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In this episode of the Precision Medicine Podcast, hosts Karan Cushman and Clynt Taylor welcome back Dr. Luis Raez, Medical Director and Chief Scientific Officer at Memorial Cancer Institute who is joined by Dr. Pranil Chandra, Chief Genomic Officer at PathGroup.  Together, we discuss the key barriers to performing comprehensive genomic profiling in lung cancer; how collaboration between oncologists and pathologists can enable a more consistent approach; and the improvements that should be made to close the gaps between the available life-extending, targeted therapies on the market today and the lung cancer patients who need them.  To read the full summary, download the transcript and subscribe to receive future episodes straight to your in-box visit Precision Medicine Podcast Episode #58. Special thanks to our partners at Janssen Biotech for their sponsorship of this episode. We encourage you to share this episode with others in your community.

To mark the beginning of Season 5 of the Precision Medicine Podcast, we are honored to welcome Dr. Debra Patt, Executive Vice President of Texas Oncology. As an oncologist and breast cancer specialist at one of the nation’s largest community cancer practices, Dr. Patt is on the frontlines of oncology care every day. She joins us to discuss how Texas Oncology uses clinical decision-support technologies and health economics and health services research (HEOR) to deliver more consistent precision oncology care to patients at over 200 locations across Texas.  Tune in and subscribe to get the latest episode delivered straight to your in-box.

In this episode, we are joined by Dr. Karen Winkfield, Executive Director of the Meharry-Vanderbilt Alliance, appointee to President Joe Biden's National Cancer Advisory Board, and co-host of the weekly podcast, 3 Black Docs, which is dedicated to educating the community about health and health disparities in an approachable and entertaining way. Dr. Winkfield’s commitment to her calling was clear by the fact that she joins us during her vacation to discuss racial disparities in the healthcare system that prevent many Black patients from seeking and receiving appropriate care. She tells us that she didn’t discover her calling early and, due to family and cultural barriers of her own, she almost didn’t pursue it at all. In fact, it took the support of a dedicated high-school teacher and nine emotional years to finish her undergraduate degree in biochemistry to get her where she is today as a practicing radiation oncologist. Off the top we ask Dr. Winkfield what can be learned from greater participation of underrepresented groups in clinical trials or greater participation in the healthcare system. She notes that Black people are still dying of cancer at a much higher rate than the rest of the population, and while there are some biologic reasons, much of the cause is under-representation in cancer clinical trials.   We point out her step-by-step plan to address this type of imbalance in the healthcare system, and we are reminded that this is nothing new as she has been working to help address it for decades. She says, "Okay, I laid out a plan, but there's been a plan out for ending cancer disparities for over 20 years." The unequal burden document that was essentially kind of written by the Institutes of Medicine. Congress actually was the one who said, "Hey, we need to kind of understand what's going on with this cancer disparities thing." The whole plan is outlined. ​ Part of what the challenge is now is, do we have the will, do we have the will to do what is needed? Yes, I mean, there are those of us who've been kind of yelling from the mountaintops for decades now that we need to do something different because people are dying.”   She goes on to explain that balancing disparity isn’t as easy as, say, offering translation services, because institutionalized racism runs so deep that it presents barriers at every step. For instance, she says that if you look at the Cancer Genome Atlas Program, which has over 11,000 primary cancer samples, only 25 of those specimens are from prostate cancers derived from Black men, despite the fact that Black men not only have a much greater risk of developing prostate cancer, probably twice as high as any other racial ethnic group, and they're two-and-a-half times as likely to die of prostate cancer. She says, in America, your wealth directly impacts your health. Your zip code impacts your outcome more than your genetic code.   We naturally asked what role technology can play in eliminating healthcare disparities, and she says that without more representative patient samples, trials and access, precision medicine can never be precise. In fact, she believes precision medicine can actually deepen the divide if it is not used with precision in terms of the whole person. Where do they come from? What are barriers to them accessing precision medicine, such as transportation or even paying for parking?   Dr. Winkfield is a strong proponent of navigators who help cancer patients overcome those institutional barriers to ensure that they have equal access to the promise of precision medicine. She says, “These are the things, the social determinants of health, if we can stop and just see the person in front of us and say, what is it that you need to help you along your cancer journey? That to me is being precise.”

In episode 55 of the Precision Medicine Podcast, we welcome Dr. Stephen Kingsmore, President and CEO of the Rady Children's Institute for Genomic Medicine. Dr. Kingsmore joins us to discuss the extraordinary role whole genome sequencing is playing in prolonging and improving the life of critically ill newborns. Read the full summary and tune in here!

Dr. Christian Rolfo, President of the International Society of Liquid Biopsy and Associate Director for Clinical Research at the Center of Thoracic Oncology at the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City, joins us to explain the unique role liquid biopsies are playing in the diagnosis and treatment of cancer. Read the full summary, subscribe and tune in here. Learn more about our lead sponsor Trapelo Health here.

In this Precision Medicine Podcast episode, we are joined by Dr. Belinda King-Kallimanis, Director of Patient-Focused Research at LUNGevity—an organization that brings together research, education and support services for patients and caregivers in the lung cancer community—and Nichelle Stigger, LUNGevity board member and lung cancer survivor. They sat down with us to discuss everything from the importance of patient-friendly language in lung cancer to discrepancies in access to biomarker testing and what LUNGevity is doing to improve the status quo. Read the full summary and listen here.

In celebration of the three-year anniversary of the Precision Medicine Podcast, we take a look back at how far precision diagnostics have come with the help of one of our first guests Hannah Mamuszka, Founder and CEO of Alva10, and her colleague Lena Chaihorsky. Both women are focused on resolving the knowledge gap between payers and diagnostic companies and moving diagnostics to the forefront of the precision medicine conversation. Read the full summary and tune in here!

In this episode, in honor of Breast Cancer Awareness Month, we speak with Ali Rogin, author of Beat Breast Cancer Like a Boss and award-winning producer of PBS NewsHour. Ali is what is commonly known as a breast cancer previvor, someone who knows they have a mutation that may lead to cancer and takes preventative steps to avoid a diagnosis. With the growth of genetic testing and precision medicine and the ability to isolate genes that can lead to cancer, more and more people may fall into the category of previvors. For instance, women that have the BRCA 1 or 2 mutation, as Rogin does, have a 70% chance of developing breast cancer by the age of 80. Rogin says progress in precision medicine has given these women options they would never have had before, enabling them to make proactive, informed decisions about their future health.

For our 50th episode, we welcome Dr. Kashyap Patel, medical oncologist and CEO of Carolina Blood and Cancer Center, current president of the Community Oncology Alliance (COA), and author of the book, Between Life and Death: From Despair to Hope. Dr. Patel explains the social determinants that can impact the quality of care and opportunity for precision medicine that patients—and specifically oncology patients—receive. For him, Covid-19 brought to light the impact that disparities in healthcare can have for all of us. He notes that one in three cancer deaths could be prevented if disparities didn't exist and that disparities result in 230B of excess expense. Read the full summary, listen and subscribe to the Precision Medicine Podcast here.

In this episode of the Precision Medicine Podcast, Janine Morales, PhD, Chief Scientific Officer at Trapelo Health takes us inside the complex world of evidence-based decision making in oncology. Specifically, she dives deeps into some of the nuances in the latest targeted therapy approvals and explains how having access to a real-time knowledge-base and a team of experts that curate current clinical evidence can empower physicians to make more appropriate decisions at the point of care. Read the full summary here and subscribe to join us in the advancement of precision medicine.

Dr. Howard McLeod is Medical Director for Precision Medicine at The Geriatric Oncology Consortium, a fellow of the American Society of Clinical Oncology and has worked on research projects with some of the most notable institutions around the world, including FDA, NIH, and NCI. We cover a lot of ground with Dr. McLeod in this podcast, including career advice, the advancement of precision medicine technology and the positive impact of COVID on telemedicine and clinical trials. Read the full summary and tune in to the audio here.

Bill Bonello, president of NeoGenomics Informatics, and Clynt Taylor, president of Trapelo Health, discuss challenges in precision medicine and how evidence-based technologies can help deliver more appropriate, value-based care to more patients.As a subtext to the discussion is the recent acquisition of Trapelo Health, creator of clinical decision-making platform Trapelo, by NeoGenomics Informatics, provider of bioinformatics services. This acquisition is aimed at improving access to precision medicine testing and treatment. Read the full summary and learn more about Trapelo here.

In this notable episode, Dr. Caroline Carney, Chief Medical Officer at Magellan Health, and Clynt Taylor, CEO at Trapelo Health, join us to discuss how collaborative technologies can help payers more effectively manage the cost of precision oncology while delivering the best outcomes for patients. Read the full summary.

In this episode, Dr. F. Anthony Greco, medical oncologist at Tennessee Oncology, discusses the role that precision medicine has played in improving our diagnosis and treatment of cancer.

In this Part 2 podcast featuring Dr. Gabriel A. Bien-Willner, Medical Director of the MolDX programat Palmetto GBA, we dive into the core challenges that payers face in navigating the explosion of precision medicine tests and treatments, and specifically how the prior authorization process can be streamlined by keeping payers updated on changes in coverage policy for new genes or CDx. Be sure to tune in to Part 1 with Dr. Bien-Willner who speaks about reshaping reimbursement policies for genetic and genomic testing.

Christopher Boone, Vice President and Global Head of Health Economics & Outcomes Research at AbbVie, shares his thoughts on how using data to understand a patient’s real-world environment can expand the practice of Precision Medicine.

It is fitting that our first guests on Season 3 of the Precision Medicine Podcast are Rob Metcalf, CEO of Concert Genetics and Clynt Taylor, CEO of Trapelo Health who are both innovators in precision medicine technology. What we learn from them in this episode is that after 20 years of hearing about the “promise of precision medicine,” technology has reached a critical point where it can begin to accelerate that progress. Read the full summary, listen and learn more here.

In this episode, and in honor of lung cancer awareness month we had the opportunity to speak with Dr. Luis Raez, Medical Director and Chief of Hematology Oncology at Memorial Cancer Institute who focuses on treating lung cancer. Hear how the emergence of next-generation sequencing has changed his approach to lung cancer treatment, what notable discoveries in lung cancer have occurred over the last year, and how he sees COVID-19 impacting the treatment of cancer. Tune in to the full episode here.

In the first of a two-part podcast, Gabriel A. Bien-Willner MD, PhD, FCAP, Medical Director at MolDX, and Chief Medical Officer at Palmetto GBA shares how he has helped implement payer controls and coverage and set policies for affiliated Medicare Administrative Contractors in 28 states. In the past, payers have had to navigate the growing field of precision medicine without the benefit of expertise, so their only guidance came from the NCCN or consultations with other experts in the field. Today, under his direction, Palmetto GBA is able to base its policies on evidentiary reviews, and he believes this form of evidence-based decision-making should be an industrywide standard.

Dr. Mark Moasser, a physician-scientist and breast cancer specialist at the University of California, San Francisco discusses his research focus on the HER2 oncogene, the latest trial findings and the importance of improving patient access to clinical trials. At Trapelo, connecting oncologists with patient-appropriate clinical trials is a major part of our mission, so we were grateful for the opportunity to talk to Dr. Moasser and learn more about his thoughts on this matter. Tune in to the full episode to learn more about his current research and perspective on the future of precision medicine.