:23,166 --> 00:48:24,601 WHAT ARE MORE INNOVATIVE WAYS TO 1403 00:48:24,668 --> 00:48:25,068 MOVE FORWARD. 1404 00:48:25,135 --> 00:48:27,404 SO IT'S REALLY FACT-FINDING AT 1405 00:48:27,471 --> 00:48:28,272 THIS POINT. 1406 00:48:28,338 --> 00:48:29,940 THE DELIVERABLES, I HAVE SORT OF 1407 00:48:30,007 --> 00:48:31,174 A LIST OF INFORMATION THAT I 1408 00:48:31,241 --> 00:48:32,809 WANT THEM TO COME BACK WITH AND 1409 00:48:32,876 --> 00:48:35,646 SOME SUGGESTIONS, NOT TO WRITE 1410 00:48:35,712 --> 00:48:38,515 THE GRANT BUT TO COME UP WITH A 1411 00:48:38,582 --> 00:48:39,383 DIRECTION THAT THEY THINK THAT 1412 00:48:39,449 --> 00:48:40,617 WE NEED TO GO. 1413 00:48:40,684 --> 00:48:42,252 AND THEY HAVE A SIX-MONTH 1414 00:48:42,319 --> 00:48:44,121 TIMELINE. 1415 00:48:44,187 --> 00:48:45,555 THEY HAVE NOT BEEN FORMULAE 1416 00:48:45,622 --> 00:48:47,858 CHARGED YET, THE CLOCK HASN'T 1417 00:48:47,924 --> 00:48:49,092 START THE TICKING SO IT WILL BE 1418 00:48:49,159 --> 00:48:49,993 SIX MONTHS FROM A MONTH FROM 1419 00:48:50,060 --> 00:48:53,664 NOW. 1420 00:48:53,730 --> 00:48:55,198 BUT I'M REALLY EXCITED TO HEAR 1421 00:48:55,265 --> 00:48:55,766 WHAT THEY LEARN. 1422 00:48:55,832 --> 00:48:57,968 I WISH I COULD BE A FLY ON THE 1423 00:48:58,035 --> 00:48:58,835 WALL AT ALL THEIR MEETINGS. 1424 00:48:58,902 --> 00:49:04,541 >> THAT'S EXCITING. 1425 00:49:04,608 --> 00:49:05,942 >> ANOTHER QUESTION RELATED TO 1426 00:49:06,009 --> 00:49:06,209 BUDGET. 1427 00:49:06,276 --> 00:49:10,580 WE TALKED ABOUT INTRAMURAL 1428 00:49:10,647 --> 00:49:14,518 ISSUES, THRAS AN NCTN GRANT 1429 00:49:14,584 --> 00:49:16,086 BUDGET ISSUE, THERE'S ALSO A 1430 00:49:16,153 --> 00:49:17,087 PAYLINE ISSUE. 1431 00:49:17,154 --> 00:49:19,690 JUST LIKE INTRAMURAL PEOPLE, 1432 00:49:19,756 --> 00:49:22,359 PEOPLE AREN'T GETTING GRANTS 1433 00:49:22,426 --> 00:49:22,993 EXTRAMURALLY, THEY'RE GOING TO 1434 00:49:23,060 --> 00:49:24,194 LEAVE THE FIELD. 1435 00:49:24,261 --> 00:49:30,100 I KNOW IT'S A BALANCING ACT, 1436 00:49:30,167 --> 00:49:31,168 INTRAVERSUS EXTRA, BUT HOW ARE 1437 00:49:31,234 --> 00:49:33,103 YOU REALLY GOING TO BALANCE 1438 00:49:33,170 --> 00:49:35,205 THAT, ESPECIALLY IN A TIME OF 1439 00:49:35,272 --> 00:49:35,906 CONSTRAINED BUDGETS ANYWAY? 1440 00:49:35,972 --> 00:49:37,140 >> I CAME FROM THE EXTRAMURAL 1441 00:49:37,207 --> 00:49:37,374 WORLD. 1442 00:49:37,441 --> 00:49:40,243 I HAD TWO R01s UP UNTIL 1443 00:49:40,310 --> 00:49:43,680 DECEMBER 17TH OF THIS YEAR, SO I 1444 00:49:43,747 --> 00:49:45,982 KNOW HOW IT IS TO LIVE ON THAT 1445 00:49:46,049 --> 00:49:46,750 PAYLINE. 1446 00:49:46,817 --> 00:49:49,753 I KNOW WHAT IT IS FOR THE K 1447 00:49:49,820 --> 00:49:50,754 AWARDEES WHO ARE LOOKING FOR THE 1448 00:49:50,821 --> 00:49:51,822 GRANT THAT'S GOING TO GET THEM 1449 00:49:51,888 --> 00:49:52,356 THE JOB. 1450 00:49:52,422 --> 00:49:54,591 MY HUSBAND IS STILL AN 1451 00:49:54,658 --> 00:49:56,560 R01 FUNDED INVESTIGATOR. 1452 00:49:56,626 --> 00:49:58,662 SO NO NCI GRANTS FOR HIM 1453 00:49:58,729 --> 00:50:01,064 ANYMORE, BUT HE HAS OTHER GRANTS 1454 00:50:01,131 --> 00:50:03,166 AND I GET TO HEAR ABOUT 1455 00:50:03,233 --> 00:50:06,336 GRANT-WRITING ALL THE TIME. 1456 00:50:06,403 --> 00:50:08,004 SO I LIVE AND BREATHE THAT 1457 00:50:08,071 --> 00:50:08,638 WORLD. 1458 00:50:08,705 --> 00:50:10,674 I KNOW THE DIFFERENCE BETWEEN 9% 1459 00:50:10,741 --> 00:50:12,843 AND 10%, THAT THERE IS A 1460 00:50:12,909 --> 00:50:14,044 PSYCHOLOGICALLY VERY LARGE 1461 00:50:14,111 --> 00:50:21,651 DIFFERENCE THERE. 1462 00:50:21,718 --> 00:50:23,186 I HAVE TO TRY TO KEEP ALL OF THE 1463 00:50:23,253 --> 00:50:26,456 COMPONENTS MOVING, AND THAT'S 1464 00:50:26,523 --> 00:50:27,624 ABOUT ALL I CAN SAY AT THIS 1465 00:50:27,691 --> 00:50:28,225 POINT. 1466 00:50:28,291 --> 00:50:30,961 WE REALLY NEED A BUDGET SO I CAN 1467 00:50:31,027 --> 00:50:32,195 MAKE A FIRM STATEMENT ABOUT 1468 00:50:32,262 --> 00:50:35,599 WHERE WE'RE GOING TO TAKE A 1469 00:50:35,665 --> 00:50:35,832 PAYLINE. 1470 00:50:35,899 --> 00:50:36,800 >> THANK YOU SO MUCH FOR 1471 00:50:36,867 --> 00:50:37,667 SPENDING SOME TIME WITH US. 1472 00:50:37,734 --> 00:50:39,035 I'M GOING TO TAKE THE LIBERTY OF 1473 00:50:39,102 --> 00:50:43,073 ASKING THE LAST QUESTION. 1474 00:50:43,140 --> 00:50:46,076 SO I LOVE HOW YOU SEE CANCER 1475 00:50:46,143 --> 00:50:49,012 RESEARCH AS BEING A TEAM. 1476 00:50:49,079 --> 00:50:50,013 AND THAT YOU HAVE WORKED WITH 1477 00:50:50,080 --> 00:50:54,484 THAT BECAUSE IN THE PAST, -- 1478 00:50:54,551 --> 00:50:56,086 VALUE THE CONTRIBUTIONS THAT WE 1479 00:50:56,153 --> 00:50:56,286 MAKE. 1480 00:50:56,353 --> 00:50:58,355 WHAT DO YOU SEE THE ADVOCATES' 1481 00:50:58,422 --> 00:50:59,222 ROLE ON THE TEAM? 1482 00:50:59,289 --> 00:51:01,258 >> SO EVERY TEAM NEEDS TO HAVE 1483 00:51:01,324 --> 00:51:03,360 AN ADVOCATE. 1484 00:51:03,427 --> 00:51:10,133 I THINK -- SO WE CAN'T MAKE 1485 00:51:10,200 --> 00:51:11,234 PROGRESS UNLESS WE KNOW WHERE TO 1486 00:51:11,301 --> 00:51:13,470 PUT OUR EFFORTS. 1487 00:51:13,537 --> 00:51:17,107 I FEEL LIKE ADVOCATES ARE 1488 00:51:17,174 --> 00:51:18,842 TELLING US WHAT'S REALLY 1489 00:51:18,909 --> 00:51:20,177 IMPORTANT, WHERE IS THE BURNING 1490 00:51:20,243 --> 00:51:21,611 FIRE TODAY, YOU KNOW, WE MIGHT 1491 00:51:21,678 --> 00:51:23,780 FEEL LIKE WE CAN SMELL THE SMOKE 1492 00:51:23,847 --> 00:51:26,550 BUT WHERE IS THE FIRE IS WHERE 1493 00:51:26,616 --> 00:51:27,784 WE'RE GOING TO MAKE THE BIGGEST 1494 00:51:27,851 --> 00:51:28,084 DIFFERENCE. 1495 00:51:28,151 --> 00:51:32,389 SO I THINK WE HAVE THEM THERE. 1496 00:51:32,456 --> 00:51:33,990 THE THREE ADVOCATES THAT I 1497 00:51:34,057 --> 00:51:35,725 TALKED ABOUT, WHERE DID THEY 1498 00:51:35,792 --> 00:51:36,259 MAKE A BIG DIFFERENCE? 1499 00:51:36,326 --> 00:51:37,794 IT WAS PARTLY RAISING AWARENESS, 1500 00:51:37,861 --> 00:51:39,396 BUT THEY WERE THE ONES WHO WERE 1501 00:51:39,463 --> 00:51:40,664 SAYING WE KEEP TALKING TO 1502 00:51:40,730 --> 00:51:42,499 DOCTORS WHO HAVE NEVER HEARD OF 1503 00:51:42,566 --> 00:51:43,900 THIS, SO WE REALIZED WE HAD TO 1504 00:51:43,967 --> 00:51:45,435 START A CAMPAIGN TO TEACH 1505 00:51:45,502 --> 00:51:46,736 DOCTORS TO KNOW WHAT THIS WAS 1506 00:51:46,803 --> 00:51:47,671 ALL ABOUT. 1507 00:51:47,737 --> 00:51:49,739 TO MAKE THIS A PART OF THEIR 1508 00:51:49,806 --> 00:51:52,375 NORMAL VOCABULARY, EVEN IF IT 1509 00:51:52,442 --> 00:51:53,777 WAS A PIECE THEY WOULDN'T SEE 1510 00:51:53,844 --> 00:51:56,346 FOR MAYBE THEIR ENTIRE LIFETIME, 1511 00:51:56,413 --> 00:51:57,113 BUT THEY KNEW IT. 1512 00:51:57,180 --> 00:52:00,083 BECAUSE THERE ARE OTHER DISEASES 1513 00:52:00,150 --> 00:52:02,185 WE'VE NEVER HEARD OF, THAT WE'VE 1514 00:52:02,252 --> 00:52:02,619 NEVER SEEN. 1515 00:52:02,686 --> 00:52:03,954 >> ON OUR END, THERE'S A LOT OF 1516 00:52:04,020 --> 00:52:05,589 DIFFERENT TYPES OF ADVOCACY. 1517 00:52:05,655 --> 00:52:07,724 WE'VE GOT PEOPLE WHO ARE RAISING 1518 00:52:07,791 --> 00:52:13,063 WEARNESS, I RIB RIBBON CUTTINGSD 1519 00:52:13,129 --> 00:52:14,564 PEER SUPPORT AND EVERYONE ELSE'S 1520 00:52:14,631 --> 00:52:16,166 TABLE IS INVOLVED IN LIKE THE 1521 00:52:16,233 --> 00:52:17,467 RESEARCH ADVOCATE ACTIVITIES 1522 00:52:17,534 --> 00:52:18,401 WHICH CAN BE A LITTLE BIT 1523 00:52:18,468 --> 00:52:22,339 DIFFERENT AND WHO HAVE ACCESS TO 1524 00:52:22,405 --> 00:52:25,842 TRAINING HOW TO DO IT, ACCESS TO 1525 00:52:25,909 --> 00:52:30,280 OPPORTUNITIES, AND ACCESS TO 1526 00:52:30,347 --> 00:52:30,747 MENTORSHIP. 1527 00:52:30,814 --> 00:52:32,015 WE HAD A DISCUSSION, YOU KNOW, 1528 00:52:32,082 --> 00:52:33,216 IT'S NOT JUST WHAT WE NEED TO 1529 00:52:33,283 --> 00:52:40,390 KNOW BUT HOW TO ENGAGE IN THE 1530 00:52:40,457 --> 00:52:42,192 ROLE OF EVIDENCE-BASED MEDICINE. 1531 00:52:42,259 --> 00:52:44,861 >> LET ME TELL YOU ANOTHER 1532 00:52:44,928 --> 00:52:46,129 ADVOCACY STORY, A VERY SHORT 1533 00:52:46,196 --> 00:52:48,031 ONE. 1534 00:52:48,098 --> 00:52:50,867 SO I MET AN ADVOCATE FOR KIDNEY 1535 00:52:50,934 --> 00:52:51,401 CANCER ONLINE. 1536 00:52:51,468 --> 00:52:53,937 SHE SEEMED FUN AND INTERESTING 1537 00:52:54,004 --> 00:52:57,140 AND SHE'S A SOFTWARE ENGINEER, 1538 00:52:57,207 --> 00:52:58,341 SO -- SHE'S ABOUT THE AGE OF ALL 1539 00:52:58,408 --> 00:52:59,943 OF OUR GRADUATE STUDENTS AND 1540 00:53:00,010 --> 00:53:03,547 POSTDOCS IN MY LAB AND MY 1541 00:53:03,613 --> 00:53:05,649 HUSBAND'S LAB HAS ALWAYS DONE AN 1542 00:53:05,715 --> 00:53:06,950 ANNUAL RETREAT WHERE WE SPEND 1543 00:53:07,017 --> 00:53:08,518 THREE DAYS IN A LAB MEETING AND 1544 00:53:08,585 --> 00:53:10,220 WE JUST THINK IT'S WONDERFUL. 1545 00:53:10,287 --> 00:53:11,421 IT IS, YOU GET EVERYBODY 1546 00:53:11,488 --> 00:53:12,489 TOGETHER, THEY COME FROM VERY 1547 00:53:12,556 --> 00:53:13,823 DIFFERENT BACKGROUNDS AND THEY 1548 00:53:13,890 --> 00:53:14,691 THINK HARD ABOUT WHERE THEY'RE 1549 00:53:14,758 --> 00:53:16,226 GOING WITH THEIR PROJECTS GOING 1550 00:53:16,293 --> 00:53:17,394 FORWARD, AND THERE'S 1551 00:53:17,460 --> 00:53:18,562 IMMUNOLOGISTS AND BASIC 1552 00:53:18,628 --> 00:53:19,262 SCIENTISTS AND EVERYTHING IN 1553 00:53:19,329 --> 00:53:19,863 BETWEEN. 1554 00:53:19,930 --> 00:53:21,665 AND SO WE INVITED HER TO COME 1555 00:53:21,731 --> 00:53:23,533 AND SHARE HER EXPERIENCE WITH 1556 00:53:23,600 --> 00:53:23,767 US. 1557 00:53:23,833 --> 00:53:26,069 WE SAID YOU DON'T HAVE TO STAY 1558 00:53:26,136 --> 00:53:27,037 FOR THREE DAYS OF THE LAB 1559 00:53:27,103 --> 00:53:28,171 MEETING AND SHE SAID OH, I WANT 1560 00:53:28,238 --> 00:53:29,506 TO BE THERE FOR THE WHOLE TIME. 1561 00:53:29,573 --> 00:53:33,410 AND SHE WAS PHENOMENAL. 1562 00:53:33,476 --> 00:53:35,512 AND HER STORY REALLY RESONATED 1563 00:53:35,579 --> 00:53:36,880 WITH SOME PEOPLE WHO ARE 1564 00:53:36,947 --> 00:53:38,081 STUDYING MITOSIS, RIGHT? 1565 00:53:38,148 --> 00:53:40,984 THEY ARE STUDYING HOW 1566 00:53:41,051 --> 00:53:42,652 CHROMOSOMES SEPARATE, REALLY FAR 1567 00:53:42,719 --> 00:53:44,387 REMOVED FROM CANCER, REALLY 1568 00:53:44,454 --> 00:53:45,855 SEPARATE, AND THEY FOUND HER 1569 00:53:45,922 --> 00:53:48,158 STORY TO BE INSPIRATIONAL FOR 1570 00:53:48,224 --> 00:53:50,327 THEIR WORK, AND THEN SHE ASKED A 1571 00:53:50,393 --> 00:53:52,896 TON OF QUESTIONS IN OUR SESSION, 1572 00:53:52,963 --> 00:53:54,197 AND SHE FORCED THE GRADUATE 1573 00:53:54,264 --> 00:53:55,999 STUDENTS TO SPEAK IN A NORMAL 1574 00:53:56,066 --> 00:53:57,000 LANGUAGE AND TO REALLY THINK 1575 00:53:57,067 --> 00:53:59,469 ABOUT WHAT THEY'RE DOING, AND I 1576 00:53:59,536 --> 00:54:00,670 THINK IT HELPED THEM DEVELOP 1577 00:54:00,737 --> 00:54:02,405 THEIR OWN PROJECTS BY EXPLAINING 1578 00:54:02,472 --> 00:54:04,007 TO SOMEONE WHO WAS OUTSIDE OF 1579 00:54:04,074 --> 00:54:05,742 THEIR ZONE. 1580 00:54:05,809 --> 00:54:07,377 SO I THINK THAT ADVOCATES HAVE 1581 00:54:07,444 --> 00:54:09,946 ROLES IN ALL DIFFERENT KINDS OF 1582 00:54:10,013 --> 00:54:16,086 PLACES. 1583 00:54:16,152 --> 00:54:18,521 >> THANK YOU SO MUCH FOR THAT. 1584 00:54:18,588 --> 00:54:20,123 >> I JUST WANTED TO ADD, YOU 1585 00:54:20,190 --> 00:54:21,825 KNOW, WE'RE TALKING ABOUT 1586 00:54:21,891 --> 00:54:23,660 DIFFERENT WAYS ADVOCATES ENGAGE, 1587 00:54:23,727 --> 00:54:25,428 YOU ALSO MENTIONED THE BSA 1588 00:54:25,495 --> 00:54:26,997 WORKING GROUP RELATED TO 1589 00:54:27,063 --> 00:54:28,765 COMMUNITY CANCER CARE. 1590 00:54:28,832 --> 00:54:30,266 THERE WILL BE ADVOCATES ON THAT 1591 00:54:30,333 --> 00:54:32,135 WORKING GROUP OR INVITATIONS 1592 00:54:32,202 --> 00:54:33,837 HAVEN'T GONE OUT, THINGS STOOD 1593 00:54:33,903 --> 00:54:35,338 UP, IS THAT SOMETHING YOUR TEAM 1594 00:54:35,405 --> 00:54:39,309 HAS ASKED FOR -- [INAUDIBLE] 1595 00:54:39,376 --> 00:54:40,610 COMPONENT OF THAT ISSUE? 1596 00:54:40,677 --> 00:54:41,745 >> THANKS FOR BRINGING THAT UP. 1597 00:54:41,811 --> 00:54:43,513 I DID WANT TO SAY, THE NAMES 1598 00:54:43,580 --> 00:54:45,615 HAVEN'T BEEN LISTED -- HAVEN'T 1599 00:54:45,682 --> 00:54:47,283 BEEN RELEASED YET BUT WE'VE BEEN 1600 00:54:47,350 --> 00:54:48,485 TALKING WITH AMY TOO TO MAKE 1601 00:54:48,551 --> 00:54:49,886 SURE THAT WE'VE GOT SOMEONE ON 1602 00:54:49,953 --> 00:54:51,021 THAT COMMITTEE WHO WILL BE -- 1603 00:54:51,087 --> 00:54:52,255 AND THEY MIGHT SAY NO, SO IT 1604 00:54:52,322 --> 00:54:53,256 COULD BE SOMEONE ELSE. 1605 00:54:53,323 --> 00:54:58,428 SO WE'LL JUST SEE. 1606 00:54:58,495 --> 00:54:59,596 >> THANK YOU SO MUCH. 1607 00:54:59,663 --> 00:55:00,463 WE JUST APPRECIATE THE TIME 1608 00:55:00,530 --> 00:55:01,164 YOU'RE SPENDING WITH US AND 1609 00:55:01,231 --> 00:55:02,265 EVERYTHING THAT YOU'RE DOING ON 1610 00:55:02,332 --> 00:55:04,601 BEHALF OF PEOPLE WITH CANCER AND 1611 00:55:04,668 --> 00:55:07,671 GETTING THE RESEARCH AND JUST 1612 00:55:07,737 --> 00:55:08,371 OPERATING -- YOU KNOW, M 1613 00:55:08,438 --> 00:55:10,640 COULDING TO THIS SPACE IN A VERY 1614 00:55:10,707 --> 00:55:11,441 DIFFICULT BUDGET TIME. 1615 00:55:11,508 --> 00:55:13,076 SO THANK YOU FOR ALL THAT YOU 1616 00:55:13,143 --> 00:55:13,810 DO. 1617 00:55:13,877 --> 00:55:15,045 AND WHILE WE'RE TRANSITIONING TO 1618 00:55:15,111 --> 00:55:17,947 THE NEXT SPEAKER, WE HAVE A 1619 00:55:18,014 --> 00:55:20,050 MEMBER WHO HAS JOINED AND WE'D 1620 00:55:20,116 --> 00:55:23,453 LIKE TO GIVE MELINDA A CHANCE TO 1621 00:55:23,520 --> 00:55:24,888 INTRODUCE YOURSELF. 1622 00:55:24,954 --> 00:55:26,122 WE WENT AROUND THE TABLE EARLIER 1623 00:55:26,189 --> 00:55:30,126 JUST GIVING OUR NAMES, BASIC 1624 00:55:30,193 --> 00:55:31,127 ORGANIZATION AND WE'RE FROM. 1625 00:55:31,194 --> 00:55:32,462 SO WELCOME, MELINDA. 1626 00:55:32,529 --> 00:55:35,665 GOOD TO SEE YOU. 1627 00:55:35,732 --> 00:55:38,368 >> GOOD TO SEE YOU GUYS. 1628 00:55:38,435 --> 00:55:42,672 I'M SORRY I'M NOT WITH YOU, I AM 1629 00:55:42,739 --> 00:55:44,441 BELINDA BACHINI FROM BILLINGS, 1630 00:55:44,507 --> 00:55:46,843 MONTANA, AND I AM THE DIRECTOR 1631 00:55:46,910 --> 00:55:48,712 OR CHIEF PATIENT OFFICER WITH 1632 00:55:48,778 --> 00:55:49,713 THE CHOLANGIOCARCINOMA 1633 00:55:49,779 --> 00:55:50,013 FOUNDATION. 1634 00:55:50,080 --> 00:55:52,515 HAPPY TO BE HERE AND ENJOYED 1635 00:55:52,582 --> 00:55:52,816 YOUR SPEECH. 1636 00:55:52,882 --> 00:55:56,386 THANK YOU SO MUCH. 1637 00:55:56,453 --> 00:55:58,321 >> THANK YOU, MELINDA. 1638 00:55:58,388 --> 00:56:00,890 AND I GUESS WE CAN GET SET UP 1639 00:56:00,957 --> 00:56:11,334 FOR OUR NEXT SPEAKER. 1640 00:56:12,368 --> 00:56:17,006 NEXT WE ARE WELCOMING DR. LORI 1641 00:56:17,073 --> 00:56:19,309 MINASIAN, DEPUTY DIRECTOR OF THE 1642 00:56:19,375 --> 00:56:20,710 NCI DIVISION CANCER PREVENTION 1643 00:56:20,777 --> 00:56:22,145 WHO'S GOING TO TALK ABOUT THE 1644 00:56:22,212 --> 00:56:23,413 CANCER SCREENING RESEARCH 1645 00:56:23,480 --> 00:56:24,047 NETWORK. 1646 00:56:24,114 --> 00:56:32,555 WE FIRST HEARD ABOUT THIS FROM 1647 00:56:32,622 --> 00:56:35,191 DR. CASSELL AND THEN DR. LOWY SO 1648 00:56:35,258 --> 00:56:36,326 WE'VE BEEN FOLLOWING ALONG WITH 1649 00:56:36,392 --> 00:56:37,427 SOME EXCITING THINGS THAT ARE 1650 00:56:37,494 --> 00:56:38,194 HAPPENING HERE AND WE'RE LOOKING 1651 00:56:38,261 --> 00:56:39,062 FORWARD TO HEARING MORE. 1652 00:56:39,129 --> 00:56:39,696 THANK YOU SO MUCH. 1653 00:56:39,763 --> 00:56:40,563 >> THANK YOU. 1654 00:56:40,630 --> 00:56:42,298 CAN YOU HEAR ME? 1655 00:56:42,365 --> 00:56:43,600 OKAY. 1656 00:56:43,666 --> 00:56:46,002 IT'S A PLEASURE TO BE HERE 1657 00:56:46,069 --> 00:56:46,436 TODAY. 1658 00:56:46,503 --> 00:56:48,271 I'M GOING TO WALK YOU THROUGH 1659 00:56:48,338 --> 00:56:51,741 SORT OF OUR THINKING AND THE 1660 00:56:51,808 --> 00:56:54,577 DEVELOPMENT OF THE CANCER 1661 00:56:54,644 --> 00:56:55,912 SCREENING RESEARCH NETWORK. 1662 00:56:55,979 --> 00:56:56,846 PLEASE FEEL FREE TO ASK 1663 00:56:56,913 --> 00:56:58,047 QUESTIONS AND I WOULD REALLY 1664 00:56:58,114 --> 00:57:00,250 LIKE YOUR INPUT. 1665 00:57:00,316 --> 00:57:01,651 BY THE END OF TODAY TOURING THE 1666 00:57:01,718 --> 00:57:02,819 DISCUSSION, IF YOU CAN TELL ME 1667 00:57:02,886 --> 00:57:05,855 WHAT YOU THINK I NEED TO KNOW 1668 00:57:05,922 --> 00:57:10,460 GOING FORWARD, AS WE BRING THIS 1669 00:57:10,527 --> 00:57:11,861 VERY COMPLEX INITIATIVE FORWARD. 1670 00:57:11,928 --> 00:57:14,130 SO ON BEHALF OF NCI'S 1671 00:57:14,197 --> 00:57:15,665 MULTI-CANCER DETECTION TRIAL 1672 00:57:15,732 --> 00:57:18,935 TEAM, WHICH IS QUITE A LARGE 1673 00:57:19,002 --> 00:57:20,537 TEAM, SPANNING NOT JUST THE 1674 00:57:20,603 --> 00:57:21,304 DIVISION CANCER PREVENTION BUT 1675 00:57:21,371 --> 00:57:22,472 WE HAVE MEMBERS FROM THE 1676 00:57:22,539 --> 00:57:25,074 DIVISION OF CANCER CONTROL AND 1677 00:57:25,141 --> 00:57:26,876 POPULATION SCIENCES, THE 1678 00:57:26,943 --> 00:57:28,244 DIVISION OF CANCER TREATMENT AND 1679 00:57:28,311 --> 00:57:31,981 DIAGNOSIS, WE HAVE MEMBERS FROM 1680 00:57:32,048 --> 00:57:33,550 THE CENTER FOR STRATEGIC 1681 00:57:33,616 --> 00:57:35,418 INITIATIVES, WE HAVE FDA 1682 00:57:35,485 --> 00:57:38,822 MEMBERS, CMS MEMBERS, MEMBERS 1683 00:57:38,888 --> 00:57:41,357 FROM THE OFFICE OF ADVOCACY 1684 00:57:41,424 --> 00:57:44,194 RELATIONS, AND THE OFFICE OF 1685 00:57:44,260 --> 00:57:47,263 COMMUNICATIONS. 1686 00:57:47,330 --> 00:57:49,065 SO TODAY'S TALK, I'M GOING TO 1687 00:57:49,132 --> 00:57:50,066 DIVIDE INTO A COUPLE OF 1688 00:57:50,133 --> 00:57:50,800 DIFFERENT SECTIONS. 1689 00:57:50,867 --> 00:57:52,569 FIRST WHAT ARE MULTI-CANCER 1690 00:57:52,635 --> 00:57:54,070 DETECTION ASSAYS? 1691 00:57:54,137 --> 00:57:56,239 WHY DOES NCI NEED TO STUDY 1692 00:57:56,306 --> 00:57:56,673 THESE? 1693 00:57:56,739 --> 00:57:58,341 SPECIFICALLY FOR CANCER 1694 00:57:58,408 --> 00:57:58,908 SCREENING. 1695 00:57:58,975 --> 00:57:59,976 THE DEVELOPMENT OF THE NEW 1696 00:58:00,043 --> 00:58:01,778 CANCER SCREENING RESEARCH 1697 00:58:01,845 --> 00:58:04,013 NETWORK, AND WHAT -- AND OUR 1698 00:58:04,080 --> 00:58:05,715 NEXT STEPS. 1699 00:58:05,782 --> 00:58:09,719 SO WHAT ARE THESE ASSAYS? 1700 00:58:09,786 --> 00:58:11,788 THEY'RE ESSENTIALLY BLOOD TESTS 1701 00:58:11,855 --> 00:58:14,190 THAT MEASURE DIFFERENT BIOLOGIC 1702 00:58:14,257 --> 00:58:15,291 SIGNALS IN YOUR BLOOD. 1703 00:58:15,358 --> 00:58:16,993 THESE SIGNALS COULD BE CHANGES 1704 00:58:17,060 --> 00:58:20,029 IN DNA SUCH AS METHYLATION, 1705 00:58:20,096 --> 00:58:21,698 FRAGMENTATION, MUTATIONS, DNA 1706 00:58:21,764 --> 00:58:22,966 MUTATIONS FROM TUMORS. 1707 00:58:23,032 --> 00:58:25,034 THEY COULD BE RNA, THEY COULD BE 1708 00:58:25,101 --> 00:58:26,936 PROTEIN BIOMARKERS, THEY CAN 1709 00:58:27,003 --> 00:58:28,705 EVEN BE COMBINATIONS OF THOSE, A 1710 00:58:28,771 --> 00:58:31,207 LITTLE BIT OF PROTEIN BIOMARKER, 1711 00:58:31,274 --> 00:58:34,043 A LITTLE BIT OF MUTATIONS, THROW 1712 00:58:34,110 --> 00:58:35,578 IN SOME METHYLATION, ADD IT 1713 00:58:35,645 --> 00:58:36,980 TOGETHER, THAT'S YOUR ASSAY. 1714 00:58:37,046 --> 00:58:38,715 OKAY? 1715 00:58:38,781 --> 00:58:40,683 THE PRESUMPTION IS THAT THE 1716 00:58:40,750 --> 00:58:42,752 CANCER CELLS SECRETE THIS OR 1717 00:58:42,819 --> 00:58:43,953 RELEASE THIS INTO BODY FLUIDS 1718 00:58:44,020 --> 00:58:46,222 THAT ARE MEASURABLE. 1719 00:58:46,289 --> 00:58:47,223 THEY'RE BEING DEVELOPED RIGHT 1720 00:58:47,290 --> 00:58:49,125 NOW TO SCREEN FOR MULTIPLE 1721 00:58:49,192 --> 00:58:51,628 DIFFERENT CANCERS WITH ONE BLOOD 1722 00:58:51,694 --> 00:58:53,830 TEST, WITH A SINGLE BLOOD TEST. 1723 00:58:53,897 --> 00:58:55,131 THERE ARE TWO PARTS TO THESE 1724 00:58:55,198 --> 00:58:55,732 ASSAYS. 1725 00:58:55,798 --> 00:58:56,866 THE FIRST PART IS THE 1726 00:58:56,933 --> 00:58:59,068 BIOCHEMICAL MEASUREMENT. 1727 00:58:59,135 --> 00:59:01,838 THE SECOND PART IS A SOFTWARE 1728 00:59:01,905 --> 00:59:03,139 ALGORITHM THAT THE COMPANIES 1729 00:59:03,206 --> 00:59:05,775 DEVELOP WHICH DETERMINES THE CUT 1730 00:59:05,842 --> 00:59:07,076 POINTS, WHAT'S A POSITIVE TEST 1731 00:59:07,143 --> 00:59:13,616 AND WHAT'S A NEGATIVE TEST. 1732 00:59:13,683 --> 00:59:15,652 SO IN THE PUBLIC DISCUSSION, 1733 00:59:15,718 --> 00:59:17,854 THESE ARE TYPICALLY CALLED 1734 00:59:17,921 --> 00:59:19,188 MULTI-CANCER EARLY DETECTION 1735 00:59:19,255 --> 00:59:22,125 ASSAYS. 1736 00:59:22,191 --> 00:59:24,727 AND AD AT SOME POINT EARLY ON WN 1737 00:59:24,794 --> 00:59:27,764 WE WERE TALKING, DR. DOUG LOWY 1738 00:59:27,830 --> 00:59:28,965 SUGGESTED THAT MAYBE WE DON'T 1739 00:59:29,032 --> 00:59:29,966 KNOW SPECIFICALLY THAT THESE 1740 00:59:30,033 --> 00:59:32,468 ASSAYS ARE, IN FACT, DETECTING 1741 00:59:32,535 --> 00:59:34,203 CANCER SUFFICIENTLY EARLY ENOUGH 1742 00:59:34,270 --> 00:59:37,073 TO MAKE A DIFFERENCE, SONIC IS 1743 00:59:37,140 --> 00:59:39,142 MOVING FORWARD CALLING THE 1744 00:59:39,208 --> 00:59:41,444 MULTI-CANCER DETECTION ASSAYS 1745 00:59:41,511 --> 00:59:44,914 UNTIL WE KNOW -- UNTIL WE HAVE 1746 00:59:44,981 --> 00:59:46,549 SUFFICIENT EVIDENCE THAT THEY 1747 00:59:46,616 --> 00:59:47,750 TRULY DIAGNOSE THEM AT EARLY 1748 00:59:47,817 --> 00:59:51,020 STAGES. 1749 00:59:51,087 --> 00:59:51,721 OKAY. 1750 00:59:51,788 --> 00:59:53,489 THIS IS A TABLE THAT IS NOT 1751 00:59:53,556 --> 00:59:54,590 INTENDED FOR YOU TO READ ALL OF 1752 00:59:54,657 --> 00:59:57,794 THE INFORMATION, BUT ON THE FAR 1753 00:59:57,860 --> 00:59:59,862 LEFT, YOU CAN SEE A VARIETY OF 1754 00:59:59,929 --> 01:00:00,330 DIFFERENT COMPANIES. 1755 01:00:00,396 --> 01:00:01,998 THERE ARE MULTIPLE DIFFERENT 1756 01:00:02,065 --> 01:00:04,500 COMPANIES DEVELOPING DIFFERENT 1757 01:00:04,567 --> 01:00:05,034 ASSAYS. 1758 01:00:05,101 --> 01:00:06,903 IN THE TECHNOLOGY SIDE, YOU CAN 1759 01:00:06,970 --> 01:00:08,071 SEE THAT THERE ARE VARIOUS 1760 01:00:08,137 --> 01:00:08,905 DIFFERENT TECHNOLOGIES. 1761 01:00:08,972 --> 01:00:11,040 THEY'RE NOT ALL THE SAME 1762 01:00:11,107 --> 01:00:12,575 TECHNOLOGY. 1763 01:00:12,642 --> 01:00:14,310 THIS TABLE WAS DEVELOPED BY 1764 01:00:14,377 --> 01:00:16,579 LOOKING AT PUBLICLY AVAILABLE 1765 01:00:16,646 --> 01:00:20,416 DATA, AND THEN ON THE RIGHT, YOU 1766 01:00:20,483 --> 01:00:22,919 SEE THE CANCER TYPE THAT EACH OF 1767 01:00:22,986 --> 01:00:26,155 THESE ASSAYS CLAIM TO DETECT. 1768 01:00:26,222 --> 01:00:27,256 OKAY? 1769 01:00:27,323 --> 01:00:29,759 SO THE KEY IS THAT IT'S A 1770 01:00:29,826 --> 01:00:30,626 PATCHWORK. 1771 01:00:30,693 --> 01:00:32,562 THEY DETECT DIFFERENT KINDS OF 1772 01:00:32,628 --> 01:00:34,297 CANCERS, SOME OF IT BASED UPON 1773 01:00:34,364 --> 01:00:35,531 THE DIFFERENT TECHNOLOGY THAT 1774 01:00:35,598 --> 01:00:41,838 THEY'RE USING. 1775 01:00:41,904 --> 01:00:44,640 SO YOU HAVE A BLOOD TEST, IT'S 1776 01:00:44,707 --> 01:00:46,409 RUN, AND IT'S POSITIVE. 1777 01:00:46,476 --> 01:00:47,744 WHAT DOES THAT MEAN? 1778 01:00:47,810 --> 01:00:50,079 DOES IT MEAN YOU HAVE CANCER? 1779 01:00:50,146 --> 01:00:51,614 IT'S A SIGNAL THAT YOU MIGHT 1780 01:00:51,681 --> 01:00:53,149 HAVE CANCER. 1781 01:00:53,216 --> 01:00:54,450 IT'S A PREDICTION THAT YOU MIGHT 1782 01:00:54,517 --> 01:00:55,852 HAVE CANCER. 1783 01:00:55,918 --> 01:00:58,121 SO IF YOU HAVE A POSITIVE 1784 01:00:58,187 --> 01:00:59,522 FINDING, THE NEXT THING YOU KNOW 1785 01:00:59,589 --> 01:01:02,058 IS THAT YOU'LL NEED ADDITIONAL 1786 01:01:02,125 --> 01:01:03,226 WORKUP. 1787 01:01:03,292 --> 01:01:06,195 IT'S NOT DIAGNOSTIC. 1788 01:01:06,262 --> 01:01:06,629 OKAY. 1789 01:01:06,696 --> 01:01:07,930 SO WHAT DOES IT MEAN? 1790 01:01:07,997 --> 01:01:11,334 A POSITIVE SIGNAL MEANS THAT YOU 1791 01:01:11,401 --> 01:01:13,503 WILL NEED ADDITIONAL DIAGNOSTIC 1792 01:01:13,569 --> 01:01:14,070 FOLLOW-UP. 1793 01:01:14,137 --> 01:01:16,539 THERE MIGHT BE CANCER. 1794 01:01:16,606 --> 01:01:19,142 IN POINTING TO WHAT DIAGNOSTIC 1795 01:01:19,208 --> 01:01:21,210 WORKUP YOU HAVE, THERE ARE TWO 1796 01:01:21,277 --> 01:01:24,580 WAY FOS S TO GO ABOUT IT. 1797 01:01:24,647 --> 01:01:26,182 IF YOU'RE A WOMAN AND YOU HAVE A 1798 01:01:26,249 --> 01:01:28,151 MAMMOGRAM, AND YOU HAVE A 1799 01:01:28,217 --> 01:01:30,219 ABNORMALITY ON YOUR MAMMOGRAM, 1800 01:01:30,286 --> 01:01:32,622 TYPICALLY YOU'LL HAVE ADDITIONAL 1801 01:01:32,688 --> 01:01:34,357 BREAST IMAGING OR YOU'LL HAVE A 1802 01:01:34,424 --> 01:01:35,992 BIOPSY AND BASED UPON THAT 1803 01:01:36,059 --> 01:01:37,760 IMAGE, THE DOCTOR WILL KNOW 1804 01:01:37,827 --> 01:01:39,128 WHERE TO BIOPSY. 1805 01:01:39,195 --> 01:01:40,997 BUT YOU'VE GOT A BLOOD TEST 1806 01:01:41,064 --> 01:01:43,166 THAT'S POSITIVE, WHERE DO YOU 1807 01:01:43,232 --> 01:01:43,499 BEGIN? 1808 01:01:43,566 --> 01:01:48,071 SOME OF THESE ASSAYS POINT TO A 1809 01:01:48,137 --> 01:01:50,139 SPECIFIC ORGAN TO START YOUR 1810 01:01:50,206 --> 01:01:50,907 DIAGNOSTIC WORKUP. 1811 01:01:50,973 --> 01:01:52,809 SO THEY'LL SAY IT'S A POSITIVE 1812 01:01:52,875 --> 01:01:56,813 TEST AND THE FIRST PREDICTOR OR 1813 01:01:56,879 --> 01:01:58,648 ORGAN TO LOOK AT IS BREAST. 1814 01:01:58,714 --> 01:02:00,183 MAYBE SECOND IS COLON. 1815 01:02:00,249 --> 01:02:02,418 MAYBE THIRD IS SOMETHING ELSE. 1816 01:02:02,485 --> 01:02:04,487 SO THAT THE PHYSICIAN HAS SOME 1817 01:02:04,554 --> 01:02:06,155 AREA TO START THAT DIAGNOSTIC 1818 01:02:06,222 --> 01:02:08,057 WORKUP. 1819 01:02:08,124 --> 01:02:09,425 OTHERS DON'T GIVE YOU A TISSUE 1820 01:02:09,492 --> 01:02:12,228 OF ORIGIN PREDICTION. 1821 01:02:12,295 --> 01:02:13,863 THE NEXT STEP, THEN, IS WHOLE 1822 01:02:13,930 --> 01:02:14,430 BODY IMAGING. 1823 01:02:14,497 --> 01:02:16,399 THAT CAN BE A WHOLE BODY MRI, 1824 01:02:16,466 --> 01:02:19,669 THAT CAN BE A PET CT. 1825 01:02:19,735 --> 01:02:29,145 THAT'S THE NEXT STEP. 1826 01:02:29,212 --> 01:02:29,712 OKAY. 1827 01:02:29,779 --> 01:02:31,647 WHAT DOES A NEGATIVE TEST MEAN? 1828 01:02:31,714 --> 01:02:34,383 A NEGATIVE TEST MEANS EITHER 1829 01:02:34,450 --> 01:02:37,320 THAT THERE IS NO SIGNAL THAT IS 1830 01:02:37,386 --> 01:02:38,621 MEASURED, THOSE BIOCHEMICAL 1831 01:02:38,688 --> 01:02:40,022 MEASUREMENTS WERE NOT FOUND IN 1832 01:02:40,089 --> 01:02:41,157 BLOOD AT THE TIME THEY WERE 1833 01:02:41,224 --> 01:02:42,658 DRAWN AND AT THE TIME THE ASSAY 1834 01:02:42,725 --> 01:02:45,061 WAS RUN. 1835 01:02:45,128 --> 01:02:46,262 OR THERE WAS A LITTLE BIT OF A 1836 01:02:46,329 --> 01:02:48,664 SIGNAL BUT IT DIDN'T REACH THAT 1837 01:02:48,731 --> 01:02:48,931 CUT POINT. 1838 01:02:48,998 --> 01:02:50,700 THINK OF A PSA. 1839 01:02:50,766 --> 01:02:55,538 A PSA OF 1 AS OPPOSED TO 5. 1840 01:02:55,605 --> 01:02:56,739 DOES A NEGATIVE TEST MEAN 1841 01:02:56,806 --> 01:02:57,707 THERE'S NO CANCER? 1842 01:02:57,773 --> 01:03:00,309 THERE ARE A COUPLE OF 1843 01:03:00,376 --> 01:03:01,944 PUBLICATIONS OUT THERE, THE 1844 01:03:02,011 --> 01:03:04,447 LARGEST ONE RIGHT NOW IS A PATH 1845 01:03:04,514 --> 01:03:06,716 PATHFINDER STUDY WHICH WAS 1846 01:03:06,782 --> 01:03:07,783 PUBLISHED IN AUGUST IN LANCET 1847 01:03:07,850 --> 01:03:08,885 AND THERE WERE, IN FACT, 1848 01:03:08,951 --> 01:03:10,286 PARTICIPANTS THAT WERE DIAGNOSED 1849 01:03:10,353 --> 01:03:11,821 WITHIN A YEAR OF HAVING THAT 1850 01:03:11,888 --> 01:03:14,457 WITH A CANCER. 1851 01:03:14,524 --> 01:03:16,292 SO A NEGATIVE TEST DOESN'T 1852 01:03:16,359 --> 01:03:16,893 NECESSARILY INDICATE THAT YOU 1853 01:03:16,959 --> 01:03:20,663 DON'T HAVE CANCER. 1854 01:03:20,730 --> 01:03:22,064 GOING BACK TO OUR SLIDE WITH THE 1855 01:03:22,131 --> 01:03:25,234 DIFFERENT TECHNOLOGIES, MAYBE 1856 01:03:25,301 --> 01:03:27,370 THE CANCER TYPE THAT PERSON 1857 01:03:27,436 --> 01:03:28,905 DEVELOPED JUST WAS NOT 1858 01:03:28,971 --> 01:03:39,282 MEASURABLE BY THAT TECHNOLOGY. 1859 01:03:39,348 --> 01:03:39,615 OKAY. 1860 01:03:39,682 --> 01:03:41,684 ARE THERE QUESTIONS SO FAR? 1861 01:03:41,751 --> 01:03:43,219 IT COMPLICATED, IT REALLY IS. 1862 01:03:43,286 --> 01:03:45,521 SO WHY DOES NCI NEED TO STUDY 1863 01:03:45,588 --> 01:03:46,455 THESE SPECIFICALLY FOR CANCER 1864 01:03:46,522 --> 01:03:50,159 SCREENING? 1865 01:03:50,226 --> 01:03:51,194 THIS SHOULD BE PRETTY FAMILIAR 1866 01:03:51,260 --> 01:03:52,461 TO MOST OF YOU AROUND THE TABLE. 1867 01:03:52,528 --> 01:03:53,563 WE KNOW THAT THERE'S CANCER 1868 01:03:53,629 --> 01:03:55,498 SCREENING THAT EXISTS FOR A 1869 01:03:55,565 --> 01:03:57,667 HANDFUL OF DISEASES. 1870 01:03:57,733 --> 01:03:59,635 FOR BREAST CANCER, PROSTATE 1871 01:03:59,702 --> 01:04:02,939 CANCER, LUNG CANCER, COLORECTAL, 1872 01:04:03,005 --> 01:04:03,839 CERVICAL CANCER. 1873 01:04:03,906 --> 01:04:07,743 AND YOU CAN SEE THAT TYPICALLY 1874 01:04:07,810 --> 01:04:09,111 THE MOST COMMON CANCERS ARE THE 1875 01:04:09,178 --> 01:04:10,913 ONES THAT WE SCREEN FOR. 1876 01:04:10,980 --> 01:04:16,886 WE ALSO KNOW THAT THESE CANCER 1877 01:04:16,953 --> 01:04:19,855 ARE RESPONSIBLE FOR SOME OF THE 1878 01:04:19,922 --> 01:04:21,123 LARGEST MORTALITY, LUNG CANCER 1879 01:04:21,190 --> 01:04:22,091 BEING THE CANCER ON THIS LIST 1880 01:04:22,158 --> 01:04:25,027 THAT HAS THE LARGEST AMOUNT, 1881 01:04:25,094 --> 01:04:27,763 THAT CONTRIBUTED THE MOST TO 1882 01:04:27,830 --> 01:04:31,367 CANCER MORTALITY. 1883 01:04:31,434 --> 01:04:32,468 BUT WE ALSO KNOW THAT MORE THAN 1884 01:04:32,535 --> 01:04:35,171 HALF THE CANCER DEATHS ARE FROM 1885 01:04:35,238 --> 01:04:37,273 SITES, OR ORGAN SITES, THAT HAVE 1886 01:04:37,340 --> 01:04:38,574 NO SCREENING TESTS AT ALL, 1887 01:04:38,641 --> 01:04:40,309 INCLUDING DEADLY CANCERS SUCH AS 1888 01:04:40,376 --> 01:04:42,211 PANCREATIC AND OVARIAN CANCER. 1889 01:04:42,278 --> 01:04:43,913 SO WE NEED MORE SCREENING TESTS. 1890 01:04:43,980 --> 01:04:45,781 AND WE NEED EASY SCREENING 1891 01:04:45,848 --> 01:04:48,150 TESTS. 1892 01:04:48,217 --> 01:04:50,786 HOW COULD THESE POTENTIALLY HELP 1893 01:04:50,853 --> 01:04:52,555 US? 1894 01:04:52,622 --> 01:04:54,257 SCREENS AT ORGAN SITES 1895 01:04:54,323 --> 01:04:55,324 CURRENTLY -- WE COULD 1896 01:04:55,391 --> 01:04:56,425 POTENTIALLY SCREEN FOR MULTIPLE 1897 01:04:56,492 --> 01:04:57,627 ORGAN SITES THAT WE DON'T HAVE 1898 01:04:57,693 --> 01:04:58,861 SCREENING FOR, AND THAT'S A GOOD 1899 01:04:58,928 --> 01:05:00,496 THING. 1900 01:05:00,563 --> 01:05:02,565 THESE TESTS MAY POTENTIALLY 1901 01:05:02,632 --> 01:05:04,100 DETECT CANCERS THAT ARE HARD TO 1902 01:05:04,166 --> 01:05:04,667 IDENTIFY. 1903 01:05:04,734 --> 01:05:07,670 THEY MAY ALSO POTENTIALLY 1904 01:05:07,737 --> 01:05:08,638 IDENTIFY CANCERS FROM DIFFERENT 1905 01:05:08,704 --> 01:05:11,674 SITES IN A SIMPLE, CONVENIENT, 1906 01:05:11,741 --> 01:05:12,341 EASY WAY. 1907 01:05:12,408 --> 01:05:14,644 AND MANY OF YOU MAY HAVE HEARD 1908 01:05:14,710 --> 01:05:16,912 "IT'S JUST A BLOOD TEST." 1909 01:05:16,979 --> 01:05:18,748 AND THEY RELY ON A BLOOD DRAW 1910 01:05:18,814 --> 01:05:21,150 THAT MAY BE VERY ACCEPTABLE TO 1911 01:05:21,217 --> 01:05:22,785 PATIENTS AS OPPOSED TO A 1912 01:05:22,852 --> 01:05:24,287 COLONOSCOPY, AS OPPOSED TO SOME 1913 01:05:24,353 --> 01:05:26,055 OTHER TEST THAT'S A BIT MORE 1914 01:05:26,122 --> 01:05:28,257 CHALLENGING TO GET. 1915 01:05:28,324 --> 01:05:31,160 BUT DO WE KNOW ENOUGH ABOUT 1916 01:05:31,227 --> 01:05:33,062 THESE ASSAYS AND HOW THEY WORK 1917 01:05:33,129 --> 01:05:35,665 TO SAY, YES, LET'S PUT THEM OUT 1918 01:05:35,731 --> 01:05:37,400 THERE TOMORROW? 1919 01:05:37,466 --> 01:05:39,468 IS THERE ENOUGH FOR THESE TO BE 1920 01:05:39,535 --> 01:05:44,173 USED TODAY IN PRACTICE? 1921 01:05:44,240 --> 01:05:45,241 THERE'S STILL A LOT OF 1922 01:05:45,308 --> 01:05:45,908 UNANSWERED QUESTIONS. 1923 01:05:45,975 --> 01:05:47,643 WILL USING THESE TESTS IN PEOPLE 1924 01:05:47,710 --> 01:05:49,045 WITHOUT SYMPTOMS SAVE LIVES? 1925 01:05:49,111 --> 01:05:51,347 WILL IT ACTUALLY REDUCE CANCER 1926 01:05:51,414 --> 01:05:54,317 MORTALITY? 1927 01:05:54,383 --> 01:05:55,818 WHAT KIND AND HOW MANY 1928 01:05:55,885 --> 01:05:57,687 DIAGNOSTIC TESTS ARE NEEDED FOR 1929 01:05:57,753 --> 01:05:58,120 DIAGNOSIS? 1930 01:05:58,187 --> 01:05:58,754 DO WE KNOW? 1931 01:05:58,821 --> 01:05:59,955 DOES IT DIFFER BY ORGAN SITE? 1932 01:06:00,022 --> 01:06:03,659 WHAT HAPPENS IF YOU HAVE A 1933 01:06:03,726 --> 01:06:06,062 POSITIVE MCD ASSAY, YOU GO 1934 01:06:06,128 --> 01:06:07,163 THROUGH THE WORKUP AND THERE'S 1935 01:06:07,229 --> 01:06:08,664 NO CANCER, AND ABOUT TWO THIRDS 1936 01:06:08,731 --> 01:06:09,432 OF THE PATIENTS IN THE 1937 01:06:09,498 --> 01:06:10,966 LITERATURE WILL HAVE NO CANCER 1938 01:06:11,033 --> 01:06:13,269 AFTER A POSITIVE TEST. 1939 01:06:13,336 --> 01:06:15,171 SOME OF THE COMPANIES ARE SAYING 1940 01:06:15,237 --> 01:06:17,807 DO A BLOOD TEST EVERY SIX 1941 01:06:17,873 --> 01:06:18,374 MONTHS. 1942 01:06:18,441 --> 01:06:20,343 SOME CLINICS ARE BEING SET UP TO 1943 01:06:20,409 --> 01:06:23,379 SAY LET'S IMAGE PEOPLE ON AN 1944 01:06:23,446 --> 01:06:24,780 ONGOING BASIS, LET'S FIND OUT 1945 01:06:24,847 --> 01:06:25,781 WHAT'S GOING ON. 1946 01:06:25,848 --> 01:06:29,018 HOW SOON AFTER A POSITIVE WITH A 1947 01:06:29,085 --> 01:06:30,653 NEGATIVE WORKUP DO YOU FIND 1948 01:06:30,720 --> 01:06:33,622 CANCER? 1949 01:06:33,689 --> 01:06:34,857 HOW MANY PEOPLE WILL BE 1950 01:06:34,924 --> 01:06:38,060 SUBJECTED TO UNNECESSARY 1951 01:06:38,127 --> 01:06:39,695 INVASIVE PROCEDURES IN ORDER TO 1952 01:06:39,762 --> 01:06:40,696 FIND OUT WHETHER OR NOT THEY 1953 01:06:40,763 --> 01:06:42,131 HAVE CANCER? 1954 01:06:42,198 --> 01:06:43,632 WILL PEOPLE STOP USING STANDARD 1955 01:06:43,699 --> 01:06:45,267 OF CARE SCREENING IN THE FACE OF 1956 01:06:45,334 --> 01:06:46,669 A NEGATIVE TEST? 1957 01:06:46,736 --> 01:06:48,104 I HAVE A NEGATIVE TEST, DO I 1958 01:06:48,170 --> 01:06:50,272 NEED THAT MAMMOGRAM? 1959 01:06:50,339 --> 01:06:52,441 WILL A BLOOD TEST MAKE SCREENING 1960 01:06:52,508 --> 01:06:55,411 MORE ACCESSIBLE OR EXACERBATE 1961 01:06:55,478 --> 01:06:57,279 DISPARITIES? 1962 01:06:57,346 --> 01:06:58,681 A BLOOD TEST IS EASY TO DO. 1963 01:06:58,748 --> 01:07:00,783 A FOLLOW-UP MRI MAY NOT BE SO 1964 01:07:00,850 --> 01:07:01,617 EASY TO DO. 1965 01:07:01,684 --> 01:07:04,019 SO WILL WE MAKE IT EASIER OR 1966 01:07:04,086 --> 01:07:06,122 WILL WE MAKE IT HARDER AND WILL 1967 01:07:06,188 --> 01:07:08,391 WE DROP OFF IN TERMS OF THE 1968 01:07:08,457 --> 01:07:09,692 DIAGNOSTIC WORKUP? 1969 01:07:09,759 --> 01:07:12,294 AND THEN WILL THESE ASSAYS LEAD 1970 01:07:12,361 --> 01:07:14,029 TO OVERDIAGNOSIS OF MORE 1971 01:07:14,096 --> 01:07:15,364 INDOLENT CANCERS OR WILL THEY 1972 01:07:15,431 --> 01:07:17,867 REALLY HELP US FIND THE MORE 1973 01:07:17,933 --> 01:07:19,268 AGGRESSIVE CANCERS THAT IF WE 1974 01:07:19,335 --> 01:07:20,469 INTERVENE, CAN MAKE A HUGE 1975 01:07:20,536 --> 01:07:21,003 DIFFERENCE? 1976 01:07:21,070 --> 01:07:25,908 WE DON'T KNOW THE ANSWER. 1977 01:07:25,975 --> 01:07:27,343 AND SOME ADDITIONAL TESTS, THERE 1978 01:07:27,410 --> 01:07:28,644 ARE FALSE NEGATIVES THAT WE NEED 1979 01:07:28,711 --> 01:07:29,078 TO UNDERSTAND. 1980 01:07:29,145 --> 01:07:30,579 THERE ARE FALSE POSITIVE RESULTS 1981 01:07:30,646 --> 01:07:32,014 THAT WE NEED TO UNDERSTAND. 1982 01:07:32,081 --> 01:07:35,518 NOW THESE ALREADY EXIST FOR 1983 01:07:35,584 --> 01:07:38,120 COLONOSCOPY, FORFEIT TESTS, FOR 1984 01:07:38,187 --> 01:07:39,588 MAMMOGRAMS, FOR PSA, BUT WE 1985 01:07:39,655 --> 01:07:42,625 UNDERSTAND HOW TO USE THEM IN A 1986 01:07:42,691 --> 01:07:43,826 WAY BECAUSE THERE'S SUFFICIENT 1987 01:07:43,893 --> 01:07:46,195 DATA OUT THERE. 1988 01:07:46,262 --> 01:07:47,530 AND THEN THERE'S THE POSSIBILITY 1989 01:07:47,596 --> 01:07:49,365 THAT EARLY DETECTION MAY NOT 1990 01:07:49,432 --> 01:07:50,466 MAKE A DIFFERENCE BECAUSE OUR 1991 01:07:50,533 --> 01:07:51,767 TREATMENT JUST ISN'T GOOD ENOUGH 1992 01:07:51,834 --> 01:07:52,768 RIGHT NOW. 1993 01:07:52,835 --> 01:07:56,372 AND HOW DOES THAT IMPACT, AND 1994 01:07:56,439 --> 01:07:57,373 WE'LL TALK A LITTLE BIT MORE 1995 01:07:57,440 --> 01:07:59,775 ABOUT THAT. 1996 01:07:59,842 --> 01:08:03,145 THE CURRENT STATUS OF THESE 1997 01:08:03,212 --> 01:08:04,780 ASSAYS TODAY, THE FOOD AND DRUG 1998 01:08:04,847 --> 01:08:06,415 ADMINISTRATION HAS NOT GIVEN 1999 01:08:06,482 --> 01:08:08,818 MARKET AUTHORIZATION TO ANY OF 2000 01:08:08,884 --> 01:08:10,319 THESE MCD ASSAYS. 2001 01:08:10,386 --> 01:08:12,822 THE MCD ASSAYS ARE NOT 2002 01:08:12,888 --> 01:08:15,024 REIMBURSED BY THE CENTERS FOR 2003 01:08:15,090 --> 01:08:16,859 MEDICARE, MEDICAID SERVICES, AND 2004 01:08:16,926 --> 01:08:19,061 IN A RECENT STUDY OF ABOUT 19 2005 01:08:19,128 --> 01:08:21,363 MAJOR PAYORS, NONE OF THEM HAVE 2006 01:08:21,430 --> 01:08:23,732 REPORTED COVERING. 2007 01:08:23,799 --> 01:08:24,867 SOME HOSPITAL SYSTEMS ARE 2008 01:08:24,934 --> 01:08:26,902 STARTING TO COVER IT KNOWING 2009 01:08:26,969 --> 01:08:29,305 THAT THEY WILL COVER THE WORKUP 2010 01:08:29,371 --> 01:08:32,141 WITHIN THEIR SYSTEM. 2011 01:08:32,208 --> 01:08:34,543 BUT THERE'S STILL -- IT STILL 2012 01:08:34,610 --> 01:08:34,877 EVOLVING. 2013 01:08:34,944 --> 01:08:36,412 AND THEN THERE ARE NO PRACTICE 2014 01:08:36,479 --> 01:08:37,046 GUIDELINES. 2015 01:08:37,112 --> 01:08:38,481 THERE ARE NO CLINICAL PRACTICE 2016 01:08:38,547 --> 01:08:40,115 GUIDELINES BECAUSE THERE'S 2017 01:08:40,182 --> 01:08:42,384 INSUFFICIENT DATA AT THIS TIME. 2018 01:08:42,451 --> 01:08:43,686 FOR DEVELOPMENT OF PRACTICE 2019 01:08:43,752 --> 01:08:48,524 GUIDELINES. 2020 01:08:48,591 --> 01:08:49,525 WHAT DO WE HAVE IN THE 2021 01:08:49,592 --> 01:08:50,593 LITERATURE TO DATE? 2022 01:08:50,659 --> 01:08:55,464 SO TWO OF THE PEOPLE ON OUR TE 2023 01:08:55,531 --> 01:09:01,637 TEAM, ELYSE LEEVAN, AND PAUL P 2024 01:09:01,704 --> 01:09:03,439 PINSKY, WHO HAS EXTENSIVE CANCER 2025 01:09:03,506 --> 01:09:05,307 VEENING EXPERTISE AND HAS BEEN 2026 01:09:05,374 --> 01:09:08,043 INVOLVED IN OUR STUDY, DID A 2027 01:09:08,110 --> 01:09:09,678 LITERATURE REVIEW LAST SUMMER 2028 01:09:09,745 --> 01:09:13,382 WHERE THEY LOOKED AT ALL OF THE 2029 01:09:13,449 --> 01:09:14,683 LITERATURE, THEY DID A 2030 01:09:14,750 --> 01:09:17,086 SYSTEMATIC REVIEW FOR THE 2031 01:09:17,152 --> 01:09:18,053 PREDICTIVE PERFORMANCE OF 2032 01:09:18,120 --> 01:09:20,155 CELL-FREE NUCLEIC ACIDS, WHAT DO 2033 01:09:20,222 --> 01:09:22,758 YOU SEE WITH THESE ASSAYS THAT 2034 01:09:22,825 --> 01:09:25,794 MEASURE NUCLEIC ACID? 2035 01:09:25,861 --> 01:09:28,564 AND TO DATE, THERE ARE ACTUALLY 2036 01:09:28,631 --> 01:09:29,632 RELATIVELY FEW PUBLISHED STUDIES 2037 01:09:29,698 --> 01:09:29,965 OUT THERE. 2038 01:09:30,032 --> 01:09:32,134 MOST OF THESE, WHEN YOU ACTUALLY 2039 01:09:32,201 --> 01:09:33,335 LOOK AT THE TABLE THAT THEY 2040 01:09:33,402 --> 01:09:35,905 CREATED, MOST OF THESE TESTS 2041 01:09:35,971 --> 01:09:37,373 ACTUALLY DETECT LATE-STAGE FAR 2042 01:09:37,439 --> 01:09:39,542 BETTER THAN EARLIER STAGE. 2043 01:09:39,608 --> 01:09:41,410 AND EVEN FOR THOSE CANCER TYPES, 2044 01:09:41,477 --> 01:09:43,913 WHEN AN MCD SAID THEY DETECT 2045 01:09:43,979 --> 01:09:45,314 FIVE DIFFERENT CANCER TYPES, THE 2046 01:09:45,381 --> 01:09:46,649 SENSITIVITY FOR EACH OF THOSE 2047 01:09:46,715 --> 01:09:49,118 CANCER TYPES WAS DIFFERENT. 2048 01:09:49,184 --> 01:09:52,321 AND IT DIFFERS BY STAGE AS WELL. 2049 01:09:52,388 --> 01:10:01,397 SO IT'S VERY COMPLEX. 2050 01:10:01,463 --> 01:10:09,338 THE HALLMARK OF THE SI CINQUINOE 2051 01:10:09,405 --> 01:10:11,440 IS THAT YOU SCREEN A POPULATION 2052 01:10:11,507 --> 01:10:12,441 BECAUSE ULTIMATELY THAT 2053 01:10:12,508 --> 01:10:13,742 SCREENING PROCESS WILL LEAD TO A 2054 01:10:13,809 --> 01:10:16,045 REDUCTION IN MORTALITY FROM THAT 2055 01:10:16,111 --> 01:10:16,478 DISEASE. 2056 01:10:16,545 --> 01:10:18,647 THAT'S WHY YOU INVEST IN 2057 01:10:18,714 --> 01:10:22,318 POPULATION-BASED SCREENING. 2058 01:10:22,384 --> 01:10:23,953 SO THE QUESTION WE DON'T KNOW IS 2059 01:10:24,019 --> 01:10:25,354 WILL SCREENING PEOPLE WITH THESE 2060 01:10:25,421 --> 01:10:26,555 TESTS ACTUALLY REDUCE DEATHS 2061 01:10:26,622 --> 01:10:30,392 FROM CANCER? 2062 01:10:30,459 --> 01:10:31,460 AND IN ORDER TO ACHIEVE THIS 2063 01:10:31,527 --> 01:10:32,895 GOAL, YOU REALLY NEED TO BE ABLE 2064 01:10:32,962 --> 01:10:39,001 TO DETECT EARLY STAGE OPTIMALLY. 2065 01:10:39,068 --> 01:10:41,971 SO WITH ALL OF THESE, DETECTING 2066 01:10:42,037 --> 01:10:43,172 EARLY STAGE HAS LOWER 2067 01:10:43,238 --> 01:10:44,273 SENSITIVITY THAN IN LATE STAGE. 2068 01:10:44,340 --> 01:10:45,641 IT MAY BE GOOD ENOUGH BUT IT 2069 01:10:45,708 --> 01:10:47,643 STILL LOWER. 2070 01:10:47,710 --> 01:10:49,612 AND IF THEY DON'T DO -- IF THESE 2071 01:10:49,678 --> 01:10:51,680 ASSAYS DON'T DO A GOOD JOB OR 2072 01:10:51,747 --> 01:10:54,316 DON'T DO A SUFFICIENTLY GOOD JOB 2073 01:10:54,383 --> 01:10:56,352 OF DETECTING THE CANCER AT THE 2074 01:10:56,418 --> 01:10:57,886 EARLIEST STAGE OR AT THE STAGE 2075 01:10:57,953 --> 01:11:01,190 IT'S TREATABLE, WILL IT, IN 2076 01:11:01,256 --> 01:11:03,492 FACT, HELP REDUCE DEATH AND 2077 01:11:03,559 --> 01:11:04,560 SUFFERING FROM CANCER? 2078 01:11:04,627 --> 01:11:06,195 AND REMEMBER, THESE DIFFERENT 2079 01:11:06,261 --> 01:11:07,396 CANCERS THAT WE'RE TALKING ABOUT 2080 01:11:07,463 --> 01:11:09,031 HAVE DIFFERENT NATURAL 2081 01:11:09,098 --> 01:11:09,498 HISTORIES. 2082 01:11:09,565 --> 01:11:12,434 THE NATURAL HISTORY FOR PROSTATE 2083 01:11:12,501 --> 01:11:14,169 CANCER IS VERY DIFFERENT THAN 2084 01:11:14,236 --> 01:11:17,339 THE NATURAL HISTORY FOR PAN 2085 01:11:17,406 --> 01:11:18,207 KREETIVE CANCER, OVARIAN CANCER. 2086 01:11:18,273 --> 01:11:19,708 SO THEY'RE NOT APPLES TO APPLES. 2087 01:11:19,775 --> 01:11:20,943 THEY'RE NOT EVEN DIFFERENT 2088 01:11:21,010 --> 01:11:22,478 FLAVORS OF APPLES. 2089 01:11:22,544 --> 01:11:24,413 THEY'RE APPLES AND ORANGES AND 2090 01:11:24,480 --> 01:11:31,520 THROW IN A TOMATO FOR GOOD 2091 01:11:31,587 --> 01:11:31,854 MEASURE. 2092 01:11:31,920 --> 01:11:33,055 YOU KNOW THEY HAVE DIFFERENT 2093 01:11:33,122 --> 01:11:33,722 NATURAL HISTORIES. 2094 01:11:33,789 --> 01:11:36,325 SO IT'S NOT ENOUGH TO JUST SAY 2095 01:11:36,392 --> 01:11:37,860 THEY MOVE FROM STAGE IV TO STAGE 2096 01:11:37,926 --> 01:11:39,495 III FOR ALL THESE DIFFERENT 2097 01:11:39,561 --> 01:11:39,928 CANCERS. 2098 01:11:39,995 --> 01:11:41,263 BECAUSE THE PROGNOSIS OF A 2099 01:11:41,330 --> 01:11:43,999 PATIENT WITH PANCREATIC CANCER 2100 01:11:44,066 --> 01:11:45,601 STAGE III IS DIFFERENT THAN THAT 2101 01:11:45,668 --> 01:11:47,503 PROGNOSIS FOR A PANCREATIC 2102 01:11:47,569 --> 01:11:52,174 CANCER PATIENT, PROSTATE CANCER 2103 01:11:52,241 --> 01:11:53,342 OR LYMPHOMA, VERY DIFFERENT. 2104 01:11:53,409 --> 01:11:54,510 SO HOW DO YOU PUT THEM ALL 2105 01:11:54,576 --> 01:11:54,843 TOGETHER? 2106 01:11:54,910 --> 01:11:55,711 THAT'S THE QUESTION. 2107 01:11:55,778 --> 01:12:01,283 AND THEN JUST TO MAKE THE POINT 2108 01:12:01,350 --> 01:12:07,089 A LITTLE BIT MORE, IN THE 2109 01:12:07,156 --> 01:12:09,725 PROSTATE CANCER LUNG AND 2110 01:12:09,792 --> 01:12:10,693 PREVENTION STUDY WHICH WAS 2111 01:12:10,759 --> 01:12:12,327 STARTED OUT IN THE 90s AND 2112 01:12:12,394 --> 01:12:14,296 REPORTED OUT IN THE 2010s, WE 2113 01:12:14,363 --> 01:12:17,900 SHOWED FROM THE U.S. STUDY THAT 2114 01:12:17,966 --> 01:12:24,239 SCREENING WOMEN WITH 2115 01:12:24,306 --> 01:12:26,341 TRANSVAGINAL ULTRASOUNDS AND 2116 01:12:26,408 --> 01:12:28,177 C125 DID NOT WORK, IT DID NOT 2117 01:12:28,243 --> 01:12:31,980 REDUCE MORTALITY BUT ABOUT HALF 2118 01:12:32,047 --> 01:12:33,849 OF THE WOMEN IN THE STUDY 2119 01:12:33,916 --> 01:12:35,617 ALREADY HAD OVARIES REMOVED, 2120 01:12:35,684 --> 01:12:37,886 SO -- BUT THE UK RAN A VERY 2121 01:12:37,953 --> 01:12:40,222 LARGE CANCER SCREENING STUDY 2122 01:12:40,289 --> 01:12:41,757 LOOKING AT OVARIAN CANCER, 2123 01:12:41,824 --> 01:12:43,058 LOOKING AT WOMEN, GENERAL 2124 01:12:43,125 --> 01:12:44,693 POPULATION, NOT HIGH RISK WOMEN, 2125 01:12:44,760 --> 01:12:46,995 GENERAL POPULATION WOMEN, WHERE 2126 01:12:47,062 --> 01:12:49,631 THEY RECRUITED OVER 200 THOWL 2127 01:12:49,698 --> 01:12:51,800 WOMEN, AND FOLLOWED THEM. 2128 01:12:51,867 --> 01:12:55,804 USED AN ALGORITHM THAT LOOKED AT 2129 01:12:55,871 --> 01:12:57,673 CL125 FIRST AND IT WAS ABNORMAL, 2130 01:12:57,740 --> 01:13:00,275 WENT ON TO HAVE A TRANSVAGINAL 2131 01:13:00,342 --> 01:13:01,610 ULTRASOUND, AND SHOWED THAT YOU 2132 01:13:01,677 --> 01:13:03,245 COULD SHIFT FROM LATE STAGE TO 2133 01:13:03,312 --> 01:13:04,546 EARLY STAGE OVARIAN CANCER. 2134 01:13:04,613 --> 01:13:06,982 WE ACTUALLY DID SHOW YOU REDUCE 2135 01:13:07,049 --> 01:13:08,817 THE NUMBER OF LATE STAGE DISEASE 2136 01:13:08,884 --> 01:13:10,119 AND INCREASE THE NUMBER OF EARLY 2137 01:13:10,185 --> 01:13:11,453 STAGE DISEASE, FOR WHICH THOSE 2138 01:13:11,520 --> 01:13:12,755 WOMEN THEN GOT TREATED. 2139 01:13:12,821 --> 01:13:17,359 BUT IT DID NOT CHANGE MORTALITY. 2140 01:13:17,426 --> 01:13:19,161 IF THIS STUDY WERE RUN TODAY, 2141 01:13:19,228 --> 01:13:22,030 MAYBE THINGS WOULD BE A LITTLE 2142 01:13:22,097 --> 01:13:26,068 BIT DIFFERENT BECAUSE THIS IS 2143 01:13:26,135 --> 01:13:33,809 ALL DRIVEN WHICH ABOUT HYBRID 2144 01:13:33,876 --> 01:13:35,010 SEROUS OVARIAN CANCER WHEN THIS 2145 01:13:35,077 --> 01:13:35,778 STUDY STARTED. 2146 01:13:35,844 --> 01:13:36,979 WE DIDN'T EVEN REALLY UNDERSTAND 2147 01:13:37,045 --> 01:13:40,149 HOW TO TREAT IT, WE KNOW BETTER 2148 01:13:40,215 --> 01:13:43,118 NOW BUT SO AT THIS POINT IN 2149 01:13:43,185 --> 01:13:45,053 TIME, WHAT WE HAVE IS THE U.S. 2150 01:13:45,120 --> 01:13:46,088 PREVENTIVE SERVICES TASK FORCE 2151 01:13:46,155 --> 01:13:47,489 HAS RECOMMENDED NO SCREENING FOR 2152 01:13:47,556 --> 01:13:48,791 AVERAGE RISK WOMEN FOR OVARIAN 2153 01:13:48,857 --> 01:13:50,425 CANCER. 2154 01:13:50,492 --> 01:13:51,860 SO THAT'S SORT OF THE EVIDENCE 2155 01:13:51,927 --> 01:13:54,696 BASE THAT IS USED TO GENERATE 2156 01:13:54,763 --> 01:14:00,602 POLICIES AND GUIDELINES. 2157 01:14:00,669 --> 01:14:01,870 SO HOW ARE WE NOW ADDRESSING 2158 01:14:01,937 --> 01:14:02,337 THIS? 2159 01:14:02,404 --> 01:14:03,772 KNOWING THAT WE BASICALLY NEED 2160 01:14:03,839 --> 01:14:06,809 TO GENERATE THE EVIDENCE TO 2161 01:14:06,875 --> 01:14:08,410 UNDERSTAND WHAT THESE ASSAYS ARE 2162 01:14:08,477 --> 01:14:13,315 ABOUT, HOW TO USE THEM. 2163 01:14:13,382 --> 01:14:14,550 OUR GOAL IS TO CREATE THE 2164 01:14:14,616 --> 01:14:16,718 EVIDENCE BASE TO UNDERSTAND HOW 2165 01:14:16,785 --> 01:14:18,253 THESE TOOLS WORK OR DON'T WORK, 2166 01:14:18,320 --> 01:14:20,355 HOW TO USE THEM IF THEY WORK, 2167 01:14:20,422 --> 01:14:23,625 HOW TO USE THEM TOGETHER OR BY 2168 01:14:23,692 --> 01:14:24,893 THEMSELVES, BECAUSE THEY MEASURE 2169 01:14:24,960 --> 01:14:29,865 DIFFERENT THINGS. 2170 01:14:29,932 --> 01:14:31,033 SO WHAT ARE WE DOING? 2171 01:14:31,099 --> 01:14:32,568 SO THE FIRST THING -- WELL, NOT 2172 01:14:32,634 --> 01:14:33,902 THE FIRST THING WE'VE DONE. 2173 01:14:33,969 --> 01:14:35,304 ACTUALLY WE'VE DONE SEVERAL 2174 01:14:35,370 --> 01:14:36,471 THINGS IN PARALLEL, BUT ONE OF 2175 01:14:36,538 --> 01:14:37,706 THE THINGS THAT JUST GOT STARTED 2176 01:14:37,773 --> 01:14:40,709 THAT WE LAUNCHED IN FEBRUARY IS 2177 01:14:40,776 --> 01:14:41,977 THE NEW CANCER SCREENING 2178 01:14:42,044 --> 01:14:44,146 RESEARCH NETWORK, WHOSE CORE 2179 01:14:44,213 --> 01:14:46,215 GOAL IS TO EVALUATE EMERGING 2180 01:14:46,281 --> 01:14:47,316 TECHNOLOGIES FOR THE PURPOSE OF 2181 01:14:47,382 --> 01:14:50,819 CANCER SCREENING. 2182 01:14:50,886 --> 01:14:54,389 WE'VE ENGAGED M CD DEVELOPERS 2183 01:14:54,456 --> 01:14:55,457 THROUGH THIS PROCESS BECAUSE THE 2184 01:14:55,524 --> 01:14:57,259 FIRST OPPORTUNITY FOR THE CANCER 2185 01:14:57,326 --> 01:14:58,026 SCREENING RESEARCH NETWORK IS A 2186 01:14:58,093 --> 01:14:59,795 PILOT STUDY, AND WE'VE ACTUALLY 2187 01:14:59,862 --> 01:15:03,599 BEEN PRETTY PLEASED WITH THE 2188 01:15:03,665 --> 01:15:05,000 RESPONSES THAT WE'VE HAD FROM 2189 01:15:05,067 --> 01:15:06,969 THE MCD ASSAY DEVELOPERS. 2190 01:15:07,035 --> 01:15:08,170 WE'VE BEEN COLLABORATING WITH 2191 01:15:08,237 --> 01:15:09,171 OTHER FEDERAL AGENCIES. 2192 01:15:09,238 --> 01:15:12,574 WE HAVE MEMBERS FROM FDA AND CMS 2193 01:15:12,641 --> 01:15:14,276 ON OUR TRIAL TEAM. 2194 01:15:14,343 --> 01:15:16,745 WE HAVE PARTICIPATION FROM VA 2195 01:15:16,812 --> 01:15:18,313 AND DOD AND MOST RECENTLY HAVE 2196 01:15:18,380 --> 01:15:21,917 COME TO FIND SOME 2197 01:15:21,984 --> 01:15:23,452 REPRESENTATIVES FROM HRSA AND 2198 01:15:23,518 --> 01:15:25,320 THE INDIAN HEALTH SERVICE THAT 2199 01:15:25,387 --> 01:15:28,624 WE'LL REACH OUT TO AS WELL. 2200 01:15:28,690 --> 01:15:29,925 SO WHAT DOES THE CANCER 2201 01:15:29,992 --> 01:15:32,427 SCREENING RESEARCH NETWORK LOOK 2202 01:15:32,494 --> 01:15:34,429 LIKE? 2203 01:15:34,496 --> 01:15:36,665 THE CORE OBJECTIVE IS TO 2204 01:15:36,732 --> 01:15:37,666 EVALUATE EMERGING TECHNOLOGIES 2205 01:15:37,733 --> 01:15:40,602 FOR CANCER SCREENING, TO CONDUCT 2206 01:15:40,669 --> 01:15:41,737 MULTICENTER CANCER SCREENING 2207 01:15:41,803 --> 01:15:43,472 TRIALS AND STUDIES IN DIVERSE 2208 01:15:43,538 --> 01:15:44,973 POPULATIONS, AND IN ORDER FOR US 2209 01:15:45,040 --> 01:15:46,742 TO MAKE THESE RESULTS 2210 01:15:46,808 --> 01:15:47,743 GENERALIZABLE TO THE AMERICAN 2211 01:15:47,809 --> 01:15:49,912 POPULATION. 2212 01:15:49,978 --> 01:15:51,213 EVALUATE EMERGING MODALITIES FOR 2213 01:15:51,280 --> 01:15:52,648 CANCER SCREENING WITH THE GOAL 2214 01:15:52,714 --> 01:15:54,850 OF REDUCING CANCER-RELATED 2215 01:15:54,917 --> 01:15:57,052 MORBIDITY AND MORTALITY. 2216 01:15:57,119 --> 01:15:58,220 EVALUATE STRATEGIES AND 2217 01:15:58,287 --> 01:16:00,522 APPROACHES TO RISK-BASED 2218 01:16:00,589 --> 01:16:02,224 SCREENING, SO THAT WE CAN 2219 01:16:02,291 --> 01:16:04,459 ULTIMATELY TAKE THIS FROM 2220 01:16:04,526 --> 01:16:08,397 EVERYBODY TO USE YOUR RISK FOR 2221 01:16:08,463 --> 01:16:09,798 CANCER, WHAT ARE THE OPTIMAL 2222 01:16:09,865 --> 01:16:12,334 ASSAYS THAT WE NEED TO USE IN 2223 01:16:12,401 --> 01:16:15,404 YOU, TO ASSESS YOUR -- TO SCREEN 2224 01:16:15,470 --> 01:16:16,738 YOU FOR CANCER. 2225 01:16:16,805 --> 01:16:18,907 AND THEN ULTIMATELY OVER TIME, 2226 01:16:18,974 --> 01:16:20,208 EVALUATE STRATEGIES TO IMPROVE 2227 01:16:20,275 --> 01:16:21,944 THE IMPLEMENTATION OF CANCER 2228 01:16:22,010 --> 01:16:23,478 SCREENING. 2229 01:16:23,545 --> 01:16:27,516 ONE OF THE DISAPPOINTMENTS IS 2230 01:16:27,582 --> 01:16:32,087 THE LACK OF UPTAKE, OF LOW DOSE 2231 01:16:32,154 --> 01:16:34,089 CT SCREENING FOR LUNG CANCER 2232 01:16:34,156 --> 01:16:35,390 WHEN IT'S BEEN CLEARLY 2233 01:16:35,457 --> 01:16:36,625 DEMONSTRATED TO REDUCE MORTALITY 2234 01:16:36,692 --> 01:16:40,095 FROM LUNG CANCER. 2235 01:16:40,162 --> 01:16:43,932 SO WE SPENT THE 2022 BASICALLY 2236 01:16:43,999 --> 01:16:45,233 WORKING AND GOING THROUGH ALL 2237 01:16:45,300 --> 01:16:46,768 THE DIFFERENT LEVELS OF 2238 01:16:46,835 --> 01:16:48,203 APPROVAL, PUTTING THIS TOGETHER, 2239 01:16:48,270 --> 01:16:52,040 WRITING THE RFA, AND THE RFAs 2240 01:16:52,107 --> 01:16:55,544 WERE RELEASED IN NOVEMBER OF 2241 01:16:55,610 --> 01:16:56,178 2022. 2242 01:16:56,244 --> 01:17:00,015 THE GOAL WAS TO HAVE DIFFERENT 2243 01:17:00,082 --> 01:17:01,984 ACCRUAL SITES, A COORDINATING 2244 01:17:02,050 --> 01:17:03,752 AND COMMUNICATION CENTER, AND A 2245 01:17:03,819 --> 01:17:05,454 STATISTICS AND DATA MANAGEMENT 2246 01:17:05,520 --> 01:17:06,088 CENTERMENT AND BECAUSE THIS IS 2247 01:17:06,154 --> 01:17:07,756 SUCH A CHALLENGING AREA TO WRAP 2248 01:17:07,823 --> 01:17:09,091 YOUR HEAD AROUND, WE WANTED TO 2249 01:17:09,157 --> 01:17:10,859 MAKE SURE THAT THE COORDINATING 2250 01:17:10,926 --> 01:17:13,228 CENTER HAD COMMUNICATIONS 2251 01:17:13,295 --> 01:17:14,329 EXPERTISE IN ADDITION TO KNOWING 2252 01:17:14,396 --> 01:17:17,199 HOW TO RUN THE TRIALS 2253 01:17:17,265 --> 01:17:17,833 THEMSELVES. 2254 01:17:17,899 --> 01:17:19,067 ONE OF THE THINGS THEY WILL BE 2255 01:17:19,134 --> 01:17:19,835 SETTING UP IN ADDITION TO 2256 01:17:19,901 --> 01:17:22,571 SETTING UP A COMMUNITY ADVISORY 2257 01:17:22,637 --> 01:17:25,307 BOARD, THEY WILL ALSO BE SETTING 2258 01:17:25,374 --> 01:17:28,477 UP A PATIENT PORTAL IN ADDITION 2259 01:17:28,543 --> 01:17:31,747 SO THAT WE CAN HAVE 2260 01:17:31,813 --> 01:17:32,748 PATIENT-SPECIFIC INFORMATION 2261 01:17:32,814 --> 01:17:35,884 GENERATED AS WELL. 2262 01:17:35,951 --> 01:17:37,986 SO WHEN WE CONCEIVED THIS, WE 2263 01:17:38,053 --> 01:17:39,388 SAID IF YOU LOOK AT THE BLUE 2264 01:17:39,454 --> 01:17:41,223 BANNER AT THE BOTTOM, WE WANTED 2265 01:17:41,289 --> 01:17:42,891 A VARIETY OF DIFFERENT 2266 01:17:42,958 --> 01:17:44,860 HEALTHCARE PRACTICES. 2267 01:17:44,926 --> 01:17:47,362 ACADEMIC CENTERS, HEALTHCARE 2268 01:17:47,429 --> 01:17:49,031 SYSTEMS, PRACTICE-BASED 2269 01:17:49,097 --> 01:17:49,765 NETWORKS, COMMUNITY NETWORKS. 2270 01:17:49,831 --> 01:17:51,600 WE WANTED TO SEE A SPECTRUM OF 2271 01:17:51,666 --> 01:17:52,200 THIS. 2272 01:17:52,267 --> 01:17:53,502 WE KNEW WE WERE STARTING THIS 2273 01:17:53,568 --> 01:17:55,137 OUT AS A PILOT AND WANTED TO BE 2274 01:17:55,203 --> 01:17:57,539 ABLE TO SEE WHAT THE EXPERIENCE 2275 01:17:57,606 --> 01:17:58,874 WAS IN DIFFERENT HEALTHCARE 2276 01:17:58,940 --> 01:18:00,509 SETTINGS IN THE U.S. 2277 01:18:00,575 --> 01:18:05,113 AND AGAIN, OUR COORDINATING AND 2278 01:18:05,180 --> 01:18:05,881 COMMUNICATIONS CENTER WILL HAVE 2279 01:18:05,947 --> 01:18:07,816 A PARTICIPANT ADVISORY BOARD AS 2280 01:18:07,883 --> 01:18:12,454 WELL AS A PORTAL FOR ARE 2281 01:18:12,521 --> 01:18:13,522 PARTICIPANTS -- PARTICIPANT 2282 01:18:13,588 --> 01:18:14,623 ENGAGEMENT AS WELL. 2283 01:18:14,689 --> 01:18:16,491 THIS IS OUR BRAND NEW GRAPHIC 2284 01:18:16,558 --> 01:18:21,096 RELEASED WHEN WE LAUNCHED THE 2285 01:18:21,163 --> 01:18:21,329 NETWORK. 2286 01:18:21,396 --> 01:18:22,964 AS YOU CAN SEE, WE HAVE OUR 2287 01:18:23,031 --> 01:18:25,600 GRANTEES LISTED, AND SO WE HAVE 2288 01:18:25,667 --> 01:18:27,002 OUR COMMUNICATION AND 2289 01:18:27,069 --> 01:18:27,836 COORDINATING CENTER IS THE FRED 2290 01:18:27,903 --> 01:18:29,304 HUTCH AND THE STATISTICS AND 2291 01:18:29,371 --> 01:18:31,606 DATA MANAGEMENT CENTER IS ALSO 2292 01:18:31,673 --> 01:18:33,041 AT FRED HUTCH, WHICH MAKES IT A 2293 01:18:33,108 --> 01:18:35,377 LITTLE EASIER, MAYBE. 2294 01:18:35,444 --> 01:18:37,946 AND THEN OUR ACCESS HUBS ARE 2295 01:18:38,013 --> 01:18:39,081 QUITE DIFFERENT. 2296 01:18:39,147 --> 01:18:41,049 IF YOU JUST LOOK AT THE TITLES, 2297 01:18:41,116 --> 01:18:44,319 THESE ARE THE AWARDEES OF THE 2298 01:18:44,386 --> 01:18:44,886 GRANT APPLICATION. 2299 01:18:44,953 --> 01:18:47,923 YOU CAN SEE HENRY FORD HEALTH 2300 01:18:47,989 --> 01:18:49,691 SYSTEM, AND THE MICHIGAN STATE 2301 01:18:49,758 --> 01:18:51,560 UNIVERSITY HEALTH SCIENCES AT 2302 01:18:51,626 --> 01:18:54,629 THE TOP WILL COME BACK. 2303 01:18:54,696 --> 01:18:55,163 KAISER NORTH AND SOUTH 2304 01:18:55,230 --> 01:18:57,866 CALIFORNIA. 2305 01:18:57,933 --> 01:18:58,433 OKLAHOMA. 2306 01:18:58,500 --> 01:19:00,202 THE UNIVERSITY OF OKLAHOMA. 2307 01:19:00,268 --> 01:19:03,138 THE UNIVERSITY OF COLORADO. 2308 01:19:03,205 --> 01:19:05,407 THE UNIVERSITY OF NORTH 2309 01:19:05,474 --> 01:19:06,808 CAROLINA, VIRGINIA COMMONWEALTH, 2310 01:19:06,875 --> 01:19:07,742 WASHINGTON UNIVERSITY IN 2311 01:19:07,809 --> 01:19:09,010 ST. LOUIS, THE DEPARTMENT OF 2312 01:19:09,077 --> 01:19:09,945 DEFENSE AND THE DEPARTMENT OF 2313 01:19:10,011 --> 01:19:10,479 THE VA. 2314 01:19:10,545 --> 01:19:12,547 SO THIS LOOKS LIKE THE USUAL 2315 01:19:12,614 --> 01:19:13,181 SUSPECTS. 2316 01:19:13,248 --> 01:19:14,716 WE PUT AN RFA OUT. 2317 01:19:14,783 --> 01:19:17,119 WE SAID WE WANT DIFFERENT 2318 01:19:17,185 --> 01:19:18,653 HEALTHCARE ENTITIES AND WE 2319 01:19:18,720 --> 01:19:20,188 FUNDED THE USUAL SUSPECTS. 2320 01:19:20,255 --> 01:19:21,523 RIGHT? 2321 01:19:21,590 --> 01:19:22,757 NOT REALLY. 2322 01:19:22,824 --> 01:19:26,328 EACH OF THESE ACCESS HUBS IS A 2323 01:19:26,394 --> 01:19:28,330 PACKAGE, A CONSORTIUM, IF YOU 2324 01:19:28,396 --> 01:19:30,165 WILL. 2325 01:19:30,232 --> 01:19:31,833 UNDER OUR SEVEN FUNDED ACCESS 2326 01:19:31,900 --> 01:19:33,135 HUBS, BECAUSE WE ARE NOT FUNDING 2327 01:19:33,201 --> 01:19:34,669 THE DOD AND WE ARE NOT FUNDING 2328 01:19:34,736 --> 01:19:35,203 THE VA. 2329 01:19:35,270 --> 01:19:36,304 THEY ARE BRINGING THEIR 2330 01:19:36,371 --> 01:19:37,973 RESOURCES TO THE TABLE TO HELP 2331 01:19:38,039 --> 01:19:40,275 US OUT BECAUSE THEY WANT TO 2332 01:19:40,342 --> 01:19:41,910 PARTICIPATE IN THIS ACTIVITY AND 2333 01:19:41,977 --> 01:19:44,079 THEY WANT TO BE A PART OF THIS 2334 01:19:44,146 --> 01:19:44,980 IMPORTANT PROJECT. 2335 01:19:45,046 --> 01:19:48,083 BUT UNDER OUR SEVEN FUNDED 2336 01:19:48,150 --> 01:19:49,818 ORGANIZATIONS, YOU WILL SEE THAT 2337 01:19:49,885 --> 01:19:52,420 WE HAVE ABOUT 15 FEDERALLY 2338 01:19:52,487 --> 01:19:53,355 QUALIFIED HEALTH CENTERS THAT 2339 01:19:53,421 --> 01:19:56,057 ARE FUNDED THROUGH HRSA. 2340 01:19:56,124 --> 01:19:59,461 THESE ARE HEALTHCARE CENTERS 2341 01:19:59,528 --> 01:20:01,196 WHERE PEOPLE WHO HAVE LIMITED TO 2342 01:20:01,263 --> 01:20:02,197 NO HEALTH INSURANCE ACTUALLY 2343 01:20:02,264 --> 01:20:03,298 SEEK THEIR DAY TO DAY 2344 01:20:03,365 --> 01:20:04,399 HEALTHCARE. 2345 01:20:04,466 --> 01:20:05,700 IN ADDITION, WE HAVE RURAL 2346 01:20:05,767 --> 01:20:06,001 SITES. 2347 01:20:06,067 --> 01:20:09,171 IF YOU LOOK AT VIRGINIA 2348 01:20:09,237 --> 01:20:09,838 COMMONWEALTH UNIVERSITY AND LOOK 2349 01:20:09,905 --> 01:20:12,174 AT THE PACKAGE THAT THEY HAVE 2350 01:20:12,240 --> 01:20:14,442 DEVELOPED, ESSENTIALLY THEIR 2351 01:20:14,509 --> 01:20:18,346 ACCRUAL ORGANIZATION IS THE 2352 01:20:18,413 --> 01:20:19,047 VIRGINIA COMMONWEALTH 2353 01:20:19,114 --> 01:20:19,614 UNIVERSITY. 2354 01:20:19,681 --> 01:20:20,782 THEY'RE HIRING A GROUP OF 2355 01:20:20,849 --> 01:20:22,384 PEOPLE, THEY'VE GOT CLINICS ALL 2356 01:20:22,450 --> 01:20:25,620 OVER THE STATE, AND THEY'RE 2357 01:20:25,687 --> 01:20:26,621 PLANNING TO SEND THEIR STAFF OUT 2358 01:20:26,688 --> 01:20:28,356 TO THE DIFFERENT CLINICS, 2359 01:20:28,423 --> 01:20:30,325 RECRUIT PARTICIPANTS THERE, 2360 01:20:30,392 --> 01:20:34,262 POTENTIALLY SEND THEIR BLOOD 2361 01:20:34,329 --> 01:20:35,130 FORWARD, ENGAGE PARTICIPANTS IN 2362 01:20:35,197 --> 01:20:36,264 THAT AREA, SO THAT THE RURAL 2363 01:20:36,331 --> 01:20:38,867 SITES DON'T HAVE TO BE 2364 01:20:38,934 --> 01:20:41,036 PARTICIPANTS, DON'T HAVE TO GO 2365 01:20:41,102 --> 01:20:42,637 THROUGH ALL THE REGULATORY 2366 01:20:42,704 --> 01:20:44,806 ISSUES FOR BEING INVESTIGATORS 2367 01:20:44,873 --> 01:20:47,742 IN OUR SYSTEM, BUT STILL TO BE 2368 01:20:47,809 --> 01:20:53,114 ACTIVELY ENGAGED IN THIS. 2369 01:20:53,181 --> 01:20:54,449 KAISER HAS A HIGHLY DIVERSE 2370 01:20:54,516 --> 01:20:55,083 POPULATION. 2371 01:20:55,150 --> 01:20:57,185 HENRY FORD HAS ALREADY 2372 01:20:57,252 --> 01:20:58,153 DEMONSTRATED, ACTUALLY ALL OF 2373 01:20:58,220 --> 01:21:00,455 THESE ORGANIZATIONS HAVE 2374 01:21:00,522 --> 01:21:01,423 DEMONSTRATED RECRUITMENT OF 2375 01:21:01,489 --> 01:21:04,292 HIGHLY DIVERSE POPULATIONS TO 2376 01:21:04,359 --> 01:21:05,727 OTHER CANCER PREVENTION, CANCER 2377 01:21:05,794 --> 01:21:08,563 SCREENING STUL DIS. 2378 01:21:08,630 --> 01:21:10,098 THE UNIVERSITY OF OKLAHOMA IS 2379 01:21:10,165 --> 01:21:11,833 ENGAGING AT LEAST ONE TRIBAL 2380 01:21:11,900 --> 01:21:14,169 NATION, POSSIBLY AS MANY AS 2381 01:21:14,236 --> 01:21:15,237 FOUR, DEPENDING. 2382 01:21:15,303 --> 01:21:17,205 THE BIGGEST CHALLENGE WE HAVE 2383 01:21:17,272 --> 01:21:19,474 WITH THAT IS UNDERSTANDING DAY 2384 01:21:19,541 --> 01:21:21,409 TO SOVEREIGNTY AND WE HAVE SOME 2385 01:21:21,476 --> 01:21:22,177 FOLLOW-UP CONVERSATIONS THAT WE 2386 01:21:22,244 --> 01:21:25,547 ARE GOING TO HAVE WITH THE PI 2387 01:21:25,614 --> 01:21:28,617 FOR THIS ACCESS HUB, AS WELL AS 2388 01:21:28,683 --> 01:21:29,618 REPRESENTATIVES FROM THE TRIBAL 2389 01:21:29,684 --> 01:21:29,951 NATIONS. 2390 01:21:30,018 --> 01:21:33,488 I CAN TELL YOU THAT THE 2391 01:21:33,555 --> 01:21:38,126 COMMUNITY ADVISORY BO BOARD THAT 2392 01:21:38,193 --> 01:21:39,894 FRED HUTCH IS STANDING UP 2393 01:21:39,961 --> 01:21:42,764 ALREADY ENGAGES AT LEAST ONE OR 2394 01:21:42,831 --> 01:21:45,166 TWO PATIENT ADVOCATES, ONE OF 2395 01:21:45,233 --> 01:21:47,202 WHOM IS A MEMBER OF A DIFFERENT 2396 01:21:47,269 --> 01:21:50,105 TRIBAL NATION. 2397 01:21:50,171 --> 01:21:52,607 WE HAVE A VARIETY OF DIFFERENT 2398 01:21:52,674 --> 01:21:52,941 SETTINGS. 2399 01:21:53,008 --> 01:21:54,342 SO THAT EVEN THOUGH YOU CAN SEE 2400 01:21:54,409 --> 01:21:56,344 WHEN YOU LOOK AT THEM, IT LOOKS 2401 01:21:56,411 --> 01:21:57,545 LIKE THE USUAL SUSPECTS. 2402 01:21:57,612 --> 01:22:00,515 WHEN YOU DIG DOWN, WE REALLY ARE 2403 01:22:00,582 --> 01:22:02,250 FINDING THAT THESE ORGANIZATIONS 2404 01:22:02,317 --> 01:22:04,319 HAVE BEEN VERY THOUGHTFUL IN 2405 01:22:04,386 --> 01:22:06,221 THEIR APPROACH TO HOW THEY'RE 2406 01:22:06,288 --> 01:22:12,460 GOING TO RECRUIT PARTICIPANTS. 2407 01:22:12,527 --> 01:22:13,194 THE VANGUARD STUDY. 2408 01:22:13,261 --> 01:22:14,863 THIS IS THE PILOT STUDY THAT WE 2409 01:22:14,929 --> 01:22:17,766 ARE STANDING UP HOPEFULLY IN 2410 01:22:17,832 --> 01:22:18,833 '24. 2411 01:22:18,900 --> 01:22:20,969 OKAY? 2412 01:22:21,036 --> 01:22:22,437 IT'S COMPLICATED. 2413 01:22:22,504 --> 01:22:24,606 WE INTEND TO RANDOMIZE 2414 01:22:24,673 --> 01:22:26,141 PARTICIPANTS TO ONE OF THREE 2415 01:22:26,207 --> 01:22:27,342 DIFFERENT ARMS. 2416 01:22:27,409 --> 01:22:29,878 ONE ARM IS A CONTROL ARM. 2417 01:22:29,944 --> 01:22:33,815 ONE ARM WILL BE MCD NUMBER 1. 2418 01:22:33,882 --> 01:22:35,216 AND THE SECOND -- THE THIRD ARM 2419 01:22:35,283 --> 01:22:37,552 WILL BE MCD NUMBER 2. 2420 01:22:37,619 --> 01:22:40,288 WE'RE NOT COMBINING MCDs. 2421 01:22:40,355 --> 01:22:47,429 ONE ARM PER MCD ASSAY. 2422 01:22:47,495 --> 01:22:48,863 EVERYBODY IS RANDOMIZED BECAUSE 2423 01:22:48,930 --> 01:22:50,065 THE FIRST OBJECTIVE OF THE 2424 01:22:50,131 --> 01:22:52,467 VANGUARD STUDY IS TO ASSESS 2425 01:22:52,534 --> 01:22:53,935 PARTICIPANT WILLINGNESS TO BE 2426 01:22:54,002 --> 01:22:56,438 RANDOMIZED TO THIS KIND OF A 2427 01:22:56,504 --> 01:22:58,406 DESIGN. 2428 01:22:58,473 --> 01:22:59,941 WHY WOULD WE HAVE PARTICIPANTS 2429 01:23:00,008 --> 01:23:01,042 BEING RANDOMIZED ALL THE TIME, 2430 01:23:01,109 --> 01:23:02,677 THE QUESTION IS IN THE CURRENT 2431 01:23:02,744 --> 01:23:04,212 ENVIRONMENT, WHERE WE HAVE OUR 2432 01:23:04,279 --> 01:23:06,314 PEOPLE JUST GOING TO GO AND GET 2433 01:23:06,381 --> 01:23:08,416 THESE ASSAYS IF THEY'RE 2434 01:23:08,483 --> 01:23:09,517 COMMERCIALLY AVAILABLE, OR ARE 2435 01:23:09,584 --> 01:23:12,020 THEY WILLING TO ENGAGE IN THE 2436 01:23:12,087 --> 01:23:13,521 RESEARCH OPPORTUNITY AND BE 2437 01:23:13,588 --> 01:23:15,390 WILLING TO RANDOMIZE IN THIS 2438 01:23:15,457 --> 01:23:16,825 PARTICULAR SETTING, THEIR RISK 2439 01:23:16,891 --> 01:23:22,430 WOULD BE 30%, 33%, A THIRD, RAN 2440 01:23:22,497 --> 01:23:23,531 RANDOMIZED TO THE CONTROL ARM. 2441 01:23:23,598 --> 01:23:24,632 OKAY. 2442 01:23:24,699 --> 01:23:25,700 EVERYBODY WILL BE OFFERED 2443 01:23:25,767 --> 01:23:27,402 STANDARD OF CARE SCREENING. 2444 01:23:27,469 --> 01:23:30,105 WE WILL CAPTURE ALL CANCERS. 2445 01:23:30,171 --> 01:23:32,741 WE'LL CAPTURE THEIR HISTOLOGY, 2446 01:23:32,807 --> 01:23:33,842 THEIR HISTOPATHOLOGY, THE 2447 01:23:33,908 --> 01:23:34,943 MARKERS THAT ARE ASSOCIATED WITH 2448 01:23:35,009 --> 01:23:35,377 IT. 2449 01:23:35,443 --> 01:23:37,779 IT DOESN'T MATTER WHETHER OR NOT 2450 01:23:37,846 --> 01:23:40,849 THOSE ASSAYS SAY THEY DETECT 2451 01:23:40,915 --> 01:23:43,284 THAT CANCER, WE WILL COLLECT ALL 2452 01:23:43,351 --> 01:23:44,586 CANCERS ACROSS THIS. 2453 01:23:44,652 --> 01:23:46,654 THE OTHER OBJECTIVES INVOLVE 2454 01:23:46,721 --> 01:23:47,856 DETERMINING ADHERENCE. 2455 01:23:47,922 --> 01:23:51,126 WILL THESE PARTICIPANTS FOLLOW 2456 01:23:51,192 --> 01:23:51,526 THROUGH? 2457 01:23:51,593 --> 01:23:53,361 WHAT ARE THE CHALLENGES, THE 2458 01:23:53,428 --> 01:23:54,262 BARRIERS, PARTICULARLY OUR FOLKS 2459 01:23:54,329 --> 01:23:55,263 IN THE FEDERALLY QUALIFIED 2460 01:23:55,330 --> 01:23:56,498 HEALTH CENTERS. 2461 01:23:56,564 --> 01:23:58,433 WE ACTUALLY EARLY ON HAD A 2462 01:23:58,500 --> 01:24:01,102 CONVERSATION WITH A WOMAN THAT 2463 01:24:01,169 --> 01:24:02,637 RUNS ONE OF THE FEDERALLY 2464 01:24:02,704 --> 01:24:04,038 QUALIFIED HEALTH CENTERS HERE IN 2465 01:24:04,105 --> 01:24:05,173 MARYLAND AND FOUND THAT SHE HAD 2466 01:24:05,240 --> 01:24:06,708 QUITE A FEW CHALLENGES. 2467 01:24:06,775 --> 01:24:07,909 THE MOST SIGNIFICANT CHALLENGE 2468 01:24:07,976 --> 01:24:09,778 SHE HAD WAS FINDING THE 2469 01:24:09,844 --> 01:24:11,279 RESOURCES SO THAT THESE 2470 01:24:11,346 --> 01:24:12,514 PARTICIPANTS COULD, IN FACT, GET 2471 01:24:12,580 --> 01:24:16,017 THE FOLLOW-UP FOR THE POSITIVE 2472 01:24:16,084 --> 01:24:17,218 TEST, WHATEVER IT WAS. 2473 01:24:17,285 --> 01:24:19,721 YOU KNOW, AN ABNORMAL MAMMOGRAM, 2474 01:24:19,788 --> 01:24:21,055 CAN THEY GET THE FOLLOW-UP FOR 2475 01:24:21,122 --> 01:24:28,163 THAT? 2476 01:24:28,229 --> 01:24:30,732 EVALUATE THE FEASIBILITY OF THE 2477 01:24:30,799 --> 01:24:31,466 PROTOCOL-DEFINED DIAGNOSTIC 2478 01:24:31,533 --> 01:24:32,033 WORKUPS. 2479 01:24:32,100 --> 01:24:33,868 WE'RE STILL TRYING TO FIGURE OUT 2480 01:24:33,935 --> 01:24:35,904 HOW WE SHOULD -- WHETHER WE 2481 01:24:35,970 --> 01:24:37,272 SHOULD GATHER THAT DATA, HOW WE 2482 01:24:37,338 --> 01:24:38,039 SHOULD ASSESS THAT. 2483 01:24:38,106 --> 01:24:39,774 DETERMINE THE RELIABILITY AND 2484 01:24:39,841 --> 01:24:41,209 THE TIMELINESS OF THE BLOOD 2485 01:24:41,276 --> 01:24:44,179 SPECIMEN TESTING AND RETURN BY 2486 01:24:44,245 --> 01:24:45,513 THE MCD COMPANIES. 2487 01:24:45,580 --> 01:24:46,815 WE'VE BEEN VERY FORTUNATE WITH 2488 01:24:46,881 --> 01:24:51,653 THE ENGAGEMENT OF THE M SAID 2489 01:24:51,719 --> 01:24:53,888 COMPANIES, BUT THAT'S ONE OF THE 2490 01:24:53,955 --> 01:24:55,924 OBJECTIVES OF THIS PILOT STUDY. 2491 01:24:55,990 --> 01:24:57,592 AND THEN IDENTIFY FACILITATORS 2492 01:24:57,659 --> 01:24:59,994 AND BARRIERS TO RECRUITING AND 2493 01:25:00,061 --> 01:25:01,663 RETENTION, TO RECRUITMENT AND 2494 01:25:01,729 --> 01:25:03,064 RETENTION AND COMPLIANCE OF 2495 01:25:03,131 --> 01:25:04,532 DIFFERENT PARTICIPANT GROUPS. 2496 01:25:04,599 --> 01:25:07,035 WE KNOW THERE ARE CHALLENGES, WE 2497 01:25:07,101 --> 01:25:09,771 NEED TO CODE GUY THEM, THERE MAY 2498 01:25:09,838 --> 01:25:11,673 BE UNIQUE ONES THAT WE NEED TO 2499 01:25:11,739 --> 01:25:14,075 KNOW ABOUT BEFORE WE LAUNCH A 2500 01:25:14,142 --> 01:25:15,276 MUCH LARGER TRIAL. 2501 01:25:15,343 --> 01:25:18,913 THIS IS DESIGNED TO BE VERY 2502 01:25:18,980 --> 01:25:20,982 PARALLEL, TO BE A MINI VERSION 2503 01:25:21,049 --> 01:25:24,385 OF THE VERY LARGE RANDOMIZED 2504 01:25:24,452 --> 01:25:27,455 CONTROL TRIAL THAT WE WOULD 2505 01:25:27,522 --> 01:25:28,423 ULTIMATELY LIKE TO RUN IF WE 2506 01:25:28,490 --> 01:25:29,557 HAVE THE RESOURCES. 2507 01:25:29,624 --> 01:25:30,758 WE'RE HOPING TO STEP THIS UP IN 2508 01:25:30,825 --> 01:25:33,628 A WAY THAT WE LEARN HOW BEST TO 2509 01:25:33,695 --> 01:25:36,998 DESIGN THAT TRIAL. 2510 01:25:37,065 --> 01:25:37,999 BECAUSE THE BIGGEST CHALLENGE 2511 01:25:38,066 --> 01:25:39,434 HERE IS WHAT IS THE DIFFERENCE 2512 01:25:39,501 --> 01:25:42,070 IN DESIGNING A SCREENING TRIAL 2513 01:25:42,136 --> 01:25:45,573 WHEN THE SCREENING MODALITY CAN 2514 01:25:45,640 --> 01:25:46,875 DETECT POSSIBLY MANY DIFFERENT 2515 01:25:46,941 --> 01:25:48,409 TYPES OF CANCER. 2516 01:25:48,476 --> 01:25:50,979 SO THAT'S WHAT WE'RE DEALING 2517 01:25:51,045 --> 01:25:52,480 WITH. 2518 01:25:52,547 --> 01:25:54,782 IN TERMS OF THINKING THROUGH THE 2519 01:25:54,849 --> 01:25:56,451 ANALYTIC DESIGN FOR THIS KIND OF 2520 01:25:56,518 --> 01:25:56,818 AN APPROACH. 2521 01:25:56,885 --> 01:25:59,854 THE ASSAY SELECTION PROCESS. 2522 01:25:59,921 --> 01:26:01,856 SO BEFORE WE EVEN GOT TO THE 2523 01:26:01,923 --> 01:26:03,291 WORKSHOP, WE HAD PEOPLE SAYING, 2524 01:26:03,358 --> 01:26:04,459 DO YOU EVEN KNOW THESE COMPANIES 2525 01:26:04,526 --> 01:26:06,461 ARE GOING TO WORK WITH YOU? 2526 01:26:06,528 --> 01:26:09,297 AND SO WE PUT OUT A REQUEST FOR 2527 01:26:09,364 --> 01:26:11,733 INFORMATION IN JANUARY '22 AND 2528 01:26:11,799 --> 01:26:13,935 HAD A NICE RESPONSE. 2529 01:26:14,002 --> 01:26:18,706 WE ENDED UP TALKING TO EVERY 2530 01:26:18,773 --> 01:26:20,275 SINGLE COMPANY THAT RESPONDED TO 2531 01:26:20,341 --> 01:26:21,009 US. 2532 01:26:21,075 --> 01:26:23,778 WE EVEN HAD A PARTICIPANT 2533 01:26:23,845 --> 01:26:26,180 RESPOND TO THE REQUEST FOR 2534 01:26:26,247 --> 01:26:27,282 INFORMATION, WANTED TO KNOW 2535 01:26:27,348 --> 01:26:28,516 WHERE TO SIGN UP. 2536 01:26:28,583 --> 01:26:30,585 AND IN FACT, THROUGH THIS WHOLE 2537 01:26:30,652 --> 01:26:33,221 PROCESS, IN FACT, AFTER THE 2538 01:26:33,288 --> 01:26:37,959 LAUNCH, THE PUBLIC LAUNCH, 2539 01:26:38,026 --> 01:26:40,662 ELYSSE LEEVAN WAS GETTING EMAILS 2540 01:26:40,728 --> 01:26:41,896 FROM PARTICIPANTS WANTING TO 2541 01:26:41,963 --> 01:26:43,097 KNOW HOW AND WHEN THEY COULD 2542 01:26:43,164 --> 01:26:43,331 SIGN UP. 2543 01:26:43,398 --> 01:26:45,533 SO THAT'S REASSURING AT MANY 2544 01:26:45,600 --> 01:26:46,200 DIFFERENT LEVELS. 2545 01:26:46,267 --> 01:26:46,834 BUT WE DID. 2546 01:26:46,901 --> 01:26:48,703 WE HAD COMPANIES COME TO US AND 2547 01:26:48,770 --> 01:26:49,671 SAY THEY WERE VERY INTERESTED, 2548 01:26:49,737 --> 01:26:50,905 THEY WANTED TO HAVE A 2549 01:26:50,972 --> 01:26:52,674 DISCUSSION, WE WALKED THROUGH, 2550 01:26:52,740 --> 01:26:55,643 AND THAT'S HOW WE LEARN THE SO 2551 01:26:55,710 --> 01:26:56,844 MUCH ABOUT SOME OF THESE 2552 01:26:56,911 --> 01:26:58,179 COMPANIES. 2553 01:26:58,246 --> 01:27:00,148 HOW, IN FACT, THE TECHNOLOGY IS 2554 01:27:00,214 --> 01:27:01,049 DIFFERENT POTENTIALLY. 2555 01:27:01,115 --> 01:27:02,483 THEY ARE MORE THAN HAPPY TO TALK 2556 01:27:02,550 --> 01:27:04,218 TO US ABOUT THE TECHNOLOGY. 2557 01:27:04,285 --> 01:27:05,520 IT'S A LITTLE MORE CHALLENGING 2558 01:27:05,587 --> 01:27:08,189 TO HAVE THEM TALK ABOUT THE 2559 01:27:08,256 --> 01:27:10,158 SOFTWARE ALGORITHM, WHAT'S A 2560 01:27:10,224 --> 01:27:11,559 POSITIVE AND WHAT'S A NEGATIVE. 2561 01:27:11,626 --> 01:27:13,795 SO WITH ALL THAT INFORMATION, 2562 01:27:13,861 --> 01:27:15,196 KNOWING THAT WE WOULD 2563 01:27:15,263 --> 01:27:18,499 POTENTIALLY HAVE PARTNERS, WE 2564 01:27:18,566 --> 01:27:19,834 DECIDED THAT WE NEEDED ACTUALLY 2565 01:27:19,901 --> 01:27:22,370 TO HAVE A FORMAL PROCESS FOR HOW 2566 01:27:22,437 --> 01:27:24,439 TO ENGAGE THEM, AND TO SELECT 2567 01:27:24,505 --> 01:27:26,541 THEM FOR THE VANGUARD STUDY. 2568 01:27:26,608 --> 01:27:28,843 SO WE HELD A VIRTUAL WORKSHOP 2569 01:27:28,910 --> 01:27:32,413 THAT WE INVITED -- WE PUT IT IN 2570 01:27:32,480 --> 01:27:35,617 THE GUIDE, WE INVITED AS MANY 2571 01:27:35,683 --> 01:27:37,352 PEOPLE NATIONALLY, 2572 01:27:37,418 --> 01:27:37,986 INTERNATIONALLY, WE SAID THERE 2573 01:27:38,052 --> 01:27:40,188 WAS NO LIMITATION, COME, LISTEN. 2574 01:27:40,254 --> 01:27:43,758 AND WE HAD, I THINK, 500 FEEM ON 2575 01:27:43,825 --> 01:27:46,828 THE VIRTUAL WEBINAR. 2576 01:27:46,894 --> 01:27:47,428 500 PEOPLE. 2577 01:27:47,495 --> 01:27:48,830 BUT EVEN BEFORE WE DID THIS, WE 2578 01:27:48,896 --> 01:27:51,032 ALSO SAID, OKAY, THERE'S NOT 2579 01:27:51,099 --> 01:27:52,000 MUCH PUBLISHED DATA. 2580 01:27:52,066 --> 01:27:53,801 HOW ARE WE GOING -- ARE WE JUST 2581 01:27:53,868 --> 01:27:55,203 GOING TO TRUST ALL THE ASSAY 2582 01:27:55,269 --> 01:27:55,536 COMPANIES? 2583 01:27:55,603 --> 01:27:58,740 OR ARE WE GOING TO, YOU KNOW, 2584 01:27:58,806 --> 01:28:02,276 HAVE SOME WAY OF TESTING? 2585 01:28:02,343 --> 01:28:04,812 SO WENT TO THE ALLIANCE FOR 2586 01:28:04,879 --> 01:28:05,747 ONCOLOGY CLINICAL TRIALS, AND 2587 01:28:05,813 --> 01:28:07,615 SAID WOULD YOU BE WILLING TO 2588 01:28:07,682 --> 01:28:12,320 PARTNER WITH US AND CREATE AN 2589 01:28:12,387 --> 01:28:13,855 MCD BIOBANK SO THEY DID, AND 2590 01:28:13,921 --> 01:28:17,392 DEVELOPED BASICALLY A PROTOCOL 2591 01:28:17,458 --> 01:28:20,328 THAT WAS -- BY BLOOD COLLECTION 2592 01:28:20,395 --> 01:28:24,098 FOR US TO SEND COMPANIES 2593 01:28:24,165 --> 01:28:24,899 SPECIMENS SO THEY COULD RUN 2594 01:28:24,966 --> 01:28:25,967 THEIR ASSAYS, GIVE US THE 2595 01:28:26,034 --> 01:28:27,168 RESULTS BACK IN A BLINDED 2596 01:28:27,235 --> 01:28:30,938 FASHION, AND WE'D HAVE AT LEAST 2597 01:28:31,005 --> 01:28:34,108 SOME MEASURE WITH WHICH TO 2598 01:28:34,175 --> 01:28:35,410 EVALUATE THEM. 2599 01:28:35,476 --> 01:28:37,045 THE ALLIANCE RECRUITED MORE THAN 2600 01:28:37,111 --> 01:28:38,680 A THOUSAND PERSONS WITH NO 2601 01:28:38,746 --> 01:28:40,481 EVIDENCE OF CANCER. 2602 01:28:40,548 --> 01:28:42,784 THEY RECRUITED ABOUT 800 TO 2603 01:28:42,850 --> 01:28:45,753 DATE, MAYBE 900 NOW, PERSONS 2604 01:28:45,820 --> 01:28:47,321 WITH NEWLY DIAGNOSED CANCER. 2605 01:28:47,388 --> 01:28:49,824 SO THEY SET UP A SYSTEM SO THAT 2606 01:28:49,891 --> 01:28:52,060 THEY GOT THEM THROUGH, AND IN 2607 01:28:52,126 --> 01:28:54,362 FACT WE ALLOWED THEM TO RECRUIT 2608 01:28:54,429 --> 01:28:55,463 PARTICIPANTS GOING TO SURGERY 2609 01:28:55,530 --> 01:28:57,198 WHO DIDN'T HAVE A DEFINITIVE 2610 01:28:57,265 --> 01:28:59,434 DIAGNOSIS OF CANCER, JUST SO WE 2611 01:28:59,500 --> 01:29:01,169 COULD MAKE SURE WE HAD 2612 01:29:01,235 --> 01:29:03,037 SUFFICIENT NUMBERS OF NEWLY 2613 01:29:03,104 --> 01:29:04,539 DIAGNOSED CANCERS, AND WE LOOKED 2614 01:29:04,605 --> 01:29:05,807 AT A SPECTRUM OF DIFFERENT KINDS 2615 01:29:05,873 --> 01:29:06,374 OF CANCERS. 2616 01:29:06,441 --> 01:29:07,709 THIS HAS BEEN JUST A FABULOUS 2617 01:29:07,775 --> 01:29:08,042 PARTNERSHIP. 2618 01:29:08,109 --> 01:29:09,243 THEY HAVE COME TO THE TABLE, 2619 01:29:09,310 --> 01:29:10,678 WORKED WITH US IN SUCH A 2620 01:29:10,745 --> 01:29:11,312 COLLABORATIVE WAY. 2621 01:29:11,379 --> 01:29:17,151 IT'S JUST BEEN A JOY. 2622 01:29:17,218 --> 01:29:22,323 THIS WAS DONE IN UNDER TWO YEA 2623 01:29:22,390 --> 01:29:23,291 YEARS. 2624 01:29:23,357 --> 01:29:24,726 SO IN THE ASSAY WORKSHOP, WE 2625 01:29:24,792 --> 01:29:25,593 HOSTED THE WORKSHOP. 2626 01:29:25,660 --> 01:29:26,828 WE SAID AT THE END OF THE 2627 01:29:26,894 --> 01:29:28,029 WORKSHOP, WE GAVE EVERYBODY A 2628 01:29:28,096 --> 01:29:29,230 DATE APPLICATIONS WERE DUE, AND 2629 01:29:29,297 --> 01:29:31,766 WE MADE THE APPLICATION PROCESS 2630 01:29:31,833 --> 01:29:33,634 RELATIVELY SIMPLE AND 2631 01:29:33,701 --> 01:29:34,402 STRAIGHTFORWARD. 2632 01:29:34,469 --> 01:29:37,138 WE REVIEWED ALL THE APPLICATIONS 2633 01:29:37,205 --> 01:29:41,909 AND THEN RANKED THE ASSAYS, WE 2634 01:29:41,976 --> 01:29:43,177 ALLOWED AN ASSAY COMPANY TO 2635 01:29:43,244 --> 01:29:44,512 SUBMIT MORE THAN ONE ASSAY TO 2636 01:29:44,579 --> 01:29:46,714 US, AND WE HAD A COUPLE OF 2637 01:29:46,781 --> 01:29:49,016 COMPANIES SUBMIT MORE THAN ONE 2638 01:29:49,083 --> 01:29:49,684 ASSAY. 2639 01:29:49,751 --> 01:29:50,985 REVIEWED ALL THE INFORMATION, 2640 01:29:51,052 --> 01:29:52,754 THE ASSAY WORKING GROUP REVIEWED 2641 01:29:52,820 --> 01:29:54,188 ALL THE INFORMATION AND THEN WE 2642 01:29:54,255 --> 01:29:56,390 NARROWED IT DOWN TO A SMALLER 2643 01:29:56,457 --> 01:29:59,260 GROUP OF MCD ASSAY DEVELOPERS 2644 01:29:59,327 --> 01:30:00,461 AND STARTED MEETING WITH THEM TO 2645 01:30:00,528 --> 01:30:01,896 SAY OKAY, HERE'S THE NEXT STEP. 2646 01:30:01,963 --> 01:30:04,232 NOW MIND YOU, THEY'RE ALL DOING 2647 01:30:04,298 --> 01:30:06,334 THIS ON THEIR OWN. 2648 01:30:06,400 --> 01:30:07,235 WE'RE NOT PAYING THEM TO DO 2649 01:30:07,301 --> 01:30:07,535 THIS. 2650 01:30:07,602 --> 01:30:08,636 THIS IS PART OF THE PROCESS BY 2651 01:30:08,703 --> 01:30:10,738 WHICH WE'LL GO THROUGH AND TELL 2652 01:30:10,805 --> 01:30:13,474 THEM, YOU KNOW, HOW WE'LL RANK 2653 01:30:13,541 --> 01:30:15,443 THEM. 2654 01:30:15,510 --> 01:30:17,178 SO AS I STAND HERE TODAY, THE 2655 01:30:17,245 --> 01:30:18,212 ALLIANCE SPECIMENS HAVE BEEN 2656 01:30:18,279 --> 01:30:18,646 SENT TO THEM. 2657 01:30:18,713 --> 01:30:20,114 WE'VE HAD ONE COMPANY RESPOND 2658 01:30:20,181 --> 01:30:22,049 AND GIVE US THE ASSAY RESULTS 2659 01:30:22,116 --> 01:30:22,483 ALREADY. 2660 01:30:22,550 --> 01:30:28,689 SO THAT'S BEING -- THE DATA HAS 2661 01:30:28,756 --> 01:30:29,524 BEEN CLEANED. 2662 01:30:29,590 --> 01:30:30,324 WE DISCOVERED BECAUSE OF THE 2663 01:30:30,391 --> 01:30:31,325 DIFFERENT TECHNOLOGIES, THERE 2664 01:30:31,392 --> 01:30:32,393 WERE A COUPLE OF COMPANIES THAT 2665 01:30:32,460 --> 01:30:33,628 COULD NOT USE THESE SPECIMENS. 2666 01:30:33,694 --> 01:30:36,798 AND SO WE WENT BACK AND WE 2667 01:30:36,864 --> 01:30:40,968 LOOKED AT THE POCO SPECIMENS 2668 01:30:41,035 --> 01:30:44,071 THAT WERE STORED AND SOME OTHER 2669 01:30:44,138 --> 01:30:46,274 SPECIMENS AND SO WE SENT 2670 01:30:46,340 --> 01:30:50,278 ALTERNATIVE SPECIMEN COLLECTIONS 2671 01:30:50,344 --> 01:30:52,079 AND -- SO WE LOOKED AT A COUPLE 2672 01:30:52,146 --> 01:30:53,514 OF DIFFERENT THINGS WITH THE 2673 01:30:53,581 --> 01:30:56,584 EXCEPTION OF ONE COMPANY WHERE 2674 01:30:56,651 --> 01:30:58,019 THE SPECIMENS ARE GOING OUT I 2675 01:30:58,085 --> 01:30:59,020 THINK ON MONDAY, VIRTUALLY 2676 01:30:59,086 --> 01:31:00,054 EVERYBODY HAS THEIR SPECIMENS 2677 01:31:00,121 --> 01:31:00,655 RIGHT NOW. 2678 01:31:00,721 --> 01:31:03,324 SO RIGHT NOW THEY'RE ANALYZING 2679 01:31:03,391 --> 01:31:04,492 THE DATA, THEY'LL SEND IT BACK 2680 01:31:04,559 --> 01:31:06,394 TO US, THEY'VE GOT BLINDED 2681 01:31:06,460 --> 01:31:07,895 INFORMATION SO THEY'RE JUST 2682 01:31:07,962 --> 01:31:10,031 RUNNING ALL THESE ASSAYS, THEY 2683 01:31:10,097 --> 01:31:11,365 DON'T KNOW WHICH ARE CONTROLS, 2684 01:31:11,432 --> 01:31:12,867 WHICH ARE CANCERS. 2685 01:31:12,934 --> 01:31:15,269 SOME OF THE COMPANIES HAVE ASKED 2686 01:31:15,336 --> 01:31:17,638 FOR A FEW MORE TIDBITS BUT 2687 01:31:17,705 --> 01:31:18,372 THAT'S WHERE WE ARE NOW. 2688 01:31:18,439 --> 01:31:20,575 WHEN WE GET ALL THE DATA, WE'LL 2689 01:31:20,641 --> 01:31:23,344 RANK THEM, AND WE'LL COME BACK 2690 01:31:23,411 --> 01:31:25,279 TO DR. RATHMELL AND ALL THE 2691 01:31:25,346 --> 01:31:26,280 DEPUTIES AND SAY HERE'S WHAT 2692 01:31:26,347 --> 01:31:27,715 WE'D LIKE TO DO. 2693 01:31:27,782 --> 01:31:30,284 OUR NEXT STEPS. 2694 01:31:30,351 --> 01:31:31,452 CLEARLY WE'VE GOT TO SELECT THE 2695 01:31:31,519 --> 01:31:32,119 ASSAYS. 2696 01:31:32,186 --> 01:31:33,988 THAT'S TOP OF THE LIST. 2697 01:31:34,055 --> 01:31:37,959 AND WE'RE ON OUR PATH TOWARD 2698 01:31:38,025 --> 01:31:42,430 IDENTIFYING OPTIMAL ASSAYS TO 2699 01:31:42,496 --> 01:31:43,097 USE. 2700 01:31:43,164 --> 01:31:45,366 WE HAVE LAUNCHED THE NETWORK 2701 01:31:45,433 --> 01:31:45,700 FORMALLY. 2702 01:31:45,766 --> 01:31:47,602 WE HAVE STARTED OUR COORDINATING 2703 01:31:47,668 --> 01:31:48,836 AND COMMUNICATIONS CENTER. 2704 01:31:48,903 --> 01:31:51,105 IT'S STARTING TO POPULATE THE 2705 01:31:51,172 --> 01:31:53,908 FORMAL WORKING GROUP WHERE 2706 01:31:53,975 --> 01:31:55,877 PRESENTING THE WORK THAT NCI'S 2707 01:31:55,943 --> 01:31:57,178 WORK GROUPS HAVE DONE OVER THE 2708 01:31:57,245 --> 01:32:00,715 LAST FEW YEARS, WE'VE HAD AN 2709 01:32:00,781 --> 01:32:03,517 ETHICS AND EQUITY GROUP THAT RAN 2710 01:32:03,584 --> 01:32:04,819 PARTICIPANT AND PRIMARY CARE 2711 01:32:04,886 --> 01:32:05,286 FOCUS GROUPS. 2712 01:32:05,353 --> 01:32:07,588 WE HAVE A STATISTICAL DESIGN 2713 01:32:07,655 --> 01:32:08,990 GROUP THAT'S LOOKED AT MODELING 2714 01:32:09,056 --> 01:32:12,827 DIFFERENT KINDS OF THINGS FOR 2715 01:32:12,894 --> 01:32:14,495 OUR STUDY DESIGN ASSUMPTIONS. 2716 01:32:14,562 --> 01:32:15,930 WE'VE HAD A GROUP LOOKING AT 2717 01:32:15,997 --> 01:32:17,798 WHAT WE HAVE TO DO FOR THE 2718 01:32:17,865 --> 01:32:19,433 DIAGNOSTIC PATHWAY, AND THEN WE 2719 01:32:19,500 --> 01:32:20,534 ALSO HAVE PEOPLE WORKING AND 2720 01:32:20,601 --> 01:32:22,403 THINKING THROUGH RECRUITMENT AND 2721 01:32:22,470 --> 01:32:23,404 RETENTION. 2722 01:32:23,471 --> 01:32:27,441 SO WE'RE PLANNING AN IN-PERSON 2723 01:32:27,508 --> 01:32:28,075 MEETING IN MAY. 2724 01:32:28,142 --> 01:32:29,577 WE'RE HOPING TO GET ALL THE 2725 01:32:29,644 --> 01:32:31,779 PIECES OF THE PROTOCOL WRITTEN 2726 01:32:31,846 --> 01:32:33,547 AND SUBMIT THE PROTOCOL TO THE 2727 01:32:33,614 --> 01:32:37,818 CENTRAL IRB BY SUMMER OR IN THE 2728 01:32:37,885 --> 01:32:38,252 SUMMER. 2729 01:32:38,319 --> 01:32:39,720 AND THEN LAUNCH THE VANGUARD 2730 01:32:39,787 --> 01:32:44,425 BEFORE THE END OF THIS YEAR. 2731 01:32:44,492 --> 01:32:46,494 AND AS WE SAID EARLIER, CANCER 2732 01:32:46,560 --> 01:32:48,696 IS NOT ONE DISEASE. 2733 01:32:48,763 --> 01:32:50,364 THERE ARE MULTIPLE DIFFERENT 2734 01:32:50,431 --> 01:32:51,565 TECHNOLOGIES THAT ARE BEING 2735 01:32:51,632 --> 01:32:52,800 DEVELOPED THAT CAN DETECT 2736 01:32:52,867 --> 01:32:53,801 CANCER. 2737 01:32:53,868 --> 01:32:56,837 SO WHY SHOULDN'T WE THINK ABOUT 2738 01:32:56,904 --> 01:32:57,672 USING MULTIPLE DIFFERENT 2739 01:32:57,738 --> 01:32:59,407 TECHNOLOGIES? 2740 01:32:59,473 --> 01:33:02,376 FOR AN OVERALL SCREENING O 2741 01:33:02,443 --> 01:33:04,645 APPROACH. 2742 01:33:04,712 --> 01:33:07,748 AND THE GOAL OF THE CSRN IS TO 2743 01:33:07,815 --> 01:33:09,050 UNDERSTAND HOW BEST TO USE THESE 2744 01:33:09,116 --> 01:33:12,053 AND OTHER TECHNOLOGIES TO SCREEN 2745 01:33:12,119 --> 01:33:13,321 FOR MULTIPLE DIFFERENT CANCER 2746 01:33:13,387 --> 01:33:15,323 TYPES AND ULTIMATELY SAVE LIVES 2747 01:33:15,389 --> 01:33:16,757 FROM CANCER. 2748 01:33:16,824 --> 01:33:17,858 I'M HAPPY TO ANSWER ANY 2749 01:33:17,925 --> 01:33:18,960 QUESTIONS YOU HAVE. 2750 01:33:19,026 --> 01:33:20,328 AND I'M HAPPY TO LISTEN TO ANY 2751 01:33:20,394 --> 01:33:24,165 COMMENTS YOU HAVE AS WELL. 2752 01:33:24,231 --> 01:33:26,000 >> THANK YOU SO MUCH, 2753 01:33:26,067 --> 01:33:28,235 DR. MINASIAN, FOR WALKING US 2754 01:33:28,302 --> 01:33:30,538 THROUGH THIS VERY COMPLEX STUDY 2755 01:33:30,604 --> 01:33:32,173 THAT'S COME UP AND ALL THE HARD 2756 01:33:32,239 --> 01:33:34,475 WORK THAT'S GONE INTO SETTING 2757 01:33:34,542 --> 01:33:35,609 THINGS UP. 2758 01:33:35,676 --> 01:33:39,547 WHEN WE FIRST HEARD FROM DR 2759 01:33:39,613 --> 01:33:40,982 DR. CASSELL IN JUNE OF 2022, 2760 01:33:41,048 --> 01:33:45,052 ABOUT, YOU KNOW, HOW MANY MCDs 2761 01:33:45,119 --> 01:33:46,287 WERE OUT THERE AS WELL AS 2762 01:33:46,354 --> 01:33:47,588 THERE'S JUST SO MANY MOVING 2763 01:33:47,655 --> 01:33:49,557 PIECES AND IT'S JUST AMAZING TO 2764 01:33:49,623 --> 01:33:51,692 SEE THE HARD WORK THAT'S GONE 2765 01:33:51,759 --> 01:33:55,629 INTO PUTTING IT ALL TOGETHER. 2766 01:33:55,696 --> 01:33:58,599 THE ONE WORD I DIDN'T SEE, THE 2767 01:33:58,666 --> 01:34:00,134 ASYMPTOMATIC THAT WAS THROWN 2768 01:34:00,201 --> 01:34:03,637 AROUND SLOWLY, AND IF IT REALLY 2769 01:34:03,704 --> 01:34:05,139 AN INTERESTING -- YOU KNOW, WE 2770 01:34:05,206 --> 01:34:06,607 KNOW THAT EARLY DETECTION IS 2771 01:34:06,674 --> 01:34:07,742 DIFFERENT FROM SCREENING, AND, 2772 01:34:07,808 --> 01:34:11,012 YOU KNOW, I THINK I CAN SPEAK 2773 01:34:11,078 --> 01:34:13,114 FOR EVERYBODY, YOU KNOW, WE ALL 2774 01:34:13,180 --> 01:34:17,852 WANT EASY WAYS TO FIGHT CANCER 2775 01:34:17,918 --> 01:34:19,020 AND SAVE THE NEXT GENERATION. 2776 01:34:19,086 --> 01:34:20,921 WE WANT OUR FAMILY MEMBERS NOT 2777 01:34:20,988 --> 01:34:22,890 TO SUFFER OR THE PEOPLE WE LOVE. 2778 01:34:22,957 --> 01:34:24,859 AND THIS IS ESPECIALLY A VERY 2779 01:34:24,925 --> 01:34:28,295 IMPORTANT AREA TO US, AND THE 2780 01:34:28,362 --> 01:34:30,498 COMPLEXITY OF MOVING FROM SINGLE 2781 01:34:30,564 --> 01:34:33,100 CANCER TESTS TO THE MULTI-CANCER 2782 01:34:33,167 --> 01:34:34,769 DETECTION TOOLS, SOMETHING -- 2783 01:34:34,835 --> 01:34:37,304 THE ALGORITHMS ARE SOMETIMES IN 2784 01:34:37,371 --> 01:34:40,141 BLACK BOXES OR, YOU KNOW, 2785 01:34:40,207 --> 01:34:41,575 PROPRIETARY SO YOU KNOW, NOTHING 2786 01:34:41,642 --> 01:34:42,376 IS OUT THERE. 2787 01:34:42,443 --> 01:34:46,981 I GUESS MY QUESTION IS, AGAIN, 2788 01:34:47,048 --> 01:34:50,818 I'M PART OF -- OVARIAN CANCER IS 2789 01:34:50,885 --> 01:34:54,588 MY CANCER, SO WE FOLLOW THE 2790 01:34:54,655 --> 01:34:55,790 TALKS FROM BROAD REALIZING IT 2791 01:34:55,856 --> 01:34:59,060 CAN NEVER HAPPEN HERE BECAUSE 2792 01:34:59,126 --> 01:35:01,095 YOU -- BUT WE WERE SO HOPEFUL. 2793 01:35:01,162 --> 01:35:04,598 AND EVEN WITH THE STATE SHIFT, 2794 01:35:04,665 --> 01:35:07,435 THERE WAS NOT A DECREASE IN 2795 01:35:07,501 --> 01:35:08,402 MORTALITY, AND IT WAS LIKE 2796 01:35:08,469 --> 01:35:10,104 GETTING PUNCHED IN THE STOMACH. 2797 01:35:10,171 --> 01:35:11,939 AND, YOU KNOW, THE 10-PLUS YEARS 2798 01:35:12,006 --> 01:35:13,274 WAS A LONG TIME TO WAIT AND 2799 01:35:13,340 --> 01:35:16,911 WATCH FOR THESE RESULTS. 2800 01:35:16,977 --> 01:35:20,548 WE'RE SEEING ABOUT 8,000 PER ARM 2801 01:35:20,614 --> 01:35:21,615 TO GET ACCRUED. 2802 01:35:21,682 --> 01:35:24,452 WHAT TYPE OF TIMELINE, ONCE THEY 2803 01:35:24,518 --> 01:35:27,455 GET STARTED, ARE WE EXPECTING 2804 01:35:27,521 --> 01:35:29,323 TO -- YOU KNOW, WHAT'S THE BEST 2805 01:35:29,390 --> 01:35:30,991 CASE SCENARIO TO ANTICIPATE SOME 2806 01:35:31,058 --> 01:35:31,225 RESULTS? 2807 01:35:31,292 --> 01:35:34,128 >> SO THE FIRST OBJECTIVE FOR 2808 01:35:34,195 --> 01:35:37,364 THE VANGUARD STUDY IS THE 2809 01:35:37,431 --> 01:35:38,466 FEASIBILITY OF RANDOMIZATION. 2810 01:35:38,532 --> 01:35:41,869 IF WE LAUNCH THIS AND TWO YEARS 2811 01:35:41,936 --> 01:35:43,737 LATER 15 MONTHS LATER, WE FULLY 2812 01:35:43,804 --> 01:35:44,171 ACCRUED. 2813 01:35:44,238 --> 01:35:48,409 I WOULD SAY THAT'S A CAUSE FOR A 2814 01:35:48,476 --> 01:35:49,810 GREAT SUCCESS IN THAT REGARD. 2815 01:35:49,877 --> 01:35:51,345 SO I THINK IT GOING TO COME IN 2816 01:35:51,412 --> 01:35:53,714 SMALL PIECES BECAUSE THERE ARE 2817 01:35:53,781 --> 01:35:56,750 DIFFERENT PIECES TO THIS. 2818 01:35:56,817 --> 01:35:58,385 REMEMBER THAT THIS IS A PILOT. 2819 01:35:58,452 --> 01:36:00,788 SO WE'RE NOT LOOKING AT 2820 01:36:00,855 --> 01:36:01,755 MORTALITY, AND THIS NETWORK IS 2821 01:36:01,822 --> 01:36:06,060 ONLY FUNDED FOR FOUR YEARS. 2822 01:36:06,127 --> 01:36:09,363 WELL, IT WAS INTENTIONAL BECAUSE 2823 01:36:09,430 --> 01:36:12,333 IF THIS IS AS SUCCESSFUL AS WE 2824 01:36:12,399 --> 01:36:15,202 HOPE IT IS, WE MAY WANT TO 2825 01:36:15,269 --> 01:36:16,637 MODIFY THE PARAMETERS AROUND THE 2826 01:36:16,704 --> 01:36:19,673 NETWORK ITSELF WHEN WE COME 2827 01:36:19,740 --> 01:36:23,777 FORWARD THE NEXT TIME. 2828 01:36:23,844 --> 01:36:25,646 SO IT IS -- SO THERE ARE A 2829 01:36:25,713 --> 01:36:28,048 COUPLE DIFFERENT THINGS. 2830 01:36:28,115 --> 01:36:29,617 IT'S A PILOT OF THE NETWORK, 2831 01:36:29,683 --> 01:36:31,485 IT'S A PILOT OF THIS TRIAL. 2832 01:36:31,552 --> 01:36:32,486 AND IN THE THREE YEARS WE'VE 2833 01:36:32,553 --> 01:36:34,021 BEEN WORKING ON THIS, WE HAVE 2834 01:36:34,088 --> 01:36:36,790 LEARNED SO MUCH THAT I WOULD 2835 01:36:36,857 --> 01:36:39,093 IMAGINE IN THE NEXT THREE YEARS, 2836 01:36:39,160 --> 01:36:42,463 WE'LL LEARN EVEN MORE SO THAT 2837 01:36:42,530 --> 01:36:45,533 WE'LL BE EVEN -- WE'LL HAVE MORE 2838 01:36:45,599 --> 01:36:48,002 INFORMATION THAT CAN GO INTO 2839 01:36:48,068 --> 01:36:49,503 BUILDING A VERY ROBUST CANCER 2840 01:36:49,570 --> 01:36:50,938 SCREENING NETWORK. 2841 01:36:51,005 --> 01:36:53,140 >> I JUST ALSO WANTED TO SPEAK 2842 01:36:53,207 --> 01:36:55,476 TO THE NETWORK ITSELF AND HOW 2843 01:36:55,543 --> 01:36:57,011 THE RURAL SITES ARE GOING TO BE 2844 01:36:57,077 --> 01:36:58,979 BROUGHT IN, I THINK ONE OF THE 2845 01:36:59,046 --> 01:37:03,717 THINGS WE'RE HEARING TO PROMOTE 2846 01:37:03,784 --> 01:37:08,989 MCDs IS IT WILL HELP OVERCOME 2847 01:37:09,056 --> 01:37:10,191 INEQUITIES IN CARE BECAUSE IT'S 2848 01:37:10,257 --> 01:37:11,559 JUST A BLOOD TEST, BUT I REALLY 2849 01:37:11,625 --> 01:37:12,860 LIKE THAT YOU ARE ALSO LOOKING 2850 01:37:12,927 --> 01:37:17,264 AT ACCESS TO THE -- YOU KNOW, 2851 01:37:17,331 --> 01:37:18,666 ONCE SOMETHING MIGHT BE 2852 01:37:18,732 --> 01:37:19,800 INTERCEPTED, THE FOLLOW-UP 2853 01:37:19,867 --> 01:37:20,668 MODALITIES THAT NEED TO HAPPEN, 2854 01:37:20,734 --> 01:37:22,570 SO I THINK THAT IS SUCH AN 2855 01:37:22,636 --> 01:37:23,704 IMPORTANT PART OF THE NETWORK, 2856 01:37:23,771 --> 01:37:25,306 SO THANK YOU FOR YOUR WORK. 2857 01:37:25,372 --> 01:37:26,473 >> WELL, WE'RE VERY CONCERNED 2858 01:37:26,540 --> 01:37:27,675 ABOUT THAT BECAUSE, YOU KNOW, IF 2859 01:37:27,741 --> 01:37:29,076 SOMEBODY IN A RURAL PART OF THE 2860 01:37:29,143 --> 01:37:31,345 STATE HAS A POSITIVE BLOOD TEST, 2861 01:37:31,412 --> 01:37:32,980 YOU KNOW, WHAT HAPPENS NEXT? 2862 01:37:33,047 --> 01:37:34,248 DO THEY WAIT THREE MONTHS? 2863 01:37:34,315 --> 01:37:38,652 DO THEY HAVE TO TRAVEL 100, 200, 2864 01:37:38,719 --> 01:37:41,522 300 MILES TO THE CANCER CENTER 2865 01:37:41,589 --> 01:37:43,958 FOR THEIR MRI? 2866 01:37:44,024 --> 01:37:46,260 OR THEIR FOLLOW-UP TESTING? 2867 01:37:46,327 --> 01:37:47,828 WILL THAT DISCOURAGE THEM? 2868 01:37:47,895 --> 01:37:49,063 WILL THEY NOT HAVE THE RESOURCES 2869 01:37:49,129 --> 01:37:50,030 FOR THAT? 2870 01:37:50,097 --> 01:37:54,168 THERE ARE A VARIETY OF DIFFERENT 2871 01:37:54,235 --> 01:37:54,401 THINGS. 2872 01:37:54,468 --> 01:37:59,340 IF SOMEBODY CAN NASHVILLE, TO 2873 01:37:59,406 --> 01:38:00,507 TAKE THAT EXAMPLE, HAS TO WAIT 2874 01:38:00,574 --> 01:38:03,711 TWO MONTHS TO GET A CT SCAN, HOW 2875 01:38:03,777 --> 01:38:04,878 ABOUT RURAL TENNESSEE? 2876 01:38:04,945 --> 01:38:06,580 WHAT WILL THAT TAKE? 2877 01:38:06,647 --> 01:38:07,514 >> OH, YES. 2878 01:38:07,581 --> 01:38:09,883 >> AND SO WE REALLY DO WANT TO 2879 01:38:09,950 --> 01:38:10,918 CAPTURE THIS AND UNDERSTAND IT 2880 01:38:10,985 --> 01:38:15,623 IN A WAY THAT MAKES SENSE. 2881 01:38:15,689 --> 01:38:17,324 SO THAT WE CAN HAVE THE DATA. 2882 01:38:17,391 --> 01:38:19,927 ONE OF THE THINGS WE'VE BEEN 2883 01:38:19,994 --> 01:38:23,130 ASKING OUR COLLEAGUES 2884 01:38:23,197 --> 01:38:24,932 PARTICULARLY IS TO PROVIDE US 2885 01:38:24,999 --> 01:38:27,167 WITH SOME OF THE PARAMETERS OF 2886 01:38:27,234 --> 01:38:29,670 DATA THEY WOULD LIKE TO SEE IN 2887 01:38:29,737 --> 01:38:31,105 THIS STUDY. 2888 01:38:31,171 --> 01:38:32,673 >> AND YOU KNOW, JUST AS YOU 2889 01:38:32,740 --> 01:38:34,808 WERE TALKING, I'M THINKING, YOU 2890 01:38:34,875 --> 01:38:37,711 KNOW, THERE WERE PEOPLE WHO LIVE 2891 01:38:37,778 --> 01:38:39,013 NEAR MAJOR CANCER CENTERS WHO 2892 01:38:39,079 --> 01:38:41,215 MAY BE UNDERINSURED OR 2893 01:38:41,282 --> 01:38:42,916 UNDERSERVED, AND ARE THERE 2894 01:38:42,983 --> 01:38:43,884 RECRUITMENT PLANS TO MAKE SURE 2895 01:38:43,951 --> 01:38:46,053 THAT WE CAPTURE THOSE TYPES OF 2896 01:38:46,120 --> 01:38:47,187 PEOPLE AS WELL? 2897 01:38:47,254 --> 01:38:48,722 >> SO THERE ARE A COUPLE 2898 01:38:48,789 --> 01:38:49,490 DIFFERENT SCENARIOS. 2899 01:38:49,556 --> 01:38:51,692 CERTAINLY IN THE VA AND THE DOD, 2900 01:38:51,759 --> 01:38:52,893 WE'RE GOING TO HAVE ONE 2901 01:38:52,960 --> 01:38:53,661 SCENARIO. 2902 01:38:53,727 --> 01:38:57,965 RIGHT? 2903 01:38:58,032 --> 01:39:00,467 KAISER MAY BE A SIMILAR SCENARIO 2904 01:39:00,534 --> 01:39:01,935 WHERE THEY SAY THEY'RE GOING TO 2905 01:39:02,002 --> 01:39:02,936 ABSORB THE COST, IT NOT A 2906 01:39:03,003 --> 01:39:03,270 PROBLEM. 2907 01:39:03,337 --> 01:39:04,271 SO THAT COULD BE A SCENARIO 2908 01:39:04,338 --> 01:39:07,441 WHERE WE START TO UNDERSTAND IF 2909 01:39:07,508 --> 01:39:09,343 IT'S NOT AN ACCESS ISSUE, WHAT 2910 01:39:09,410 --> 01:39:12,112 ARE THE OTHER BARRIERS TO THE 2911 01:39:12,179 --> 01:39:12,513 FOLLOW-UP? 2912 01:39:12,579 --> 01:39:14,114 BECAUSE THERE'S A LOT OF 2913 01:39:14,181 --> 01:39:15,516 CONCERN, YOU KNOW, DO I HAVE 2914 01:39:15,582 --> 01:39:16,750 CANCER, AM I GOING TO BE ABLE TO 2915 01:39:16,817 --> 01:39:17,851 TAKE CARE OF MY FAMILY? 2916 01:39:17,918 --> 01:39:21,822 A LOT OF PATIENT ISSUES IN THAT 2917 01:39:21,889 --> 01:39:22,556 REGARD. 2918 01:39:22,623 --> 01:39:24,091 BUT SO THERE'S SOME PLACES IN 2919 01:39:24,158 --> 01:39:25,893 THIS THAT WE'LL BE ABLE TO 2920 01:39:25,959 --> 01:39:26,226 EXPLORE THAT. 2921 01:39:26,293 --> 01:39:27,127 THERE ARE OTHER PLACES WHERE 2922 01:39:27,194 --> 01:39:29,196 WE'LL HAVE TO LOOK VERY 2923 01:39:29,263 --> 01:39:30,164 SPECIFICALLY AT SOME OF THE 2924 01:39:30,230 --> 01:39:31,031 ACCESS ISSUES. 2925 01:39:31,098 --> 01:39:33,500 WE HAVE BUILT IN USUALLY IN OUR 2926 01:39:33,567 --> 01:39:34,401 CLINICAL TRIALS NETWORK, WE DO 2927 01:39:34,468 --> 01:39:35,803 NOT BUILD ANY PATIENT CARE COSTS 2928 01:39:35,869 --> 01:39:37,004 IN. 2929 01:39:37,071 --> 01:39:37,705 THAT, WE DON'T. 2930 01:39:37,771 --> 01:39:42,643 IN THIS ONE, WE CALLED OUT A 2931 01:39:42,710 --> 01:39:43,944 FIXED AMOUNT OF MONEY THAT THE 2932 01:39:44,011 --> 01:39:46,313 SITES COULD USE TO REIMBURSE FOR 2933 01:39:46,380 --> 01:39:48,382 SPECIFIC KINDS OF TESTS. 2934 01:39:48,449 --> 01:39:50,351 UNDERSTANDING THAT, YOU KNOW, 2935 01:39:50,417 --> 01:39:52,186 THE EXPECTATION HERE IS THAT 1% 2936 01:39:52,252 --> 01:39:53,587 OF THESE PARTICIPANTS WILL 2937 01:39:53,654 --> 01:39:54,988 ACTUALLY HAVE A POSITIVE TEST. 2938 01:39:55,055 --> 01:39:59,259 AND THE REASON WHY THE VANGUARD 2939 01:39:59,326 --> 01:40:03,597 STUDY WAS SET FOR A SAMPLE SIZE 2940 01:40:03,664 --> 01:40:04,798 OF 24,000 WAS BECAUSE WITH 2941 01:40:04,865 --> 01:40:06,667 24,000, WE'LL GET ABOUT 2942 01:40:06,734 --> 01:40:07,901 160 POSITIVE BLOOD TESTS THAT 2943 01:40:07,968 --> 01:40:11,171 WILL FOLLOW UP. 2944 01:40:11,238 --> 01:40:12,172 SO MOST OF THE PEOPLE WILL NOT 2945 01:40:12,239 --> 01:40:16,977 HAVE A POSITIVE BLOOD TEST. 2946 01:40:17,044 --> 01:40:18,445 SO WHAT DOES IT MEAN? 2947 01:40:18,512 --> 01:40:19,380 WE'RE THINKING WITH A RELATIVELY 2948 01:40:19,446 --> 01:40:20,748 SMALL AMOUNT OF MONEY, WE MIGHT 2949 01:40:20,814 --> 01:40:22,616 BE ABLE IN THIS PILOT SETTING BE 2950 01:40:22,683 --> 01:40:24,318 ABLE TO HELP FACILITATE THE 2951 01:40:24,385 --> 01:40:25,719 FOLLOW-UP THROUGH THE TRIAL, BUT 2952 01:40:25,786 --> 01:40:27,154 THAT'S NOT GOING TO BE THE 2953 01:40:27,221 --> 01:40:29,523 SCENARIO GOING FORWARD IF IT'S 2954 01:40:29,590 --> 01:40:32,659 AN ACCEPTABLE -- YOU KNOW, THERE 2955 01:40:32,726 --> 01:40:34,294 ARE GOING TO HAVE TO BE OTHER 2956 01:40:34,361 --> 01:40:35,796 MEANS TO PAY FOR THE DIAGNOSTIC 2957 01:40:35,863 --> 01:40:41,902 WORKUP IF IT'S AN APPROVE OR ANR 2958 01:40:41,969 --> 01:40:42,302 AUTHORIZED APROA. 2959 01:40:42,369 --> 01:40:43,003 >> HI. 2960 01:40:43,070 --> 01:40:47,808 THANK YOU FOR YOUR PRESENTATION. 2961 01:40:47,875 --> 01:40:49,643 COMING FROM THE LUNG SPACE WE 2962 01:40:49,710 --> 01:40:50,611 CERTAINLY HEARD FROM A LOT OF 2963 01:40:50,677 --> 01:40:51,578 COMPANIES ABOUT THIS TECHNOLOGY 2964 01:40:51,645 --> 01:40:53,213 AND IT'S SUPER EXCITING. 2965 01:40:53,280 --> 01:40:54,748 I WOULD SAY, YOU KNOW, WE'RE NOT 2966 01:40:54,815 --> 01:40:55,983 THERE YET, WHICH OBVIOUSLY THIS 2967 01:40:56,049 --> 01:40:58,185 WILL BE HELPFUL TO GET US THERE. 2968 01:40:58,252 --> 01:41:00,521 AS AN INDIVIDUAL LIKE SIGN ME UP 2969 01:41:00,587 --> 01:41:07,194 TODAY, TAKE MY BLOOD, TELL ME 2970 01:41:07,261 --> 01:41:09,296 ME -- -- SOMETHING OFF AND MAYBE 2971 01:41:09,363 --> 01:41:10,764 HOPEFULLY IT'S NOT ACTIONABLE 2972 01:41:10,831 --> 01:41:12,032 ANY TIME IN MY LIFETIME BECAUSE 2973 01:41:12,099 --> 01:41:13,066 IT'S NOT GOING TO DO ANYTHING, 2974 01:41:13,133 --> 01:41:15,769 BUT MY QUESTION IS ABOUT THE 2975 01:41:15,836 --> 01:41:17,738 QUALITY OF LIFE PIECE AND 2976 01:41:17,805 --> 01:41:20,541 LOOKING AT THE OVARIAN CANCER 2977 01:41:20,607 --> 01:41:20,874 EXAMPLE. 2978 01:41:20,941 --> 01:41:23,043 LIKE THE MORTALITY MIGHT NOT 2979 01:41:23,110 --> 01:41:25,112 CHANGE, BUT CATCHING SOMETHING 2980 01:41:25,179 --> 01:41:26,713 EARLIER CAN HELP PEOPLE MAKE 2981 01:41:26,780 --> 01:41:28,248 DIFFERENT DECISIONS AND MAYBE 2982 01:41:28,315 --> 01:41:30,651 THEY GET BETTER FROM -- 2983 01:41:30,717 --> 01:41:33,520 MANAGEMENT OR HIGHER QUALITY -- 2984 01:41:33,587 --> 01:41:36,590 KEEP THEM ALIVE BUT MIGHT MAKE 2985 01:41:36,657 --> 01:41:37,925 THEIR LIFE BETTER FOR THAT 2986 01:41:37,991 --> 01:41:38,358 INDIVIDUAL. 2987 01:41:38,425 --> 01:41:42,830 AND I KNOW THAT -- WAS BEING 2988 01:41:42,896 --> 01:41:46,400 LOOKED AT BUT AS A PATIENT 2989 01:41:46,467 --> 01:41:48,902 ADVOCATE I THINK THAT'S REALLY 2990 01:41:48,969 --> 01:41:50,871 IMPORTANT. 2991 01:41:50,938 --> 01:41:52,072 I JUST WANTED TO PUT IT OUT 2992 01:41:52,139 --> 01:41:55,075 THERE THAT IT'S MORE THAN 2993 01:41:55,142 --> 01:41:57,845 WHETHER OR NOT YOU DIE, YOU 2994 01:41:57,911 --> 01:41:58,045 KNOW. 2995 01:41:58,111 --> 01:41:58,946 >> NO QUESTION. 2996 01:41:59,012 --> 01:42:00,714 AND WE ARE GOING TO COLLECT 2997 01:42:00,781 --> 01:42:04,084 QUALITY OF LIFE AND 2998 01:42:04,151 --> 01:42:05,586 PATIENT-REPORTED OUTCOMES, 2999 01:42:05,652 --> 01:42:07,421 THAT'S A KEY PART OF THIS. 3000 01:42:07,488 --> 01:42:08,388 PATIENT-REPORTED OUTCOMES THAT 3001 01:42:08,455 --> 01:42:11,024 ARE NOT EVEN JUST THE STANDARD 3002 01:42:11,091 --> 01:42:13,260 TOOLS BUT ASKING SOME OF THESE 3003 01:42:13,327 --> 01:42:14,161 EXPLICIT QUESTIONS. 3004 01:42:14,228 --> 01:42:17,231 I DON'T KNOW IF YOU REMEMBER IN 3005 01:42:17,297 --> 01:42:19,466 THE MACH TRIAL, WHEN THAT WAS 3006 01:42:19,533 --> 01:42:21,969 LAUNCHED, THERE WAS A VERY 3007 01:42:22,035 --> 01:42:24,705 SPECIFIC PRO SECTION THAT WAS 3008 01:42:24,771 --> 01:42:26,440 LIKE A CORRELATIVE STUDY IN 3009 01:42:26,507 --> 01:42:28,275 ADDITION TO MACH THAT WAS 3010 01:42:28,342 --> 01:42:30,177 LOOKING AT PATIENTS'ER SEPTIONS 3011 01:42:30,244 --> 01:42:32,012 OF WHAT IT MEANT TO BE -- IN 3012 01:42:32,079 --> 01:42:33,280 PARTICULAR WHAT IT MEANT TO GO 3013 01:42:33,347 --> 01:42:35,883 THROUGH THE BIOPSY AND THE 3014 01:42:35,949 --> 01:42:36,783 MOLECULAR CHARACTERIZATION ONLY 3015 01:42:36,850 --> 01:42:39,386 TO HAVE THEM SAY YOU'RE NOT 3016 01:42:39,453 --> 01:42:41,188 ELIGIBLE BECAUSE YOU DON'T HAVE 3017 01:42:41,255 --> 01:42:42,723 ANY TUMOR MARKERS, THAT'S IT, 3018 01:42:42,789 --> 01:42:43,156 RIGHT? 3019 01:42:43,223 --> 01:42:47,561 SO YES, WE ABSOLUTELY ARE GOING 3020 01:42:47,628 --> 01:42:48,829 TO LOOK VERY CAREFULLY AT WHAT 3021 01:42:48,896 --> 01:42:49,997 KIND OF QUALITY OF LIFE, WHAT 3022 01:42:50,063 --> 01:42:50,964 KIND OF PATIENT-REPORTED 3023 01:42:51,031 --> 01:42:52,065 OUTCOMES NEED TO BE 3024 01:42:52,132 --> 01:42:53,367 INCORPORATED, WE'LL PROBABLY USE 3025 01:42:53,433 --> 01:42:54,668 PROBABLY MORE PROMIS MEASURES 3026 01:42:54,735 --> 01:42:56,069 THAN WE USED WITH QUALITY OF 3027 01:42:56,136 --> 01:42:58,739 LIFE BECAUSE THEY MIGHT BE MORE 3028 01:42:58,805 --> 01:43:01,608 SPECIFIC TO AN ASYMPTOMATIC 3029 01:43:01,675 --> 01:43:06,580 NON-CANCER POPULATION. 3030 01:43:06,647 --> 01:43:08,382 >> THANK YOU FOR YOUR 3031 01:43:08,448 --> 01:43:09,516 PRESENTATION -- OH, SORRY, DID I 3032 01:43:09,583 --> 01:43:09,850 INTERRUPT? 3033 01:43:09,917 --> 01:43:11,184 GO AHEAD. 3034 01:43:11,251 --> 01:43:12,586 >> THANKS FOR YOUR PRESENTATION 3035 01:43:12,653 --> 01:43:13,220 AND THE WORK. 3036 01:43:13,287 --> 01:43:14,955 AS A CANCER SURVIVOR, I'VE BEEN 3037 01:43:15,022 --> 01:43:17,224 VERY INTERESTED IN THIS. 3038 01:43:17,291 --> 01:43:20,294 IT'S HARD TO GET INFORMATION 3039 01:43:20,360 --> 01:43:21,962 ABOUT IT FROM THE PUBLIC POINT 3040 01:43:22,029 --> 01:43:22,496 OF VIEW. 3041 01:43:22,563 --> 01:43:25,399 I WAS AT THE ANNUAL CONFERENCE 3042 01:43:25,465 --> 01:43:26,066 LAST SUMMER. 3043 01:43:26,133 --> 01:43:33,040 I TALKED TO GRAIL AND EX-ACT 3044 01:43:33,106 --> 01:43:36,977 SISCIENCES, I DIDN'T WANT TO PAY 3045 01:43:37,044 --> 01:43:38,245 $950 FOR THIS. 3046 01:43:38,312 --> 01:43:39,446 I WENT TO WASHINGTON HOSPITAL 3047 01:43:39,513 --> 01:43:41,148 CENTER BACK IN JULY. 3048 01:43:41,214 --> 01:43:43,250 NO CANCER SIGNAL DETECTED. 3049 01:43:43,317 --> 01:43:46,887 I UNDERSTAND THE CAVEATS, FALSE 3050 01:43:46,954 --> 01:43:48,555 AND PLUS AND MINUS. 3051 01:43:48,622 --> 01:43:53,493 I WOUT OF THE 85 PARTICIPANTS TY 3052 01:43:53,560 --> 01:43:55,662 HAD, THEY HAD ONE POSITIVE AND 3053 01:43:55,729 --> 01:43:56,930 IT WAS TO A CANCER SURVIVOR. 3054 01:43:56,997 --> 01:44:01,435 I DIDN'T HEAR ANY MORE THAN 3055 01:44:01,501 --> 01:44:03,170 THAT, BUT WE KNOW WHAT IT LIKE 3056 01:44:03,236 --> 01:44:05,606 TO BE DIAGNOSED. 3057 01:44:05,672 --> 01:44:08,308 FOR ME IT WAS STAGE IV. 3058 01:44:08,375 --> 01:44:10,510 I GOT MY COLONOSCOPY THE NEXT 3059 01:44:10,577 --> 01:44:10,844 MONTH. 3060 01:44:10,911 --> 01:44:11,578 >> THANKS, LEE. 3061 01:44:11,645 --> 01:44:12,946 WE'RE GOING TO TAKE OUR LAST 3062 01:44:13,013 --> 01:44:14,815 QUESTION FROM NICOLE. 3063 01:44:14,881 --> 01:44:16,116 >> THANK YOU. 3064 01:44:16,183 --> 01:44:17,351 THANK YOU FOR YOUR PRESENTATION. 3065 01:44:17,417 --> 01:44:19,553 I THINK IT WAS JUST REALLY 3066 01:44:19,620 --> 01:44:20,988 INTERESTING, AND COMING FROM THE 3067 01:44:21,054 --> 01:44:23,390 BRAIN TUMOR SPACE, WHERE WE NEED 3068 01:44:23,457 --> 01:44:24,825 SOME TYPE OF SCREENING, I KNOW 3069 01:44:24,891 --> 01:44:26,827 THIS IS NOT NECESSARILY GOING TO 3070 01:44:26,893 --> 01:44:28,629 WORK FOR PRAIN DUE MORE 3071 01:44:28,695 --> 01:44:29,396 PATIENTS. 3072 01:44:29,463 --> 01:44:32,566 MAYBE CSF, BUT PROBABLY NOT 3073 01:44:32,633 --> 01:44:34,267 LIKELY BLOOD BECAUSE OF THE 3074 01:44:34,334 --> 01:44:35,802 BLOOD BRAIN BARRIER, BUT I THINK 3075 01:44:35,869 --> 01:44:37,004 THERE COULD BE A LOT OF 3076 01:44:37,070 --> 01:44:38,438 POSITIVES THAT COULD COME OUT OF 3077 01:44:38,505 --> 01:44:39,373 THE EARLY SCREENING. 3078 01:44:39,439 --> 01:44:40,507 I GUESS ONE OF THE QUESTIONS 3079 01:44:40,574 --> 01:44:43,644 THAT I HAD, AND I DON'T KNOW IF 3080 01:44:43,710 --> 01:44:45,912 THIS IS -- I DON'T UNDERSTAND 3081 01:44:45,979 --> 01:44:46,980 COMPLETELY THE OVARIAN CANCER 3082 01:44:47,047 --> 01:44:49,149 STUDY BUT I'M WONDERING, DID YOU 3083 01:44:49,216 --> 01:44:51,752 SEE ANY DIFFERENCE IN MORTALITY 3084 01:44:51,818 --> 01:44:53,453 WITH DOING THE SCREENING EVEN IF 3085 01:44:53,520 --> 01:44:56,590 IT WAS DETECTED EARLIER? 3086 01:44:56,657 --> 01:44:58,759 SO DOES IT -- WAS IT LOOKED AT 3087 01:44:58,825 --> 01:45:00,460 IF THERE WERE INTERVENTIONS THAT 3088 01:45:00,527 --> 01:45:01,662 COULD HAVE BEEN DONE FOR THOSE 3089 01:45:01,728 --> 01:45:04,931 THAT WERE DIAGNOSED EARLIER 3090 01:45:04,998 --> 01:45:06,166 BECAUSE IF THERE ISN'T ANY 3091 01:45:06,233 --> 01:45:07,401 DIFFERENCE IN HOW THOSE PATIENTS 3092 01:45:07,467 --> 01:45:09,369 COULD BE TREATED ULTIMATELY, 3093 01:45:09,436 --> 01:45:10,804 THEN I WOULDN'T NECESSARILY 3094 01:45:10,871 --> 01:45:12,239 EXPECT THERE WOULD BE A DRAMATIC 3095 01:45:12,305 --> 01:45:15,342 CHANGE IN MORTALITY, BUT MAYBE 3096 01:45:15,409 --> 01:45:17,411 IF THERE WERE OTHER TREATMENTS 3097 01:45:17,477 --> 01:45:20,113 THAT COULD BE USED FOR EARLIER 3098 01:45:20,180 --> 01:45:21,782 STAGE CANCER, THEN THAT MAY 3099 01:45:21,848 --> 01:45:24,051 ULTIMATELY MAKE A DIFFERENCE FOR 3100 01:45:24,117 --> 01:45:24,384 THAT PATIENT. 3101 01:45:24,451 --> 01:45:25,852 I DON'T KNOW IF THAT MAKES 3102 01:45:25,919 --> 01:45:26,053 SENSE. 3103 01:45:26,119 --> 01:45:28,088 >> I THINK I KNOW WHERE YOU'RE 3104 01:45:28,155 --> 01:45:29,289 GOING. 3105 01:45:29,356 --> 01:45:32,559 AND MAYBE IT'S -- SO WITH 3106 01:45:32,626 --> 01:45:33,960 OVARIAN CANCER, THE FIRST LINE 3107 01:45:34,027 --> 01:45:36,063 OF TREATMENT IRRESPECTIVE OF 3108 01:45:36,129 --> 01:45:37,164 YOUR STAGE IS SURGICAL 3109 01:45:37,230 --> 01:45:37,898 RESECTION. 3110 01:45:37,964 --> 01:45:38,432 OKAY? 3111 01:45:38,498 --> 01:45:40,133 EVEN IF YOU HAVE -- YOU KNOW, 3112 01:45:40,200 --> 01:45:43,770 UNLESS YOU HAVE WIDELY 3113 01:45:43,837 --> 01:45:45,205 METASTATIC DISEASE, MOST 3114 01:45:45,272 --> 01:45:46,807 PARTICIPANTS, IF THEY JUST HAVE 3115 01:45:46,873 --> 01:45:48,141 LIVER METS, YOU KNOW, MIGHT HAVE 3116 01:45:48,208 --> 01:45:50,577 A DEVELOPING SURGERY, MAYBE 3117 01:45:50,644 --> 01:45:52,145 POTENTIALLY, SO THAT -- BECAUSE 3118 01:45:52,212 --> 01:45:54,448 WHEN YOU DEBULK THE PERITONEUM 3119 01:45:54,514 --> 01:45:55,916 AND YOU DEBULK THE WHOLE 3120 01:45:55,982 --> 01:45:57,484 ABDOMINAL CAVITY, YOU ACTUALLY 3121 01:45:57,551 --> 01:46:01,354 HAVE BETTER UPTAKE OF THE 3122 01:46:01,421 --> 01:46:01,888 CHEMOTHERAPY, PARTICULARLY 3123 01:46:01,955 --> 01:46:03,090 PLATINUM, AND YOU GET BETTER 3124 01:46:03,156 --> 01:46:03,523 RESPONSES. 3125 01:46:03,590 --> 01:46:05,058 THAT'S BEEN SHOWN IN OVARIAN 3126 01:46:05,125 --> 01:46:06,126 CANCER FOR A LONG TIME. 3127 01:46:06,193 --> 01:46:07,661 IT ONE OF THE FEW CANCERS WHERE 3128 01:46:07,728 --> 01:46:09,396 YOU DO ACTUALLY GO IN AND DO 3129 01:46:09,463 --> 01:46:09,629 THAT. 3130 01:46:09,696 --> 01:46:12,299 IN FACT, FOR A LONG TIME WE DID 3131 01:46:12,365 --> 01:46:13,400 SECONDARY DEBULKING SURGERIES 3132 01:46:13,467 --> 01:46:14,401 ALSO. 3133 01:46:14,468 --> 01:46:16,002 ONE OF THE BIG CHANGES IN 3134 01:46:16,069 --> 01:46:19,573 OVARIAN CANCER TREATMENT IS THE 3135 01:46:19,639 --> 01:46:20,240 PARK INHIBITORS. 3136 01:46:20,307 --> 01:46:21,775 AND THOSE HAVE MADE A HUGE 3137 01:46:21,842 --> 01:46:24,277 CHANGE IN HIGH GRADE SEROUS 3138 01:46:24,344 --> 01:46:25,378 DISEASE. 3139 01:46:25,445 --> 01:46:26,113 THEY'VE OVER THE LAST 10 YEARS 3140 01:46:26,179 --> 01:46:28,181 BROUGHT IT EARLIER AND EARLIER 3141 01:46:28,248 --> 01:46:29,282 INTO INTERVENTION STUDIES. 3142 01:46:29,349 --> 01:46:33,120 THIS STUDY, THE UKC TOX WAS DONE 3143 01:46:33,186 --> 01:46:34,921 PRIOR TO THE INITIATION OF ANY 3144 01:46:34,988 --> 01:46:35,822 PARK INHIBITOR THERAPY. 3145 01:46:35,889 --> 01:46:37,724 SO WHAT WE DON'T KNOW IS WHETHER 3146 01:46:37,791 --> 01:46:42,763 OR NOT WE WOULD -- SEEING A 3147 01:46:42,829 --> 01:46:43,764 MORTALITY -- IF IN FACT IT WAS 3148 01:46:43,830 --> 01:46:45,632 DONE AT A TIME WHEN, IN FACT, WE 3149 01:46:45,699 --> 01:46:47,200 HAD PARK INHIBITOR THERAPY. 3150 01:46:47,267 --> 01:46:48,802 NOW I SAY THAT ALSO BECAUSE I 3151 01:46:48,869 --> 01:46:50,937 HAD A GROUP IN MY DIVISION WHERE 3152 01:46:51,004 --> 01:46:53,607 WE DID A DEEP DIVE INTO THE POCO 3153 01:46:53,673 --> 01:46:54,107 DATA. 3154 01:46:54,174 --> 01:46:55,675 WE ACTUALLY WENT BACK TO IT AND 3155 01:46:55,742 --> 01:46:59,112 SAID OKAY, HOW WAS THE PATHOLOGY 3156 01:46:59,179 --> 01:47:00,847 CLASSIFIED, CAN WE GO BACK AND 3157 01:47:00,914 --> 01:47:02,516 LOOK AT SEPARATING THESE OUT 3158 01:47:02,582 --> 01:47:04,417 INTO TYPE 1 AND TYPE 2s, AND 3159 01:47:04,484 --> 01:47:09,890 THE PATHOLOGY WAS ALL BASED UPON 3160 01:47:09,956 --> 01:47:11,424 THE DIAGNOSTIC CRITERIA IN 19 3161 01:47:11,491 --> 01:47:16,329 NIEP 1990s AND THE EARLY 2000s 3162 01:47:16,396 --> 01:47:17,597 AND REALLY DID NOT LOOK THE A 3163 01:47:17,664 --> 01:47:18,899 SOME OF THESE NEWER THINGS. 3164 01:47:18,965 --> 01:47:23,036 SO I HAD AN OBGY THIS 3165 01:47:23,103 --> 01:47:24,171 GYNECOLOGIST LOOK AT A ROUGH -- 3166 01:47:24,237 --> 01:47:26,506 SHE LOOKED AT ALL THE PATHOLOGY 3167 01:47:26,573 --> 01:47:28,408 REPORTS, AND WE REANALYZED THE 3168 01:47:28,475 --> 01:47:31,845 DATA AND WE SAW A SLIGHT TREND 3169 01:47:31,912 --> 01:47:35,582 TOWARDS AN IMPROVEMENT IN 3170 01:47:35,649 --> 01:47:37,317 THE HIGH GRADE SEROUS OVARIAN 3171 01:47:37,384 --> 01:47:41,588 CANCER PATIENTS ON UKC TOX. 3172 01:47:41,655 --> 01:47:43,957 SO IT MAY BE THAT OVER TIME, YOU 3173 01:47:44,024 --> 01:47:46,493 COULD SHOW THAT. 3174 01:47:46,560 --> 01:47:48,562 THE HOPE AND EXPECTATION IS THAT 3175 01:47:48,628 --> 01:47:50,130 AS WE PROGRESS THROUGH THE 3176 01:47:50,197 --> 01:47:52,465 NATIONAL CANCER PLAN, WE 3177 01:47:52,532 --> 01:47:53,800 ACTUALLY DEVELOP BETTER 3178 01:47:53,867 --> 01:47:55,969 TREATMENTS THAT IF WE DID 3179 01:47:56,036 --> 01:47:57,270 TESTING EARLY ENOUGH, WE COULD 3180 01:47:57,337 --> 01:47:58,572 REALLY MAKE A DIFFERENCE. 3181 01:47:58,638 --> 01:47:59,873 SO HERE'S AN OPPORTUNITY THEN TO 3182 01:47:59,940 --> 01:48:02,275 MARRY MOVING CANCER SCREENING 3183 01:48:02,342 --> 01:48:04,244 FORWARD IN SUBSTANTIAL WAYS EVEN 3184 01:48:04,311 --> 01:48:06,446 AS WE MOVE CANCER TREATMENT 3185 01:48:06,513 --> 01:48:09,816 FORWARD SO THAT HOPEFULLY 3186 01:48:09,883 --> 01:48:12,285 THEY'LL COME TOGETHER BEFORE, 3187 01:48:12,352 --> 01:48:16,456 WHAT, 2047. 3188 01:48:16,523 --> 01:48:17,657 >> THANK YOU SO MUCH, 3189 01:48:17,724 --> 01:48:17,991 DR. MINASIAN. 3190 01:48:18,058 --> 01:48:20,594 WE ARE OUT OF TIME, SO WE ARE 3191 01:48:20,660 --> 01:48:26,032 GOING TO QUICKLY SHIFT GEARS. 3192 01:48:26,099 --> 01:48:27,133 HOLLY, THANK YOU FOR JOINING US 3193 01:48:27,200 --> 01:48:28,301 AND WE WILL -- PLEASE TAKE YOUR 3194 01:48:28,368 --> 01:48:28,635 TIME. 3195 01:48:28,702 --> 01:48:32,672 WE WILL STAY FOR Q & A AND WE 3196 01:48:32,739 --> 01:48:33,807 WILL DEVOTE SOME OF OUR LUNCH 3197 01:48:33,874 --> 01:48:35,075 HOUR TO MAKING SURE THAT WE GET 3198 01:48:35,141 --> 01:48:37,344 A FULL LEGISLATIVE REPORT AS 3199 01:48:37,410 --> 01:48:38,645 WELL AS HAVING THE TIME TO ASK A 3200 01:48:38,712 --> 01:48:41,181 FEW QUESTIONS, SO THANK YOU FOR 3201 01:48:41,248 --> 01:48:42,816 BRINGING -- BEING WITH US TODAY. 3202 01:48:42,883 --> 01:48:43,850 >> OUTSTANDING. 3203 01:48:43,917 --> 01:48:45,285 THANKS, EVERYONE, FOR HAVING ME. 3204 01:48:45,352 --> 01:48:47,854 IT'S ALWAYS GREAT TO JOIN. 3205 01:48:47,921 --> 01:48:49,055 WE CAN SKIP AHEAD TO THE NEXT 3206 01:48:49,122 --> 01:48:49,389 SLIDE. 3207 01:48:49,456 --> 01:48:50,924 I DO HAVE A LOT TO COVER IN A 3208 01:48:50,991 --> 01:48:52,525 SHORT AMOUNT OF TIME, AND I'LL 3209 01:48:52,592 --> 01:48:57,230 START WITH FY 24 APPROPRIATIONS, 3210 01:48:57,297 --> 01:49:00,634 THE CURRENT STATUS, SHIFTS IN 3211 01:49:00,700 --> 01:49:01,768 TIME LINES AND WHAT TO WATCH 3212 01:49:01,835 --> 01:49:03,103 OVER THE NEXT COUPLE OF WEEKS. 3213 01:49:03,169 --> 01:49:04,804 I'LL SPEAK BRIEFLY ABOUT NEXT 3214 01:49:04,871 --> 01:49:06,506 STOPS FOR 2025 BECAUSE, BELIEVE 3215 01:49:06,573 --> 01:49:08,008 IT OR NOT, THAT PROCESS IS ABOUT 3216 01:49:08,074 --> 01:49:09,209 TO KICK OFF AS WELL, AND BEFORE 3217 01:49:09,276 --> 01:49:12,045 I WRAP UP, I'LL COVER A BIT 3218 01:49:12,112 --> 01:49:13,413 ABOUT CONGRESSIONAL RETIREMENTS 3219 01:49:13,480 --> 01:49:14,748 AS WELL AS SOME RECENT BRIEFINGS 3220 01:49:14,814 --> 01:49:17,484 AND EVENTS THAT NCI HAS BEEN A 3221 01:49:17,550 --> 01:49:20,754 PART. 3222 01:49:20,820 --> 01:49:23,356 SO WE ARE STILL HERE IN THE 3223 01:49:23,423 --> 01:49:24,357 MIDDLE BUT HOPING TO MOVE 3224 01:49:24,424 --> 01:49:26,192 THROUGH THOSE NEXT STEPS RATHER 3225 01:49:26,259 --> 01:49:27,294 QUICK LE OVER THE NEXT FEW 3226 01:49:27,360 --> 01:49:27,627 WEEKS. 3227 01:49:27,694 --> 01:49:28,895 THE HOUSE AND SENATE ARE DEEP 3228 01:49:28,962 --> 01:49:29,963 INTO NEGOTIATIONS TO FINALIZE 3229 01:49:30,030 --> 01:49:31,731 THE LABOR HHS APPROPRIATIONS 3230 01:49:31,798 --> 01:49:33,967 BILL, WHICH INCLUDES NIH AND NCI 3231 01:49:34,034 --> 01:49:35,568 AS WELL AS SEVERAL OTHER BILLS, 3232 01:49:35,635 --> 01:49:37,504 AND WE'RE VERY HOPEFUL THEY'LL 3233 01:49:37,570 --> 01:49:39,039 COME TO AN AGREEMENT OVER THE 3234 01:49:39,105 --> 01:49:40,373 NEXT WEEK OR SO AND WE'LL SEE 3235 01:49:40,440 --> 01:49:42,309 THEM SEND A FINAL PACKAGE TO THE 3236 01:49:42,375 --> 01:49:44,577 PRESIDENT'S DESK BY MARCH 22ND. 3237 01:49:44,644 --> 01:49:46,446 THAT DEADLINE, DR. RATHMELL 3238 01:49:46,513 --> 01:49:50,016 MENTIONED. 3239 01:49:50,083 --> 01:49:51,151 SO HERE ARE ALL THE DEADLINES 3240 01:49:51,217 --> 01:49:53,286 THAT HAVE BEEN IN PLAY IN FY 24, 3241 01:49:53,353 --> 01:49:58,191 OR AT THE START OF CALENDAR 24. 3242 01:49:58,258 --> 01:49:58,959 AFTER SEVERAL CONTINUING 3243 01:49:59,025 --> 01:49:59,960 RESOLUTIONS AT THE START OF THE 3244 01:50:00,026 --> 01:50:01,795 FISCAL YEAR AND THE FALL, WE ARE 3245 01:50:01,861 --> 01:50:04,230 NOW 150 DAYS INTO THE FISCAL 3246 01:50:04,297 --> 01:50:05,598 YEAR, ALMOST HALFWAY THROUGH. 3247 01:50:05,665 --> 01:50:09,169 SO THESE EARLIER DEADLINES IN 3248 01:50:09,235 --> 01:50:12,806 LIGHT PINK IS NOW SHIFTED. 3249 01:50:12,872 --> 01:50:14,007 MARCH 1ST AND MARCH 8TH HAVE NOW 3250 01:50:14,074 --> 01:50:16,609 SHIFTED TO MARCH 8TH AND 3251 01:50:16,676 --> 01:50:17,911 MARCH 22ND AND AGAIN, WE'RE IN 3252 01:50:17,978 --> 01:50:18,678 THAT SECOND BATCH. 3253 01:50:18,745 --> 01:50:21,181 I'LL TALK MORE ABOUT THIS 3254 01:50:21,247 --> 01:50:21,948 APRIL 30TH DARKER STAR IN A 3255 01:50:22,015 --> 01:50:22,716 MOMENT. 3256 01:50:22,782 --> 01:50:24,551 IT'S ONLY RELEVANT IF CONGRESS 3257 01:50:24,617 --> 01:50:26,720 DOESN'T MEET THE MARCH 8TH AND 3258 01:50:26,786 --> 01:50:33,159 MARCH 22ND DEADLINES. 3259 01:50:33,226 --> 01:50:34,561 SO LAST WEEK AFTER A MEETING 3260 01:50:34,627 --> 01:50:35,328 BETWEEN THE PRESIDENT, VICE 3261 01:50:35,395 --> 01:50:37,397 PRESIDENT, HOUSE AND SENATE 3262 01:50:37,464 --> 01:50:38,398 LEADERSHIP, CONGRESS AGREED TO 3263 01:50:38,465 --> 01:50:39,265 ANOTHER SHORT TERM EXTENSION OF 3264 01:50:39,332 --> 01:50:43,837 THOSE DEADLINES. 3265 01:50:43,903 --> 01:50:48,174 TO PROVIDE MORE TIME TO FINALIZE 3266 01:50:48,241 --> 01:50:49,609 THE 12 SPENDING BILLS. 3267 01:50:49,676 --> 01:50:51,144 SO WE'RE GETTING CLOSE INVENTORY 3268 01:50:51,211 --> 01:50:52,779 WHAT WE HOPE IS THE FINISH LINE. 3269 01:50:52,846 --> 01:50:54,014 WANTED TO MENTION SIX BILLS THAT 3270 01:50:54,080 --> 01:50:55,048 HAVE BEEN GROUPED TOGETHER FOR 3271 01:50:55,115 --> 01:50:58,451 THIS MARCH 8TH PACKAGE THAT NEED 3272 01:50:58,518 --> 01:51:02,122 TO BE VOTED ON AND FINALIZED 3273 01:51:02,188 --> 01:51:03,323 WERE RELEASED OVER THE PAST 3274 01:51:03,390 --> 01:51:03,757 WEEKEND. 3275 01:51:03,823 --> 01:51:05,191 THEY'RE A SMALLER BATCH EVEN 3276 01:51:05,258 --> 01:51:07,227 THOUGH IT'S 6 AND 6, THEY 3277 01:51:07,293 --> 01:51:08,428 REPRESENT ABOUT LESS OF THE 3278 01:51:08,495 --> 01:51:10,096 SPENDING, ABOUT 30% OF THE 3279 01:51:10,163 --> 01:51:10,730 DISCRETIONARY FUNDING THAT 3280 01:51:10,797 --> 01:51:12,766 CONGRESS IS CONSIDERING AND THEY 3281 01:51:12,832 --> 01:51:14,768 ARE LESS CONTENTIOUS, SO THE 3282 01:51:14,834 --> 01:51:17,003 REMAINING 6 INCLUDING LABOR H 3283 01:51:17,070 --> 01:51:18,438 REPRESENT ABOUT 70% OF THE 3284 01:51:18,505 --> 01:51:19,973 DISCRETIONARY SPENDING, A LARGER 3285 01:51:20,040 --> 01:51:21,608 AND MORE CONTENTIOUS BATCH OF 3286 01:51:21,674 --> 01:51:23,309 BILLS, AND WE HOPE THAT THOSE 3287 01:51:23,376 --> 01:51:27,180 EXTRA TWO WEEKS WILL BE ENOUGH 3288 01:51:27,247 --> 01:51:27,580 TIME. 3289 01:51:27,647 --> 01:51:29,349 SO AS DR. RATHMELL MENTIONED, 3290 01:51:29,416 --> 01:51:31,051 THE BUDGET CLIMATE OVERALL IS 3291 01:51:31,117 --> 01:51:32,452 REALLY TIGHT, AND I'LL RECAP 3292 01:51:32,519 --> 01:51:34,020 MORE ABOUT THAT IN A MOMENT, BUT 3293 01:51:34,087 --> 01:51:35,922 RIGHT NOW THE COMMITTEES ARE 3294 01:51:35,989 --> 01:51:37,157 WRITING BILLS TO A TOP LINE 3295 01:51:37,223 --> 01:51:39,793 LEVEL THAT'S THE SAME AS FY 23. 3296 01:51:39,859 --> 01:51:41,628 SO REALLY NO ROOM FOR GROWTH 3297 01:51:41,694 --> 01:51:43,363 UNLESS IT AT THE EXPENSE OF 3298 01:51:43,430 --> 01:51:45,198 ANOTHER AGENCY OR PROGRAM. 3299 01:51:45,265 --> 01:51:46,633 AND SO FOR THE FIRST BATCH 3300 01:51:46,699 --> 01:51:48,234 RELEASED OVER THE WEEKEND, WE 3301 01:51:48,301 --> 01:51:50,303 REALLY SAW A COMBINATION OF FLAT 3302 01:51:50,370 --> 01:51:53,773 FUNDING IN SOME LA PLACES, MODET 3303 01:51:53,840 --> 01:51:54,874 INCREASES IN OTHER, MODEST CUTS 3304 01:51:54,941 --> 01:51:57,377 IN OTHERS, AND IT'S NOT 3305 01:51:57,444 --> 01:51:58,645 SURPRISING, THAT'S KIND OF THE 3306 01:51:58,711 --> 01:51:59,345 COMBINATION WE'D EXPECT. 3307 01:51:59,412 --> 01:52:02,048 SO FOR EXAMPLE, FDA IS HELD 3308 01:52:02,115 --> 01:52:03,249 ABOUT FLAT. 3309 01:52:03,316 --> 01:52:05,885 EPA RECEIVED ABOUT A 4% CUT TO 3310 01:52:05,952 --> 01:52:07,554 ITS BASE AND A LARGER CUT TO 3311 01:52:07,620 --> 01:52:10,156 SUPER FUND PROGRAMS. 3312 01:52:10,223 --> 01:52:10,790 THE DEPARTMENT OF AGRICULTURE 3313 01:52:10,857 --> 01:52:13,259 WOULD RECEIVE ABOUT A 1.7% 3314 01:52:13,326 --> 01:52:14,794 INCREASE, BUT THIS REPRESENTS 3315 01:52:14,861 --> 01:52:16,429 INCREASES TO SOME PROGRAMS 3316 01:52:16,496 --> 01:52:17,730 WITHIN THE AGENCY AND DECREASES 3317 01:52:17,797 --> 01:52:20,934 TO OTHERS. 3318 01:52:21,000 --> 01:52:24,304 SO TO RECAP ON HOW WE DOT HERE. 3319 01:52:24,370 --> 01:52:25,638 I THINK AT PAST BOARD MEETINGS 3320 01:52:25,705 --> 01:52:27,107 WE'VE TALKED ABOUT THE FISCAL 3321 01:52:27,173 --> 01:52:28,341 RESPONSIBILITY ACT. 3322 01:52:28,408 --> 01:52:29,943 I JUST WANTED TO INCLUDE A 3323 01:52:30,009 --> 01:52:31,878 REFRESHER AND REMINDER HERE. 3324 01:52:31,945 --> 01:52:37,951 IT WAS INCT AD IN ENACTED IN J, 3325 01:52:38,017 --> 01:52:39,486 THIS IS THE AGREEMENT THAT 3326 01:52:39,552 --> 01:52:40,787 SUSPENDED THE DEBT LIMIT UNTIL 3327 01:52:40,854 --> 01:52:42,288 2025 AND IT ALSO SET THESE 3328 01:52:42,355 --> 01:52:44,924 BUDGET CAPS FOR FY 24 AND NY25. 3329 01:52:44,991 --> 01:52:47,594 SO AGAIN FOR FY 24, FLAT AT FY 3330 01:52:47,660 --> 01:52:50,296 23 LEVELS EXCEPT FOR A 3% 3331 01:52:50,363 --> 01:52:52,132 INCREASE FOR DEFENSE AS 3332 01:52:52,198 --> 01:52:53,900 REQUESTED IN THE PRESIDENT'S 3333 01:52:53,967 --> 01:52:56,703 BUDGET, AND FOR FY 25, A 1% 3334 01:52:56,769 --> 01:52:57,804 INCREASE. 3335 01:52:57,871 --> 01:52:59,439 SO BACK TO THAT APRIL 30TH 3336 01:52:59,506 --> 01:53:01,741 DEADLINE I SHOWED YOU EARLIER, 3337 01:53:01,808 --> 01:53:04,978 IT ALSO INCLUDES THIS ADDITIONAL 3338 01:53:05,044 --> 01:53:06,279 PENALTY TO INCENTIVIZE CONGRESS 3339 01:53:06,346 --> 01:53:09,149 TO COMPLETE THE APPROPRIATIONS 3340 01:53:09,215 --> 01:53:09,883 PROCESS. 3341 01:53:09,949 --> 01:53:11,117 SO IF ANY OF THE 12 SPENDING 3342 01:53:11,184 --> 01:53:15,755 BILLS ARE NOT COMPLETED BY APRIE 3343 01:53:15,822 --> 01:53:21,127 APPLIED TO DEFENSE AND -- TO 3344 01:53:21,194 --> 01:53:22,095 DEFENSE DISCRETIONARY SPENDING 3345 01:53:22,162 --> 01:53:23,496 OFTEN REFERRED TO AS A 3346 01:53:23,563 --> 01:53:25,265 SEQUESTER, SO THAT OFFICE OF 3347 01:53:25,331 --> 01:53:26,199 MANAGEMENT AND BUDGET IMPLEMENTS 3348 01:53:26,266 --> 01:53:28,201 A SEQUESTER AND IT WOULD REALLY 3349 01:53:28,268 --> 01:53:31,371 BE UP TO OMB AS TO HOW THEY 3350 01:53:31,437 --> 01:53:34,774 WOULD APPLY THAT CUT. 3351 01:53:34,841 --> 01:53:35,208 THAT CUT. 3352 01:53:35,275 --> 01:53:36,809 SOME PROGRAMS ARE EXEMPTED, FOR 3353 01:53:36,876 --> 01:53:39,445 EXAMPLE VA HEALTHCARE, 3354 01:53:39,512 --> 01:53:40,580 ULTIMATELY THIS INCREASES THE 3355 01:53:40,647 --> 01:53:41,247 BURDEN FOR THE REST OF THE 3356 01:53:41,314 --> 01:53:42,315 BUDGET, HOWEVER, IT'S NOT CLEAR 3357 01:53:42,382 --> 01:53:44,751 HOW DEEP THOSE CUTS WOULD BE TO 3358 01:53:44,817 --> 01:53:47,453 ANY ONE AGENCY, SINCE OMB WOULD 3359 01:53:47,520 --> 01:53:48,454 HAVE DISCRETION, IT DOESN'T HAVE 3360 01:53:48,521 --> 01:53:50,190 TO BE AN ACROSS THE BOARD 1% 3361 01:53:50,256 --> 01:53:50,657 CUT. 3362 01:53:50,723 --> 01:53:52,258 SO WE'RE HOPEFUL, THOUGH, THAT 3363 01:53:52,325 --> 01:53:54,661 CONGRESS WILL FINALIZE THE 3364 01:53:54,727 --> 01:53:55,528 CURRENT SPENDING NEGOTIATIONS 3365 01:53:55,595 --> 01:53:57,897 AND WILL PASS THIS FIRST BATCH 3366 01:53:57,964 --> 01:53:59,432 BY THE END OF THE WEEK AND WILL 3367 01:53:59,499 --> 01:54:03,169 PASS THE BATCH THAT INCLUDES 3368 01:54:03,236 --> 01:54:05,905 LABOR HHS BY MARCH 22ND. 3369 01:54:05,972 --> 01:54:07,574 SO I'VE INCLUDED THIS SLIDE 3370 01:54:07,640 --> 01:54:08,808 BEFORE AND WANTED TO INCLUDE IT 3371 01:54:08,875 --> 01:54:11,344 HERE AGAIN FOR REFERENCE. 3372 01:54:11,411 --> 01:54:13,046 SO THAT YOU HAVE A SENSE AND A 3373 01:54:13,112 --> 01:54:18,084 REMINDER OF ALL-OF-US OF THE ALS 3374 01:54:18,151 --> 01:54:19,485 THAT HAVE BEEN MADE TO DATE. 3375 01:54:19,552 --> 01:54:21,454 THE SO THE PRESIDENT PROPOSED A 3376 01:54:21,521 --> 01:54:23,590 NOTABLE INCREASE FOR NCI FOR FY 3377 01:54:23,656 --> 01:54:24,157 2024. 3378 01:54:24,224 --> 01:54:25,058 IT INCLUDED SUSTAINING FUNDING 3379 01:54:25,124 --> 01:54:27,126 FOR THE CANCER MOONSHOT. 3380 01:54:27,193 --> 01:54:29,929 FY 23 WAS THE LAST YEAR OF FUNDS 3381 01:54:29,996 --> 01:54:31,464 AUTHORIZED FOR THE FIRST PHASE 3382 01:54:31,531 --> 01:54:34,234 OF THE MOONSHOT UNDER 21ST 3383 01:54:34,300 --> 01:54:37,170 CENTURY CURES SO THAT'S THAT 3384 01:54:37,237 --> 01:54:38,071 216 MILLION THAT YOU SIGH, AND 3385 01:54:38,137 --> 01:54:40,273 ALSO PROPOSED AN ADDITIONAL 3386 01:54:40,340 --> 01:54:43,209 $500 MILLION INCREASE. 3387 01:54:43,276 --> 01:54:44,310 SO IN THE HOUSE AT THE TIME THEY 3388 01:54:44,377 --> 01:54:45,812 WERE WRITING BILLS TO AN EVEN 3389 01:54:45,878 --> 01:54:48,514 LOWER SPENDING LEVEL BACK TO FY 3390 01:54:48,581 --> 01:54:50,316 22 LEVEL, SO THAT PROPOSAL HELD 3391 01:54:50,383 --> 01:54:54,554 NCI'S BASE FLAT BUT DID NOT 3392 01:54:54,621 --> 01:54:55,855 ADDRESS THE 216 MILLION. 3393 01:54:55,922 --> 01:54:58,758 THE SENATE PROPOSAL DOES ADDRESS 3394 01:54:58,825 --> 01:54:59,659 THE 216 MILLION AND APPROPRIATES 3395 01:54:59,726 --> 01:55:01,494 AN ADDITIONAL $60 MILLION FOR 3396 01:55:01,561 --> 01:55:01,928 NCI. 3397 01:55:01,995 --> 01:55:04,430 SO WE'LL BE WATCHING FOR THE 3398 01:55:04,497 --> 01:55:05,398 RELEASE OF THAT FINAL BILL 3399 01:55:05,465 --> 01:55:07,700 SOMETIME AHEAD OF THE MARCH 22ND 3400 01:55:07,767 --> 01:55:09,435 DEADLINE TO SEE WHERE ALL THESE 3401 01:55:09,502 --> 01:55:14,574 NUMBERS LAND FOR NIH AND NCI IN 3402 01:55:14,641 --> 01:55:17,210 FY 24. 3403 01:55:17,277 --> 01:55:18,411 SO THIS GRAPHIC REALLY JUST 3404 01:55:18,478 --> 01:55:21,214 ILLUSTRATES THE OVERLAPPING 3405 01:55:21,281 --> 01:55:21,814 NATURE OF THE APPROPRIATIONS 3406 01:55:21,881 --> 01:55:22,048 PROCESS. 3407 01:55:22,115 --> 01:55:24,417 SO HERE WE ARE IN MARCH, STILL 3408 01:55:24,484 --> 01:55:28,888 TRYING TO FINALIZE FY 24 FUNDING 3409 01:55:28,955 --> 01:55:30,189 AND ALSO EXPECTING TO SEE THE 3410 01:55:30,256 --> 01:55:32,358 PRESIDENT'S BUDGET RELEASED NEXT 3411 01:55:32,425 --> 01:55:36,663 WEEK. 3412 01:55:36,729 --> 01:55:37,930 OMB INDICATED THEY EXPECT TO 3413 01:55:37,997 --> 01:55:39,799 RELEASE IT ON MONDAY, MARCH 11TH 3414 01:55:39,866 --> 01:55:42,669 AND THAT REALLY KICKS OFF THE FY 3415 01:55:42,735 --> 01:55:43,403 2025 APPROPRIATIONS PROCESS, AND 3416 01:55:43,469 --> 01:55:44,904 THEN WE'LL MOVE THROUGH THOSE 3417 01:55:44,971 --> 01:55:47,206 NEXT STEPS OF OMB AND CABINET 3418 01:55:47,273 --> 01:55:48,308 LEVEL HEARINGS IN THE HOUSE AND 3419 01:55:48,374 --> 01:55:50,610 SENATE AND FOLLOWED BY THE 3420 01:55:50,677 --> 01:55:51,711 AGENCY OPERATING DIVISIONS 3421 01:55:51,778 --> 01:55:52,712 INCLUDING NIH AND THEN AGAIN 3422 01:55:52,779 --> 01:55:54,047 LATER IN THE SUMMER AND INTO THE 3423 01:55:54,113 --> 01:55:56,282 FALL FINAL NEGOTIATIONS MOVING 3424 01:55:56,349 --> 01:56:00,953 FORWARD TO FINALIZE FY 25. 3425 01:56:01,020 --> 01:56:01,721 SO A LOT OF GROUND TO COVER 3426 01:56:01,788 --> 01:56:03,456 BEFORE THEN, BUT JUST WANTED TO 3427 01:56:03,523 --> 01:56:04,657 SIGNAL THAT WE ARE LOOKING AHEAD 3428 01:56:04,724 --> 01:56:06,826 NEXT WEEK TO THE KICKOFF OF THE 3429 01:56:06,893 --> 01:56:13,266 FY 25 APPROPRIATIONS PROCESS. 3430 01:56:13,333 --> 01:56:14,267 SHIFTING GEARS AWAY FROM 3431 01:56:14,334 --> 01:56:16,102 APPROPRIATIONS. 3432 01:56:16,169 --> 01:56:17,670 I WANTED TO MENTION OTHER RECENT 3433 01:56:17,737 --> 01:56:18,504 CONGRESSIONAL ACTIVITY INCLUDING 3434 01:56:18,571 --> 01:56:19,939 THE ANNOUNCEMENT LAST WEEK FROM 3435 01:56:20,006 --> 01:56:21,441 SENATE MINORITY LEADER MITCH 3436 01:56:21,507 --> 01:56:23,076 MCCONNELL OF KENTUCKY, HE'LL BE 3437 01:56:23,142 --> 01:56:24,610 STEPPING DOWN AS LEADER IN 3438 01:56:24,677 --> 01:56:25,144 NOVEMBER. 3439 01:56:25,211 --> 01:56:26,546 HE'LL REMAIN IN THE SENATE, HE'S 3440 01:56:26,612 --> 01:56:29,182 NOT UP FOR RE-ELECTION UNTIL 3441 01:56:29,248 --> 01:56:29,615 2026. 3442 01:56:29,682 --> 01:56:31,884 SO THERE'S A NINE-MONTH RACE TO 3443 01:56:31,951 --> 01:56:33,219 SUCCEED HIM WITH SEVERAL 3444 01:56:33,286 --> 01:56:34,420 CANDIDATES FORMALLY AND 3445 01:56:34,487 --> 01:56:36,622 INFORMALLY IN THE RUNNING. 3446 01:56:36,689 --> 01:56:37,857 SENATOR JOHN CORNYN OF TEXT IS 3447 01:56:37,924 --> 01:56:41,060 TEXAS INTHE FAR RIGHT IN THAT PN 3448 01:56:41,127 --> 01:56:42,495 THE ORANGE TIE HAS ANNOUNCED 3449 01:56:42,562 --> 01:56:43,796 HE'S RUNNING. 3450 01:56:43,863 --> 01:56:45,231 SENATOR JOHN THUNE OF SOUTH 3451 01:56:45,298 --> 01:56:47,300 DAKOTA IN THE CENTER BEHIND 3452 01:56:47,367 --> 01:56:48,401 SENATOR MCCONNELL IS EXPECTED TO 3453 01:56:48,468 --> 01:56:50,136 BE A CONTENDER. 3454 01:56:50,203 --> 01:56:51,637 AND THEN JUST THIS MORNING ON 3455 01:56:51,704 --> 01:56:56,542 THE LEFT, SENATOR JOHN BARRASSO 3456 01:56:56,609 --> 01:56:58,644 OF WYOMING ANNOUNCED HE WILL NOT 3457 01:56:58,711 --> 01:56:59,946 RUN FOR THE LEADER POSITION, AND 3458 01:57:00,012 --> 01:57:02,215 RATHER HE'LL SEEK THE ASSISTANT 3459 01:57:02,281 --> 01:57:03,416 REPUBLICAN LEADER POSITION OR 3460 01:57:03,483 --> 01:57:04,751 WHIP POSITION, THE SECOND 3461 01:57:04,817 --> 01:57:06,386 HIGHEST RANKING GOP SENATOR. 3462 01:57:06,452 --> 01:57:09,355 HE'S CURRENTLY NUMBER THREE. 3463 01:57:09,422 --> 01:57:11,257 THUNE CURRENTLY SERVES AS 3464 01:57:11,324 --> 01:57:13,793 MINORITY WHIP, IT'S A TERM 3465 01:57:13,860 --> 01:57:15,428 LIMITED POSITION THAT SENATOR 3466 01:57:15,495 --> 01:57:17,029 CORNYN HELD IN THE PASS AND WE 3467 01:57:17,096 --> 01:57:17,697 EXPECT OTHERS WILL JUMP INTO THE 3468 01:57:17,764 --> 01:57:18,164 RACE. 3469 01:57:18,231 --> 01:57:20,800 THERE'S PLENTY OF TIME LEFT. 3470 01:57:20,867 --> 01:57:22,535 SO REGARDLESS OF THE OUTCOMES OF 3471 01:57:22,602 --> 01:57:23,970 THE NEXT ELECTION, THERE WILL 3472 01:57:24,036 --> 01:57:25,571 ALSO BE A LOT OF TURNOVER IN 3473 01:57:25,638 --> 01:57:27,640 CONGRESS DUE TO RETIREMENTS. 3474 01:57:27,707 --> 01:57:29,609 SEVERAL MEMBERS ARE RETIRING OR 3475 01:57:29,675 --> 01:57:31,010 SEEKING OTHER OFFICES AND I'M 3476 01:57:31,077 --> 01:57:33,446 HIGHLIGHTING A HANDFUL HERE WITH 3477 01:57:33,513 --> 01:57:36,849 A SPECIFIC RELEVANCE TO NCI. 3478 01:57:36,916 --> 01:57:40,219 SO ON THE TOP LEFT, 3479 01:57:40,286 --> 01:57:45,458 REPRESENTATIVE CATHY MCMORRIS 3480 01:57:45,525 --> 01:57:46,559 RODGERS, CHAIR OF THE HOUSE 3481 01:57:46,626 --> 01:57:47,860 ENERGY AND COMMERCE COMMITTEE. 3482 01:57:47,927 --> 01:57:50,696 NEXT TO HER, REPRESENTATIVE ANNA 3483 01:57:50,763 --> 01:57:52,565 ESHOO, RANKING MEMBER OF THE 3484 01:57:52,632 --> 01:57:54,000 HEALTH SUBCOMMITTEE. 3485 01:57:54,066 --> 01:57:56,502 ON THE LOWER LEFT, SENATOR 3486 01:57:56,569 --> 01:58:01,374 MANCHIN, KAY GRANGER OF TEXAS 3487 01:58:01,441 --> 01:58:02,275 WHO CHAIRS THE HOUSE 3488 01:58:02,341 --> 01:58:03,142 APPROPRIATIONS COMMITTEE IS 3489 01:58:03,209 --> 01:58:04,210 RETIRING AND THAT OPENS UP A 3490 01:58:04,277 --> 01:58:07,046 RACE FOR HER LEADERSHIP POSITION 3491 01:58:07,113 --> 01:58:08,014 OF THE FULL COMMITTEE IN THE 3492 01:58:08,080 --> 01:58:08,414 HOUSE. 3493 01:58:08,481 --> 01:58:10,550 AND THEN REPRESENTATIVES DERRICK 3494 01:58:10,616 --> 01:58:12,885 KILMER OF WASHINGTON AND BRIAN 3495 01:58:12,952 --> 01:58:14,153 HIGGINS OF NEW YORK WHO HAS 3496 01:58:14,220 --> 01:58:15,655 ALREADY RETIRED AND CO-CHAIRS OF 3497 01:58:15,721 --> 01:58:17,223 THE HOUSE CANCER CAUCUS. 3498 01:58:17,290 --> 01:58:18,724 SO WE'LL SEE A LOT OF NEW FACES 3499 01:58:18,791 --> 01:58:24,997 IN THE NEXT SESSION. 3500 01:58:25,064 --> 01:58:26,966 I WANTED TO HIGHLIGHT TWO RECENT 3501 01:58:27,033 --> 01:58:28,468 CONGRESSIONAL BRIEFINGS. 3502 01:58:28,534 --> 01:58:32,638 ON THE LEFT, DR. TAYLOR SUNDBY 3503 01:58:32,705 --> 01:58:34,874 PRESENTED AT A BRIEFING ON 3504 01:58:34,941 --> 01:58:35,842 NEUROFIBROMATOSIS RESEARCH 3505 01:58:35,908 --> 01:58:38,778 THAT'S HELD EACH YEAR SPONSORED 3506 01:58:38,845 --> 01:58:43,916 BY THE LITTLE S TUMOR 3507 01:58:43,983 --> 01:58:44,350 FOUNDATION. 3508 01:58:44,417 --> 01:58:50,923 ON THE RIGHT, DR. VIK 3509 01:58:50,990 --> 01:58:52,291 SAHASRABUDDHE AND REPRESENTATIVE 3510 01:58:52,358 --> 01:58:55,294 DEBBIE DINGELL. 3511 01:58:55,361 --> 01:58:56,496 HE LEADS THE LAST MILE 3512 01:58:56,562 --> 01:58:57,930 INITIATIVE FOCUSED ON CERVICAL 3513 01:58:57,997 --> 01:58:59,198 CANCER PREVENTION AND HE'S 3514 01:58:59,265 --> 01:59:00,733 PICTURED HERE WITH 3515 01:59:00,800 --> 01:59:02,802 REPRESENTATIVE DEBBIE DINGELL OF 3516 01:59:02,869 --> 01:59:04,036 MICHIGAN, CO-CHAIR OF THE CANCER 3517 01:59:04,103 --> 01:59:05,438 PREVENTION CAUCUS IN THE HOUSE. 3518 01:59:05,505 --> 01:59:07,406 AND WANTED TO FLAG I THINK 3519 01:59:07,473 --> 01:59:08,708 PROBABLY MENTIONED BEFORE IF ANY 3520 01:59:08,774 --> 01:59:10,476 OF YOUR ORGANIZATIONS ARE 3521 01:59:10,543 --> 01:59:13,946 HOSTING BRIEFINGS OR ROUNDTABLES 3522 01:59:14,013 --> 01:59:16,115 ON THE HILL AND ARE INTERESTED 3523 01:59:16,182 --> 01:59:17,450 IN HAVING SOMEONE FROM NCI, ONE 3524 01:59:17,517 --> 01:59:21,687 OF OUR RESEARCHERS OR PROGRAM 3525 01:59:21,754 --> 01:59:23,222 DIRECTORS COME AND SPEAK ABOUT 3526 01:59:23,289 --> 01:59:24,524 RESEARCH IN THAT AREA, PLEASE 3527 01:59:24,590 --> 01:59:25,091 LET ME KNOW. 3528 01:59:25,157 --> 01:59:26,592 WE'RE HAPPY TO FACILITATE THEIR 3529 01:59:26,659 --> 01:59:26,959 PARTICIPATION. 3530 01:59:27,026 --> 01:59:27,827 IT'S A GREAT OPPORTUNITY FOR 3531 01:59:27,894 --> 01:59:30,096 THEM TO PARTICIPATE IN THESE 3532 01:59:30,162 --> 01:59:32,064 EDUCATIONAL BRIEFINGS AND TO 3533 01:59:32,131 --> 01:59:34,367 HIGHLIGHT THE IMPORTANT CANCER 3534 01:59:34,433 --> 01:59:39,171 RESEARCH NCI SUPPORTING STATES 3535 01:59:39,238 --> 01:59:41,140 AND DISTRICTS ACROSS THE 3536 01:59:41,207 --> 01:59:42,675 COUNTRY. 3537 01:59:42,742 --> 01:59:43,543 I KNOW SEVERAL OF YOUR 3538 01:59:43,609 --> 01:59:45,611 ORGANIZATIONS ARE MEMBERS OF THE 3539 01:59:45,678 --> 01:59:46,379 COALITION ONE VOICE AGAINST 3540 01:59:46,445 --> 01:59:47,713 CANCER. 3541 01:59:47,780 --> 01:59:50,249 DR. RATHMELL ATTENDED THE ANNUAL 3542 01:59:50,316 --> 01:59:51,551 MEETING IN JANUARY TO INTRODUCE 3543 01:59:51,617 --> 01:59:53,052 HERSELF AND TO SHARE AN UPDATE 3544 01:59:53,119 --> 01:59:54,921 WITH OVAC MEMBERS. 3545 01:59:54,987 --> 01:59:56,656 SHE ALSO ATTENDED A 3546 01:59:56,722 --> 01:59:58,190 CONGRESSIONAL RECEPTION HONORING 3547 01:59:58,257 --> 01:59:59,725 DR. MONICA BERTAGNOLLI AND 3548 01:59:59,792 --> 02:00:03,596 WELCOMING HER AS NIH DIRECTOR. 3549 02:00:03,663 --> 02:00:06,299 DR. BERTAGNOLLI IS PICTURED WITH 3550 02:00:06,365 --> 02:00:10,236 DR. SHELLEY MOORE CAPITO OF WEST 3551 02:00:10,303 --> 02:00:13,306 VIRGINIA AND LISA LAKAS OF THE 3552 02:00:13,372 --> 02:00:14,607 AMERICAN CANCER SOCIETY. 3553 02:00:14,674 --> 02:00:15,875 THAT RECEPTION WAS GREAT 3554 02:00:15,942 --> 02:00:17,743 OPPORTUNITY FOR DR. RATHMELL TO 3555 02:00:17,810 --> 02:00:20,913 MEET REPRESENTATIVE ROSA DELORO 3556 02:00:20,980 --> 02:00:22,982 AND UR EV LEFT HERE RANKING 3557 02:00:23,049 --> 02:00:23,783 MEMBER OF THE HOUSE 3558 02:00:23,849 --> 02:00:24,650 APPROPRIATIONS COMMITTEE AND OUR 3559 02:00:24,717 --> 02:00:27,587 LABOR HHS SUBCOMMITTEE. 3560 02:00:27,653 --> 02:00:30,156 EARLIER THAT DAY, HAD A CHANCE 3561 02:00:30,222 --> 02:00:33,125 TO MEET WITH SENATOR JOHN 3562 02:00:33,192 --> 02:00:35,194 BOZEMAN OF ARKANSAS AND SENATOR 3563 02:00:35,261 --> 02:00:36,462 JACK REED OF RHODE ISLAND AND 3564 02:00:36,529 --> 02:00:38,364 EARLIER THAT MONTH SHE ALSO MET 3565 02:00:38,431 --> 02:00:42,068 WITH SENATOR SHELLEY MOORE OF 3566 02:00:42,134 --> 02:00:43,035 WEST VIRGINIA RANKING MEMBER OF 3567 02:00:43,102 --> 02:00:45,338 THE SENATE LABOR COMMITTEE AS 3568 02:00:45,404 --> 02:00:47,440 WELL AS SENATOR JERRY MORAN OF 3569 02:00:47,506 --> 02:00:48,007 KANSAS. 3570 02:00:48,074 --> 02:00:49,875 SO EXCITED TO HAVE HER UP ON THE 3571 02:00:49,942 --> 02:00:51,043 HILL AND MEETING SOME OF OUR 3572 02:00:51,110 --> 02:00:52,578 MEMBERS OF OUR SUBCOMMITTEES AND 3573 02:00:52,645 --> 02:00:53,646 HOPING TO DO MORE OF THAT SOON. 3574 02:00:53,713 --> 02:00:54,547 HAPPY TO TAKE QUESTIONS. 3575 02:00:54,614 --> 02:00:55,848 I HOPE I COVERED THAT WITH 3576 02:00:55,915 --> 02:00:57,583 ENOUGH TIME TO SPARE AND PLEASE 3577 02:00:57,650 --> 02:00:58,918 REACH OUT ANY TIME IF WE DON'T 3578 02:00:58,985 --> 02:00:59,852 HAVE A CHANCE TO COVER 3579 02:00:59,919 --> 02:01:06,258 EVERYTHING TODAY. 3580 02:01:06,325 --> 02:01:08,961 >> THANK YOU SO MUCH, HOLLY, FOR 3581 02:01:09,028 --> 02:01:11,130 YOUR SPEED AND DELIVERY OF YOUR 3582 02:01:11,197 --> 02:01:13,132 PRESENTATION, A VERY COMPLEX 3583 02:01:13,199 --> 02:01:14,367 POLITICAL CLIMATE AND ALL THE 3584 02:01:14,433 --> 02:01:16,802 GYMNASTICS THAT ARE HAPPENING TO 3585 02:01:16,869 --> 02:01:19,038 HELP KEEP OUR COUNTRY AND NCI 3586 02:01:19,105 --> 02:01:25,077 RUNNING. 3587 02:01:25,144 --> 02:01:31,017 YOU KNOW, LOOKING AT FY 25 WITH 3588 02:01:31,083 --> 02:01:32,151 B. TO OPEN, IS THERE ANY CHANCE 3589 02:01:32,218 --> 02:01:33,119 THAT CONGRESS WILL ACT AND THAT 3590 02:01:33,185 --> 02:01:35,187 WE'LL HAVE A BUDGET ANY TIME 3591 02:01:35,254 --> 02:01:39,125 SOON FOR '24 OR '25, OR ARE WE 3592 02:01:39,191 --> 02:01:42,094 LIVING IN THE LIMBO OF CRs FOR 3593 02:01:42,161 --> 02:01:42,862 A WHILE? 3594 02:01:42,928 --> 02:01:44,930 >> I MEAN, I'M VERY HOPEFUL THAT 3595 02:01:44,997 --> 02:01:46,899 THEY WILL BE MOVING QUICKLY OVER 3596 02:01:46,966 --> 02:01:48,334 THE NEXT COUPLE OF WEEKS. 3597 02:01:48,401 --> 02:01:51,537 WE'RE SEEING THIS WEEK THEY ARE 3598 02:01:51,604 --> 02:01:52,571 MOVING FORWARD WITH THAT FIRST 3599 02:01:52,638 --> 02:01:53,906 BATCH AS QUICKLY AS POSSIBLE. 3600 02:01:53,973 --> 02:01:55,341 THEY RELEASED IT OVER THE 3601 02:01:55,408 --> 02:01:59,178 WEEKEND TO ALLOW THE 72 HOURS AT 3602 02:01:59,245 --> 02:02:00,713 LEAST OF TIME FOR FOLKS TO 3603 02:02:00,780 --> 02:02:02,782 REVIEW THE BILL BEFORE VOTING ON 3604 02:02:02,848 --> 02:02:03,215 IT. 3605 02:02:03,282 --> 02:02:05,384 AND SO WE'RE HOPING TO SEE, YOU 3606 02:02:05,451 --> 02:02:07,253 KNOW, OUR BILL RELEASED THE 3607 02:02:07,319 --> 02:02:09,889 WEEKEND BEFORE HOPEFULLY AS 3608 02:02:09,955 --> 02:02:10,656 WELL. 3609 02:02:10,723 --> 02:02:12,091 SO I AM HOPEFUL THAT IT WILL BE 3610 02:02:12,158 --> 02:02:14,794 WRAPPED UP SOON FOR FY 24. 3611 02:02:14,860 --> 02:02:16,796 NOTHING IS A GUARANTEE, I'M NOT 3612 02:02:16,862 --> 02:02:17,997 MAKING ANY BIG PREDICTIONS HERE 3613 02:02:18,064 --> 02:02:19,932 BUT I'M ENCOURAGED TO SEE THINGS 3614 02:02:19,999 --> 02:02:21,300 MOVING OVER THESE NEXT COUPLE OF 3615 02:02:21,367 --> 02:02:23,202 WEEKS. 3616 02:02:23,269 --> 02:02:25,638 FOR FY 25, I THINK WE'LL HAVE TO 3617 02:02:25,705 --> 02:02:27,273 WAIT AND SEE. 3618 02:02:27,339 --> 02:02:29,041 HONESTLY WE TYPICALLY DO NOT 3619 02:02:29,108 --> 02:02:30,242 RECEIVE OUR APPROPRIATION ON 3620 02:02:30,309 --> 02:02:30,443 TIME. 3621 02:02:30,509 --> 02:02:33,112 I THINK I'VE BEEN AT NCI ALMOST 3622 02:02:33,179 --> 02:02:34,580 15 YEARS NOW AND THERE HAS BEEN 3623 02:02:34,647 --> 02:02:37,149 ONE YEAR WHERE WE HAD OUR 3624 02:02:37,216 --> 02:02:38,117 APPROPRIATION BY THE END OF 3625 02:02:38,184 --> 02:02:38,751 SEPTEMBER. 3626 02:02:38,818 --> 02:02:42,021 AND SO YOU KNOW, CRs ARE 3627 02:02:42,088 --> 02:02:42,354 FREQUENT. 3628 02:02:42,421 --> 02:02:44,990 I WOULDN'T BE SURPRISED TO SEE 3629 02:02:45,057 --> 02:02:46,726 THEM AGAIN IN FY 25. 3630 02:02:46,792 --> 02:02:48,694 HOPEFULLY NOT TAKE US HALFWAY 3631 02:02:48,761 --> 02:02:50,229 INTO THE FISCAL YEAR, YOU KNOW, 3632 02:02:50,296 --> 02:02:53,165 THERE ARE PARAMETERS SET FOR 3633 02:02:53,232 --> 02:02:55,701 '25, THIS 1% ABOVE FY 24 LEVELS 3634 02:02:55,768 --> 02:02:57,103 AND HOPEFULLY CONGRESS WILL BE 3635 02:02:57,169 --> 02:02:59,205 ABLE TO WORK WITHIN THOSE 3636 02:02:59,271 --> 02:03:01,607 PARAMETERS AND WRAP THINGS UP A 3637 02:03:01,674 --> 02:03:02,908 LITTLE CLOSER TO THE START OF 3638 02:03:02,975 --> 02:03:03,843 THE FISCAL YEAR BUT WE'LL HAVE 3639 02:03:03,909 --> 02:03:07,546 TO WAIT AND SEE. 3640 02:03:07,613 --> 02:03:11,350 >> DOES ANYONE ELSE HAVE WILL 3641 02:03:11,417 --> 02:03:14,186 ANY QUESTIONS? 3642 02:03:14,253 --> 02:03:16,922 I THINK WE'RE ALL JUST IN AWE OF 3643 02:03:16,989 --> 02:03:19,225 THE COMPLEX NATURE OF GETTING A 3644 02:03:19,291 --> 02:03:20,526 BUDGET PASSED, AND WE THANK YOU 3645 02:03:20,593 --> 02:03:23,596 FOR YOUR TIME AND FOR PRESENTING 3646 02:03:23,662 --> 02:03:24,463 TO US. 3647 02:03:24,530 --> 02:03:25,765 AMY, DO WE HAVE ANYTHING THAT WE 3648 02:03:25,831 --> 02:03:28,267 NEED TO DO BEFORE WE BREAK FOR 3649 02:03:28,334 --> 02:03:31,036 LUNCH? 3650 02:03:31,103 --> 02:03:32,238 SO WE'RE GOING TO BREAK FOR 3651 02:03:32,304 --> 02:03:35,207 LUNCH AND WE'LL BE BACK ON 3652 02:03:35,274 --> 02:03:36,609 SCHEDULE AT 1:00. 3653 02:03:36,675 --> 02:03:40,212 THANK YOU. 3654 02:03:40,279 --> 02:03:41,547 >> THANK YOU, EVERYONE, FOR 3655 02:03:41,614 --> 02:03:42,114 COMING BACK. 3656 02:03:42,181 --> 02:03:44,717 I AM NOW GOING TO CALL THE 3657 02:03:44,784 --> 02:03:49,355 MEETING BACK TO ORDER. 3658 02:03:49,421 --> 02:03:50,623 OUR FIRST UPDATE AFTER LUNCH 3659 02:03:50,689 --> 02:03:52,591 HERE IS WE ARE SO PLEASED TO 3660 02:03:52,658 --> 02:03:55,995 HAVE DR. ELIZABETH JAFFEE JOIN 3661 02:03:56,061 --> 02:03:59,198 US FROM THE PRESIDENT'S CANCER 3662 02:03:59,265 --> 02:03:59,665 PANEL. 3663 02:03:59,732 --> 02:04:00,766 SHE'S GOING TO TALK TO US A 3664 02:04:00,833 --> 02:04:02,101 LITTLE BIT ABOUT THE NATIONAL 3665 02:04:02,168 --> 02:04:02,735 CANCER PLAN. 3666 02:04:02,802 --> 02:04:05,771 IF YOU'RE NOT AWARE, THAT 3667 02:04:05,838 --> 02:04:08,574 DR. JAFFEE IS AN INTERNATIONALLY 3668 02:04:08,641 --> 02:04:15,481 RECOGNIZED IMMUNOLOGY -- DEPUTY 3669 02:04:15,548 --> 02:04:16,582 TOO DIRECTOR OF THE CANCER 3670 02:04:16,649 --> 02:04:20,486 CENTER AT JOHNS HOPKINS AND ALSO 3671 02:04:20,553 --> 02:04:21,086 A -- THE AMERICAN ASSOCIATION 3672 02:04:21,153 --> 02:04:25,891 FOR CANCER RESEARCH AND HAS 3673 02:04:25,958 --> 02:04:27,459 SERVED ON SEVERAL COMMITTEES 3674 02:04:27,526 --> 02:04:29,929 INCLUDING CO-CHAIR OF THE CANCER 3675 02:04:29,995 --> 02:04:32,264 MOONSHOT PANEL AND PAST CHAIR OF 3676 02:04:32,331 --> 02:04:33,265 THE NATIONAL CANCER ADVISORY 3677 02:04:33,332 --> 02:04:33,465 BOARD. 3678 02:04:33,532 --> 02:04:34,934 THANK YOU SO MUCH FOR COMING TO 3679 02:04:35,000 --> 02:04:36,769 OUR MEETING, DR. JAFFEE. 3680 02:04:36,836 --> 02:04:38,003 >> THANK YOU VERY MUCH FOR 3681 02:04:38,070 --> 02:04:39,839 INVITING ME TO THIS MEETING TO 3682 02:04:39,905 --> 02:04:41,307 DISCUSS HOW WE'VE BEEN 3683 02:04:41,373 --> 02:04:42,074 MONITORING THE NATIONAL CANCER 3684 02:04:42,141 --> 02:04:42,708 PLAN. 3685 02:04:42,775 --> 02:04:43,909 I JUST WANTED TO POINT OUT 3686 02:04:43,976 --> 02:04:44,977 BEFORE I GET STARTED THAT THIS 3687 02:04:45,044 --> 02:04:47,880 IS A LIVING DOCUMENT THAT WILL 3688 02:04:47,947 --> 02:04:49,181 CONTINUE TO GROW WITH THE NEEDS 3689 02:04:49,248 --> 02:04:50,482 OF ALL CANCER PATIENTS, BOTH 3690 02:04:50,549 --> 02:04:51,917 CURRENT AND FUTURE. 3691 02:04:51,984 --> 02:04:54,987 I ALSO WANT TO WELCOME ANY INPUT 3692 02:04:55,054 --> 02:04:57,823 FROM ALL STAKEHOLDERS BECAUSE WE 3693 02:04:57,890 --> 02:04:59,358 DO PROVIDE A WAY TO PROVIDE THAT 3694 02:04:59,425 --> 02:05:00,993 INPUT AT ALL TIMES. 3695 02:05:01,060 --> 02:05:02,761 IN ADDITION TO HOLDING ANNUAL 3696 02:05:02,828 --> 02:05:05,064 PUBLIC MEETINGS, WE SOLICIT 3697 02:05:05,130 --> 02:05:07,266 SUBMISSIONS VIA EMAIL AND SOCIAL 3698 02:05:07,333 --> 02:05:08,601 MEDIA TO LEARN ABOUT PROGRAMS, 3699 02:05:08,667 --> 02:05:10,135 ACTIVITIES AND ACHIEVEMENTS THAT 3700 02:05:10,202 --> 02:05:11,537 ALIGN WITH THE PLAN'S GOALS. 3701 02:05:11,604 --> 02:05:13,305 SO I'M GOING TO PRESENT TO YOU 3702 02:05:13,372 --> 02:05:15,841 THE EIGHT GOALS OF THE PLAN, AND 3703 02:05:15,908 --> 02:05:19,245 HOW WE'VE INITIATED OUR MONIT 3704 02:05:19,311 --> 02:05:20,379 MONITORING, AND I ALSO WANT TO 3705 02:05:20,446 --> 02:05:21,547 POINT OUT THAT THESE GOALS ARE 3706 02:05:21,614 --> 02:05:22,948 MEANT TO BE BROAD GOALS SO THAT 3707 02:05:23,015 --> 02:05:24,250 THEY'RE ALL INCLUSIVE. 3708 02:05:24,316 --> 02:05:26,552 WE REALIZE THAT ALL OF US ONLY 3709 02:05:26,619 --> 02:05:30,556 CONTRIBUTE TO PARTS OF THEM AND 3710 02:05:30,623 --> 02:05:31,790 AGAIN THIS IS MEANT TO BE BROAD 3711 02:05:31,857 --> 02:05:33,325 AND ALSO TO BE VERY 3712 02:05:33,392 --> 02:05:33,993 COLLABORATIVE. 3713 02:05:34,059 --> 02:05:40,366 SO WITH THAT STARTING POINT, SO 3714 02:05:40,432 --> 02:05:41,667 I WANTED TO JUST GIVE YOU A 3715 02:05:41,734 --> 02:05:44,203 LITTLE BIT OF AN OVERVIEW OF WHO 3716 02:05:44,270 --> 02:05:48,674 WE ARE AS THE PRESIDENT'S CANCER 3717 02:05:48,741 --> 02:05:49,241 ADVISORY PANEL. 3718 02:05:49,308 --> 02:05:50,643 WE'RE A THREE-MEMBER PANEL THAT 3719 02:05:50,709 --> 02:05:52,211 WAS ESTABLISHED BY THE NATIONAL 3720 02:05:52,278 --> 02:05:54,747 CANCER ACT OF 1971. 3721 02:05:54,813 --> 02:05:57,049 OUR MISSION IS TO MONITOR THE 3722 02:05:57,116 --> 02:05:58,484 DEVELOPMENT AND EXECUTION OF ALL 3723 02:05:58,550 --> 02:05:59,985 ACTIVITY OF THE NATIONAL CANCER 3724 02:06:00,052 --> 02:06:03,622 PROGRAM, SO NOT JUST THE NCI. 3725 02:06:03,689 --> 02:06:05,291 AND WE ARE EXPECTED TO REPORT 3726 02:06:05,357 --> 02:06:07,259 DIRECTLY TO THE PRESIDENT. 3727 02:06:07,326 --> 02:06:08,994 WE'RE ALSO SUPPOSED TO IDENTIFY 3728 02:06:09,061 --> 02:06:11,597 HIGH PRIORITY TOPICS FOR WHICH 3729 02:06:11,664 --> 02:06:13,065 THE PRESIDENT AND THE GOVERNMENT 3730 02:06:13,132 --> 02:06:15,134 CAN ACT ON BASED ON OUR 3731 02:06:15,200 --> 02:06:16,335 RECOMMENDATIONS. 3732 02:06:16,402 --> 02:06:17,670 I DO CHAIR THIS. 3733 02:06:17,736 --> 02:06:19,204 I HAVE TWO WONDERFUL COLLEAGUES 3734 02:06:19,271 --> 02:06:20,806 WHO WORK WITH ME, DR. MITCH 3735 02:06:20,873 --> 02:06:22,975 BERGER, HE'S AT THE UNIVERSITY 3736 02:06:23,042 --> 02:06:24,310 OF CALIFORNIA SAN FRANCISCO, AND 3737 02:06:24,376 --> 02:06:26,078 HE IS AN EXPERT IN BRAIN CANCER 3738 02:06:26,145 --> 02:06:28,013 SURGERY. 3739 02:06:28,080 --> 02:06:29,481 AND DR. CAROL BROWN AT THE 3740 02:06:29,548 --> 02:06:30,349 MEMORIAL SLOAN KETTERING CANCER 3741 02:06:30,416 --> 02:06:33,185 CENTER, AND SHE'S AN EXPERT IN 3742 02:06:33,252 --> 02:06:34,386 GYNECOLOGICAL ONCOLOGY AND ALSO 3743 02:06:34,453 --> 02:06:40,225 IN HEALTH DISPARITIES. 3744 02:06:40,292 --> 02:06:45,464 SO WE ORIGINALLY WORKED WITH DRT 3745 02:06:45,531 --> 02:06:51,070 THAT TIME WAS THE DIRECTOR OF 3746 02:06:51,136 --> 02:06:51,704 THE NATIONAL CANCER INSTITUTE, 3747 02:06:51,770 --> 02:06:55,074 AND SHE REALLY DEVELOPED THE NEW 3748 02:06:55,140 --> 02:06:56,408 NATIONAL CANCER PLAN TO ALIGN 3749 02:06:56,475 --> 02:06:58,077 WITH THE 50TH ANNIVERSARY OF THE 3750 02:06:58,143 --> 02:06:58,844 NATIONAL CANCER ACT. 3751 02:06:58,911 --> 02:07:01,146 WE TOOK PART IN HELPING HER. 3752 02:07:01,213 --> 02:07:03,782 SHE ALSO WORKED WITH HHS AND 3753 02:07:03,849 --> 02:07:04,550 WITH THE WHITE HOUSE. 3754 02:07:04,616 --> 02:07:05,651 SO THIS WAS ORIGINALLY RELEASED 3755 02:07:05,718 --> 02:07:10,022 IN APRIL OF 2023. 3756 02:07:10,089 --> 02:07:11,357 AND IT WAS BASICALLY IN 3757 02:07:11,423 --> 02:07:12,458 ALIGNMENT OF THE LONG TERM 3758 02:07:12,524 --> 02:07:13,826 INITIATIVE TO MEET THE GOALS OF 3759 02:07:13,892 --> 02:07:14,960 PRESIDENT BIDEN'S CANCER 3760 02:07:15,027 --> 02:07:16,829 MOONSHOT. 3761 02:07:16,895 --> 02:07:19,131 IT'S DESIGNED TO FACILITATE 3762 02:07:19,198 --> 02:07:20,032 COLLABORATION, COMMUNICATION, 3763 02:07:20,099 --> 02:07:23,302 OUTREACH AND PARTNERSHIPS, NOT 3764 02:07:23,369 --> 02:07:24,570 ONLY AGAIN IN CANCER RESEARCH 3765 02:07:24,636 --> 02:07:26,472 BUT IN ALL OF CANCER CARE, TO 3766 02:07:26,538 --> 02:07:28,774 REALLY BRING IN ALL OF THE 3767 02:07:28,841 --> 02:07:31,844 CANCER COMMUNITY, AND TO BE ABLE 3768 02:07:31,910 --> 02:07:33,579 TO REACH ACROSS ALL SECTORS OF 3769 02:07:33,645 --> 02:07:35,247 SOCIETY SO THAT WE CAN MAKE 3770 02:07:35,314 --> 02:07:37,116 FASTER PROGRESS IN ENDING CANCER 3771 02:07:37,182 --> 02:07:38,083 AS WE KNOW IT. 3772 02:07:38,150 --> 02:07:39,718 AND AGAIN, YOU CAN READ ABOUT 3773 02:07:39,785 --> 02:07:41,487 THIS AS WELL AS OUR ACTIVITIES 3774 02:07:41,553 --> 02:07:45,557 ON THE NATIONAL CANCER 3775 02:07:45,624 --> 02:07:47,126 PLAN.CANCER.GOV. 3776 02:07:47,192 --> 02:07:49,261 SO THESE ARE THE EIGHT GOALS, 3777 02:07:49,328 --> 02:07:51,030 AND NOT ONLY THE GOALS BUT WHAT 3778 02:07:51,096 --> 02:07:52,898 WE BELIEVE SUCCESS SHOULD LOOK 3779 02:07:52,965 --> 02:07:54,066 LIKE. 3780 02:07:54,133 --> 02:07:55,567 AND THEY INCLUDE PREVENTING 3781 02:07:55,634 --> 02:07:58,103 CANCER AND WE WANT THIS TO MEAN 3782 02:07:58,170 --> 02:08:00,105 THAT WE PREVENT CANCER IN ALL 3783 02:08:00,172 --> 02:08:02,074 PEOPLE OF OUR SOCIETY, AND WE 3784 02:08:02,141 --> 02:08:04,843 WANT EVERYONE TO BE ABLE TO 3785 02:08:04,910 --> 02:08:06,011 ADOPT PROVEN STRATEGIES THAT 3786 02:08:06,078 --> 02:08:07,312 REDUCE THE RISK OF CANCER. 3787 02:08:07,379 --> 02:08:09,515 WE NEED TO DETECT CANCER EARLY, 3788 02:08:09,581 --> 02:08:11,817 AGAIN, WE WANT TO DETECT CANCER 3789 02:08:11,884 --> 02:08:13,685 IN EVERYONE AT THE EARLIEST 3790 02:08:13,752 --> 02:08:15,320 STAGES TO ENABLE THE MOST 3791 02:08:15,387 --> 02:08:17,289 EFFECTIVE TREATMENTS. 3792 02:08:17,356 --> 02:08:18,924 WE WANT TO DEVELOP EFFECTIVE 3793 02:08:18,991 --> 02:08:20,025 TREATMENT OPTIONS. 3794 02:08:20,092 --> 02:08:21,226 WE REALIZE THAT WE'RE NOT GOING 3795 02:08:21,293 --> 02:08:23,529 TO GET RID OF ALL CANCER BY 3796 02:08:23,595 --> 02:08:24,863 DETECTING EARLY OR PREVENTING. 3797 02:08:24,930 --> 02:08:25,964 WE NEED GOOD EFFECTIVE 3798 02:08:26,031 --> 02:08:26,398 TREATMENTS. 3799 02:08:26,465 --> 02:08:27,900 WE NEED TO CONTINUE TO BE 3800 02:08:27,966 --> 02:08:29,168 VIGILANT TO DEVELOP THESE 3801 02:08:29,234 --> 02:08:30,469 TREATMENTS. 3802 02:08:30,536 --> 02:08:32,638 IMPORTANT TO ALL OF THE GOALS IS 3803 02:08:32,704 --> 02:08:34,173 TO ELIMINATE INEQUITIES. 3804 02:08:34,239 --> 02:08:35,974 AND THIS MEANS DISPARITIES IN 3805 02:08:36,041 --> 02:08:38,444 CANCER RISK FACTORS, INCIDENTS, 3806 02:08:38,510 --> 02:08:40,746 TREATMENTS, SIDE EFFECTS, 3807 02:08:40,813 --> 02:08:43,048 MORTALITY, AND ALSO WE WANT TO 3808 02:08:43,115 --> 02:08:45,017 ELIMINATE ALL OF THIS THROUGH 3809 02:08:45,084 --> 02:08:47,119 EQUITABLE ACCESS TO PREVENTION, 3810 02:08:47,186 --> 02:08:48,787 SCREENING, TREATMENT AND 3811 02:08:48,854 --> 02:08:49,955 SURVIVORSHIP CARE. 3812 02:08:50,022 --> 02:08:52,157 WE NEED TO DELIVER OPTIMAL CARE 3813 02:08:52,224 --> 02:08:53,692 AND WHAT THIS MEANS IS WE NEED 3814 02:08:53,759 --> 02:08:56,228 TO DEVELOP CARE THAT IS 3815 02:08:56,295 --> 02:08:57,362 EVIDENCE-BASED AND TO EVERYONE 3816 02:08:57,429 --> 02:08:59,832 IT HAS TO BE PATIENT-CENTERED 3817 02:08:59,898 --> 02:09:01,467 CARE THAT AGAIN PRIORITIZES 3818 02:09:01,533 --> 02:09:03,135 PREVENTION, REDUCES CANCER 3819 02:09:03,202 --> 02:09:06,338 MORBIDITY AND MORTALITY, AND 3820 02:09:06,405 --> 02:09:07,773 OVERALL WE WANT TO IMPROVE THE 3821 02:09:07,840 --> 02:09:09,641 LIVES OF CANCER SURVIVORS. 3822 02:09:09,708 --> 02:09:12,611 THOSE PEOPLE WHO ARE LIVING WITH 3823 02:09:12,678 --> 02:09:13,812 CANCER. 3824 02:09:13,879 --> 02:09:15,380 WE NEED TO ENGAGE EVERYONE. 3825 02:09:15,447 --> 02:09:17,216 EVERY PERSON WITH CANCER OR AT 3826 02:09:17,282 --> 02:09:18,450 RISK FOR CANCER HAS AN 3827 02:09:18,517 --> 02:09:19,985 OPPORTUNITY TO PARTICIPATE IN 3828 02:09:20,052 --> 02:09:21,753 RESEARCH OR OTHERWISE CONTRIBUTE 3829 02:09:21,820 --> 02:09:23,589 TO THE COLLECTIVE KNOWLEDGE 3830 02:09:23,655 --> 02:09:25,757 BASE, AND TO HELP US REMOVE THE 3831 02:09:25,824 --> 02:09:28,760 BARRIERS TO THEIR PARTICIPATION. 3832 02:09:28,827 --> 02:09:30,929 THIS IS CRITICAL TO MAKING SURE 3833 02:09:30,996 --> 02:09:32,764 THAT EVERYONE IS A PART OF 3834 02:09:32,831 --> 02:09:35,934 SOLVING THIS PROBLEM. 3835 02:09:36,001 --> 02:09:37,936 WE NEED TO MAXIMIZE DATA 3836 02:09:38,003 --> 02:09:38,604 UTILITY. 3837 02:09:38,670 --> 02:09:39,872 WE'RE AT A TIME WHERE WE HAVE SO 3838 02:09:39,938 --> 02:09:41,206 MUCH DATA, WE'RE LEARNING SO 3839 02:09:41,273 --> 02:09:43,308 MUCH IN THE HEALTHCARE SYSTEM. 3840 02:09:43,375 --> 02:09:46,044 WE NEED TO SECURE SHARING OF 3841 02:09:46,111 --> 02:09:47,779 PRIVACY PROTECTED HEALTH DATA. 3842 02:09:47,846 --> 02:09:49,481 WE NEED TO HAVE STANDARD 3843 02:09:49,548 --> 02:09:51,016 PRACTICES WHERE WE SHARE THROUGH 3844 02:09:51,083 --> 02:09:53,185 RESEARCH AND ALSO THROUGH 3845 02:09:53,252 --> 02:09:53,819 PATIENT CARE. 3846 02:09:53,886 --> 02:09:55,454 WE NEED TO BE ABLE TO SHARE SO 3847 02:09:55,521 --> 02:09:57,589 WE CAN MAKE ADVANCES MORE 3848 02:09:57,656 --> 02:09:57,890 QUICKLY. 3849 02:09:57,956 --> 02:10:00,092 THIS IS CRITICAL TO WHAT WE DO, 3850 02:10:00,159 --> 02:10:02,027 AND HOW WE MOVE FORWARD. 3851 02:10:02,094 --> 02:10:03,929 AND AGAIN WE NEED TO OPTIMIZE 3852 02:10:03,996 --> 02:10:06,331 THE WORKFORCE, AND THE PANDEMIC 3853 02:10:06,398 --> 02:10:09,501 HAS FURTHER REDUCED OUR ABILITY 3854 02:10:09,568 --> 02:10:11,303 TO RECRUIT PEOPLE INTO THE 3855 02:10:11,370 --> 02:10:11,803 WORKFORCE. 3856 02:10:11,870 --> 02:10:13,739 WE NEED PEOPLE IN THE WORKFORCE 3857 02:10:13,805 --> 02:10:16,408 IN ALL SECTORS OF HEALTHCARE. 3858 02:10:16,475 --> 02:10:19,144 THE CANCER CARE AND RESEARCH 3859 02:10:19,211 --> 02:10:20,345 WORKFORCE NEEDS TO BE DIVERSE, 3860 02:10:20,412 --> 02:10:21,780 IT NEEDS TO REFLECT THE 3861 02:10:21,847 --> 02:10:23,849 COMMUNITIES WE SERVE AND IT NEED 3862 02:10:23,916 --> 02:10:25,417 TO MEET THE NEEDS OF ALL PEOPLE 3863 02:10:25,484 --> 02:10:26,518 WITH CANCER AND THOSE AT RISK 3864 02:10:26,585 --> 02:10:27,052 FOR CANCER. 3865 02:10:27,119 --> 02:10:28,353 THIS IS THE ONLY WAY THAT WE 3866 02:10:28,420 --> 02:10:30,255 WILL ENSURE PEOPLE WILL LIVE 3867 02:10:30,322 --> 02:10:33,859 LONGER AND HEALTHIER LIVES. 3868 02:10:33,926 --> 02:10:36,161 SO OUR FIRST STEP WAS TO HAVE A 3869 02:10:36,228 --> 02:10:37,496 STAKEHOLDER MEETING AND THESE 3870 02:10:37,563 --> 02:10:39,031 ARE THE GROUPS THAT WE INVITED 3871 02:10:39,097 --> 02:10:40,332 TO THIS FIRST MEETING. 3872 02:10:40,399 --> 02:10:41,667 THIS IS BASED ON KNOWING THAT 3873 02:10:41,733 --> 02:10:42,734 THESE ARE NATIONAL GROUPS THAT 3874 02:10:42,801 --> 02:10:45,304 WORK WITH MANY DIFFERENT PEOPLE 3875 02:10:45,370 --> 02:10:47,239 IN DIFFERENT COMMUNITIES, AND 3876 02:10:47,306 --> 02:10:50,008 WHO WE KNOW ARE CONTRIBUTING TO 3877 02:10:50,075 --> 02:10:55,147 THE NATIONAL CANCER PLAN. 3878 02:10:55,214 --> 02:10:57,216 SO OUR INITIAL ASSESSMENT WAS 3879 02:10:57,282 --> 02:10:59,618 AGAIN TO ENGAGE THE COMMUNITY. 3880 02:10:59,685 --> 02:11:01,720 WE WANTED TO REVIEW ACTIVITIES 3881 02:11:01,787 --> 02:11:03,789 ADDRESSING THE GOALS OUTLINED IN 3882 02:11:03,855 --> 02:11:04,389 THE NATIONAL CANCER PLAN. 3883 02:11:04,456 --> 02:11:06,158 SO WHAT IS CURRENTLY ONGOING. 3884 02:11:06,225 --> 02:11:07,659 WE WANTED TO IDENTIFY THE 3885 02:11:07,726 --> 02:11:08,994 CHALLENGES AND ALSO THE 3886 02:11:09,061 --> 02:11:10,829 OPPORTUNITIES SO WE CAN 3887 02:11:10,896 --> 02:11:12,497 ACCELERATE PROGRESS AGAINST 3888 02:11:12,564 --> 02:11:13,465 CANCER, AND IMPORTANTLY, WE 3889 02:11:13,532 --> 02:11:15,500 WANTED TO FOSTER COLLABORATIONS 3890 02:11:15,567 --> 02:11:16,768 AMONG ALL STAKEHOLDERS SO THAT 3891 02:11:16,835 --> 02:11:18,437 WE COULD ACHIEVE COMMON GOALS 3892 02:11:18,503 --> 02:11:20,072 AND ACHIEVE THEM MORE QUICKLY. 3893 02:11:20,138 --> 02:11:21,607 SO THE FIRST STEP WAS TO LEARN 3894 02:11:21,673 --> 02:11:23,408 ABOUT PROGRAMS, ACTIVITIES AND 3895 02:11:23,475 --> 02:11:24,343 ACHIEVEMENTS THAT WERE RELEVANT 3896 02:11:24,409 --> 02:11:26,612 TO THE NATIONAL CANCER PLAN, AND 3897 02:11:26,678 --> 02:11:28,847 THIS WAS DONE THROUGH OUR FIRST 3898 02:11:28,914 --> 02:11:29,281 STAKEHOLDER MEETING. 3899 02:11:29,348 --> 02:11:30,182 YOU CAN SEE ON THE RIGHT 3900 02:11:30,249 --> 02:11:31,350 PICTURES OF SOME OF THE PEOPLE 3901 02:11:31,416 --> 02:11:32,784 WHO PARTICIPATED, AND THIS WAS 3902 02:11:32,851 --> 02:11:36,088 HELD ON SEPTEMBER 7TH, 2023. 3903 02:11:36,154 --> 02:11:39,491 AND WE ALSO HAD REQUESTED THAT 3904 02:11:39,558 --> 02:11:41,560 PEOPLE SUBMIT ANY UPDATES 3905 02:11:41,627 --> 02:11:42,894 CONTINUOUSLY VIA EMAIL AND 3906 02:11:42,961 --> 02:11:43,528 SOCIAL MEDIA. 3907 02:11:43,595 --> 02:11:44,963 WE WANT TO HEAR FROM EVERYONE. 3908 02:11:45,030 --> 02:11:46,698 WE WANT TO HEAR WHAT THE 3909 02:11:46,765 --> 02:11:47,833 OPPORTUNITIES ARE, WHAT THE 3910 02:11:47,899 --> 02:11:49,034 CHALLENGES ARE, AND WHAT 3911 02:11:49,101 --> 02:11:50,469 EVERYONE IS DOING TO ACHIEVE 3912 02:11:50,535 --> 02:11:52,237 THESE GOALS SO WE CAN LEARN FROM 3913 02:11:52,304 --> 02:11:57,142 EACH OTHER AND WORK TOGETHER. 3914 02:11:57,209 --> 02:11:58,810 SO OUR REPORT WAS PRESENTED TO 3915 02:11:58,877 --> 02:12:00,545 THE PRESIDENT ACTUALLY ON THE 3916 02:12:00,612 --> 02:12:02,281 DATE THAT WAS ON THE FIRST PAGE, 3917 02:12:02,347 --> 02:12:03,215 I MEANT TO MENTION THAT WAS THE 3918 02:12:03,282 --> 02:12:04,416 DATE WE PRESENTED TO THE 3919 02:12:04,483 --> 02:12:09,454 PRESIDENT'S TEAM. 3920 02:12:09,521 --> 02:12:11,823 , OUR FINDINGS, AND WE 3921 02:12:11,890 --> 02:12:12,691 IDENTIFIED THE FIVE PRIORITIES 3922 02:12:12,758 --> 02:12:13,592 THAT WE WERE HOPING THAT THE 3923 02:12:13,659 --> 02:12:14,259 PRESIDENT AND CONGRESS WOULD 3924 02:12:14,326 --> 02:12:17,062 WORK ON TO ADDRESS SOME CRITICAL 3925 02:12:17,129 --> 02:12:20,532 NEEDS THAT WE NEED NOW. 3926 02:12:20,599 --> 02:12:23,702 ONE INCLUDES INCREASING 3927 02:12:23,769 --> 02:12:27,339 INVESTMENT IN BIOMEDICAL 3928 02:12:27,406 --> 02:12:27,606 RESEARCH. 3929 02:12:27,673 --> 02:12:28,774 IT MAY SEEM LIKE THERE'S A LOT 3930 02:12:28,840 --> 02:12:30,409 OF MONEY GOING TO THE NCI AND 3931 02:12:30,475 --> 02:12:31,510 THE NIH. 3932 02:12:31,576 --> 02:12:32,311 IT'S NOT ENOUGH. 3933 02:12:32,377 --> 02:12:33,612 IT BARELY COVERS THE COST OF 3934 02:12:33,679 --> 02:12:34,713 LIVING INCREASES. 3935 02:12:34,780 --> 02:12:35,714 THIS HAS BEEN TRUE FOR THE PAST 3936 02:12:35,781 --> 02:12:36,581 COUPLE OF DECADES. 3937 02:12:36,648 --> 02:12:37,916 YES THE MOONSHOT MONEY HELPED 3938 02:12:37,983 --> 02:12:39,551 BUT THE MOONSHOT MONEY IS GOING 3939 02:12:39,618 --> 02:12:40,752 AWAY. 3940 02:12:40,819 --> 02:12:41,953 WE NEED ANOTHER INVESTMENT AND 3941 02:12:42,020 --> 02:12:43,522 IT'S NOT A GOOD TIME RIGHT NOW 3942 02:12:43,588 --> 02:12:44,623 IN CONGRESS TO REALLY GET THAT 3943 02:12:44,690 --> 02:12:45,357 INVESTMENT. 3944 02:12:45,424 --> 02:12:46,758 SO WEAR VERY, VERY CONCERNED AND 3945 02:12:46,825 --> 02:12:48,694 WE WANT THAT TO BE ON THE RADAR. 3946 02:12:48,760 --> 02:12:50,762 WE ALSO NEED TO ENSURE ACCESS TO 3947 02:12:50,829 --> 02:12:51,396 HIGH QUALITY INSURANCE COVERAGE 3948 02:12:51,463 --> 02:12:52,964 FOR ALL AND AS I'LL MENTION TO 3949 02:12:53,031 --> 02:12:54,199 YOU THERE ARE STATES WHERE 3950 02:12:54,266 --> 02:12:55,300 MEDICAID IS NOT REALLY HELPING 3951 02:12:55,367 --> 02:12:56,368 THE PATIENTS WHO NEED IT AND 3952 02:12:56,435 --> 02:12:57,069 I'LL TALK A LITTLE BIT MORE 3953 02:12:57,135 --> 02:12:59,004 ABOUT THAT. 3954 02:12:59,071 --> 02:13:00,672 WE NEED TO BUILD A SUSTAINABLE, 3955 02:13:00,739 --> 02:13:01,840 ROBUST AND DIVERSE WORKFORCE. 3956 02:13:01,907 --> 02:13:02,541 THIS IS CRITICAL. 3957 02:13:02,607 --> 02:13:05,077 THIS IS ABSOLUTELY CRITICAL. 3958 02:13:05,143 --> 02:13:07,179 THIS WORKFORCE NEEDS TO REFLECT 3959 02:13:07,245 --> 02:13:07,512 THE COMMUNITY. 3960 02:13:07,579 --> 02:13:09,147 IT NEEDS TO BE ABLE TO ENGAGE 3961 02:13:09,214 --> 02:13:11,783 THE COMMUNITY TO UNDERSTAND THE 3962 02:13:11,850 --> 02:13:12,751 COMMUNITY. 3963 02:13:12,818 --> 02:13:15,954 RIGHT NOW WE'RE REALLY IN A BIG 3964 02:13:16,021 --> 02:13:18,457 DILEMMA BECAUSE WITH THE 3965 02:13:18,523 --> 02:13:19,558 PANDEMIC AS I MENTIONED IN THE 3966 02:13:19,624 --> 02:13:21,960 BEGINNING, OUR WORKFORCE IS 3967 02:13:22,027 --> 02:13:22,861 SHRINKING, IT'S NOT INCREASING. 3968 02:13:22,928 --> 02:13:24,196 WE NEED WAYS IN WHICH TO ENGAGE 3969 02:13:24,262 --> 02:13:25,597 MORE PEOPLE INTO OUR WORKFORCE 3970 02:13:25,664 --> 02:13:29,334 WITH GOOD-PAYING JOBS, AND ALL 3971 02:13:29,401 --> 02:13:30,302 ASPECTS OF THE HEALTHCARE 3972 02:13:30,369 --> 02:13:32,270 WORKFORCE. 3973 02:13:32,337 --> 02:13:34,373 WE NEED TO PROMOTE DYNAMIC AND 3974 02:13:34,439 --> 02:13:35,307 SUSTAINABLE COMMUNITY 3975 02:13:35,374 --> 02:13:35,607 ENGAGEMENT. 3976 02:13:35,674 --> 02:13:36,675 I MEAN, EVERYONE HAS TO TAKE 3977 02:13:36,742 --> 02:13:37,109 PART. 3978 02:13:37,175 --> 02:13:39,344 WE CAN'T DO THIS ALONE IN ANY 3979 02:13:39,411 --> 02:13:41,313 ONE SECTOR. 3980 02:13:41,380 --> 02:13:42,280 THIS IS EVERYBODY NEEDS TO BE A 3981 02:13:42,347 --> 02:13:43,382 PART OF THE SOLUTION, EVERYONE 3982 02:13:43,448 --> 02:13:46,351 HAS TO BE PROACTIVE, AND 3983 02:13:46,418 --> 02:13:47,386 EVERYONE NEEDS TO BE PARTNERED 3984 02:13:47,452 --> 02:13:49,521 IN THIS. 3985 02:13:49,588 --> 02:13:51,723 AND WE NEED TO PRIORITIZE DATA 3986 02:13:51,790 --> 02:13:53,558 SHARING AND INTEGRATION TO EXCEL 3987 02:13:53,625 --> 02:13:53,892 RAY RESEARCH. 3988 02:13:53,959 --> 02:13:56,561 SO I'LL TAKE EACH ONE THESE AS 3989 02:13:56,628 --> 02:13:57,662 WE GO THROUGH THE NEXT SET OF 3990 02:13:57,729 --> 02:14:00,532 SLIDES. 3991 02:14:00,599 --> 02:14:02,300 SO INVESTING IN BIOMEDICAL 3992 02:14:02,367 --> 02:14:03,235 RESEARCH IS CRITICAL. 3993 02:14:03,301 --> 02:14:05,704 WE NEED TO INCREASE BOTH PUBLIC 3994 02:14:05,771 --> 02:14:06,838 AND PRIVATE INVESTMENT IN 3995 02:14:06,905 --> 02:14:08,140 BIOMEDICAL RESEARCH. 3996 02:14:08,206 --> 02:14:09,875 THEY PROVIDE COMPLEMENTARY ROLES 3997 02:14:09,941 --> 02:14:12,611 TO HELP US TRANSLATE ALL THIS 3998 02:14:12,677 --> 02:14:14,479 BIOLOGICAL KNOWLEDGE, AND IN THE 3999 02:14:14,546 --> 02:14:15,580 PAST 10 TO 15 YEARS, WE HAVE 4000 02:14:15,647 --> 02:14:17,215 LEARNED SO MUCH ABOUT SO MANY OF 4001 02:14:17,282 --> 02:14:22,421 THE DIFFERENT CANCER TYPES. 4002 02:14:22,487 --> 02:14:23,488 WHAT THIS MEANS IS WE HAVE THE 4003 02:14:23,555 --> 02:14:27,526 ABILITY TO TRANSLATE THIS INTO 4004 02:14:27,592 --> 02:14:28,627 GOOD TREATMENTS WITH BETTER 4005 02:14:28,693 --> 02:14:29,861 OUTCOMES AND GOOD PREVENTION 4006 02:14:29,928 --> 02:14:31,596 TOO, BUT IT TAKE MONEY, IT TAKES 4007 02:14:31,663 --> 02:14:33,031 MONEY FROM BOTH SECTORS NOT JUST 4008 02:14:33,098 --> 02:14:34,699 THE PUBLIC SECTOR, NOT JUST THE 4009 02:14:34,766 --> 02:14:36,101 NIH BUT WE ALSO NEED THE PRIVATE 4010 02:14:36,168 --> 02:14:37,235 SECTOR TO TAKE PART. 4011 02:14:37,302 --> 02:14:38,603 WE NEED PUBLIC INVESTMENT IN 4012 02:14:38,670 --> 02:14:40,405 CANCER RESEARCH TO KEEP UP WITH 4013 02:14:40,472 --> 02:14:43,041 THE PACE OF OUR PROGRESS AND 4014 02:14:43,108 --> 02:14:43,475 UNDERSTANDING. 4015 02:14:43,542 --> 02:14:45,143 WE HAVE THE TECHNOLOGIES, WE'RE 4016 02:14:45,210 --> 02:14:46,912 IN A TECHNOLOGICAL REVOLUTION. 4017 02:14:46,978 --> 02:14:48,747 WE'RE DOING MORE THAN EVER IN 4018 02:14:48,814 --> 02:14:49,848 UNDERSTANDING THESE DISEASES. 4019 02:14:49,915 --> 02:14:51,750 WE NEED TO KEEP UP WITH THIS AND 4020 02:14:51,817 --> 02:14:53,685 WE NEED THE PUBLIC INVESTMENT TO 4021 02:14:53,752 --> 02:14:55,454 KEEP UP WITH CANCER RESEARCH. 4022 02:14:55,520 --> 02:14:56,822 AND THEN THE PRIVATE SECTOR 4023 02:14:56,888 --> 02:14:59,224 CONTINUES TO BENEFIT FROM 4024 02:14:59,291 --> 02:15:00,192 GOVERNMENT-FUNDED RESEARCH. 4025 02:15:00,258 --> 02:15:02,794 YET MOST OF US DON'T BELIEVE 4026 02:15:02,861 --> 02:15:05,597 THEY'RE CONTRIBUTING ENOUGH TO 4027 02:15:05,664 --> 02:15:06,865 THESE EARLY DEVELOPMENTS. 4028 02:15:06,932 --> 02:15:09,734 YES, THEY HELP TO DEVELOP LATER 4029 02:15:09,801 --> 02:15:13,038 STAGE DRUGS, BUT WE NEED PRIVATE 4030 02:15:13,104 --> 02:15:15,440 SECTOR TO CONTINUE TO INVEST AND 4031 02:15:15,507 --> 02:15:17,876 AT HIGHER LEVELS IN THE EARLIEST 4032 02:15:17,943 --> 02:15:19,578 STAGES SO WE CAN BRING THESE 4033 02:15:19,644 --> 02:15:20,679 BETTER TREATMENTS TO ALL 4034 02:15:20,745 --> 02:15:22,047 PATIENTS WITH CANCER AS WELL AS 4035 02:15:22,113 --> 02:15:23,782 TO PEOPLE WHO NEED US TO PREVENT 4036 02:15:23,849 --> 02:15:27,285 CANCER. 4037 02:15:27,352 --> 02:15:29,521 WE NEED HIGH QUALITY INSURANCE 4038 02:15:29,588 --> 02:15:29,788 COVERAGE. 4039 02:15:29,855 --> 02:15:30,922 THERE ARE 10 STATES THAT JUST 4040 02:15:30,989 --> 02:15:32,891 DON'T DO THIS WELL AT ALL. 4041 02:15:32,958 --> 02:15:34,192 MEDICAID COULD ALWAYS BE BETTER 4042 02:15:34,259 --> 02:15:35,660 IN ALL OF THE STATES BUT WE NEED 4043 02:15:35,727 --> 02:15:37,229 TO EXPAND MEDICAID PROGRAMS 4044 02:15:37,295 --> 02:15:39,965 ACROSS 10 STATES THAT ARE REALLY 4045 02:15:40,031 --> 02:15:40,365 BEHIND. 4046 02:15:40,432 --> 02:15:42,033 WE NEED TO INCREASE EQUITABLE 4047 02:15:42,100 --> 02:15:44,135 ACCESS TO CANCER CARE THROUGH 4048 02:15:44,202 --> 02:15:46,304 ADEQUATE COVERAGE FOR CANCER 4049 02:15:46,371 --> 02:15:48,406 PREVENTION, SCREENING, DIAGNOSIS 4050 02:15:48,473 --> 02:15:51,276 RG, TREATMENT AND SURVIVORSHIP. 4051 02:15:51,343 --> 02:15:52,677 THERE ARE STILL GAPS IN CANCER 4052 02:15:52,744 --> 02:15:54,045 CARE OUTCOMES AMONG THE UNDER 4053 02:15:54,112 --> 02:15:56,181 INSURED AND UNINSURED 4054 02:15:56,248 --> 02:15:56,982 INDIVIDUALS AND THERE ARE SO 4055 02:15:57,048 --> 02:15:58,350 MANY OF THOSE PEOPLE OUT THERE. 4056 02:15:58,416 --> 02:15:59,718 WE HAVE TO INCLUDE THEM, WE HAVE 4057 02:15:59,784 --> 02:16:00,986 TO MAKE SURE THAT THEY ARE 4058 02:16:01,052 --> 02:16:02,320 GETTING ACCESS TO THE BEST CARE. 4059 02:16:02,387 --> 02:16:05,090 AND THE LACK OF HEALTH INSURANCE 4060 02:16:05,156 --> 02:16:06,258 OR INADEQUATE COVERAGE 4061 02:16:06,324 --> 02:16:07,926 UNDERMINES TIMELY ACCESS TO HIGH 4062 02:16:07,993 --> 02:16:08,460 QUALITY CANCER CARE. 4063 02:16:08,527 --> 02:16:09,661 THIS IS PARTICULARLY IMPORTANT 4064 02:16:09,728 --> 02:16:10,996 BECAUSE IF IT'S NOT TIMELY, 4065 02:16:11,062 --> 02:16:12,531 PEOPLE WITH BAD CANCERS THAT ARE 4066 02:16:12,597 --> 02:16:13,965 MOVING QUICKLY ARE NEVER GOING 4067 02:16:14,032 --> 02:16:15,333 TO HAVE ACCESS. 4068 02:16:15,400 --> 02:16:17,068 SO NOT ONLY DO WE NEED GOOD 4069 02:16:17,135 --> 02:16:21,873 ACCESS, IT HAS TO BE TIMELY. 4070 02:16:21,940 --> 02:16:24,109 WE NEED TO BUILD A SUSTAINABLE 4071 02:16:24,175 --> 02:16:25,410 ROBUST AND DIVERSE WORKFORCE AND 4072 02:16:25,477 --> 02:16:28,013 THIS IS CRITICAL. 4073 02:16:28,079 --> 02:16:29,114 THIS REQUIRES THE COLLABORATION 4074 02:16:29,180 --> 02:16:30,282 BETWEEN BOTH PUBLIC AND PRIVATE 4075 02:16:30,348 --> 02:16:32,350 INVESTMENT TO RECRUIT, TRAIN, 4076 02:16:32,417 --> 02:16:35,720 SUPPORT, AND RETAIN A ROBUST AND 4077 02:16:35,787 --> 02:16:36,488 DIVERSE WORKFORCE. 4078 02:16:36,555 --> 02:16:38,757 WE NEED PUBLIC AND ACADEMIC 4079 02:16:38,823 --> 02:16:41,726 SECTORS TO HAVE HELP FROM THE 4080 02:16:41,793 --> 02:16:43,662 PRIVATE SECTORS. 4081 02:16:43,728 --> 02:16:44,863 THEY'RE LEADING EFFORTS TO TRAIN 4082 02:16:44,930 --> 02:16:46,197 AND SUPPORT THE ONCOLOGY 4083 02:16:46,264 --> 02:16:48,633 WORKFORCE. 4084 02:16:48,700 --> 02:16:50,302 BUT THEY ARE NOT GETTING THE 4085 02:16:50,368 --> 02:16:51,403 FUNDING FROM THE PRIVATE SECTOR 4086 02:16:51,469 --> 02:16:53,038 THAT ARE BENEFITING FROM THESE 4087 02:16:53,104 --> 02:16:53,672 INVESTMENTS. 4088 02:16:53,738 --> 02:16:56,107 THE PRIVATE SECTOR REAPS 4089 02:16:56,174 --> 02:16:57,742 BENEFITS, PARTICULARLY FROM NIH 4090 02:16:57,809 --> 02:16:59,878 AND NCI TRAINING PROGRAMS, AND 4091 02:16:59,945 --> 02:17:01,613 THESE PROGRAMS ARE SHRINKING AS 4092 02:17:01,680 --> 02:17:03,248 THE BUDGET SHRINKS AT THE NIH 4093 02:17:03,315 --> 02:17:04,482 AND THE NCI. 4094 02:17:04,549 --> 02:17:06,051 SO WE'RE GOING TO HAVE FEWER AND 4095 02:17:06,117 --> 02:17:07,752 FEWER PEOPLE WHO ARE TRAINED IN 4096 02:17:07,819 --> 02:17:09,821 CANCER RESEARCH AND CANCER CARE 4097 02:17:09,888 --> 02:17:11,256 IF WE DON'T MAKE SURE THAT WE 4098 02:17:11,323 --> 02:17:14,793 GET THE PRIVATE SECTOR INVOLVED 4099 02:17:14,859 --> 02:17:17,195 IN SHARING, IN TRAINING PEOPLE. 4100 02:17:17,262 --> 02:17:19,864 AND CANCER CARE AND RESEARCH IS 4101 02:17:19,931 --> 02:17:21,299 UNDERMINED BY NATIONAL AND LOCAL 4102 02:17:21,366 --> 02:17:24,135 PROVIDER SHORTAGES AND LACK OF 4103 02:17:24,202 --> 02:17:25,303 WORKFORCE DIVERSITY. 4104 02:17:25,370 --> 02:17:27,505 THIS IS A PROVEN FACT, WE HAVE 4105 02:17:27,572 --> 02:17:31,309 TO CHANGE THIS. 4106 02:17:31,376 --> 02:17:36,848 OF AGAAGAIN, CONTINUING ON BUILA 4107 02:17:36,915 --> 02:17:38,583 SUSTAINABLE, ROBUST AND DIVERSE 4108 02:17:38,650 --> 02:17:40,185 WORKFORCE, WE NEED TO ENACT THE 4109 02:17:40,251 --> 02:17:43,555 LAWS TO PERMANENTLY ALLOW 4110 02:17:43,622 --> 02:17:44,689 MEDICARE COVERAGE FOR TELEHEALTH 4111 02:17:44,756 --> 02:17:45,223 SERVICES. 4112 02:17:45,290 --> 02:17:47,792 I'M NOT SURE IF YOU'RE ALL AWARE 4113 02:17:47,859 --> 02:17:50,595 BUT TELEHEALTH SERVICES HAVE -- 4114 02:17:50,662 --> 02:17:52,697 I'M NOT SURE IF YOU'RE ALL 4115 02:17:52,764 --> 02:17:55,567 AWARE, BUT TELEHEALTH SERVICES 4116 02:17:55,634 --> 02:17:57,736 HAVE -- THE RULES HAVE BEEN 4117 02:17:57,802 --> 02:17:59,137 LOOSENED DURING COVID WHICH WERE 4118 02:17:59,204 --> 02:18:00,772 VERY HELPFUL IN GETTING CANCER 4119 02:18:00,839 --> 02:18:02,474 TREAT M TO PEOPLE WHO COULD NOT 4120 02:18:02,540 --> 02:18:04,442 COME INTO THE CITY OR INTO A 4121 02:18:04,509 --> 02:18:04,943 HOSPITAL. 4122 02:18:05,010 --> 02:18:06,011 PEOPLE WHO WERE REMOTE. 4123 02:18:06,077 --> 02:18:07,412 WE NEED TO MAINTAIN THOSE 4124 02:18:07,479 --> 02:18:08,913 POLICIES TO FACILITATE 4125 02:18:08,980 --> 02:18:10,181 TELEHEALTH SERVICES SO WE CAN 4126 02:18:10,248 --> 02:18:11,616 CONTINUE TO PROMOTE THE DELIVERY 4127 02:18:11,683 --> 02:18:12,617 OF HIGH QUALITY CANCER CARE. 4128 02:18:12,684 --> 02:18:13,718 WE NEED TO OPTIMIZE 4129 02:18:13,785 --> 02:18:14,819 OPPORTUNITIES FOR TELEHEALTH 4130 02:18:14,886 --> 02:18:16,621 ACROSS STATE LINES THAT HAVE NOT 4131 02:18:16,688 --> 02:18:17,489 YET BEEN OPTIMIZED TO EXTEND THE 4132 02:18:17,555 --> 02:18:18,823 REEFN OF OUR ONCOLOGY WORKFORCE 4133 02:18:18,890 --> 02:18:20,892 SINCE WE HAVE A SHRINKING 4134 02:18:20,959 --> 02:18:21,793 WORKFORCE, MANY OF THESE PEOPLE 4135 02:18:21,860 --> 02:18:23,995 AREN'T IN AREAS WHERE WE NEED 4136 02:18:24,062 --> 02:18:25,497 THEM TO BE, NE TO HAVE OTHER 4137 02:18:25,563 --> 02:18:27,666 WAYS TO EXTEND THAT WORKFORCE. 4138 02:18:27,732 --> 02:18:29,601 AND WE NEED STRATEGIES TO ENSURE 4139 02:18:29,668 --> 02:18:31,036 THAT ONCOLOGY CARE TEAMS CAN 4140 02:18:31,102 --> 02:18:32,203 RIECH ALL INDIVIDUALS NO MATTER 4141 02:18:32,270 --> 02:18:34,973 WHERE THEY LIVE. 4142 02:18:35,040 --> 02:18:37,175 WE NEED TO PROMOTE COMMUNITY 4143 02:18:37,242 --> 02:18:37,942 ENGAGEMENT. 4144 02:18:38,009 --> 02:18:39,110 THE COMMUNITY IS EQUAL PARTNERS 4145 02:18:39,177 --> 02:18:41,813 WITH US. 4146 02:18:41,880 --> 02:18:43,581 WE NEED MORE COMMUNITY 4147 02:18:43,648 --> 02:18:43,882 ENGAGEMENT. 4148 02:18:43,948 --> 02:18:45,450 WE NEED TO ESTABLISH POLICIES 4149 02:18:45,517 --> 02:18:47,252 AND SUSTAINABLE FUNDING THAT 4150 02:18:47,318 --> 02:18:48,286 INCENTIVIZES AND SUPPORTS 4151 02:18:48,353 --> 02:18:50,488 COMMUNITY ENGAGEMENT. 4152 02:18:50,555 --> 02:18:52,657 WE NEED ENGAGEMENT OF PATIENTS 4153 02:18:52,724 --> 02:18:53,291 AND COMMUNITY WORKERS. 4154 02:18:53,358 --> 02:18:54,826 THIS IS ESSENTIAL TO ACHIEVE THE 4155 02:18:54,893 --> 02:18:56,494 GOAL OF MORE EQUITABLE CANCER 4156 02:18:56,561 --> 02:18:58,029 CARE AND CANCER CONTROL. 4157 02:18:58,096 --> 02:18:59,864 WE NEED TO FACILITATE ALIGNMENT 4158 02:18:59,931 --> 02:19:01,399 OF CANCER RESEARCH AND CLINICAL 4159 02:19:01,466 --> 02:19:03,601 CARE TO COMMUNITY PRIORITIES 4160 02:19:03,668 --> 02:19:05,070 BECAUSE CANCER RESEARCH IS 4161 02:19:05,136 --> 02:19:07,238 WORKING. 4162 02:19:07,305 --> 02:19:08,139 CANCER RESEARCH, CLINICAL 4163 02:19:08,206 --> 02:19:09,941 TRIALS, EVEN THE EARLIEST 4164 02:19:10,008 --> 02:19:11,910 CLINICAL TRIALS NOW ARE SAVING 4165 02:19:11,976 --> 02:19:12,644 LIVES. 4166 02:19:12,711 --> 02:19:14,179 WE NEED TO MAKE SURE THAT ALL 4167 02:19:14,245 --> 02:19:15,080 PATIENTS HAVE ACCESS. 4168 02:19:15,146 --> 02:19:16,681 IT'S NO LONGER A SITUATION WHERE 4169 02:19:16,748 --> 02:19:18,516 OH, THAT'S RESEARCH, THAT'S NOT 4170 02:19:18,583 --> 02:19:19,284 GOING TO HELP ME. 4171 02:19:19,350 --> 02:19:20,285 THAT'S NOT TRUE. 4172 02:19:20,351 --> 02:19:24,456 THESE NEW DRUGS ARE HAVING GOOD 4173 02:19:24,522 --> 02:19:26,324 RESULTS IN PATIENTS WITH 4174 02:19:26,391 --> 02:19:27,425 ADVANCED CANCER WHO HAVE NO 4175 02:19:27,492 --> 02:19:28,626 OTHER OPTIONS. 4176 02:19:28,693 --> 02:19:30,095 WE NEED TO MAKE SURE THIS IS 4177 02:19:30,161 --> 02:19:30,862 AVAILABLE TO EVERYONE. 4178 02:19:30,929 --> 02:19:34,365 AND WE NEED PATIENT ENGAGEMENT 4179 02:19:34,432 --> 02:19:35,366 IN HEALTHCARE AND RESEARCH SO 4180 02:19:35,433 --> 02:19:37,168 THAT WE CAN IMPROVE TRUST IN 4181 02:19:37,235 --> 02:19:38,503 WHAT WE DO. 4182 02:19:38,570 --> 02:19:40,138 WE REALIZE WE'RE NOT TRUSTED IN 4183 02:19:40,205 --> 02:19:40,638 ALL COMMUNITIES. 4184 02:19:40,705 --> 02:19:42,874 WE NEED TO IMPROVE THAT TRUST. 4185 02:19:42,941 --> 02:19:44,209 AND THIS IS CRITICAL TO OUR 4186 02:19:44,275 --> 02:19:47,812 MISSION. 4187 02:19:47,879 --> 02:19:49,314 WE NEED TO PRIORITIZE DATA 4188 02:19:49,380 --> 02:19:50,582 SHARING AND INTEGRATION. 4189 02:19:50,648 --> 02:19:52,117 THIS IS CRITICAL AGAIN, SO MUCH 4190 02:19:52,183 --> 02:19:55,053 DATA IS AVAILABLE NOW, DATA FROM 4191 02:19:55,120 --> 02:19:56,688 PRE-CLINICAL MODELS, FROM ALL 4192 02:19:56,755 --> 02:19:59,157 THE EARLY RESEARCH, BUT ALSO 4193 02:19:59,224 --> 02:19:59,624 FROM CLINICAL TRIALS. 4194 02:19:59,691 --> 02:20:01,459 WE NEED TO LEARN WHAT'S WORKING 4195 02:20:01,526 --> 02:20:02,894 AND WHAT'S NOT AND HOW TO 4196 02:20:02,961 --> 02:20:04,462 IMPROVE WHAT'S NOT WORKING. 4197 02:20:04,529 --> 02:20:05,964 THE ONLY WAY TO DO THIS IS 4198 02:20:06,030 --> 02:20:07,465 THROUGH DATA SHARING AND 4199 02:20:07,532 --> 02:20:08,533 INTEGRATION. 4200 02:20:08,600 --> 02:20:10,268 WE NEED TO ACCELERATE EFFORTS TO 4201 02:20:10,335 --> 02:20:13,271 IMPROVE AND INCENTIVIZE 4202 02:20:13,338 --> 02:20:13,671 INTEROPERABILITY. 4203 02:20:13,738 --> 02:20:14,906 WE NEED TO STANDARDIZE DATA. 4204 02:20:14,973 --> 02:20:16,908 WE NEED TO STANDARDIZE DATA 4205 02:20:16,975 --> 02:20:18,109 SHARING PLATFORMS. 4206 02:20:18,176 --> 02:20:20,145 THIS IS IMPORTANT, AND WE NEED 4207 02:20:20,211 --> 02:20:21,546 TO BE ABLE TO TEACH PEOPLE HOW 4208 02:20:21,613 --> 02:20:22,647 TO USE THEM. 4209 02:20:22,714 --> 02:20:24,816 WE NEED TO OPTIMIZE THE 4210 02:20:24,883 --> 02:20:25,583 USABILITY AND AVAILABILITY OF 4211 02:20:25,650 --> 02:20:26,284 THE DATA. 4212 02:20:26,351 --> 02:20:28,419 WE NEED TO MAKE RESULTS 4213 02:20:28,486 --> 02:20:30,188 AVAILABLE FROM ALL CANCER 4214 02:20:30,255 --> 02:20:30,755 CLINICAL TRIALS. 4215 02:20:30,822 --> 02:20:31,823 NOW HERE IS AN ISSUE. 4216 02:20:31,890 --> 02:20:33,825 A LOT OF THIS DATA IS SITTING IN 4217 02:20:33,892 --> 02:20:35,160 THE PRIVATE SECTOR IN 4218 02:20:35,226 --> 02:20:36,261 PHARMACEUTICAL COMPANIES. 4219 02:20:36,327 --> 02:20:38,163 IT'S NOT READILY AVAILABLE. 4220 02:20:38,229 --> 02:20:40,431 WE NEED TO BE READILY AVAILABLE. 4221 02:20:40,498 --> 02:20:42,634 SO WE CAN IMPROVE ON THEM. 4222 02:20:42,700 --> 02:20:44,335 WE CAN MAKE PROGRESS FASTER. 4223 02:20:44,402 --> 02:20:47,038 WE HAVE INSUFFICIENT LEVELS OF 4224 02:20:47,105 --> 02:20:48,239 INTRAOPERABILITY AND DIGITAL 4225 02:20:48,306 --> 02:20:49,274 MATURITY ACROSS HEALTHCARE 4226 02:20:49,340 --> 02:20:51,042 SYSTEMS AND I'M SURE YOU REALIZE 4227 02:20:51,109 --> 02:20:54,112 POOR HEALTHCARE SYSTEMS HAVE 4228 02:20:54,179 --> 02:20:55,947 LESS OF THESE DIGITAL SYSTEMS 4229 02:20:56,014 --> 02:20:57,649 AVAILABLE TO THEM. 4230 02:20:57,715 --> 02:20:59,717 WELL, THESE DIGITAL SYSTEMS HELP 4231 02:20:59,784 --> 02:21:01,252 NOT ONLY PEOPLE WORKING IN THE 4232 02:21:01,319 --> 02:21:02,554 HEALTHCARE SYSTEMS BUT IT ALSO 4233 02:21:02,620 --> 02:21:04,189 HELPS PATIENTS ACCESS THEIR 4234 02:21:04,255 --> 02:21:05,790 INFORMATION MORE RAPIDLY. 4235 02:21:05,857 --> 02:21:07,759 WE HAVE INCONSISTENT SHARING OF 4236 02:21:07,826 --> 02:21:09,761 CLINICAL TRIAL RESULTS, AND 4237 02:21:09,828 --> 02:21:11,262 AGAIN, THIS IS IN PART DUE TO 4238 02:21:11,329 --> 02:21:13,531 THE FACT THAT A LOT OF THIS DATA 4239 02:21:13,598 --> 02:21:14,599 SITS IN PHARMACEUTICAL 4240 02:21:14,666 --> 02:21:18,136 COMPANIES. 4241 02:21:18,203 --> 02:21:20,004 SO WHAT ARE THE NEXT STEPS? 4242 02:21:20,071 --> 02:21:21,639 WELL, THE NEXT STEPS ARE THAT WE 4243 02:21:21,706 --> 02:21:24,375 ARE CONTINUING TO ASSESS 4244 02:21:24,442 --> 02:21:25,944 PROGRESS AND IDENTIFY 4245 02:21:26,010 --> 02:21:28,379 OPPORTUNITIES TO BE MORE 4246 02:21:28,446 --> 02:21:30,114 EFFICIENT, AND EFFECTIVE IN THE 4247 02:21:30,181 --> 02:21:32,617 GOALS OF THIS PLAN TO MAKE SURE 4248 02:21:32,684 --> 02:21:34,319 THAT WE'RE ENGAGING ALL 4249 02:21:34,385 --> 02:21:35,286 STAKEHOLDERS THROUGH PUBLIC 4250 02:21:35,353 --> 02:21:35,887 MEETINGS. 4251 02:21:35,954 --> 02:21:37,589 OUR NEXT MEETING WILL BE NEXT 4252 02:21:37,655 --> 02:21:38,156 SEPTEMBER. 4253 02:21:38,223 --> 02:21:39,624 WE'LL DO A YEARLY MEETING THAT 4254 02:21:39,691 --> 02:21:41,159 WILL BE PUBLIC. 4255 02:21:41,226 --> 02:21:42,694 WE'LL INVITE DIFFERENT GROUPS OF 4256 02:21:42,760 --> 02:21:45,230 PEOPLE TO THAT MEETING, SO WE'RE 4257 02:21:45,296 --> 02:21:48,299 GIVING FAIR TIME TO ALL SECTORS 4258 02:21:48,366 --> 02:21:50,935 OF THE CANCER COMMUNITY. 4259 02:21:51,002 --> 02:21:52,770 AND WE'RE GOING TO ENCOURAGE AND 4260 02:21:52,837 --> 02:21:54,272 MONITOR PUBLIC SUBMISSIONS AND 4261 02:21:54,339 --> 02:21:56,674 DISCUSSIONS IN REALTIME SO THAT 4262 02:21:56,741 --> 02:21:58,977 WE CAN AGAIN ENGAGE DIFFERENT 4263 02:21:59,043 --> 02:22:03,114 GROUPS AND MAKE CONNECTIONS AND 4264 02:22:03,181 --> 02:22:04,549 IDENTIFY THE OPPORTUNITIES WHERE 4265 02:22:04,616 --> 02:22:06,351 WE NEED TO DO BETTER AND MORE 4266 02:22:06,417 --> 02:22:07,151 RAPIDLY. 4267 02:22:07,218 --> 02:22:09,621 WE'RE ALSO -- WE HAVE ANOTHER 4268 02:22:09,687 --> 02:22:11,990 INITIATIVE THAT'S ONGOING. 4269 02:22:12,056 --> 02:22:15,493 WE ARE ALSO TAKING ON REDUCING 4270 02:22:15,560 --> 02:22:17,228 CANCER CARE INEQUITIES THROUGH 4271 02:22:17,295 --> 02:22:20,298 LEVERAGING TECHNOLOGY TO ENHANCE 4272 02:22:20,365 --> 02:22:21,199 PATIENT NAVIGATION FROM THE TIME 4273 02:22:21,266 --> 02:22:23,067 OF A POTENTIAL NEW DIAGNOSIS OF 4274 02:22:23,134 --> 02:22:25,670 CANCER THROUGH THE CONTINUUM OF 4275 02:22:25,737 --> 02:22:26,905 CANCER CARE. 4276 02:22:26,971 --> 02:22:28,773 WE REALIZE THAT THERE ARE MANY 4277 02:22:28,840 --> 02:22:29,874 TECHNOLOGIES OUT THERE. 4278 02:22:29,941 --> 02:22:30,875 THEY'RE BEING DEVELOPED AGAIN IN 4279 02:22:30,942 --> 02:22:33,611 THE PRIVATE SECTOR FOR THE MOST 4280 02:22:33,678 --> 02:22:35,046 PART WITHOUT PATIENT CENTRIC 4281 02:22:35,113 --> 02:22:35,813 INFORMATION. 4282 02:22:35,880 --> 02:22:39,083 WE REALIZE THAT THESE CAN BE 4283 02:22:39,150 --> 02:22:44,522 LEVERAGED TO FACILITATE THE 4284 02:22:44,589 --> 02:22:45,156 NAVIGATORS WE HAVE SO THEY CAN 4285 02:22:45,223 --> 02:22:47,692 DO A BETTER JOB, AND WE CAN ALSO 4286 02:22:47,759 --> 02:22:50,094 FACILITATE PATIENT ACCESS 4287 02:22:50,161 --> 02:22:50,828 DURING -- FROM THE TIME OF 4288 02:22:50,895 --> 02:22:52,030 DIAGNOSIS AND THROUGH ALL OF 4289 02:22:52,096 --> 02:22:53,131 THEIR CARE. 4290 02:22:53,197 --> 02:22:55,199 SO WE HAVE ALREADY CONDUCTED 4291 02:22:55,266 --> 02:22:56,834 NATIONAL MEETINGS, WE'VE HAD 4292 02:22:56,901 --> 02:22:59,070 THREE MEETINGS IN THE FALL FOR 4293 02:22:59,137 --> 02:23:00,071 THE SERIES THAT WE'RE WORKING 4294 02:23:00,138 --> 02:23:01,706 ON, AND WE'RE NOW DEVELOPING OUR 4295 02:23:01,773 --> 02:23:03,675 REPORT TO THE PRESIDENT ON THE 4296 02:23:03,741 --> 02:23:05,076 CHALLENGES AND POTENTIAL 4297 02:23:05,143 --> 02:23:06,411 SOLUTIONS OF LEVERAGING 4298 02:23:06,477 --> 02:23:07,912 TECHNOLOGY TO ENHANCE PATIENT 4299 02:23:07,979 --> 02:23:13,051 NAVIGATION. 4300 02:23:13,117 --> 02:23:14,819 I THINK THAT MAY BE IT BUT I DO 4301 02:23:14,886 --> 02:23:17,555 HAVE JUST A FEW FINAL SUMMARY 4302 02:23:17,622 --> 02:23:19,424 POINTS. 4303 02:23:19,490 --> 02:23:22,260 I DO BELIEVE WE NEED PUBLIC 4304 02:23:22,327 --> 02:23:24,529 COLLABORATIVE PUBLIC AND PRIVATE 4305 02:23:24,595 --> 02:23:26,698 INVESTMENTS TO RECRUIT, TRAIN 4306 02:23:26,764 --> 02:23:29,867 AND SUPPORT AND RETAIN A DIVERSE 4307 02:23:29,934 --> 02:23:31,002 WORKFORCE FOR BOTH CANCER 4308 02:23:31,069 --> 02:23:32,737 RESEARCH AND CANCER CARE AND WE 4309 02:23:32,804 --> 02:23:34,872 NEED TO ENGAGE PHARMA IN 4310 02:23:34,939 --> 02:23:35,506 PARTICULAR TO CONTRIBUTE AND 4311 02:23:35,573 --> 02:23:36,307 SHARE IN THIS COST. 4312 02:23:36,374 --> 02:23:37,608 WE NEED CONGRESS TO ENACT LAWS 4313 02:23:37,675 --> 02:23:40,244 TO PERMANENTLY ALLOW MEDICARE 4314 02:23:40,311 --> 02:23:42,046 COVERAGE OF A FULL COMPLEMENT OF 4315 02:23:42,113 --> 02:23:43,681 TELEHEALTH SERVICES, AND STATES 4316 02:23:43,748 --> 02:23:45,550 NEED TO CONTINUE TO EXPAND 4317 02:23:45,616 --> 02:23:46,451 ACCESS TO TELEHEALTH. 4318 02:23:46,517 --> 02:23:48,987 SO IT'S REALLY, AGAIN, A 4319 02:23:49,053 --> 02:23:50,755 COLLABORATION BETWEEN CONGRESS 4320 02:23:50,822 --> 02:23:51,255 AND STATES. 4321 02:23:51,322 --> 02:23:52,924 WE ARE WORRIED ABOUT THE 4322 02:23:52,991 --> 02:23:54,892 EMERGENCY PROVISION BY MEDICARE 4323 02:23:54,959 --> 02:23:55,960 FOR TELEHEALTH COVERAGE, THAT'S 4324 02:23:56,027 --> 02:23:57,729 GOING TO END IN 2024. 4325 02:23:57,795 --> 02:24:00,198 THIS NEEDS TO BE EXPANDED. 4326 02:24:00,264 --> 02:24:02,233 IT WILL CONTINUE FOR BEHAVIORAL 4327 02:24:02,300 --> 02:24:04,569 APPOINTMENTS BUT NOT FOR 4328 02:24:04,635 --> 02:24:06,170 NON-BEHAVIORAL PROBLEM 4329 02:24:06,237 --> 02:24:07,705 APPOINTMENTS. 4330 02:24:07,772 --> 02:24:09,007 THERE'S UNEVEN DISTRIBUTION OF 4331 02:24:09,073 --> 02:24:10,942 ONCOLOGY PROFESSIONALS ACROSS 4332 02:24:11,009 --> 02:24:12,577 THE COUNTRY AFFECTING REMOTE AND 4333 02:24:12,643 --> 02:24:14,312 HEAVILY POPULATED AREAS, SO 4334 02:24:14,379 --> 02:24:16,214 AGAIN, WE NEED THIS TELEHEALTH 4335 02:24:16,280 --> 02:24:19,517 TO BE AVAILABLE BECAUSE THIS 4336 02:24:19,584 --> 02:24:20,918 WILL EXTEND THE REACH OF OUR 4337 02:24:20,985 --> 02:24:21,352 ONCOLOGY WORKFORCE. 4338 02:24:21,419 --> 02:24:22,053 THIS IS CRITICAL. 4339 02:24:22,120 --> 02:24:23,054 THIS IS AN EMERGENCY. 4340 02:24:23,121 --> 02:24:23,521 THIS IS URGENT. 4341 02:24:23,588 --> 02:24:25,723 HE WITH ALL NEED TO MAKE SURE 4342 02:24:25,790 --> 02:24:26,991 THIS HAPPENS. 4343 02:24:27,058 --> 02:24:28,626 SO WITH THAT, I'LL THANK YOU ALL 4344 02:24:28,693 --> 02:24:29,761 FOR YOUR TIME AND ATTENTION, AND 4345 02:24:29,827 --> 02:24:32,630 I'D LIKE TO OPEN IT UP TO 4346 02:24:32,697 --> 02:24:33,297 QUESTIONS OR DISCUSSION. 4347 02:24:33,364 --> 02:24:38,469 THANK YOU. 4348 02:24:38,536 --> 02:24:40,138 >> THANK YOU SO MUCH, 4349 02:24:40,204 --> 02:24:42,874 DR. JAFFEE, FOR YOUR UPDATE ON 4350 02:24:42,940 --> 02:24:44,275 THE NATIONAL CANCER PLAN AND 4351 02:24:44,342 --> 02:24:47,278 WHAT IS HAPPENING. 4352 02:24:47,345 --> 02:24:49,347 DOES ANYONE HAVE ANY -- NICOLE? 4353 02:24:49,414 --> 02:24:50,982 YOU CAN ASK YOUR QUESTION. 4354 02:24:51,049 --> 02:24:53,317 >> THANK YOU, DR. JAFFEE, FOR 4355 02:24:53,384 --> 02:24:54,952 YOUR PRESENTATION. 4356 02:24:55,019 --> 02:24:59,457 I HAVE A QUESTION ON THE NUMBER 4357 02:24:59,524 --> 02:25:04,495 FIVE OF YOUR PRIORITY AREAS ON 4358 02:25:04,562 --> 02:25:06,264 PRIORITIZING DATA SHARING AND 4359 02:25:06,330 --> 02:25:07,698 INTEGRATION, AND ONE OF THE BIG 4360 02:25:07,765 --> 02:25:11,602 ISSUES THAT YOU ADDRESSED IS 4361 02:25:11,669 --> 02:25:13,237 THAT A LOT OF PHARMACEUTICAL 4362 02:25:13,304 --> 02:25:15,940 COMPANIES, THIS DATA SITS WITH 4363 02:25:16,007 --> 02:25:18,676 THEM, AND THESE TRIALS, 4364 02:25:18,743 --> 02:25:20,078 ESPECIALLY NEGATIVE TRIALS, WE 4365 02:25:20,144 --> 02:25:21,679 DON'T NECESSARILY GET ACCESS TO 4366 02:25:21,746 --> 02:25:26,617 THAT DATA. 4367 02:25:26,684 --> 02:25:29,887 EVEN THOSE THAT ARE POSITIVE 4368 02:25:29,954 --> 02:25:34,092 TRIAL, THERE'S A LOT O OF DATA E 4369 02:25:34,158 --> 02:25:35,226 DON'T GET ACCESS TO. 4370 02:25:35,293 --> 02:25:36,494 SO WHAT ARE SOME OF THE 4371 02:25:36,561 --> 02:25:37,462 APPROACHES OR THE TACTICS OR 4372 02:25:37,528 --> 02:25:38,529 INCENTIVES THAT YOU THINK COULD 4373 02:25:38,596 --> 02:25:39,397 MAKE PROGRESS IN THAT AREA 4374 02:25:39,464 --> 02:25:40,531 BECAUSE I SEE THAT IT'S 4375 02:25:40,598 --> 02:25:41,732 CONTINUING TO BE A LARGE BARRIER 4376 02:25:41,799 --> 02:25:43,434 THAT WE CAN'T SEEM TO OVERCOME. 4377 02:25:43,501 --> 02:25:45,136 >> RIGHT, AND YOU'RE ABSOLUTELY 4378 02:25:45,203 --> 02:25:45,937 RIGHT AND YOU HIT ON IT. 4379 02:25:46,003 --> 02:25:47,672 WE NEED GOOD INCENTIVES. 4380 02:25:47,738 --> 02:25:49,974 SO THE WHITE HOUSE ASKED ME THAT 4381 02:25:50,041 --> 02:25:50,575 TOO. 4382 02:25:50,641 --> 02:25:51,976 WHEN I PRESENTED THIS LAST WEEK. 4383 02:25:52,043 --> 02:25:54,645 I THINK IT'S A GREAT QUESTION. 4384 02:25:54,712 --> 02:25:56,047 I'LL TELL YOU WHAT MY ANSWER IS. 4385 02:25:56,114 --> 02:25:57,315 IT MAY NOT BE THE BEST ANSWER 4386 02:25:57,381 --> 02:25:58,683 BUT IT MAY BE ONE SUGGESTION. 4387 02:25:58,750 --> 02:26:01,786 I MEAN, IT IS COMPLEX. 4388 02:26:01,853 --> 02:26:02,887 SO EVERYBODY HAS TO WIN. 4389 02:26:02,954 --> 02:26:04,122 I BELIEVE EVERYBODY HAS TO WIN. 4390 02:26:04,188 --> 02:26:05,123 THAT'S WHAT WE DO IN AMERICA. 4391 02:26:05,189 --> 02:26:06,557 WE ALL WANT TO WIN, RIGHT? 4392 02:26:06,624 --> 02:26:07,692 WE ALL HAVE TO GET SOMETHING OUT 4393 02:26:07,759 --> 02:26:11,095 OF TO BE INCENTIVIZED. 4394 02:26:11,162 --> 02:26:12,563 PHARMA, YOU KNOW, THEY PUT A LOT 4395 02:26:12,630 --> 02:26:15,766 OF MONEY INTO DRUG DEVELOPMENT. 4396 02:26:15,833 --> 02:26:17,135 THEY ARE HELD TO HIGH STANDARDS 4397 02:26:17,201 --> 02:26:19,036 BY THE FDA. 4398 02:26:19,103 --> 02:26:21,239 THE FDA HAS TO MAKE SURE THAT 4399 02:26:21,305 --> 02:26:23,474 ANY OF THEIR REGULATIONS AREN'T 4400 02:26:23,541 --> 02:26:25,443 GOING -- THEY CAN SHARE DATA 4401 02:26:25,510 --> 02:26:26,677 AREN'T GOING TO HURT THEIR 4402 02:26:26,744 --> 02:26:29,747 PATHWAY TO DEVELOPMENT OF THEIR 4403 02:26:29,814 --> 02:26:29,947 DRUGS. 4404 02:26:30,014 --> 02:26:30,982 THAT'S VERY IMPORTANT BECAUSE 4405 02:26:31,048 --> 02:26:31,883 THEIR DRUG DEVELOPMENT IS VERY 4406 02:26:31,949 --> 02:26:32,917 IMPORTANT TO US TOO, RIGHT? 4407 02:26:32,984 --> 02:26:34,852 THEY'RE DOING A GOOD THING FOR 4408 02:26:34,919 --> 02:26:35,019 US. 4409 02:26:35,086 --> 02:26:36,721 THEY ALSO NEED TO -- IF THEY'RE 4410 02:26:36,787 --> 02:26:38,789 GOING TO SHARE DATA, YOU KNOW, 4411 02:26:38,856 --> 02:26:40,591 WE HAVE COMPETITION IN THIS 4412 02:26:40,658 --> 02:26:40,825 COUNTRY. 4413 02:26:40,892 --> 02:26:41,893 I'M NOT GOING TO ARGUE WHETHER 4414 02:26:41,959 --> 02:26:44,529 WE SHOULD OR NOT AROUND 4415 02:26:44,595 --> 02:26:44,862 HEALTHCARE. 4416 02:26:44,929 --> 02:26:46,664 THE THING IS WE DO. 4417 02:26:46,731 --> 02:26:48,232 WELL, DO WE NEED TO HAVE AN 4418 02:26:48,299 --> 02:26:52,670 INCENTIVE THAT ALLOWS HOW LONG 4419 02:26:52,737 --> 02:26:56,607 THEY HAVE THE RIGHT TO PROVIDE 4420 02:26:56,674 --> 02:26:58,543 THESE DRUGS BEFORE OTHERS 4421 02:26:58,609 --> 02:26:58,976 COMPETE WITH THEM. 4422 02:26:59,043 --> 02:27:01,846 YOU KNOW, LENGTHEN THAT A LITTLE 4423 02:27:01,913 --> 02:27:05,750 BIT SO THAT THEY ARE ABLE TO 4424 02:27:05,816 --> 02:27:07,451 BENEFIT BY GETTING THEIR DATA 4425 02:27:07,518 --> 02:27:08,619 EARLY TO US AND SHARING. 4426 02:27:08,686 --> 02:27:10,655 NOW, THE NCI HAS DONE A GREAT 4427 02:27:10,721 --> 02:27:14,559 JOB OF MAKING EVERYBODY PUT DATA 4428 02:27:14,625 --> 02:27:17,161 FROM CLINICAL TRIALS ON THEIR 4429 02:27:17,228 --> 02:27:18,262 WEBSITE EARLY, AND THAT'S 4430 02:27:18,329 --> 02:27:19,764 NEGATIVE AND POSITIVE DATA. 4431 02:27:19,830 --> 02:27:20,765 SO THERE IS NEGATIVE DATA OUT 4432 02:27:20,831 --> 02:27:20,965 THERE. 4433 02:27:21,032 --> 02:27:23,267 THE PROBLEM IS, THE 4434 02:27:23,334 --> 02:27:24,035 PHARMACEUTICAL COMPANY ISN'T 4435 02:27:24,101 --> 02:27:24,569 HELD TO THAT. 4436 02:27:24,635 --> 02:27:28,906 SO I DO THINK THAT WE COULD ASK 4437 02:27:28,973 --> 02:27:30,641 THEM TO MAKE SURE THAT THEY 4438 02:27:30,708 --> 02:27:32,410 CONTRIBUTE THAT INFORMATION AS 4439 02:27:32,476 --> 02:27:34,178 WELL IN A TIMELY FASHION, AND 4440 02:27:34,245 --> 02:27:34,612 THAT'S THE PROBLEM. 4441 02:27:34,679 --> 02:27:36,714 THIS ALL HAS TO BE DONE IN A 4442 02:27:36,781 --> 02:27:38,583 TIMELY FASHION. 4443 02:27:38,649 --> 02:27:40,117 AND AGAIN, WHAT IS THE INCENTIVE 4444 02:27:40,184 --> 02:27:40,918 FOR THEM TO DO THAT? 4445 02:27:40,985 --> 02:27:42,153 WELL, TO ME THE INCENTIVE WOULD 4446 02:27:42,220 --> 02:27:46,824 BE TO MAKE SURE THAT THE FDA HAS 4447 02:27:46,891 --> 02:27:47,792 GIVEN THEM GUIDANCE THAT THEY 4448 02:27:47,858 --> 02:27:51,829 WILL BE ABLE TO CONTINUE THEIR 4449 02:27:51,896 --> 02:27:52,597 DEVELOPMENT BECAUSE THEY'RE 4450 02:27:52,663 --> 02:27:54,098 WORRIED THIS DATA MIGHT BE USED 4451 02:27:54,165 --> 02:27:56,067 IN THE WRONG WAY. 4452 02:27:56,133 --> 02:27:58,903 THERE ARE OTHER ISSUES AS WELL, 4453 02:27:58,970 --> 02:28:01,572 AND ALSO GIVING THEM SOME MORE 4454 02:28:01,639 --> 02:28:02,773 LEEWAY IN HOW LONG THEY HAVE TO 4455 02:28:02,840 --> 02:28:04,976 BE ABLE TO HAVE THEIR DRUG AS 4456 02:28:05,042 --> 02:28:09,313 THE FIRST DRUG APPROVED AND, YOU 4457 02:28:09,380 --> 02:28:12,917 KNOW, DISTRIBUTED. 4458 02:28:12,984 --> 02:28:14,719 >> I'D LIKE TO ADD TO THAT DATA 4459 02:28:14,785 --> 02:28:15,720 SHARING ISSUE. 4460 02:28:15,786 --> 02:28:17,255 ONCE THE DRUG HAS BEEN APPROVED 4461 02:28:17,321 --> 02:28:18,522 AND GETS OUT TO THE REAL WORLD, 4462 02:28:18,589 --> 02:28:20,591 THERE'S A LOT OF VALUE IN THIS 4463 02:28:20,658 --> 02:28:22,026 REAL WORLD EVIDENCE, REAL WORLD 4464 02:28:22,093 --> 02:28:24,161 DATA, BUT A LOT OF COMPANIES, 4465 02:28:24,228 --> 02:28:30,167 DATA MANAGEMENT COMPANIES CAN 4466 02:28:30,234 --> 02:28:31,602 SCOOP UP THAT DATA, THEY HAVE 4467 02:28:31,669 --> 02:28:32,803 CONTRACTS WITH HOSPITALS AND 4468 02:28:32,870 --> 02:28:33,738 HOSPITAL SYSTEMS, THEY SCOOP UP 4469 02:28:33,804 --> 02:28:35,039 THAT DATA, THEY PROVIDE THAT 4470 02:28:35,106 --> 02:28:36,574 DATA TO THEIR CUSTOMERS BUT 4471 02:28:36,641 --> 02:28:38,509 DON'T PROVIDE IT OUTSIDE OF THAT 4472 02:28:38,576 --> 02:28:40,144 NETWORK. 4473 02:28:40,211 --> 02:28:42,880 AND I JUST SEE ALL THE STOVE 4474 02:28:42,947 --> 02:28:45,149 PIPE DATA, I'M A REAL BELIEVER 4475 02:28:45,216 --> 02:28:45,549 IN CROWDSOURCING. 4476 02:28:45,616 --> 02:28:46,984 IF THAT DATA WERE AVAILABLE FOR 4477 02:28:47,051 --> 02:28:48,319 PEOPLE TO MUCK AROUND IN, WE 4478 02:28:48,386 --> 02:28:50,888 COULD PROBABLY FIND AMAZING 4479 02:28:50,955 --> 02:28:52,223 THINGS BUT WE'LL NEVER GET A 4480 02:28:52,290 --> 02:28:53,124 CHANCE TO SEE IT. 4481 02:28:53,190 --> 02:28:54,725 >> YOU'RE ABSOLUTELY RIGHT. 4482 02:28:54,792 --> 02:28:55,660 I TOTALLY AGREE. 4483 02:28:55,726 --> 02:28:56,861 AND AGAIN, YOU KNOW, IT'S THE 4484 02:28:56,927 --> 02:28:58,629 PRIVATE SECTOR THAT HAS -- WE 4485 02:28:58,696 --> 02:28:59,930 HAVE TO HAVE SOME RULES AROUND 4486 02:28:59,997 --> 02:29:01,966 THIS WHERE THEY ALSO ARE 4487 02:29:02,033 --> 02:29:02,533 INCENTIVIZED. 4488 02:29:02,600 --> 02:29:03,601 I HAVEN'T THOUGHT ABOUT WHAT IS 4489 02:29:03,668 --> 02:29:06,237 THE BEST WAY TO INCENTIVIZE 4490 02:29:06,304 --> 02:29:07,705 THAT, BUT YOU KNOW, IT DEPENDS 4491 02:29:07,772 --> 02:29:10,374 ON WHO IT IS AND WHAT THEIR 4492 02:29:10,441 --> 02:29:12,643 GOALS ARE IN ACCUMULATING THAT 4493 02:29:12,710 --> 02:29:13,177 DATA. 4494 02:29:13,244 --> 02:29:14,879 ARE THEY GOING TO USE IT FOR 4495 02:29:14,945 --> 02:29:15,780 BIOMARKERS, YOU KNOW, ARE THERE 4496 02:29:15,846 --> 02:29:17,415 WAYS IN WHICH WE CAN INCENTIVIZE 4497 02:29:17,481 --> 02:29:20,217 THAT THEY WOULD SHARE THIS DATA. 4498 02:29:20,284 --> 02:29:21,419 I THINK THE GOVERNMENT CAN HELP 4499 02:29:21,485 --> 02:29:21,886 WITH THAT. 4500 02:29:21,952 --> 02:29:23,120 THAT'S SOMETHING WHERE MAYBE THE 4501 02:29:23,187 --> 02:29:26,924 WHITE HOUSE CAN REALLY WORK TO 4502 02:29:26,991 --> 02:29:29,460 HELP WITH INCENTIVIZING. 4503 02:29:29,527 --> 02:29:31,629 I SEE VICKIE, YOU HAVE YOUR HAND 4504 02:29:31,696 --> 02:29:32,530 UP. 4505 02:29:32,596 --> 02:29:34,332 >> DR. JAFFEE, THANK YOU VERY 4506 02:29:34,398 --> 02:29:35,333 MUCH FOR THAT PRESENTATION. 4507 02:29:35,399 --> 02:29:37,168 I HAVE BEEN FOLLOWING THE 4508 02:29:37,234 --> 02:29:40,771 NATIONAL CANCER PLAN VERY 4509 02:29:40,838 --> 02:29:44,241 CLOSELY, AND I WONDER, IN THIS 4510 02:29:44,308 --> 02:29:45,443 CONVERSATION ABOUT THE PRIVATE 4511 02:29:45,509 --> 02:29:52,016 SECTOR AND DATA HOW OFTEN THERE 4512 02:29:52,083 --> 02:29:55,086 ARE MULTI-STAKEHOLDER MEETINGS 4513 02:29:55,152 --> 02:29:57,088 WHERE -- WITH THE RIGHT PEOPLE 4514 02:29:57,154 --> 02:30:02,893 FROM THESE COMPANIES, THAT CAN 4515 02:30:02,960 --> 02:30:04,362 BEGIN BUILDING THE TRUST AND 4516 02:30:04,428 --> 02:30:06,564 UNDERSTANDING EACH OTHER'S 4517 02:30:06,630 --> 02:30:07,732 RISK/REWARD BEHAVIOR SO THAT YOU 4518 02:30:07,798 --> 02:30:13,037 CAN BUILD THAT -- REPRESENT A 4519 02:30:13,104 --> 02:30:14,638 COALITION OF CHILDHOOD CANCER 4520 02:30:14,705 --> 02:30:15,606 ORGANIZATIONS, ABOUT 120 OF 4521 02:30:15,673 --> 02:30:17,975 THEM, AND WE HAVE, I THINK, 4522 02:30:18,042 --> 02:30:19,844 PRETTY REASONABLY GOOD 4523 02:30:19,910 --> 02:30:21,345 RELATIONSHIPS WITH SOME OF THE 4524 02:30:21,412 --> 02:30:22,980 INDUSTRY PARTNERS AND WORKING 4525 02:30:23,047 --> 02:30:27,151 ALSO IN EUROPE A LOT. 4526 02:30:27,218 --> 02:30:28,786 THE MULTI-STAKEHOLDER THINGS 4527 02:30:28,853 --> 02:30:31,122 DON'T BREAK DOWN ALL THE DATA 4528 02:30:31,188 --> 02:30:35,059 SILOS, BUT IT DOES HELP WHEN WE 4529 02:30:35,126 --> 02:30:36,927 KNOW EACH OTHER A LITTLE BETTER. 4530 02:30:36,994 --> 02:30:38,329 >> I TOTALLY AGREE WITH YOU AND 4531 02:30:38,396 --> 02:30:40,398 THAT WAS ANOTHER RECOMMENDATION 4532 02:30:40,464 --> 02:30:42,800 TO THE WHITE HOUSE, THAT THAT IS 4533 02:30:42,867 --> 02:30:43,901 SOMETHING THAT THEY COULD 4534 02:30:43,968 --> 02:30:46,036 CONVENE, RIGHT? 4535 02:30:46,103 --> 02:30:47,004 AND THEN WE WERE PLANNING OUR 4536 02:30:47,071 --> 02:30:48,773 NEXT PUBLIC MEETING BUT THAT'S 4537 02:30:48,839 --> 02:30:50,975 NOT UNTIL SEPTEMBER WILL BE TO 4538 02:30:51,041 --> 02:30:52,877 INVITE COMMUNITY-BASED GROUPS 4539 02:30:52,943 --> 02:30:56,380 AND PHARMACEUTICAL COMPANIES TO 4540 02:30:56,447 --> 02:30:58,449 TALK ABOUT DATA SHARING AND ALSO 4541 02:30:58,516 --> 02:30:59,517 WORKFORCE, COMMUNITY WORKFORCE. 4542 02:30:59,583 --> 02:31:00,751 SO I TOTALLY AGREE BUT I THINK 4543 02:31:00,818 --> 02:31:02,186 WE HAVE TO DO IT IN DIFFERENT 4544 02:31:02,253 --> 02:31:02,420 VENUES. 4545 02:31:02,486 --> 02:31:04,121 I THINK WE'LL HAVE ONE VEEN EU, 4546 02:31:04,188 --> 02:31:05,823 BUT I THINK ANOTHER VENUE WOULD 4547 02:31:05,890 --> 02:31:06,924 BE FOR THE WHITE HOUSE TO 4548 02:31:06,991 --> 02:31:07,391 CONVENE THAT. 4549 02:31:07,458 --> 02:31:08,626 AND I THINK THEY'VE DONE THIS IN 4550 02:31:08,692 --> 02:31:10,194 SOME WAYS DURING THE MOONSHOT. 4551 02:31:10,261 --> 02:31:11,862 I THINK THEN VICE PRESIDENT 4552 02:31:11,929 --> 02:31:13,464 BIDEN WAS DOING SOME OF THAT AND 4553 02:31:13,531 --> 02:31:15,599 THEN OF COURSE HE RAN FOR 4554 02:31:15,666 --> 02:31:16,700 PRESIDENT. 4555 02:31:16,767 --> 02:31:17,568 SO THAT WAS ONE OF OUR 4556 02:31:17,635 --> 02:31:18,869 SUGGESTIONS TO THE WHITE HOUSE 4557 02:31:18,936 --> 02:31:20,938 WHEN WE MET WITH THEM LAST WEEK. 4558 02:31:21,005 --> 02:31:21,739 BUT THANK YOU, YOU'RE ABSOLUTELY 4559 02:31:21,806 --> 02:31:25,976 CORRECT. 4560 02:31:26,043 --> 02:31:30,247 ANY OTHER QUESTIONS? 4561 02:31:30,314 --> 02:31:31,449 WELL, THANK YOU ALL FOR INVITING 4562 02:31:31,515 --> 02:31:32,283 ME. 4563 02:31:32,349 --> 02:31:32,750 I'M SORRY? 4564 02:31:32,817 --> 02:31:37,221 >> HI, THIS IS KRISTEN SANTIAGO. 4565 02:31:37,288 --> 02:31:39,023 I DON'T KNOW IF YOU SEE US OR -- 4566 02:31:39,089 --> 02:31:39,356 WHO KNOWS. 4567 02:31:39,423 --> 02:31:40,991 IT'S NOT REALLY A QUESTION BUT 4568 02:31:41,058 --> 02:31:42,092 MORE SO A COMMENT AND MY 4569 02:31:42,159 --> 02:31:43,494 THINKING IS HOW DO WE MAKE SURE 4570 02:31:43,561 --> 02:31:44,462 THAT THIS ISN'T JUST SOMETHING 4571 02:31:44,528 --> 02:31:46,330 THAT SITS ON A SHELF, AND THAT 4572 02:31:46,397 --> 02:31:47,565 IT'S REALLY GOOD WORK AND I 4573 02:31:47,631 --> 02:31:50,334 THINK WE ALL CAN STAND BEHIND 4574 02:31:50,401 --> 02:31:51,635 WHAT'S WRITTEN DOWN AND WHAT'S 4575 02:31:51,702 --> 02:31:54,405 HAPPENING IN THE DISCUSSIONS. 4576 02:31:54,472 --> 02:31:56,006 AND THE KIND OF PLEDGES THAT 4577 02:31:56,073 --> 02:31:58,042 PEOPLE HAVE MADE AND THE 4578 02:31:58,108 --> 02:32:00,578 APPENDIX B IN HERE ARE AWESOME, 4579 02:32:00,644 --> 02:32:02,313 BUT HOW DO WE KEEP THOSE THINGS 4580 02:32:02,379 --> 02:32:03,747 MOVING FORWARD AND I ALWAYS GO 4581 02:32:03,814 --> 02:32:05,683 TO PAYMENT SO YOU'RE SAYING 4582 02:32:05,749 --> 02:32:09,487 EVERYONE HAS TO WIN AND PEOPLE 4583 02:32:09,553 --> 02:32:11,055 CHANGE THEIR BEHAVIOR WHEN YOU 4584 02:32:11,121 --> 02:32:12,056 PAY THEM GENERALLY SPEAKING IN 4585 02:32:12,122 --> 02:32:12,623 MY EXPERIENCE. 4586 02:32:12,690 --> 02:32:16,026 SO WHAT ARE THINGS THAT WE AS 4587 02:32:16,093 --> 02:32:19,530 THE ADVOCACY COMMUNITY CAN DO 4588 02:32:19,597 --> 02:32:21,198 AROUND THAT, BUT THERE'S A LOT 4589 02:32:21,265 --> 02:32:24,602 OF ENERGY BEHIND IT, BUT I JUST 4590 02:32:24,668 --> 02:32:26,036 HATE TO SEE GOOD ENERGY SIT ON 4591 02:32:26,103 --> 02:32:28,439 THE SHELF FOR TO THEN COME OUT 4592 02:32:28,506 --> 02:32:30,040 AND PAY FOR IN ANOTHER 10 YEARS 4593 02:32:30,107 --> 02:32:31,141 OR SO. 4594 02:32:31,208 --> 02:32:32,776 >> YOUR COMMENT IS EXTREMELY 4595 02:32:32,843 --> 02:32:36,247 HELPFUL AND RIGHT ON, AND I 4596 02:32:36,313 --> 02:32:37,781 THINK ALL OF YOU DO A LOT. 4597 02:32:37,848 --> 02:32:40,518 KNOWING WHAT WE'RE THINKING, YOU 4598 02:32:40,584 --> 02:32:42,353 KNOW, OUR HOPE IS THAT IN 4599 02:32:42,419 --> 02:32:43,354 BRINGING THIS TO DIFFERENT 4600 02:32:43,420 --> 02:32:45,389 COMMUNITIES INCLUDING TO THIS 4601 02:32:45,456 --> 02:32:49,360 MEETING HERE, ALL OF YOU WILL 4602 02:32:49,426 --> 02:32:50,895 THINK IN YOUR ORGANIZATIONS HOW 4603 02:32:50,961 --> 02:32:52,129 CAN WE THINK ABOUT PROVIDING 4604 02:32:52,196 --> 02:32:53,464 SUGGESTIONS FOR INCENTIVES FOR 4605 02:32:53,531 --> 02:32:55,833 THE DIFFERENT SECTORS TO WORK 4606 02:32:55,900 --> 02:32:56,600 TOGETHER, WORKING WITH OTHER 4607 02:32:56,667 --> 02:32:58,235 GROUPS, TELLING US -- LETTING US 4608 02:32:58,302 --> 02:32:59,904 KNOW WHAT WE CAN DO MORE TO HELP 4609 02:32:59,970 --> 02:33:00,704 THE EFFORTS. 4610 02:33:00,771 --> 02:33:01,672 I AGREE WITH YOU, I DON'T WANT 4611 02:33:01,739 --> 02:33:03,107 THIS SITTING ON A SHELF. 4612 02:33:03,173 --> 02:33:05,843 AND I KNOW MONICA DIDN'T WANT 4613 02:33:05,910 --> 02:33:07,111 THIS SITTING ON A SHELF AND I 4614 02:33:07,177 --> 02:33:08,746 KNOW KIM, THE CURRENT NCI 4615 02:33:08,812 --> 02:33:09,613 DIRECTOR, DOESN'T WANT THIS 4616 02:33:09,680 --> 02:33:10,781 SITTING ON A SHELF. 4617 02:33:10,848 --> 02:33:11,649 WE'RE ALL INVESTED. 4618 02:33:11,715 --> 02:33:13,951 EVERYBODY WHO HAS WORKED ON 4619 02:33:14,018 --> 02:33:15,819 THIS, YOU KNOW, WHO ARE 4620 02:33:15,886 --> 02:33:17,988 MONITORING THIS ARE VERY 4621 02:33:18,055 --> 02:33:18,489 INVESTED. 4622 02:33:18,556 --> 02:33:19,390 WE JUST NEED GUIDANCE FROM ALL 4623 02:33:19,456 --> 02:33:20,824 OF YOU, AND THAT'S WHY THANK YOU 4624 02:33:20,891 --> 02:33:22,793 FOR INVITING ME AND MY BRINGING 4625 02:33:22,860 --> 02:33:23,627 THIS TO YOU AND, YOU KNOW, IF 4626 02:33:23,694 --> 02:33:25,930 YOU HAVE SUGGESTIONS, WE ARE 4627 02:33:25,996 --> 02:33:27,231 OPEN TO HEARING THEM. 4628 02:33:27,298 --> 02:33:28,265 WE'LL COME TALK WHEREVER YOU 4629 02:33:28,332 --> 02:33:31,035 WANT US TO TALK. 4630 02:33:31,101 --> 02:33:33,337 WE'LL -- WHATEVER YOU THINK WE 4631 02:33:33,404 --> 02:33:35,039 CAN DO TO HELP ALL OF YOU IN 4632 02:33:35,105 --> 02:33:35,706 YOUR MISSION AND WE HOPE YOU 4633 02:33:35,773 --> 02:33:40,644 WILL HELP US IN OUR MISSION. 4634 02:33:40,711 --> 02:33:42,446 >> WELL, THANK YOU, DR. JAFFEE, 4635 02:33:42,513 --> 02:33:44,214 FOR SPENDING TIME WITH US, AND 4636 02:33:44,281 --> 02:33:46,817 BRINGING US UP TO DATE ON, YOU 4637 02:33:46,884 --> 02:33:48,819 KNOW, THE PROGRESS AND THE 4638 02:33:48,886 --> 02:33:49,987 UPCOMING MEETINGS AND 4639 02:33:50,054 --> 02:33:52,056 STAKEHOLDER MEETINGS. 4640 02:33:52,122 --> 02:33:53,691 WE'LL PUT THESE ON OUR 4641 02:33:53,757 --> 02:33:55,092 CALENDARS, AND WE JUST 4642 02:33:55,159 --> 02:33:56,393 APPRECIATE YOU UPDATING US AND 4643 02:33:56,460 --> 02:33:58,162 WE HOPE TO HEAR ANOTHER UPDATE 4644 02:33:58,228 --> 02:33:59,263 IN THE FUTURE. 4645 02:33:59,330 --> 02:34:00,097 >> THANK YOU VERY MUCH. 4646 02:34:00,164 --> 02:34:02,266 THANK YOU ALL FOR WHAT YOU DO. 4647 02:34:02,333 --> 02:34:04,435 TAKE CARE. 4648 02:34:04,501 --> 02:34:05,336 >> OKAY. 4649 02:34:05,402 --> 02:34:07,271 AND WITH THAT, WE ARE COMING TO 4650 02:34:07,338 --> 02:34:10,274 A QUICK 15-MINUTE BREAK. 4651 02:34:10,341 --> 02:34:11,408 SO PLEASE, WE WILL ADJOURN FOR 4652 02:34:11,475 --> 02:34:16,380 15 MINUTES AND BE BACK AT 1:45. 4653 02:34:16,447 --> 02:34:16,547 YES. 4654 02:34:16,614 --> 02:34:19,750 THANK YOU. 4655 02:34:19,817 --> 02:34:20,918 >> HELLO, EVERYONE. 4656 02:34:20,985 --> 02:34:22,753 WELCOME BACK. 4657 02:34:22,820 --> 02:34:25,155 I AM CALLING THE MEETING BACK TO 4658 02:34:25,222 --> 02:34:26,190 ORDER FOR OUR NEXT PRESENTATION. 4659 02:34:26,256 --> 02:34:28,826 WE'RE GOING TO WELCOME DR. JULIE 4660 02:34:28,892 --> 02:34:34,365 KLEMM, PROGRAM DIRECTOR IN THE 4661 02:34:34,431 --> 02:34:35,799 NCI CENTER FOR STRATEGIC 4662 02:34:35,866 --> 02:34:37,534 SCIENTIFIC INITIATIVE TO DELIVER 4663 02:34:37,601 --> 02:34:41,905 HER EXCITING PRESENTATION ON AI. 4664 02:34:41,972 --> 02:34:42,406 >> THANK YOU VERY MUCH. 4665 02:34:42,473 --> 02:34:45,275 I WANT TO THANK THE NCI'S OFFICE 4666 02:34:45,342 --> 02:34:47,177 OF ADVOCACY RELATIONS FOR 4667 02:34:47,244 --> 02:34:48,312 INVITING ME TO SPEAK WITH YOU 4668 02:34:48,379 --> 02:34:49,380 ALL TODAY. 4669 02:34:49,446 --> 02:34:51,215 THE RAPID ADVANCEMENT OF 4670 02:34:51,281 --> 02:34:52,116 ARTIFICIAL INTELLIGENCE IS 4671 02:34:52,182 --> 02:34:53,450 IMPACTING MANY ASPECTS OF OUR 4672 02:34:53,517 --> 02:34:54,718 LIVES, AND TODAY I WANT TO TALK 4673 02:34:54,785 --> 02:34:55,919 ABOUT ITS CURRENT APPLICATIONS 4674 02:34:55,986 --> 02:34:57,121 AND ITS PROMISE FOR CANCER 4675 02:34:57,187 --> 02:35:02,226 RESEARCH. 4676 02:35:02,292 --> 02:35:03,961 IN MY TALK TODAY, I'LL GIVE A 4677 02:35:04,028 --> 02:35:05,963 BRIEF INTRODUCTION TO THE RISE 4678 02:35:06,030 --> 02:35:06,563 OF ARTIFICIAL INTELLIGENCE AND 4679 02:35:06,630 --> 02:35:08,766 THE WAYS IT'S ADVANCING CANCER 4680 02:35:08,832 --> 02:35:10,501 RESEARCH, AND ALSO TALK ABOUT 4681 02:35:10,567 --> 02:35:11,835 THE INCREASING CONCERNS ABOUT 4682 02:35:11,902 --> 02:35:13,570 THE ETHICAL CONSIDERATIONS 4683 02:35:13,637 --> 02:35:17,775 REGARDING THE USE OF A.I. AND 4684 02:35:17,841 --> 02:35:19,209 HOW NCI IS PARTNERING ACROSS THE 4685 02:35:19,276 --> 02:35:20,310 GOVERNMENT TO ADDRESS THESE 4686 02:35:20,377 --> 02:35:21,945 CONCERNS. 4687 02:35:22,012 --> 02:35:23,714 AND AS THE FEDERAL GOVERNMENT'S 4688 02:35:23,781 --> 02:35:25,115 PRIMARY FUNDER OF CANCER 4689 02:35:25,182 --> 02:35:26,083 RESEARCH, I'LL ALSO DISCUSS A 4690 02:35:26,150 --> 02:35:29,119 FEW OF THE MAJOR AREAS OF NCI 4691 02:35:29,186 --> 02:35:35,225 FUNDED RESEARCH USING A.I. 4692 02:35:35,292 --> 02:35:37,294 WE USE THIS TERM ARTIFICIAL 4693 02:35:37,361 --> 02:35:38,595 INTELLIGENCE TO DESCRIBE REALLY 4694 02:35:38,662 --> 02:35:41,498 A BROAD CATEGORY OF COMPUTER 4695 02:35:41,565 --> 02:35:43,901 SYSTEMS THAT CAN LEARN PATTERNS 4696 02:35:43,967 --> 02:35:47,371 IN DATA IN WAYS THAT MIMIC HUMAN 4697 02:35:47,438 --> 02:35:47,705 INTELLIGENCE. 4698 02:35:47,771 --> 02:35:50,974 AND THESE APPROACHES CAN BE 4699 02:35:51,041 --> 02:35:52,176 APPLIED ACROSS THE SPECTRUM OF 4700 02:35:52,242 --> 02:35:54,912 CANCER RESEARCH AND CLINICAL 4701 02:35:54,978 --> 02:35:55,646 PRACTICE THAT INCLUDES 4702 02:35:55,713 --> 02:35:56,447 APPLICATIONS IN CANCER SCREENING 4703 02:35:56,513 --> 02:36:00,117 AND DIAGNOSIS, DRUG DISCOVERY, 4704 02:36:00,184 --> 02:36:03,153 CANCER SURVEILLANCE, HEALTHCARE 4705 02:36:03,220 --> 02:36:04,888 DELIVERY, AS WELL AS TO DERIVE 4706 02:36:04,955 --> 02:36:10,794 MECHANISTIC INSIGHTS. 4707 02:36:10,861 --> 02:36:13,063 IN RECENT YEARS, THERE'S BEEN 4708 02:36:13,130 --> 02:36:14,698 ADVANCES IN THREE AREAS THAT 4709 02:36:14,765 --> 02:36:15,999 HAVE ALL CONVERGED THAT ARE 4710 02:36:16,066 --> 02:36:18,102 LEADING TO THESE PROMISING NEW 4711 02:36:18,168 --> 02:36:20,370 APPLICATIONS OF A.I. IN CANCER 4712 02:36:20,437 --> 02:36:20,971 RESEARCH. 4713 02:36:21,038 --> 02:36:22,873 THIS INCLUDES MAJOR PROGRESS IN 4714 02:36:22,940 --> 02:36:26,176 THE METHODS AND ALGORITHMS FOR 4715 02:36:26,243 --> 02:36:28,078 TRAINING ARTIFICIAL INTELLIGENCE 4716 02:36:28,145 --> 02:36:29,213 MODELS, AS WELL AS IMPROVEMENTS 4717 02:36:29,279 --> 02:36:30,748 IN THE HARDWARE THAT ARE NEEDED 4718 02:36:30,814 --> 02:36:32,483 TO TRAIN THESE MODELS. 4719 02:36:32,549 --> 02:36:34,852 AND FINALLY, AND IMPORTANTLY, 4720 02:36:34,918 --> 02:36:36,386 INCREASED ACCESS TO THE LARGE 4721 02:36:36,453 --> 02:36:40,624 VOLUMES OF CANCER DATA, SUCH AS 4722 02:36:40,691 --> 02:36:42,025 IMAGING, GENOMICS, AS WELL AS 4723 02:36:42,092 --> 02:36:44,461 CLINICAL DATA. 4724 02:36:44,528 --> 02:36:55,038 LET'S SEE, I LOST THE SLIDES. 4725 02:36:57,274 --> 02:36:57,341 GREAT. 4726 02:36:57,407 --> 02:36:57,775 THANK YOU. 4727 02:36:57,841 --> 02:36:58,842 AND YOU CAN GO TO THE NEXT 4728 02:36:58,909 --> 02:36:59,176 SLIDE, PLEASE. 4729 02:36:59,243 --> 02:37:02,579 THANK YOU. 4730 02:37:02,646 --> 02:37:04,214 THE TECHNICAL LANDSCAPE OF 4731 02:37:04,281 --> 02:37:07,251 ARTIFICIAL INTELLIGENCE IS VERY 4732 02:37:07,317 --> 02:37:09,453 COMPLEX, WITH MANY CATEGORIES OF 4733 02:37:09,520 --> 02:37:12,189 METHODS AND CLASSES OF 4734 02:37:12,256 --> 02:37:13,724 APPLICATIONS, BUT I THINK IT'S 4735 02:37:13,791 --> 02:37:15,726 USEFUL TO THINK OF A.I. IN TWO 4736 02:37:15,793 --> 02:37:17,828 GENERAL CATEGORIES: PREDICTIVE 4737 02:37:17,895 --> 02:37:22,566 AND GENERATIVE. 4738 02:37:22,633 --> 02:37:23,767 PREDICTIVE A.I. IS ABLE TO LEARN 4739 02:37:23,834 --> 02:37:25,803 PATTERNS IN A DATASET AND THEN 4740 02:37:25,869 --> 02:37:27,237 USE THAT TRAINING TO MAKE 4741 02:37:27,304 --> 02:37:28,839 PREDICTIONS ON A SIMILAR CLASS 4742 02:37:28,906 --> 02:37:31,909 OF DATA THAT IT'S NEVER SEEN. 4743 02:37:31,975 --> 02:37:34,645 SO AN EXAMPLE OF PREDICTIVE A.I. 4744 02:37:34,711 --> 02:37:36,380 IS AN ARTIFICIAL INTELLIGENCE 4745 02:37:36,446 --> 02:37:37,548 MODEL THAT'S TRAINED TO 4746 02:37:37,614 --> 02:37:38,882 DISTINGUISH IMAGES OF BENIGN 4747 02:37:38,949 --> 02:37:42,152 SKIN LESIONS FROM MALIGNANT 4748 02:37:42,219 --> 02:37:43,220 MELANOMA. 4749 02:37:43,287 --> 02:37:44,755 THE CATEGORY OF ARTIFICIAL 4750 02:37:44,822 --> 02:37:45,722 INTELLIGENCE THAT'S GETTING A 4751 02:37:45,789 --> 02:37:49,927 GREAT DEAL OF ATTENTION TODAY IS 4752 02:37:49,993 --> 02:37:51,228 GENERATIVE A.I., WHERE NEW 4753 02:37:51,295 --> 02:37:52,930 CONTENT IS CREATED BASED ON 4754 02:37:52,996 --> 02:37:56,099 LEARNED PATTERNS FROM EXISTING 4755 02:37:56,166 --> 02:37:56,533 DATA. 4756 02:37:56,600 --> 02:37:57,835 AN EXAMPLE HERE WOULD BE A 4757 02:37:57,901 --> 02:38:00,237 CHATBOT THAT COULD TAKE IN A 4758 02:38:00,304 --> 02:38:01,338 CLINICAL REPORT, AND THEN 4759 02:38:01,405 --> 02:38:02,639 PRODUCE A PLAIN LANGUAGE SUMMARY 4760 02:38:02,706 --> 02:38:09,713 OF THAT REPORT. 4761 02:38:09,780 --> 02:38:12,583 IN CANCER RESEARCH, PREDICTIVE 4762 02:38:12,649 --> 02:38:14,218 A.I. HAS PRODUCED THE MOST 4763 02:38:14,284 --> 02:38:16,520 RESULTS TO DATE, AND THIS IS 4764 02:38:16,587 --> 02:38:18,121 ESPECIALLY IN THE IMAGING REALM, 4765 02:38:18,188 --> 02:38:19,890 WHERE IT'S BEING USED TO 4766 02:38:19,957 --> 02:38:22,593 INCREASE THE ACCURACY AND THE 4767 02:38:22,659 --> 02:38:24,328 REPRODUCIBILITY IN MEDICAL IMAGE 4768 02:38:24,394 --> 02:38:26,530 ANALYSIS. 4769 02:38:26,597 --> 02:38:29,032 ONE RECENT EXAMPLE IS FROM THIS 4770 02:38:29,099 --> 02:38:30,834 NCI-FUNDED STUDY FROM LEE COOPER 4771 02:38:30,901 --> 02:38:33,470 AND HIS TEAM AT NORTHWESTERN 4772 02:38:33,537 --> 02:38:36,006 UNIVERSITY, WHO DEVELOPED AN 4773 02:38:36,073 --> 02:38:37,875 A.I. MODEL TO PREDICT SURVIVAL 4774 02:38:37,941 --> 02:38:41,578 OUTCOMES FOR PATIENTS WITH 4775 02:38:41,645 --> 02:38:42,813 INVASIVE NON-METASTATIC BREAST 4776 02:38:42,880 --> 02:38:45,048 CANCER USING HISTOPATHOLOGY 4777 02:38:45,115 --> 02:38:46,783 SLIDE IMAGES. 4778 02:38:46,850 --> 02:38:50,520 WHILE PATHOLOGISTS GRADE THE 4779 02:38:50,587 --> 02:38:51,588 MICROSCOPIC APPEARANCE OF BREAST 4780 02:38:51,655 --> 02:38:52,890 TISSUE BASED ON THE CANCER 4781 02:38:52,956 --> 02:38:54,558 ELEMENTS, THIS NEW METHOD 4782 02:38:54,625 --> 02:38:57,094 ASSESSES THE TISSUE LARGELY 4783 02:38:57,160 --> 02:39:00,697 BASED ON THE NON-TUMOR ASPECTS, 4784 02:39:00,764 --> 02:39:02,232 THE STROMAL AND IMMUNE FEATURES 4785 02:39:02,299 --> 02:39:03,166 OF THE SLIDE. 4786 02:39:03,233 --> 02:39:06,336 AND IN THIS STUDY, THE A.I. 4787 02:39:06,403 --> 02:39:08,739 METHOD CONSISTENTLY OUTPERFORMED 4788 02:39:08,805 --> 02:39:09,940 PATHOLOGISTS IN PREDICTING 4789 02:39:10,007 --> 02:39:10,974 SURVIVAL OUTCOMES, SUGGESTING IT 4790 02:39:11,041 --> 02:39:12,976 COULD BE A VALUABLE TOOL TO 4791 02:39:13,043 --> 02:39:16,113 SUPPORT PATHOLOGISTS AND TO HELP 4792 02:39:16,179 --> 02:39:17,581 TAILOR TREATMENT DECISIONS FOR 4793 02:39:17,648 --> 02:39:23,887 INDIVIDUAL PATIENTS. 4794 02:39:23,954 --> 02:39:25,088 PREDICTIVE A.I. HAS ALSO 4795 02:39:25,155 --> 02:39:27,491 PERFORMED VERY WELL IN 4796 02:39:27,557 --> 02:39:28,358 EXTRACTING INFORMATION FROM 4797 02:39:28,425 --> 02:39:30,594 CLINICAL DOCUMENTS. 4798 02:39:30,661 --> 02:39:32,095 CANCER REGISTRIES INCLUDING 4799 02:39:32,162 --> 02:39:35,365 THOSE SUPPORTED BY THE NCI'S 4800 02:39:35,432 --> 02:39:36,566 SURVEILLANCE EPIDEMIOLOGY AND 4801 02:39:36,633 --> 02:39:40,604 END RESULTS OR SEER PROGRAM 4802 02:39:40,671 --> 02:39:44,308 COLLECT DATA ON HISTOLOGICAL 4803 02:39:44,374 --> 02:39:44,975 CANCER CHARACTERISTICS, AND THIS 4804 02:39:45,042 --> 02:39:48,011 INFORMATION PRIMARILY RESIDES IN 4805 02:39:48,078 --> 02:39:50,314 UNSTRUCTURED, HIGHLY DIVERSE 4806 02:39:50,380 --> 02:39:51,815 PATHOLOGY REPORTS. 4807 02:39:51,882 --> 02:39:54,151 AND EXTRACTING INFORMATION FROM 4808 02:39:54,217 --> 02:39:56,219 THESE REPORTS HAS BEEN TYPICALLY 4809 02:39:56,286 --> 02:39:58,722 PERFORMED BY HUMAN CURATORS FOR 4810 02:39:58,789 --> 02:40:00,857 THE NECESSARY QUALITY. 4811 02:40:00,924 --> 02:40:02,292 AND THIS IS A TIME-CONSUMING 4812 02:40:02,359 --> 02:40:03,293 TASK. 4813 02:40:03,360 --> 02:40:05,662 IN THIS NCI FUNDED STUDY, A 4814 02:40:05,729 --> 02:40:07,197 PREDICTIVE MODEL HAS BEEN 4815 02:40:07,264 --> 02:40:09,166 DEVELOPED THAT EXTRACTS 4816 02:40:09,232 --> 02:40:11,134 INFORMATION FROM UNSTRUCTURED 4817 02:40:11,201 --> 02:40:12,936 PATHOLOGY REPORTS FOR FIVE 4818 02:40:13,003 --> 02:40:14,171 CHARACTERISTICS THAT ARE 4819 02:40:14,237 --> 02:40:16,073 REPORTABLE TO CANCER REGISTRIES. 4820 02:40:16,139 --> 02:40:18,608 AND THIS HAS THE POTENTIAL TO 4821 02:40:18,675 --> 02:40:21,144 MASSIVELY SPEED UP A PREVIOUSLY 4822 02:40:21,211 --> 02:40:22,546 MANUAL PROCESS, AND IMPROVE THE 4823 02:40:22,612 --> 02:40:24,648 TIME LINES FOR CANCER REGISTRY 4824 02:40:24,715 --> 02:40:30,187 REPORTING. 4825 02:40:30,253 --> 02:40:32,622 A CRITICAL CHALLENGE OF 4826 02:40:32,689 --> 02:40:33,357 ARTIFICIAL INTELLIGENCE METHODS 4827 02:40:33,423 --> 02:40:36,727 IS THAT THEY OFTEN LACK 4828 02:40:36,793 --> 02:40:37,828 INTERPRETABILITY. 4829 02:40:37,894 --> 02:40:39,596 THEY'RE OFTEN BLACK BOXES THAT 4830 02:40:39,663 --> 02:40:42,165 ARE OPTIMIZED FOR PREDICTION 4831 02:40:42,232 --> 02:40:43,600 ACCURACY, BUT WITHOUT THE 4832 02:40:43,667 --> 02:40:46,970 ABILITY TO REALLY UNDERSTAND 4833 02:40:47,037 --> 02:40:48,171 WHAT ARE THE FEATURES AND THE 4834 02:40:48,238 --> 02:40:49,706 DATA THAT ARE DRIVING THE 4835 02:40:49,773 --> 02:40:50,941 PREDICTIONS? 4836 02:40:51,008 --> 02:40:56,146 SUPPORTED BY NCI, A GROUP AT 4837 02:40:56,213 --> 02:40:58,115 SAN DIEGO IS DOING SOME 4838 02:40:58,181 --> 02:41:00,283 GROUNDBREAKING WORK TO BEGIN TO 4839 02:41:00,350 --> 02:41:01,051 TACKLE THIS PROBLEM. 4840 02:41:01,118 --> 02:41:04,221 IN THIS STUDY, THEY COMBINED A 4841 02:41:04,287 --> 02:41:04,721 CONVENTIONAL ARTIFICIAL 4842 02:41:04,788 --> 02:41:05,489 INTELLIGENCE MODEL WITH ONE THAT 4843 02:41:05,555 --> 02:41:08,592 WAS CONSTRAINED WITH BIOLOGICAL 4844 02:41:08,658 --> 02:41:11,628 NETWORK KNOWLEDGE, AND THEN 4845 02:41:11,695 --> 02:41:12,396 THEY'D COMBINE THESE TWO MODELS 4846 02:41:12,462 --> 02:41:14,698 TO PREDICT THE SENSITIVITY OF 4847 02:41:14,765 --> 02:41:16,366 TUMOR-DERIVED CELL LINES TO 4848 02:41:16,433 --> 02:41:17,534 CERTAIN COMPOUNDS. 4849 02:41:17,601 --> 02:41:19,403 AND THIS BIOLOGICALLY 4850 02:41:19,469 --> 02:41:21,571 CONSTRAINED MODEL ALLOWED THEM 4851 02:41:21,638 --> 02:41:23,573 TO UNDERSTAND WHICH BIOLOGICAL 4852 02:41:23,640 --> 02:41:25,842 PATHWAYS WERE INFLUENCING DRUG 4853 02:41:25,909 --> 02:41:28,245 RESPONSE, AND THEY THEN USED 4854 02:41:28,311 --> 02:41:30,313 THIS INFORMATION TO 4855 02:41:30,380 --> 02:41:32,015 EXPERIMENTALLY VALIDATE SOME OF 4856 02:41:32,082 --> 02:41:32,783 THEIR PREDICTIONS. 4857 02:41:32,849 --> 02:41:34,317 THIS ABILITY TO UNDERSTAND HOW 4858 02:41:34,384 --> 02:41:36,953 THESE MODELS BEHAVE WILL HELP TO 4859 02:41:37,020 --> 02:41:38,922 INCREASE THE ACCOUNTABILITY AND 4860 02:41:38,989 --> 02:41:47,764 THE TRUST IN THESE PREDICTIONS. 4861 02:41:47,831 --> 02:41:49,299 SO GENERATIVE A.I. TECHNOLOGY IS 4862 02:41:49,366 --> 02:41:51,935 GETTING A GREAT DEAL OF 4863 02:41:52,002 --> 02:41:53,203 ATTENTION THESE DAYS AND LARGE 4864 02:41:53,270 --> 02:41:55,205 LANGUAGE MODELS OR LLMs, WHICH 4865 02:41:55,272 --> 02:41:57,441 HAVE BEEN TRAINED ON VERY LARGE 4866 02:41:57,507 --> 02:41:59,976 AMOUNTS OF TEXT USING A 4867 02:42:00,043 --> 02:42:01,078 REVOLUTIONARY A.I. METHOD 4868 02:42:01,144 --> 02:42:02,879 DEVELOPED AT GOOGLE ARE REALLY 4869 02:42:02,946 --> 02:42:05,082 DRIVING THIS ATTENTION. 4870 02:42:05,148 --> 02:42:07,484 CHATBOTS BASED ON THESE LLMs 4871 02:42:07,551 --> 02:42:09,352 HAVE THE ABILITY TO GENERATE 4872 02:42:09,419 --> 02:42:10,954 LANGUAGE THAT RESEMBLES THAT 4873 02:42:11,021 --> 02:42:12,923 PRODUCED BY HUMANS, AND THE 4874 02:42:12,989 --> 02:42:14,691 ABILITY TO INTERACT WITH THESE 4875 02:42:14,758 --> 02:42:16,860 MODELS REALLY MAKE THEM 4876 02:42:16,927 --> 02:42:18,195 ATTRACTIVE TOOLS IN VARIOUS 4877 02:42:18,261 --> 02:42:20,797 FIELDS, INCLUDING BIOMEDICAL 4878 02:42:20,864 --> 02:42:23,867 RESEARCH AND MEDICINE. 4879 02:42:23,934 --> 02:42:25,168 IN RESEARCH, CHATBOTS ARE 4880 02:42:25,235 --> 02:42:26,803 ALREADY IMPROVING ACCESS TO 4881 02:42:26,870 --> 02:42:28,138 SCIENTIFIC KNOWLEDGE AND 4882 02:42:28,205 --> 02:42:29,306 ASSISTING WITH TASKS LIKE 4883 02:42:29,372 --> 02:42:32,375 COMPUTER PROGRAMMING. 4884 02:42:32,442 --> 02:42:34,344 FOR PATIENT CARE, CHATBOTS CAN 4885 02:42:34,411 --> 02:42:35,112 HELP SUMMARIZE COMPLEX 4886 02:42:35,178 --> 02:42:38,014 INFORMATION FOR PATIENTS, AND 4887 02:42:38,081 --> 02:42:39,583 POTENTIAL -- HAVE THE POTENTIAL 4888 02:42:39,649 --> 02:42:40,684 TO PROVIDE PATIENTS WITH MORE 4889 02:42:40,750 --> 02:42:43,386 DIRECT ACCESS TO MEDICAL 4890 02:42:43,453 --> 02:42:44,221 KNOWLEDGE. 4891 02:42:44,287 --> 02:42:46,089 CHATBOTS CAN ALSO PLAY A ROLE IN 4892 02:42:46,156 --> 02:42:48,091 SCIENTIFIC AND MEDICAL EDUCATION 4893 02:42:48,158 --> 02:42:50,894 BY PROVIDING BREAKDOWNS OF 4894 02:42:50,961 --> 02:42:53,396 COMPLEX TOPICS AND THEY CAN EVEN 4895 02:42:53,463 --> 02:42:54,731 PROVIDE SIMULATED CONVERSATIONS 4896 02:42:54,798 --> 02:42:56,366 WITH PATIENTS TO ALLOW MEDICAL 4897 02:42:56,433 --> 02:42:58,201 STUDENTS TO PRACTICE TAKING 4898 02:42:58,268 --> 02:43:03,840 MEDICAL HISTORIES. 4899 02:43:03,907 --> 02:43:04,975 IT WOULD REALLY BE HARD TO 4900 02:43:05,041 --> 02:43:06,710 OVERSTATE THE IMPACT THIS 4901 02:43:06,776 --> 02:43:09,112 TECHNOLOGY IS HAVING ACROSS ALL 4902 02:43:09,179 --> 02:43:11,748 SECTORS, INCLUDING BIOMEDICINE, 4903 02:43:11,815 --> 02:43:15,285 WITH PREPRINTS AND PAPERS BEING 4904 02:43:15,352 --> 02:43:17,053 PUBLISHED AT AN INCREDIBLE RATE 4905 02:43:17,120 --> 02:43:18,622 THAT ARE SHOWING THE PROMISE FOR 4906 02:43:18,688 --> 02:43:19,723 MEDICAL AND RESEARCH 4907 02:43:19,789 --> 02:43:28,131 APPLICATIONS. 4908 02:43:28,198 --> 02:43:29,566 BECAUSE THIS TECHNOLOGY IS SO 4909 02:43:29,633 --> 02:43:30,567 POWERFUL, THERE ARE INCREASING 4910 02:43:30,634 --> 02:43:31,768 QUESTIONS AND CONCERNS ABOUT ITS 4911 02:43:31,835 --> 02:43:34,938 SAFETY AND TRUSTWORTHINESS. 4912 02:43:35,005 --> 02:43:36,006 SOME QUESTIONS YOU MAY HAVE 4913 02:43:36,072 --> 02:43:38,475 ABOUT THE USE OF ARTIFICIAL 4914 02:43:38,542 --> 02:43:39,609 INTELLIGENCE IN CANCER RESEARCH 4915 02:43:39,676 --> 02:43:41,478 AND CARE MIGHT BE, WHAT IS THE 4916 02:43:41,545 --> 02:43:44,714 ACCURACY AND RELIABILITY OF THE 4917 02:43:44,781 --> 02:43:46,616 ANSWERS PRODUCED BY A GIVEN 4918 02:43:46,683 --> 02:43:47,484 TECHNOLOGY? 4919 02:43:47,551 --> 02:43:49,553 HOW ARE SENSITIVE DATA HANDLED, 4920 02:43:49,619 --> 02:43:51,521 STORED AND SHARED IN THE CONTEXT 4921 02:43:51,588 --> 02:43:53,924 OF THESE A.I. APPLICATIONS? 4922 02:43:53,990 --> 02:43:55,759 WHAT ARE THE ETHICAL 4923 02:43:55,825 --> 02:43:57,227 CONSIDERATIONS SURROUNDING THE 4924 02:43:57,294 --> 02:43:59,162 USE OF PATIENT DATA FOR TRAINING 4925 02:43:59,229 --> 02:44:01,231 A.I. MODELS? 4926 02:44:01,298 --> 02:44:03,166 HOW DO THESE COMPLEX ALGORITHMS 4927 02:44:03,233 --> 02:44:03,500 WORK? 4928 02:44:03,567 --> 02:44:06,236 WHAT ARE THE FEATURES AND THE 4929 02:44:06,303 --> 02:44:07,337 TRAINING DATA THAT ARE DRIVING 4930 02:44:07,404 --> 02:44:08,305 THE RESPONSES? 4931 02:44:08,371 --> 02:44:09,306 AND REALLY IMPORTANTLY, COULD 4932 02:44:09,372 --> 02:44:11,508 THERE BE UNINTENDED CONSEQUENCES 4933 02:44:11,575 --> 02:44:14,911 OF APPLYING A GIVEN ARTIFICIAL 4934 02:44:14,978 --> 02:44:19,683 INTELLIGENCE TECHNOLOGY? 4935 02:44:19,749 --> 02:44:22,185 IN LIGHT OF CONCERNS LIKE THESE, 4936 02:44:22,252 --> 02:44:23,587 THE FEDERAL GOVERNMENT HAS BEEN 4937 02:44:23,653 --> 02:44:26,089 TAKING STEPS TO ADVANCE ETHICAL 4938 02:44:26,156 --> 02:44:27,524 AND RESPONSIBLE ARTIFICIAL 4939 02:44:27,591 --> 02:44:29,726 INTELLIGENCE DEVELOPMENT, AND 4940 02:44:29,793 --> 02:44:33,096 MOST RECENTLY IN OCTOBER 2023, 4941 02:44:33,163 --> 02:44:34,965 THE WHITE HOUSE RELEASED AN 4942 02:44:35,031 --> 02:44:37,267 EXECUTIVE ORDER TO ESTABLISH A 4943 02:44:37,334 --> 02:44:39,970 GOVERNMENT-WIDE EFFORT TO GUIDE 4944 02:44:40,036 --> 02:44:40,470 RESPONSIBLE ARTIFICIAL 4945 02:44:40,537 --> 02:44:43,273 INTELLIGENCE DEVELOPMENT. 4946 02:44:43,340 --> 02:44:46,209 IN RESPONSE TO THIS EXECUTIVE 4947 02:44:46,276 --> 02:44:46,876 ORDER, HEALTH AND HUMAN SERVICES 4948 02:44:46,943 --> 02:44:48,278 IS DEVELOPING A STRATEGIC PLAN 4949 02:44:48,345 --> 02:44:50,013 FOR A.I. THAT ADDRESSES THE 4950 02:44:50,080 --> 02:44:52,616 ELEMENTS OF THIS ORDER, AND 4951 02:44:52,682 --> 02:44:53,850 SEVERAL NCI STAFF ARE INVOLVED 4952 02:44:53,917 --> 02:44:59,522 IN THIS ACTIVITY. 4953 02:44:59,589 --> 02:45:02,259 THERE ARE SEVERAL EFFORTS 4954 02:45:02,325 --> 02:45:04,227 UNDERWAY TO PROVIDE GUIDANCE FOR 4955 02:45:04,294 --> 02:45:05,662 THE DEVELOPMENT AND 4956 02:45:05,729 --> 02:45:08,265 IMPLEMENTATION OF ETHICAL AND 4957 02:45:08,331 --> 02:45:09,866 TRUSTWORTHY A.I. 4958 02:45:09,933 --> 02:45:11,334 AN IMPORTANT TOOL THAT THE 4959 02:45:11,401 --> 02:45:12,135 NATIONAL INSTITUTE OF STANDARDS 4960 02:45:12,202 --> 02:45:17,374 AND TECHNOLOGY OR NIST HAS 4961 02:45:17,440 --> 02:45:18,908 DEVELOPED IS AN A.I. RISK 4962 02:45:18,975 --> 02:45:19,676 MANAGEMENT FRAMEWORK. 4963 02:45:19,743 --> 02:45:22,412 THIS PROVIDES GUIDANCE FOR THE 4964 02:45:22,479 --> 02:45:24,481 RESPONSIBLE DEVELOPMENT OF AN 4965 02:45:24,547 --> 02:45:25,248 A.I. SYSTEM THAT PROMPTS 4966 02:45:25,315 --> 02:45:26,983 ORGANIZATIONS TO REALLY THINK 4967 02:45:27,050 --> 02:45:28,351 CRITICALLY ABOUT THE CONTEXT IN 4968 02:45:28,418 --> 02:45:31,454 WHICH A SYSTEM WILL BE USED AND 4969 02:45:31,521 --> 02:45:32,789 THE POTENTIAL UNEXPECTED 4970 02:45:32,856 --> 02:45:34,724 IMPACTS. 4971 02:45:34,791 --> 02:45:36,226 THERE'S ALSO A PROJECT UNDERWAY 4972 02:45:36,293 --> 02:45:39,696 AT THE NATIONAL ACADEMY OF 4973 02:45:39,763 --> 02:45:41,798 MEDICINE SUPPORTED BY NIH AMONG 4974 02:45:41,865 --> 02:45:43,900 OTHER ORGANIZATIONS TO DEVELOP A 4975 02:45:43,967 --> 02:45:47,837 HEALTHCARE A.I. CODE OF CONDUCT, 4976 02:45:47,904 --> 02:45:48,638 AND THE GOAL OF THIS PROJECT IS 4977 02:45:48,705 --> 02:45:51,141 TO PROVIDE A GUIDING FRAMEWORK 4978 02:45:51,207 --> 02:45:53,009 FOR ENSURING THAT A.I. AND ITS 4979 02:45:53,076 --> 02:45:54,177 APPLICATIONS IN HEALTH, 4980 02:45:54,244 --> 02:45:57,814 HEALTHCARE AND BIOMEDICAL 4981 02:45:57,881 --> 02:45:59,282 SCIENCE PERFORM SAFELY, RELIABLY 4982 02:45:59,349 --> 02:46:05,288 AND ETHICALLY. 4983 02:46:05,355 --> 02:46:06,690 AT THE NIH, THE ACTIVITIES TO 4984 02:46:06,756 --> 02:46:08,658 ENGAGE THE COMMUNITY AND TO 4985 02:46:08,725 --> 02:46:10,393 ESTABLISH GUIDELINES FOR 4986 02:46:10,460 --> 02:46:12,696 TRUSTWORTHY AND ETHICAL A.I. ARE 4987 02:46:12,762 --> 02:46:15,532 PRIMARILY BEING LED BY THE NIH 4988 02:46:15,598 --> 02:46:17,600 OFFICE OF DATA SCIENCE STRATEGY, 4989 02:46:17,667 --> 02:46:19,469 AND NCI IS WORKING CLOSELY WITH 4990 02:46:19,536 --> 02:46:22,439 THEM ON THESE EFFORTS. 4991 02:46:22,505 --> 02:46:24,941 THIS HAS INCLUDED TWO COMMUNITY 4992 02:46:25,008 --> 02:46:26,576 ENGAGEMENT EVENTS TO GATHER 4993 02:46:26,643 --> 02:46:28,111 INPUT ON THE COMMUNITY'S 4994 02:46:28,178 --> 02:46:30,180 THOUGHTS AND FEEDBACK ON FRAME 4995 02:46:30,246 --> 02:46:33,149 WORKS AND GAPS FOR ETHICAL AND 4996 02:46:33,216 --> 02:46:34,150 TRUSTWORTHY A.I. 4997 02:46:34,217 --> 02:46:37,053 NCI ALSO HELD AN EQUITABLE AND 4998 02:46:37,120 --> 02:46:39,589 ENGAGED A.I. WORKSHOP TO ADVANCE 4999 02:46:39,656 --> 02:46:41,591 BIOMARKER RESEARCH, AND THIS 5000 02:46:41,658 --> 02:46:43,393 INCLUDED A SESSION ON PATIENT 5001 02:46:43,460 --> 02:46:47,130 ENGAGED A.I. 5002 02:46:47,197 --> 02:46:48,431 WHAT'S CLEAR FROM ALL OF THESE 5003 02:46:48,498 --> 02:46:50,834 WORKSHOPS IS THAT A SUSTAINED 5004 02:46:50,900 --> 02:46:53,103 AND ONGOING ENGAGEMENT WITH ALL 5005 02:46:53,169 --> 02:46:56,706 STAKEHOLDERS IN THE COMMUNITY IS 5006 02:46:56,773 --> 02:46:57,807 REQUIRED TO DEVELOP APPROPRIATE 5007 02:46:57,874 --> 02:46:59,109 GUIDELINES FOR THE USE OF A.I. 5008 02:46:59,175 --> 02:47:01,511 THAT WILL BALANCE SAFETY WITH 5009 02:47:01,578 --> 02:47:09,719 SCIENTIFIC ADVANCES. 5010 02:47:09,786 --> 02:47:10,453 ANOTHER IMPORTANT CONSIDERATION 5011 02:47:10,520 --> 02:47:11,788 FOR RESPONSIBLE A.I. DEVELOPMENT 5012 02:47:11,855 --> 02:47:16,726 IS ENSURING DIVERSITY AND 5013 02:47:16,793 --> 02:47:17,694 REPRESENTEDNESS IN THE UPCOMING 5014 02:47:17,761 --> 02:47:18,495 WORKFORCE. 5015 02:47:18,561 --> 02:47:20,196 THE A.I. FIELD CURRENTLY LACKS 5016 02:47:20,263 --> 02:47:21,631 DIVERSITY IN ITS RESEARCH AND 5017 02:47:21,698 --> 02:47:24,601 DATA AND IN RECOGNITION OF THIS, 5018 02:47:24,667 --> 02:47:26,669 IN 2021, THE NIH OFFICE OF DATA 5019 02:47:26,736 --> 02:47:29,606 SCIENCE STRATEGY LAUNCHED THE 5020 02:47:29,672 --> 02:47:31,341 A.I. CONSORTIUM TO ADVANCE 5021 02:47:31,408 --> 02:47:33,676 HEALTH EQUITY AND RESEARCH 5022 02:47:33,743 --> 02:47:35,712 DIVERSITY, OR THE SO-CALLED AIM 5023 02:47:35,779 --> 02:47:38,014 AHEAD PROGRAM, AND THIS PROGRAM 5024 02:47:38,081 --> 02:47:40,417 SEEKS TO INCREASE THE 5025 02:47:40,483 --> 02:47:42,118 PARTICIPATION AND REPRESENTATION 5026 02:47:42,185 --> 02:47:45,789 OF RESEARCHERS IN COMMUNITIES 5027 02:47:45,855 --> 02:47:48,425 THAT ARE CURRENTLY 5028 02:47:48,491 --> 02:47:49,292 UNDERREPRESENTED IN ARTIFICIAL 5029 02:47:49,359 --> 02:47:50,226 INTELLIGENCE DEVELOPMENT, AS 5030 02:47:50,293 --> 02:47:52,796 WELL AS TO ADDRESS HEALTH 5031 02:47:52,862 --> 02:47:56,065 DISPARITIES AND INEQUITIES USING 5032 02:47:56,132 --> 02:47:57,934 ARTIFICIAL INTELLIGENCE, AND 5033 02:47:58,001 --> 02:47:59,702 ALSO TO IMPROVE THE CAPABILITIES 5034 02:47:59,769 --> 02:48:08,077 OF THIS EMERGING TECHNOLOGY. 5035 02:48:08,144 --> 02:48:09,712 AT THE NCI, ARTIFICIAL 5036 02:48:09,779 --> 02:48:10,513 INTELLIGENCE RESEARCH IS 5037 02:48:10,580 --> 02:48:12,182 SUPPORTED THROUGH A WIDE VARIETY 5038 02:48:12,248 --> 02:48:14,217 OF GRANT AND CONTRACT PROGRAMS, 5039 02:48:14,284 --> 02:48:18,288 AND ELEMENTS OF ARTIFICIAL 5040 02:48:18,354 --> 02:48:19,589 INTELLIGENCE ARE EMBEDDED IN 5041 02:48:19,656 --> 02:48:21,191 NUMEROUS NCI-SUPPORTED PROGRAMS 5042 02:48:21,257 --> 02:48:24,194 AS THE CANCER RESEARCH COMMUNITY 5043 02:48:24,260 --> 02:48:26,229 INCREASINGLY INCORPORATES A.I. 5044 02:48:26,296 --> 02:48:29,199 METHODS INTO DISCOVERY AND 5045 02:48:29,265 --> 02:48:29,833 TRANSLATIONAL RESEARCH AS WELL 5046 02:48:29,899 --> 02:48:31,267 AS CLINICAL PRACTICE. 5047 02:48:31,334 --> 02:48:33,470 AND THE NEED TO PROVIDE 5048 02:48:33,536 --> 02:48:35,004 CONNECTION AND COORDINATION 5049 02:48:35,071 --> 02:48:37,540 ACROSS ALL THESE ACTIVITIES, AS 5050 02:48:37,607 --> 02:48:38,741 WELL AS TO COORDINATE 5051 02:48:38,808 --> 02:48:39,576 PARTNERSHIPS WITH OTHER 5052 02:48:39,642 --> 02:48:43,079 INSTITUTES AND AGENCIES, LED US 5053 02:48:43,146 --> 02:48:45,849 TO ESTABLISH THE TRANS NCI 5054 02:48:45,915 --> 02:48:46,716 ARTIFICIAL INTELLIGENCE WORKING 5055 02:48:46,783 --> 02:48:47,717 GROUP IN 2020. 5056 02:48:47,784 --> 02:48:49,018 AND THIS INCLUDES 5057 02:48:49,085 --> 02:48:50,119 REPRESENTATIVES FROM THE 5058 02:48:50,186 --> 02:48:52,088 MAJORITY OF NCI'S DIVISIONS, 5059 02:48:52,155 --> 02:48:53,623 OFFICES AND CENTERS, AND THIS 5060 02:48:53,690 --> 02:48:56,559 INCLUDES OUR OFFICE ADVOCACY 5061 02:48:56,626 --> 02:48:57,694 RELATIONS TO ENSURE THE CONCERNS 5062 02:48:57,760 --> 02:48:59,195 OF THE PATIENT COMMUNITY ARE 5063 02:48:59,262 --> 02:49:09,239 CONSIDERED IN THESE DISCUSSIONS. 5064 02:49:09,305 --> 02:49:10,340 BECAUSE THE FIELD OF ARTIFICIAL 5065 02:49:10,406 --> 02:49:11,407 INTELLIGENCE IS WORKING SO FAST, 5066 02:49:11,474 --> 02:49:13,142 OUR WORKING GROUP RECENTLY LAWN 5067 02:49:13,209 --> 02:49:18,581 OFFOFFERED A NEW UNIQUE SERIES F 5068 02:49:18,648 --> 02:49:20,350 WEBINARS CALLED CANCER A.I. 5069 02:49:20,416 --> 02:49:20,884 CONVERSATIONS. 5070 02:49:20,950 --> 02:49:24,053 THESE ARE BIMONTHLY ONE HOUR 5071 02:49:24,120 --> 02:49:25,722 VIRTUAL EVENTS FEATURING TIMELY 5072 02:49:25,788 --> 02:49:27,123 TOPICS RELATED TO THE 5073 02:49:27,190 --> 02:49:27,690 APPLICATION OF ARTIFICIAL 5074 02:49:27,757 --> 02:49:28,758 INTELLIGENCE AND CANCER 5075 02:49:28,825 --> 02:49:29,392 RESEARCH. 5076 02:49:29,459 --> 02:49:30,827 EACH OF THESE EVENTS FEATURES 5077 02:49:30,894 --> 02:49:32,128 SHORT TALKS FROM TWO TO THREE 5078 02:49:32,195 --> 02:49:33,696 SUBJECT MATTER EXPERTS WHO WILL 5079 02:49:33,763 --> 02:49:35,265 OFFER DIVERSE PERSPECTIVES ON 5080 02:49:35,331 --> 02:49:37,200 THE SESSION TOPIC, AND THIS IS 5081 02:49:37,267 --> 02:49:39,836 THEN FOLLOWED BY A MODERATED 5082 02:49:39,903 --> 02:49:40,570 PANEL DISCUSSION. 5083 02:49:40,637 --> 02:49:42,405 OUR NEXT TWO SESSIONS COMING UP 5084 02:49:42,472 --> 02:49:44,173 IN MARCH AND MAY WILL BOTH 5085 02:49:44,240 --> 02:49:46,576 ADDRESS ASPECTS OF MACHINE 5086 02:49:46,643 --> 02:49:47,777 LEARNING OR ARTIFICIAL 5087 02:49:47,844 --> 02:49:50,046 INTELLIGENCE IN CANCER CARE 5088 02:49:50,113 --> 02:49:50,747 DELIVERY. 5089 02:49:50,813 --> 02:49:51,948 THESE FORUMS ARE OPEN TO THE 5090 02:49:52,015 --> 02:49:53,349 PUBLIC AND YOU'RE VERY WELCOME 5091 02:49:53,416 --> 02:49:59,489 TO REGISTER AND ATTEND. 5092 02:49:59,556 --> 02:50:01,391 WE'VE ALSO RECENTLY LAUNCHED THE 5093 02:50:01,457 --> 02:50:02,759 NEW ARTIFICIAL INTELLIGENCE IN 5094 02:50:02,825 --> 02:50:05,595 CANCER RESEARCH WEBPAGES ON 5095 02:50:05,662 --> 02:50:06,696 CANCER.GOV TO PROVIDE 5096 02:50:06,763 --> 02:50:09,766 INFORMATION TO THE CANCER 5097 02:50:09,832 --> 02:50:11,935 RESEARCH COMMUNITY ABOUT NCI 5098 02:50:12,001 --> 02:50:14,571 FUNDING OPPORTUNITIES AND EVENTS 5099 02:50:14,637 --> 02:50:15,905 RELATED TO ARTIFICIAL 5100 02:50:15,972 --> 02:50:21,044 INTELLIGENCE IN CANCER RESEARCH. 5101 02:50:21,110 --> 02:50:22,445 I WANT TO END BY SHARING A FEW 5102 02:50:22,512 --> 02:50:24,981 MORE EXAMPLES OF NCI-FUNDED 5103 02:50:25,048 --> 02:50:25,982 RESEARCH THAT'S SHOWING THE 5104 02:50:26,049 --> 02:50:27,750 PROMISE OF SOME OF THE LATEST 5105 02:50:27,817 --> 02:50:30,587 A.I. TECHNOLOGIES. 5106 02:50:30,653 --> 02:50:33,122 THIS STUDY FROM RESEARCHERS AT 5107 02:50:33,189 --> 02:50:33,957 HARVARD MEDICAL SCHOOL THAT WAS 5108 02:50:34,023 --> 02:50:35,458 PUBLISHED JUST LAST MONTH 5109 02:50:35,525 --> 02:50:37,093 DEMONSTRATED THAT A LARGE 5110 02:50:37,160 --> 02:50:39,562 LANGUAGE MODEL COULD BE USED TO 5111 02:50:39,629 --> 02:50:40,396 EFFICIENTLY EXTRACT SOCIAL 5112 02:50:40,463 --> 02:50:42,699 DETERMINANTS OF HEALTH 5113 02:50:42,765 --> 02:50:45,201 CATEGORIES FROM NARRATIVE OR 5114 02:50:45,268 --> 02:50:47,704 UNSTRUCTURED TEXT IN ELECTRONIC 5115 02:50:47,770 --> 02:50:50,239 HEALTH RECORDS. 5116 02:50:50,306 --> 02:50:51,107 WHILE SOCIAL DETERMINANTS OF 5117 02:50:51,174 --> 02:50:52,842 HEALTH PLAY A CRITICAL ROLE IN 5118 02:50:52,909 --> 02:50:54,711 PATIENT OUTCOMES, THIS 5119 02:50:54,777 --> 02:50:57,313 INFORMATION IS OFTEN INCOMPLETE 5120 02:50:57,380 --> 02:51:00,183 IN THE STRUCTURED DATA. 5121 02:51:00,249 --> 02:51:01,150 THESE RESULTS DEMONSTRATE THE 5122 02:51:01,217 --> 02:51:02,585 POTENTIAL OF LARGE LANGUAGE 5123 02:51:02,652 --> 02:51:04,988 MODEL TECHNOLOGY IN IMPROVING 5124 02:51:05,054 --> 02:51:06,522 OUR UNDERSTANDING OF REAL WORLD 5125 02:51:06,589 --> 02:51:08,391 EVIDENCE ON SOCIAL DETERMINANTS 5126 02:51:08,458 --> 02:51:10,059 OF HEALTH AND ULTIMATELY 5127 02:51:10,126 --> 02:51:11,127 ASSISTING IN IDENTIFYING 5128 02:51:11,194 --> 02:51:14,297 PATIENTS WHO COULD BENEFIT FROM 5129 02:51:14,364 --> 02:51:21,704 MORE RESOURCE SUPPORT. 5130 02:51:21,771 --> 02:51:23,072 RESEARCH BEING SUPPORTED BY NCI 5131 02:51:23,139 --> 02:51:23,973 IS ALSO ADDRESSING CHALLENGES 5132 02:51:24,040 --> 02:51:27,243 WITH HAVING ACCESS TO SUFFICIENT 5133 02:51:27,310 --> 02:51:29,212 REPRESENTATIVE DATA TO TRAIN AN 5134 02:51:29,278 --> 02:51:30,680 A.I. MODEL THAT WILL PERFORM 5135 02:51:30,747 --> 02:51:32,482 WELL ACROSS MANY SITES, NOT JUST 5136 02:51:32,548 --> 02:51:36,886 THE SITE IT WAS TRAINED ON. 5137 02:51:36,953 --> 02:51:38,755 AND AN APPROACH THAT'S CALLED 5138 02:51:38,821 --> 02:51:40,256 FEDERATED LEARNING ALLOWS 5139 02:51:40,323 --> 02:51:41,391 MULTIPLE ORGANIZATIONS TO 5140 02:51:41,457 --> 02:51:43,226 COLLABORATIVELY TRAIN AN A.I. 5141 02:51:43,292 --> 02:51:44,360 MODEL WHILE AT THE SAME TIME 5142 02:51:44,427 --> 02:51:45,862 ENSURING THAT THE DATA REMAINS 5143 02:51:45,928 --> 02:51:48,398 ON THEIR SITE AND DECENTRALIZED, 5144 02:51:48,464 --> 02:51:49,799 WHICH IS CRITICALLY IMPORTANT 5145 02:51:49,866 --> 02:51:51,801 FOR PRIVATE DATA. 5146 02:51:51,868 --> 02:51:59,208 IN THIS STUDY FROM SPEAR OWES 5147 02:51:59,275 --> 02:52:01,177 FAUCES GROUP, THEY DEVELOPED A 5148 02:52:01,244 --> 02:52:02,712 FEDERATED LEARNING TECHNOLOGY 5149 02:52:02,779 --> 02:52:04,380 THAT WAS USED TO SUPPORT THE 5150 02:52:04,447 --> 02:52:06,683 LARGEST BIOMEDICAL FEDERATED 5151 02:52:06,749 --> 02:52:08,084 LEARNING PROJECT TO DATE THAT 5152 02:52:08,151 --> 02:52:09,852 INVOLVED DATA FROM 71 SITES 5153 02:52:09,919 --> 02:52:10,920 ACROSS 6 CONTINENTS TO GENERATE 5154 02:52:10,987 --> 02:52:13,523 A MODEL FOR AUTOMATIC TUMOR 5155 02:52:13,589 --> 02:52:16,693 BOUNDARY DETECTION FOR 5156 02:52:16,759 --> 02:52:17,060 GLIOBLASTOMA. 5157 02:52:17,126 --> 02:52:20,229 SO I WANT TO END BY NOTING THAT 5158 02:52:20,296 --> 02:52:22,665 ADVANCING THE APPROPRIATE USE OF 5159 02:52:22,732 --> 02:52:23,566 ARTIFICIAL INTELLIGENCE IN 5160 02:52:23,633 --> 02:52:25,835 CANCER RESEARCH AND CARE IS 5161 02:52:25,902 --> 02:52:28,104 SUPPORTING ALL ASPECTS OF THE 5162 02:52:28,171 --> 02:52:29,772 NATIONAL CANCER PLAN, 5163 02:52:29,839 --> 02:52:31,174 PARTICULARLY THE GOAL OF 5164 02:52:31,240 --> 02:52:33,142 MAXIMIZING DATA UTILITY. 5165 02:52:33,209 --> 02:52:34,811 TOWARD THE ULTIMATE GOAL OF 5166 02:52:34,877 --> 02:52:37,080 ENDING CANCER AS WE KNOW IT. 5167 02:52:37,146 --> 02:52:39,615 AND NCI IS COMMITTED TO 5168 02:52:39,682 --> 02:52:41,050 DEVELOPING TRUSTWORTHY ENGAGED 5169 02:52:41,117 --> 02:52:44,387 AND ETHICAL APPROACHES FOR THE 5170 02:52:44,454 --> 02:52:46,823 APPLICATION OF A.I. IN CANCER 5171 02:52:46,889 --> 02:52:47,890 RESEARCH, AND WE'RE WORKING IN 5172 02:52:47,957 --> 02:52:49,092 PARTNERSHIP WITH THE NIH AND 5173 02:52:49,158 --> 02:52:50,526 OTHER FEDERAL GOVERNMENT 5174 02:52:50,593 --> 02:52:51,961 AGENCIES TO DEVELOP THE 5175 02:52:52,028 --> 02:52:53,930 APPROPRIATE GUIDELINES AND 5176 02:52:53,996 --> 02:52:54,530 POLICIES. 5177 02:52:54,597 --> 02:52:55,765 AND WE KNOW THAT IT CRITICAL 5178 02:52:55,832 --> 02:52:58,000 THAT WE CONTINUE TO ENGAGE WITH 5179 02:52:58,067 --> 02:52:59,268 ALL STAKEHOLDERS, INCLUDING 5180 02:52:59,335 --> 02:53:01,137 PATIENTS, TO REALIZE THE 5181 02:53:01,204 --> 02:53:02,238 POTENTIAL IMPACT OF THIS 5182 02:53:02,305 --> 02:53:06,809 POWERFUL TECHNOLOGY. 5183 02:53:06,876 --> 02:53:07,577 THANK YOU VERY MUCH, AND I WOULD 5184 02:53:07,643 --> 02:53:08,678 BE VERY HAPPY TO TAKE YOUR 5185 02:53:08,745 --> 02:53:11,614 QUESTIONS AND TO HEAR YOUR 5186 02:53:11,681 --> 02:53:12,014 COMMENTS. 5187 02:53:12,081 --> 02:53:13,750 >> THANK YOU SO MUCH, DR. KLEMM, 5188 02:53:13,816 --> 02:53:17,453 FOR PRESENTING THIS VERY 5189 02:53:17,520 --> 02:53:18,454 INTERESTING PRESENTATION ON A.I. 5190 02:53:18,521 --> 02:53:21,557 I THINK WE'RE ALL CURIOUS ABOUT 5191 02:53:21,624 --> 02:53:23,793 WHAT'S GOING ON AND HOW IT 5192 02:53:23,860 --> 02:53:25,762 IMPACTS YOUR RESEARCH AND 5193 02:53:25,828 --> 02:53:26,429 EVENTUALLY PATIENTS. 5194 02:53:26,496 --> 02:53:35,638 I SEE VICKIE HAS A QUESTION. 5195 02:53:35,705 --> 02:53:37,673 >> I WAS SAYING, ANNIE, YOU 5196 02:53:37,740 --> 02:53:38,875 USUALLY START US OFF WITH THE 5197 02:53:38,941 --> 02:53:41,310 BEST QUESTION SO I CAN HOLD MINE 5198 02:53:41,377 --> 02:53:42,245 IF YOU'VE GOT ONE QUEUED UP. 5199 02:53:42,311 --> 02:53:45,381 IF NOT, I HAVE A SPECIFIC 5200 02:53:45,448 --> 02:53:48,985 QUESTION ABOUT ALPHA FOLD. 5201 02:53:49,051 --> 02:53:50,753 AND WHEN ALPHA FOLD CAME OUT, I 5202 02:53:50,820 --> 02:53:54,357 THOUGHT IT WAS MAYBE THE COOLEST 5203 02:53:54,423 --> 02:53:55,358 APPLICATION OF A.I. THAT I WAS 5204 02:53:55,424 --> 02:53:57,226 EVER GOING TO BE ABLE TO THINK 5205 02:53:57,293 --> 02:54:00,496 OF, AND THEN ALPHA FOLD 2. 5206 02:54:00,563 --> 02:54:04,600 I FEEL LIKE LAST FALL SORT OF 5207 02:54:04,667 --> 02:54:09,005 THE PROMISE OF ALPHA FOLD AND 5208 02:54:09,071 --> 02:54:10,173 THE CONNECTION TO DRUG DISCOVERY 5209 02:54:10,239 --> 02:54:11,374 WAS A LITTLE -- THEY KIND OF 5210 02:54:11,440 --> 02:54:13,142 BACKED OFF OF THAT, AND I JUST 5211 02:54:13,209 --> 02:54:16,646 WANTED TO HEAR WHAT YOU WERE 5212 02:54:16,712 --> 02:54:17,847 THINKING THESE DAYS ABOUT THE 5213 02:54:17,914 --> 02:54:20,483 MORE NARROW LANGUAGE MODELS LIKE 5214 02:54:20,550 --> 02:54:21,484 THAT THAT ARE VERY SPECIFIC BUT 5215 02:54:21,551 --> 02:54:25,855 THAT COULD HELP US A LOT WITH 5216 02:54:25,922 --> 02:54:27,190 KIND OF THE MANPOWER ISSUE THAT 5217 02:54:27,256 --> 02:54:29,025 WE WERE TALKING ABOUT AS A 5218 02:54:29,091 --> 02:54:33,963 COMMUNITY EARLIER IN THE DAY. 5219 02:54:34,030 --> 02:54:35,264 >> THAT'S A GREAT QUESTION. 5220 02:54:35,331 --> 02:54:37,667 THERE'S A LOT OF NUANCES IN YOUR 5221 02:54:37,733 --> 02:54:41,037 QUESTION. 5222 02:54:41,103 --> 02:54:42,605 TALKING SPECIFICALLY ABOUT 5223 02:54:42,672 --> 02:54:43,706 ALPHAFOLD AND DRUG DEVELOPMENT, 5224 02:54:43,773 --> 02:54:46,008 I THINK THIS IS AN AREA THAT NCI 5225 02:54:46,075 --> 02:54:47,977 IS VERY INTERESTED IN EXPLORING 5226 02:54:48,044 --> 02:54:49,612 MORE AND IN FACT AS PART OF THE 5227 02:54:49,679 --> 02:54:53,349 CANCER MOONSHOT, NCI IS WORKING 5228 02:54:53,416 --> 02:54:57,753 WITH DOE AND FDA ACTUALLY TO PUT 5229 02:54:57,820 --> 02:54:58,855 TOGETHER A WORKSHOP SPECIFICALLY 5230 02:54:58,921 --> 02:55:00,857 ABOUT HOW CAN WE BETTER LEVERAGE 5231 02:55:00,923 --> 02:55:03,092 ARTIFICIAL INTELLIGENCE METHODS 5232 02:55:03,159 --> 02:55:07,330 TO TARGET PREVIOUSLY UNDRUGGABLE 5233 02:55:07,396 --> 02:55:08,030 CANCER TARGETS. 5234 02:55:08,097 --> 02:55:09,365 THAT MAY INVOLVE STRUCTURAL 5235 02:55:09,432 --> 02:55:10,900 BIOLOGY APPROACHES LIKE 5236 02:55:10,967 --> 02:55:13,302 ALPHAFOLD, BUT ALSO LEVERAGING 5237 02:55:13,369 --> 02:55:15,171 AN IMPROVED UNDERSTANDING OF 5238 02:55:15,238 --> 02:55:16,806 BIOLOGICAL KNOWLEDGE THAT CAN BE 5239 02:55:16,873 --> 02:55:18,574 GAINED THROUGH A.I. THAT CAN 5240 02:55:18,641 --> 02:55:19,876 HELP US THINK OF MORE CLEVER 5241 02:55:19,942 --> 02:55:22,078 WAYS TO TARGET OTHER PARTS OF A 5242 02:55:22,144 --> 02:55:28,284 BIOLOGICAL PATHWAY IN WHICH AN 5243 02:55:28,351 --> 02:55:28,885 UNDRUGGABLE TARGET MIGHT SIT. 5244 02:55:28,951 --> 02:55:29,752 SO THIS IS A VERY IMPORTANT AREA 5245 02:55:29,819 --> 02:55:31,520 THAT WE ARE WORKING ON PURSUING 5246 02:55:31,587 --> 02:55:32,955 IN THE COMING YEAR. 5247 02:55:33,022 --> 02:55:35,558 YOU ALSO HAD A QUESTION ABOUT 5248 02:55:35,625 --> 02:55:37,426 USING TO ADDRESS SOME OF OUR 5249 02:55:37,493 --> 02:55:38,728 WORKFORCE ISSUES, AND I THINK 5250 02:55:38,794 --> 02:55:40,529 THAT'S A VERY IMPORTANT PART OF 5251 02:55:40,596 --> 02:55:44,300 THE PROMISE OF ARTIFICIAL 5252 02:55:44,367 --> 02:55:45,735 INTELLIGENCE. 5253 02:55:45,801 --> 02:55:48,704 AGAIN, I SPOKE TO SOME OF THE 5254 02:55:48,771 --> 02:55:49,906 EDUCATIONAL POSSIBILITIES, YOU 5255 02:55:49,972 --> 02:55:52,508 KNOW, MEDICAL STUDENTS USING TO 5256 02:55:52,575 --> 02:55:54,076 INCREASE -- YOU KNOW, TO HELP 5257 02:55:54,143 --> 02:55:56,379 THEM LEARN THE KNOWLEDGE THEY 5258 02:55:56,445 --> 02:55:58,047 NEED TO PRACTICE BEING BETTER 5259 02:55:58,114 --> 02:55:59,882 DOCTORS BY USING THESE CHATBOTS 5260 02:55:59,949 --> 02:56:02,685 AS PROXIES FOR DOING PATIENT 5261 02:56:02,752 --> 02:56:03,519 INTERVIEWS, I THINK THERE ARE A 5262 02:56:03,586 --> 02:56:06,822 TON OF OPPORTUNITIES TO USE THIS 5263 02:56:06,889 --> 02:56:07,790 TECHNOLOGY TO WORK MORE 5264 02:56:07,857 --> 02:56:13,162 EFFICIENTLY. 5265 02:56:13,229 --> 02:56:17,600 >> THANK YOU. 5266 02:56:17,667 --> 02:56:18,668 >> HI, DR. KLEMM. 5267 02:56:18,734 --> 02:56:20,236 THANK YOU FOR THAT PRESENTATION. 5268 02:56:20,303 --> 02:56:21,737 I, TOO, THINK THERE'S A LOT OF 5269 02:56:21,804 --> 02:56:26,976 PROMISE WITH A.I. TECHNOLOGY, 5270 02:56:27,043 --> 02:56:28,311 BUT I WILL SAY THERE ARE ALSO 5271 02:56:28,377 --> 02:56:29,745 SOME CONCERNS, SOME OF WHICH YOU 5272 02:56:29,812 --> 02:56:33,783 BROUGHT UP, AND I WAS AT A 5273 02:56:33,849 --> 02:56:34,984 RECENT MEETING WITH OTHER GRAND 5274 02:56:35,051 --> 02:56:36,652 MAKERS AND WE WERE -- 5275 02:56:36,719 --> 02:56:37,920 GRANTMAKERS AND WE WERE TALKING 5276 02:56:37,987 --> 02:56:40,122 ABOUT HOW INCREASINGLY VERY 5277 02:56:40,189 --> 02:56:42,858 QUICKLY INVESTIGATORS ARE USING 5278 02:56:42,925 --> 02:56:47,129 A.I., GENERATIVE A.I. TO WRITE 5279 02:56:47,196 --> 02:56:53,169 APPLICATIONS, PULLING BACKGROUND 5280 02:56:53,235 --> 02:56:54,136 INFORMATION THAT MAY OR MAY NOT 5281 02:56:54,203 --> 02:56:56,005 BE BACKED UP BY REAL DATA, AND 5282 02:56:56,072 --> 02:56:58,741 SOME OF THESE CONCERNS ABOUT HOW 5283 02:56:58,808 --> 02:57:01,277 DO WE AS GRANTMAKERS ADDRESS 5284 02:57:01,344 --> 02:57:02,812 THAT OR SHOULD WE ADDRESS THAT 5285 02:57:02,878 --> 02:57:05,181 IN ANY WAY? 5286 02:57:05,247 --> 02:57:06,349 AND I'M JUST CURIOUS IF YOU HAVE 5287 02:57:06,415 --> 02:57:09,352 ANY THOUGHTS ON THAT. 5288 02:57:09,418 --> 02:57:10,987 >> I THINK THAT IS ONE OF THE 5289 02:57:11,053 --> 02:57:13,656 CONCERNS WE'RE SEEING AS PEOPLE 5290 02:57:13,723 --> 02:57:16,659 USING THESE TECHNOLOGIES WITHOUT 5291 02:57:16,726 --> 02:57:18,394 KIND OF A HUMAN IN THE LOOP 5292 02:57:18,461 --> 02:57:19,028 STEP, RIGHT? 5293 02:57:19,095 --> 02:57:20,997 SO I THINK MANY OF US HAVE SEEN 5294 02:57:21,063 --> 02:57:23,766 HOW HELPFUL IT CAN BE TO USE A 5295 02:57:23,833 --> 02:57:25,368 CHATBOT TO HELP SUMMARIZE 5296 02:57:25,434 --> 02:57:27,803 INFORMATION OR MAYBE TO BETTER 5297 02:57:27,870 --> 02:57:28,871 STRUCTURE SOME TEXT THAT YOU'VE 5298 02:57:28,938 --> 02:57:30,106 WRITTEN, BUT I THINK WE ALL HAVE 5299 02:57:30,172 --> 02:57:32,274 TO BE MINDFUL OF SOME OF THE 5300 02:57:32,341 --> 02:57:35,144 CURRENT LIMITATIONS ABOUT BEING 5301 02:57:35,211 --> 02:57:37,380 SKEPTICAL ABOUT SOME OF THE 5302 02:57:37,446 --> 02:57:42,051 ANSWERS. 5303 02:57:42,118 --> 02:57:43,252 AND IT IMPORTANT THAT WE USE 5304 02:57:43,319 --> 02:57:45,755 THESE AS A TOOL WITH OUR OWN 5305 02:57:45,821 --> 02:57:46,856 OVERSIGHT AND VALIDATION. 5306 02:57:46,922 --> 02:57:48,724 I THINK THE AREA OF VALIDATING 5307 02:57:48,791 --> 02:57:50,393 THE RESULTS FROM A.I. TECHNOLOGY 5308 02:57:50,459 --> 02:57:52,328 IS GOING TO BE AN INCREASING 5309 02:57:52,395 --> 02:57:55,097 AREA OF FOCUS. 5310 02:57:55,164 --> 02:57:56,399 I KNOW THERE ARE SOME EFFORTS 5311 02:57:56,465 --> 02:57:58,034 UNDERWAY TO WATERMARK 5312 02:57:58,100 --> 02:57:59,368 INFORMATION THAT'S CLEARLY COME 5313 02:57:59,435 --> 02:58:01,904 FROM CHATBOTS SO WE CAN SEE, YOU 5314 02:58:01,971 --> 02:58:04,740 KNOW, AND BE TRANSPARENT ABOUT 5315 02:58:04,807 --> 02:58:06,742 INFORMATION THAT'S COME FROM 5316 02:58:06,809 --> 02:58:07,676 CHATBOTS. 5317 02:58:07,743 --> 02:58:11,847 AND SO I THINK IT IS A POWERFUL 5318 02:58:11,914 --> 02:58:13,282 TOOL FOR HELPING US DO OUR WORK, 5319 02:58:13,349 --> 02:58:16,118 BUT IT'S NOT NECESSARILY A 5320 02:58:16,185 --> 02:58:18,120 SUBSTITUTE FOR THAT HUMAN IN THE 5321 02:58:18,187 --> 02:58:25,561 LOOP VALIDATION. 5322 02:58:25,628 --> 02:58:26,962 >> I WAS JUST GOING TO FOLLOW ON 5323 02:58:27,029 --> 02:58:27,396 WITH THAT. 5324 02:58:27,463 --> 02:58:31,333 THERE WAS AN ARTICLE IN STAT 5325 02:58:31,400 --> 02:58:32,968 THIS WEEK ABOUT THE LARGE 5326 02:58:33,035 --> 02:58:36,072 LANGUAGE MODELS LEARNING ON DATA 5327 02:58:36,138 --> 02:58:44,713 THAT HAD EMBEDDED RACIST AND 5328 02:58:44,780 --> 02:58:45,915 DISCRIMINATORY THINGS. 5329 02:58:45,981 --> 02:58:51,487 IS THAT PART OF THE ETHICAL 5330 02:58:51,554 --> 02:58:52,888 GUIDELINES THAT YOU SPOKE SO 5331 02:58:52,955 --> 02:58:54,590 ELOQUENTLY ABOUT A LITTLE BIT, 5332 02:58:54,657 --> 02:58:57,760 TO MAKE SURE THAT LANGUAGE 5333 02:58:57,827 --> 02:59:00,596 MODELS DON'T EXTEND THINGS THAT 5334 02:59:00,663 --> 02:59:02,598 HAD THEIR ROOTS IN EUGENICS, FOR 5335 02:59:02,665 --> 02:59:04,333 INSTANCE? 5336 02:59:04,400 --> 02:59:05,234 >> YEAH, EXACTLY. 5337 02:59:05,301 --> 02:59:09,171 SO SOME OF THESE MODELS FROM THE 5338 02:59:09,238 --> 02:59:10,806 LARGE COMPANIES HAVE BEEN 5339 02:59:10,873 --> 02:59:12,241 TRAINED ON DATA FROM ACROSS THE 5340 02:59:12,308 --> 02:59:15,544 INTERNET THAT I THINK WE ALL 5341 02:59:15,611 --> 02:59:17,847 KNOW IS RIDDLED WITH STEREOTYPES 5342 02:59:17,913 --> 02:59:21,484 AND SO FORTH, AND THAT'S ONE OF 5343 02:59:21,550 --> 02:59:23,219 THE IMPORTANT CONCERNS THAT CAME 5344 02:59:23,285 --> 02:59:25,754 OUT RIGHT AWAY AS, YOU KNOW, 5345 02:59:25,821 --> 02:59:28,023 WHEN CHATGPT WAS RELEASED, WERE 5346 02:59:28,090 --> 02:59:30,025 THE STEREOTYPES THAT COULD BE 5347 02:59:30,092 --> 02:59:34,964 REINFORCED HERE. 5348 02:59:35,030 --> 02:59:36,298 AND ESPECIALLY IN MEDICINE, WE 5349 02:59:36,365 --> 02:59:38,000 NEED TO ENSURE THAT THE DATA 5350 02:59:38,067 --> 02:59:39,902 THAT MODELS WERE USING TO MAKE 5351 02:59:39,969 --> 02:59:42,838 PATIENT DECISIONS WITH AND SO 5352 02:59:42,905 --> 02:59:44,807 FORTH IS APPROPRIATELY BALANCED. 5353 02:59:44,874 --> 02:59:48,210 AND THERE ARE EFFORTS ALSO TO 5354 02:59:48,277 --> 02:59:50,746 CREATE APPROACHES TO BE ABLE TO 5355 02:59:50,813 --> 02:59:52,948 IDENTIFY UNDERLYING BIASES IN 5356 02:59:53,015 --> 02:59:58,621 DATASETS, AND I KNOW THE CHATGPT 5357 02:59:58,687 --> 03:00:00,556 AND OTHER -- BART AND SO FORTH, 5358 03:00:00,623 --> 03:00:01,390 THESE COMPANIES ARE LOOKING AT 5359 03:00:01,457 --> 03:00:04,927 WAYS TO BETTER TUNE THESE MODELS 5360 03:00:04,994 --> 03:00:08,430 TO BE ABLE TO MINIMIZE THOSE 5361 03:00:08,497 --> 03:00:08,964 BIASES. 5362 03:00:09,031 --> 03:00:10,332 BUT IT'S A VERY IMPORTANT 5363 03:00:10,399 --> 03:00:14,336 CONCERN THAT I THINK THAT'S WHAT 5364 03:00:14,403 --> 03:00:15,304 WE NEED TO CONTINUE TO THINK 5365 03:00:15,371 --> 03:00:17,406 ABOUT HOW DO WE ADDRESS THAT 5366 03:00:17,473 --> 03:00:19,175 RISK WHEN WE'RE USING IT FOR 5367 03:00:19,241 --> 03:00:22,778 MAKING IMPORTANT DECISIONS. 5368 03:00:22,845 --> 03:00:26,815 >> SWITCHING BACK A LITTLE BIT 5369 03:00:26,882 --> 03:00:30,553 TO THE PREDICTIVE A.I. AND 5370 03:00:30,619 --> 03:00:32,955 THINGS BEING THE BLACK BOXES AS 5371 03:00:33,022 --> 03:00:33,923 WELL AS VISIBLE MACHINE 5372 03:00:33,989 --> 03:00:35,090 LEARNING, ARE THERE CERTAIN 5373 03:00:35,157 --> 03:00:43,132 AREAS THAT ARE MORE HARDER TO BE 5374 03:00:43,199 --> 03:00:44,466 AWARE OF WHETHER OR NOT VISIBLE 5375 03:00:44,533 --> 03:00:45,668 MACHINE LEARNING IS HAPPENING, 5376 03:00:45,734 --> 03:00:46,902 AND FOR PATIENT WHO MAY BE 5377 03:00:46,969 --> 03:00:48,370 HAVING THEIR CARE DECIDED BY, 5378 03:00:48,437 --> 03:00:51,974 YOU KNOW, A.I. OR TESTING OR 5379 03:00:52,041 --> 03:00:54,677 OTHER THINGS, HA IS THERE ANY WY 5380 03:00:54,743 --> 03:00:56,779 FOR OUR PATIENTS TO ASK OR FIND 5381 03:00:56,845 --> 03:01:00,749 OUT WHETHER OR NOT THE ALGORITHM 5382 03:01:00,816 --> 03:01:02,384 IS VISIBLE OR IF IT'S IN A BLACK 5383 03:01:02,451 --> 03:01:02,818 BOX? 5384 03:01:02,885 --> 03:01:04,587 WHAT CAN WE DO ON OUR SIDE? 5385 03:01:04,653 --> 03:01:08,958 >> WELL, I THINK PATIENTS SHOULD 5386 03:01:09,024 --> 03:01:10,226 ALWAYS BE ASKING THE HARD 5387 03:01:10,292 --> 03:01:12,161 QUESTIONS OF THEIR DOCTOR. 5388 03:01:12,228 --> 03:01:13,629 SO I THINK THAT IS SOMETHING 5389 03:01:13,696 --> 03:01:16,665 THAT PATIENTS CAN AND SHOULD DO. 5390 03:01:16,732 --> 03:01:16,799 , 5391 03:01:16,865 --> 03:01:18,968 IS ASK THOSE QUESTIONS. 5392 03:01:19,034 --> 03:01:19,635 ABOUT HOW 5393 03:01:19,702 --> 03:01:22,471 THEIR DATA IS BEING ANALYZED. 5394 03:01:22,538 --> 03:01:25,374 IN TERMS OF DATA THAT MIGHT BE 5395 03:01:25,441 --> 03:01:27,309 MORE DIFFICULT FOR CREATING 5396 03:01:27,376 --> 03:01:29,612 VISIBLE MODELS, IT IS -- IT'S A 5397 03:01:29,678 --> 03:01:32,281 VERY ACTIVE AREA OF RESEARCH 5398 03:01:32,348 --> 03:01:34,883 RIGHT NOW, THIS NEED TO HAVE 5399 03:01:34,950 --> 03:01:36,218 EXPLAINABLE MODELS TO ENSURE 5400 03:01:36,285 --> 03:01:38,320 THAT THE FEATURES THAT THESE 5401 03:01:38,387 --> 03:01:43,025 MODELS ARE RECOGNIZING ARE 5402 03:01:43,092 --> 03:01:43,859 UNDERSTANDABLE AND APPROPRIATE 5403 03:01:43,926 --> 03:01:45,794 IS GOING TO BE CRITICAL TO 5404 03:01:45,861 --> 03:01:48,197 INCREASING THE ADOPTION OF THESE 5405 03:01:48,264 --> 03:01:48,631 TECHNOLOGIES. 5406 03:01:48,697 --> 03:01:51,467 EVEN IN COMPUTER VISION, THERE 5407 03:01:51,533 --> 03:01:57,573 IS INCREASING RESEARCH TO BE 5408 03:01:57,640 --> 03:01:58,407 ABLE TO EXPLAIN SOME OF THE 5409 03:01:58,474 --> 03:02:00,042 FEATURES THAT THE MODELS BEING 5410 03:02:00,109 --> 03:02:00,709 TRAINED ON. 5411 03:02:00,776 --> 03:02:06,849 SO I THINK TH THIS IS A AN AREAF 5412 03:02:06,915 --> 03:02:07,316 ACTIVE RESEARCH. 5413 03:02:07,383 --> 03:02:09,151 BUT I THINK THIS IS WHEREAS WE 5414 03:02:09,218 --> 03:02:10,252 CONTINUE TO DEVELOP THESE 5415 03:02:10,319 --> 03:02:11,320 ETHICAL GUIDELINES INVOLVING 5416 03:02:11,387 --> 03:02:12,254 PATIENTS IN THESE CONVERSATIONS 5417 03:02:12,321 --> 03:02:14,023 I THINK IS IMPORTANT, AND HAVING 5418 03:02:14,089 --> 03:02:15,491 PATIENTS ASK THE HARD QUESTIONS, 5419 03:02:15,557 --> 03:02:19,261 I THINK IS CRITICAL TO ENSURING 5420 03:02:19,328 --> 03:02:21,463 THAT THESE CONSIDERATIONS MAY 5421 03:02:21,530 --> 03:02:30,005 REMAIN ON THE FOREFRONT. 5422 03:02:30,072 --> 03:02:31,640 >> NO FURTHER QUESTION, I JUST 5423 03:02:31,707 --> 03:02:32,808 WANT TO THANK YOU FOR SPENNING 5424 03:02:32,875 --> 03:02:36,145 SPENDINGTIME WITH US AND BRINGIS 5425 03:02:36,211 --> 03:02:37,479 TO OUR ATTENTION AND HELPING US 5426 03:02:37,546 --> 03:02:40,516 WITH SOME LANGUAGE AROUND THIS 5427 03:02:40,582 --> 03:02:43,686 RAPIDLY EMERGING FIELD, AND 5428 03:02:43,752 --> 03:02:45,554 EXCITING AND SCARY AT THE SAME 5429 03:02:45,621 --> 03:02:45,754 TIME. 5430 03:02:45,821 --> 03:02:47,056 SO THANK YOU FOR YOUR WORK AND 5431 03:02:47,122 --> 03:02:48,090 WHAT YOU ARE DOING AND FOR 5432 03:02:48,157 --> 03:02:48,924 SPENDING TIME WITH US. 5433 03:02:48,991 --> 03:02:49,758 >> THANK YOU FOR THE 5434 03:02:49,825 --> 03:02:53,495 OPPORTUNITY. 5435 03:02:53,562 --> 03:02:54,396 >> OKAY. 5436 03:02:54,463 --> 03:02:57,733 DO WE HAVE ANYTHING ELSE 5437 03:02:57,800 --> 03:02:58,200 BEFORE -- OKAY. 5438 03:02:58,267 --> 03:03:01,503 SO BEFORE WE GET TO GO HOME, WE 5439 03:03:01,570 --> 03:03:04,340 NEED TO APPROVE THE SUMMARY OF 5440 03:03:04,406 --> 03:03:05,574 OUR LAST MEETING. 5441 03:03:05,641 --> 03:03:06,675 IT WAS INCLUDED IN THE BOARD 5442 03:03:06,742 --> 03:03:09,278 MATERIALS AND SO BEFORE WE CAN 5443 03:03:09,345 --> 03:03:10,546 VOTE ON IT, I NEED TO HAVE A 5444 03:03:10,612 --> 03:03:11,980 MOTION TO APPROVE IT. 5445 03:03:12,047 --> 03:03:14,450 >> I'LL JUST POINT OUT IT WASN'T 5446 03:03:14,516 --> 03:03:16,885 A VIRTUAL MEETING, IT WAS AN 5447 03:03:16,952 --> 03:03:17,386 IN-PERSON MEETING? 5448 03:03:17,453 --> 03:03:19,355 IT SAYS VIRTUAL MEETING. 5449 03:03:19,421 --> 03:03:22,591 >> DO YOU MEAN THE LAST -- 5450 03:03:22,658 --> 03:03:30,232 >> OCTOBER 4TH? 5451 03:03:30,299 --> 03:03:32,534 >> OH, IT SAYS VIRTUAL ON IT. 5452 03:03:32,601 --> 03:03:34,069 SO WE CAN APPROVE WITH THAT 5453 03:03:34,136 --> 03:03:34,303 CHANGE. 5454 03:03:34,370 --> 03:03:36,004 >> I MOVE TO APPROVE. 5455 03:03:36,071 --> 03:03:36,372 >> OKAY. 5456 03:03:36,438 --> 03:03:37,606 SO DO I HAVE A SECOND TO APPROVE 5457 03:03:37,673 --> 03:03:38,407 WITH THE CHANGE? 5458 03:03:38,474 --> 03:03:38,607 OKAY. 5459 03:03:38,674 --> 03:03:40,175 >> I SECOND THE CHANGE ALSO. 5460 03:03:40,242 --> 03:03:41,810 >> OKAY. 5461 03:03:41,877 --> 03:03:42,478 THAT'S PERFECT. 5462 03:03:42,544 --> 03:03:43,679 OKAY. 5463 03:03:43,746 --> 03:03:45,214 SO ALL OF THOSE IN FAVOR, PLEASE 5464 03:03:45,280 --> 03:03:49,485 SAY AYE. 5465 03:03:49,551 --> 03:03:50,486 ANY OPPOSED? 5466 03:03:50,552 --> 03:03:53,389 HEARING NONE OPPOSED, IT CARRIES 5467 03:03:53,455 --> 03:03:55,090 UNANIMOUSLY, AND DO WE HAVE ANY 5468 03:03:55,157 --> 03:03:58,060 OTHER -- OUR NEXT MEETING WILL 5469 03:03:58,127 --> 03:04:00,562 BE WEDNESDAY, JUNE 26TH. 5470 03:04:00,629 --> 03:04:03,732 THIS ONE WILL BE VIRTUAL. 5471 03:04:03,799 --> 03:04:07,035 AND WITH THAT, I THINK AMY AND 5472 03:04:07,102 --> 03:04:11,006 VINCENT AND THE WHOLE TEAM, I 5473 03:04:11,073 --> 03:04:13,175 THANK DR. RATHMELL FOR BEING 5474 03:04:13,242 --> 03:04:15,811 WITH US AND EVERYONE HERE, SO 5475 03:04:15,878 --> 03:04:17,379 THANK YOU ALL AND SAFE TRAVELS 5476 03:04:17,446 --> 03:04:17,813 HOME. 5477 03:04:17,880 --> 03:04:18,347 THANKS, EVERYBODY. 5478 03:04:18,414 --> 03:04:19,281 WE ARE NOW ADJOURNED. 5479 03:04:19,348 --> 03:04:29,525 THANK YOU.