Latest / Get Real with Jim Weiss / Alicia Zhou, CEO of Cancer Research Institute

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Alicia Zhou, CEO of Cancer Research Institute · Get Real with Jim Weiss

• 0:09
  Speaker 1: I'm Jim Weiss, chairman and founder of Real Chemistry, and
• 0:12
  Speaker 1: this is the Get Real with the Chairman podcast. I'm
• 0:19
  Speaker 1: delighted to have doctor Alisha Zoo with us today as
• 0:22
  Speaker 1: the CEO of the Cancer Research Institute. She's a key
• 0:26
  Speaker 1: player in cancer innovation. With her extensive background in academia, healthcare,
• 0:31
  Speaker 1: and nonprofits, Alisha offers unique insights into the future of
• 0:35
  Speaker 1: cancer research. We'll discuss the latest and immunotherapy and explore
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  Speaker 1: the potential of AI in early diagnosis and prevention. Alisha
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  Speaker 1: will also share how she's guiding CRI toward new horizons.
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  Speaker 1: This conversation was incredibly enlightening and I believe you'll find
• 0:53
  Speaker 1: it just as engaging. Please remember to rate, review, and subscribe.
• 0:57
  Speaker 1: Every interaction helps us as we reach a broader audience.
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  Speaker 1: Enjoy the episode from wherever you're tuning in. Thanks for
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  Speaker 1: coming on the podcast because I think it's such an
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  Speaker 1: exciting new era. After ten years of my own personal
• 1:13
  Speaker 1: involvement in the Cancer Research Institute about where it's going,
• 1:17
  Speaker 1: how it's going to go, you choosing to join and
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  Speaker 1: think about a renewed vision, obviously based on what we've accomplished,
• 1:27
  Speaker 1: but where we're going to go is really important, So
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  Speaker 1: tell me why did you do this?
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  Speaker 2: Totally?
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  Speaker 3: Well, first of all, thank you so much for having
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  Speaker 3: me on this show. I'm really excited to be chatting
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  Speaker 3: with you. This is such an important topic and it's
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  Speaker 3: such an interesting time for me in a.
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  Speaker 2: Therapy and cancer research. So why did I do this?
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  Speaker 3: It's a really good question. It's one that I ask
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  Speaker 3: myself sometimes, but I would say, fundamentally, my identity is
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  Speaker 3: that I'm a biology nerge. At the heart of it,
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  Speaker 3: I am fascinated by the world of biology, molecular biology,
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  Speaker 3: and then how do we apply that towards human health?
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  Speaker 3: And for me, I started out my training actually in academia,
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  Speaker 3: really thinking that that was the sort of career I
• 2:06
  Speaker 3: wanted to pursue, and then I realized very quickly that
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  Speaker 3: I wanted to have more impact, and so I spent
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  Speaker 3: several years at the bench, you know, actually ten plus
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  Speaker 3: years training at institutions like MIT, Harvard, at UCSF working
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  Speaker 3: in molecular biology, studying ONCA genes. And then the last
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  Speaker 3: ten years I spent in a startup called color that
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  Speaker 3: was really trying to change the way we could access
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  Speaker 3: germine testing for cancer predisposition, and so that was really
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  Speaker 3: about getting technology into the hands of patients, which I
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  Speaker 3: felt was a really important next chapter for me. And
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  Speaker 3: so in many ways for me now coming into the
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  Speaker 3: Cancer Research Institute as a nonprofit, I think I'd bring
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  Speaker 3: a really unique perspective. I've spent ten plus years at
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  Speaker 3: the Bench, I spent another ten years being the chief
• 2:47
  Speaker 3: science officer of a healthcare startup in industry. I've looked
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  Speaker 3: at this problem from the oncagen gata function side. I
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  Speaker 3: spent the last nine plus years we're looking at it
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  Speaker 3: from the loss of function German line side.
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  Speaker 2: And now at.
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  Speaker 3: CRI, the real focus here is how do we bring
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  Speaker 3: that all together with the lens of a nonprofit and
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  Speaker 3: looking at tuur micro environment and the role of the
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  Speaker 3: immune system and how we really battle and fight this disease.
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  Speaker 2: And so it's a really sort of full.
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  Speaker 3: Circle for me, sort of sampling from all of these
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  Speaker 3: different places to now be here at CRI.
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  Speaker 1: So as a CEO, I mean, can you encapsulate the
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  Speaker 1: vision for people as to where we go? I guess
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  Speaker 1: what's passed this prologue.
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  Speaker 3: I appreciate that.
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  Speaker 2: I mean I think what's past is important.
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  Speaker 3: I think One of the things about CRIS has this
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  Speaker 3: long standing legacy of funding cancer immine therapy research really
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  Speaker 3: from its very roots. You know, it started out seventy
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  Speaker 3: years ago at a time when no one really understood
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  Speaker 3: or believed that in immune therapy as a category could exist.
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  Speaker 3: So I think that's a big piece of the legacy
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  Speaker 3: of where we started. The thing about CRI is that
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  Speaker 3: we have had the opportunity to be at the frontline
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  Speaker 3: of sort of breakthrough scientific discoveries in the field immune therapy.
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  Speaker 3: We were right there at the sidelines funding some of
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  Speaker 3: that important work from the very beginning. I think at
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  Speaker 3: our roots we are a research bench oriented organization. We
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  Speaker 3: really believe in the power of basic science. But I
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  Speaker 3: think what's also really important when I think about what
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  Speaker 3: the next step is for CRI, is how do we
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  Speaker 3: now fully look at where our legacy has led us to.
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  Speaker 3: We now have today dozens of immunotherapies that are FDA
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  Speaker 3: approved and available for first line treatment and patients. So
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  Speaker 3: as an organization, it's important for us to continue to
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  Speaker 3: keep on in that narrative. So there's a couple important things.
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  Speaker 3: Research programs are of course important, and they are the
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  Speaker 3: legacy of the work that we've done, but now we
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  Speaker 3: also have the opportunity to work in clinical programs. And
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  Speaker 3: here I'm talking about clinical trials and making sure that
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  Speaker 3: the right combinations of therapies are being tested and treated
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  Speaker 3: in patients, but also novel technologies are being brought to
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  Speaker 3: bear for patient treatments. I think also is really important
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  Speaker 3: in this current field of life sciences. All of life
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  Speaker 3: sciences is now embracing the sort of data driven discovery
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  Speaker 3: is so for CRI, it's important for us also to
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  Speaker 3: recognize the importance of adopting data and so for me,
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  Speaker 3: that means that we need to start a new pillar
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  Speaker 3: that's really embracing data programs. And then the fourth pillar
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  Speaker 3: that I think is incredibly important and for us not
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  Speaker 3: to forget, is the patient side. To ensure that now
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  Speaker 3: that we've benefited from and had the opportunity to bring
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  Speaker 3: all of these life changing immune therapies to market, we
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  Speaker 3: now have the opportunity and the privilege to serve the
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  Speaker 3: patients who are now being treated by those same therapies.
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  Speaker 3: And so for me, it's really these four pillars clinical research,
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  Speaker 3: data and patients. And that's really the full story of
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  Speaker 3: what CRIS intact.
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  Speaker 1: Can be and data you mean the molecular data, right,
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  Speaker 1: you were talking about that's different than clinical or bench science,
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  Speaker 1: you know, So is that bioinformat What is that?
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  Speaker 3: That's a great question.
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  Speaker 2: So I think the thing for us to realize is
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  Speaker 2: that the.
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  Speaker 3: Data revolution, the AI revolution, is here in every single second.
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  Speaker 3: And obviously we've seen that takeover in multiple different parts
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  Speaker 3: of our lives as consumers, we see it every day.
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  Speaker 3: How has that affected life sciences? I think the best
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  Speaker 3: most poignant way to think about it is this year's
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  Speaker 3: Nobel Prize in Chemistry went to a combination of AI
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  Speaker 3: and molecular biology, right, so we saw for the first
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  Speaker 3: time a basic science Nobel Prize actually also was there
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  Speaker 3: to honor the impact of AI in helping to solve
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  Speaker 3: the protein folding problem, and that was the award that
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  Speaker 3: was given this year in chemistry, which was really that
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  Speaker 3: marriage of large language models and the ability to use
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  Speaker 3: generative AI to test any number of combinations added to
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  Speaker 3: the base of knowledge or biochemistry that we had about
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  Speaker 3: protein folding. And it was this combination that really solved
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  Speaker 3: that particular problem, which was pretty interesting to see but
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  Speaker 3: also made us realize it is this intersection that's really
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  Speaker 3: going to be the next way to discovery. So then
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  Speaker 3: the question is for immunotherapy, what does that mean. We
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  Speaker 3: know that the data technologies are there, we know that
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  Speaker 3: llms exist, we know that there are neural networks and
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  Speaker 3: machine learning algorithms are being developed. But at the end
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  Speaker 3: of the day, in order to apply that to our field,
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  Speaker 3: we need to supply the clean data on which to
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  Speaker 3: train those algorithms. And so for me, then I'm asking
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  Speaker 3: myself what are the molecular data that are needed or
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  Speaker 3: the drug development pipeline from pre clinical all the way
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  Speaker 3: through to clinical development that are necessary to be generated
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  Speaker 3: sort of that data lake, that data pool that can
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  Speaker 3: be then used by these very advanced algorithms to find
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  Speaker 3: us new treatments.
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  Speaker 2: And so that's the place where I think we need
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  Speaker 2: to invest.
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  Speaker 1: I'm glad to hear your view of focusing, right, because
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  Speaker 1: focus all this helps to get us to that next thing.
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  Speaker 1: When you think of immunotherapy today, is it everything we've
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  Speaker 1: traditionally thought about help us understand well in by immunotherapy?
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  Speaker 3: This is a really good question. So I think the
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  Speaker 3: way to think about this is there are today four
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  Speaker 3: categories of treatments that we can employ when it comes
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  Speaker 3: to treating cancer. Those four categories are surgery, radiation, chemotherapy,
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  Speaker 3: and the last category is immune therapy. So the question
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  Speaker 3: is what's the difference between immunotherapy and say, traditional chemotherapy.
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  Speaker 2: The most simple way to think about this is.
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  Speaker 3: That chemotherapy is meant to treat the tumor. Immunotherapy is
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  Speaker 3: there to treat the immune system. And by doing this
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  Speaker 3: we are activating the immune system to be able to
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  Speaker 3: attack the cancer. And so this is actually a really
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  Speaker 3: novel way of thinking about how we treat cancer. It's
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  Speaker 3: about activating an existing mechanism that we have in our bodies,
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  Speaker 3: our immune systems, and targeting it towards the disease that
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  Speaker 3: is cancer. And so it's really thinking about how do
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  Speaker 3: we activate at it and target this very effective sort
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  Speaker 3: of defect negatives that we have in our bodies. How
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  Speaker 3: do we use that to go after cancer? And the
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  Speaker 3: answer is actually it doesn't always work by itself, and
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  Speaker 3: it doesn't always work for all tumors. But in many cases,
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  Speaker 3: what we find is that imminotherapy in combination with chemotherapy, radiation,
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  Speaker 3: and surgery can be the right formula for treating cancer.
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  Speaker 3: I think the things to recognize and understand is that immunotherapy,
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  Speaker 3: just like chemotherapies, have to undergo the same rigorous clinical
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  Speaker 3: trial testing process as any other drug. So one of
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  Speaker 3: the first things that happens in a clinical trial is
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  Speaker 3: that your phase one clinical trial is you're testing dose
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  Speaker 3: and safety. So what you're doing is you're actually going
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  Speaker 3: to start and do escalating dose of your therapy. You're
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  Speaker 3: not even looking for efficacy. You're not looking to see
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  Speaker 3: that it's actually making a difference in terms of treating
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  Speaker 3: the tumor, stopping the tumor, or shrinking the tumor.
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  Speaker 2: What you're looking for is.
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  Speaker 3: What's the tolerated dose within a patient, and then what
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  Speaker 3: are the side effects that are experienced. So it is
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  Speaker 3: definitely true that imminotherapy does have side effects. I also
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  Speaker 3: know that these drugs are thoroughly tested for these kinds
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  Speaker 3: of safety concerns. The other thing to know here is
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  Speaker 3: that often immune therapy is given in combination with chemo therapy.
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  Speaker 1: You rarely see them not put together. I know that
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  Speaker 1: in my own experience. But what role does CRII play
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  Speaker 1: in that in exploring new combinations. It seems that we
• 10:20
  Speaker 1: put kutur to next to a lot of things. Not
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  Speaker 1: everything has happened, right.
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  Speaker 3: Yes, So where I think the most important part of
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  Speaker 3: what CI has done and was quite unique about us
• 10:31
  Speaker 3: as an organization is that from the very beginning, we've
• 10:33
  Speaker 3: always wanted to fund scientists. And what I mean by
• 10:37
  Speaker 3: that is that we really believe that the individual themselves
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  Speaker 3: is capable of making breakthroughs, and so we actually select
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  Speaker 3: our awards based off of the individual, the person the scientists,
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  Speaker 3: and not necessarily based off of the projects. Now, obviously
• 10:52
  Speaker 3: the projects have a lot to do with the outcomes
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  Speaker 3: that can be achieved by those scientists, but I think
• 10:57
  Speaker 3: it's actually kind of similar to that sort of VC
• 11:00
  Speaker 3: funding model of funding founders not companies. Similarly, CRI funds scientists,
• 11:06
  Speaker 3: not projects, and I think that's what makes it very unique,
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  Speaker 3: and I think that's why we have such a high
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  Speaker 3: hit rate in terms of funding some of the best
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  Speaker 3: up and coming and brightest scientists. I think the other
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  Speaker 3: thing that's really important is the stage at which we fund.
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  Speaker 3: We fund postdoc fellows and we fund mid career scientists
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  Speaker 3: and our star ward These are two very important moments
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  Speaker 3: within an academic scientist's career where that extra bit of
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  Speaker 3: funding can make a huge difference in terms of the
• 11:30
  Speaker 3: impact that that person can have. It can mean the
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  Speaker 3: difference between buying that microscope that you need for your.
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  Speaker 2: Experiments versus not.
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  Speaker 3: It can be the difference between hiring that technician that
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  Speaker 3: you need versus not. And so I think it's very
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  Speaker 3: important that we continue that work. In terms of the
• 11:44
  Speaker 3: areas that I want to change, I think it's more
• 11:47
  Speaker 3: about thinking about the growth potential. So today CRI is
• 11:51
  Speaker 3: able to raise and gifts with about thirty million dollars
• 11:55
  Speaker 3: in funding a year, which I think is a significant
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  Speaker 3: impact and allows us to fund some of these research
• 12:00
  Speaker 3: programs if we are to really do the full spectrum
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  Speaker 3: diversified program funding that I like to do, which is
• 12:08
  Speaker 3: clinical programs, research programs, data and patient programs. That requires
• 12:13
  Speaker 3: top line growth.
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  Speaker 2: And so for me, it's not.
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  Speaker 3: Necessarily about stopping things, but it's more about investing in
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  Speaker 3: and diversifying the set of programs that we work on
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  Speaker 3: and that I think really can add up to much
• 12:26
  Speaker 3: larger impact than just research funding alone. So I think
• 12:29
  Speaker 3: it's about really how to invest in that ecosystem. For example,
• 12:32
  Speaker 3: building that data asset will accelerate the research program. There's
• 12:36
  Speaker 3: obviously a synergy there, and so it's really about thinking
• 12:39
  Speaker 3: about how we do that.
• 12:40
  Speaker 1: One of the things we do with the podcast is
• 12:42
  Speaker 1: my audience to whom we market to. I mean, maybe
• 12:46
  Speaker 1: you could tell me the audience, what are some of
• 12:49
  Speaker 1: the ways you'd like to begin to partner with them
• 12:52
  Speaker 1: going forward to the future.
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  Speaker 3: Yeah, this is an excellent question. So I think there's
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  Speaker 3: a couple of different areas to think about. So ultimately,
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  Speaker 3: CRI is a philanthropically funded nonprofit organization, and so it's
• 13:03
  Speaker 3: always important for us to be able to find the
• 13:06
  Speaker 3: right donors who are mission oriented and want to donate
• 13:09
  Speaker 3: their funding towards scientific impact.
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  Speaker 2: That's firston and foremost.
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  Speaker 3: But I also think as a nonprofit organization in the
• 13:16
  Speaker 3: cancer space, I think it is our unique spot in
• 13:21
  Speaker 3: the cancer ecosystem to think about how we maximize our
• 13:25
  Speaker 3: impact through partnership. Unlike in academia or in industry, we aren't
• 13:30
  Speaker 3: incentivized to compete. Our goal here actually is to maximize
• 13:34
  Speaker 3: the impact of donor dollars. And so my thought here
• 13:37
  Speaker 3: is where are the right contributions of know how for
• 13:41
  Speaker 3: convening thought leadership and also bringing together the right group
• 13:45
  Speaker 3: of folks to be able to move the field forward.
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  Speaker 2: So for example, there are areas of work.
• 13:51
  Speaker 3: Where the right thing to do is not necessarily to
• 13:53
  Speaker 3: put funding, but actually to put effort and some elbow grease.
• 13:57
  Speaker 3: So let's talk about, for example, the way we think
• 13:59
  Speaker 3: about adoption of imminotherapy and technologies in the world. What
• 14:04
  Speaker 3: we know today is that immunotherapies are mostly accessible for
• 14:08
  Speaker 3: folks that can access an academic medical center and get
• 14:11
  Speaker 3: treatment through one of these very well renowned and CI
• 14:14
  Speaker 3: cancer centers. But we also know that immunotherapy is very
• 14:19
  Speaker 3: useful to all sorts of patients regardless of where it's
• 14:22
  Speaker 3: getting treated. If you're at a community clinic, that's also
• 14:24
  Speaker 3: really important. There's currently a lack of adoption and education
• 14:28
  Speaker 3: of community oncologists and how best to use immunotherapies. So,
• 14:31
  Speaker 3: for example, typically in an academic medical center, you see
• 14:35
  Speaker 3: a patient that's presenting with non small cell lung cancer.
• 14:38
  Speaker 3: One of the worst things you would do is to
• 14:40
  Speaker 3: run a biomarker test to determine whether this individual has
• 14:43
  Speaker 3: PDL one and if they are PDO long and high,
• 14:47
  Speaker 3: you will put that person on an imminotherapy before you've
• 14:50
  Speaker 3: been start chemotherapy in a community clinic. If you didn't
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  Speaker 3: know that, a lot of times what happens is the
• 14:56
  Speaker 3: same patient might present and you don't get that PDL
• 14:58
  Speaker 3: one biomarker test done. Instead, you put that patient directly
• 15:02
  Speaker 3: onto chemotherapy, which actually means they're now excluded from being
• 15:04
  Speaker 3: able to treat it by immunotherapy. So there's a real
• 15:07
  Speaker 3: access and education barrier there, and so for those kinds
• 15:11
  Speaker 3: of efforts, it's really important to bring together the right
• 15:13
  Speaker 3: groups of people to talk about how we can break
• 15:16
  Speaker 3: down the barriers of access, improve adoption, and education within
• 15:20
  Speaker 3: the healthcare provider community. And so there's all sorts of
• 15:23
  Speaker 3: different partnerships that are possible there.
• 15:25
  Speaker 1: That leads me to another question. What's holding back even
• 15:29
  Speaker 1: more progress in all of this? Is it funding? Right?
• 15:33
  Speaker 1: Are their diversity challenges? Yeah, the healthcare systems come under
• 15:37
  Speaker 1: quite a little bit of fire political factors. What do
• 15:41
  Speaker 1: you think are some of the things that are holding
• 15:44
  Speaker 1: things up as much as we've made amazing progress.
• 15:48
  Speaker 3: I kind of have multiple answers to this question, so
• 15:50
  Speaker 3: maybe we'll just start with I'll give you two one
• 15:53
  Speaker 3: on the innovation side, I do think that the next
• 15:58
  Speaker 3: set of breakthroughs will come from an initial set of
• 16:02
  Speaker 3: hypotheses that are tested in silico first, so I mean
• 16:07
  Speaker 3: using computational methods first. I just think that what we
• 16:11
  Speaker 3: have seen is that being able to try and model
• 16:17
  Speaker 3: out different combinations using computational models is a much faster
• 16:23
  Speaker 3: way to test initially all of your hypotheses about drug combinations. Now,
• 16:28
  Speaker 3: the only way for those models be somewhat accurate, because
• 16:32
  Speaker 3: of course all models are wrong, but some are.
• 16:34
  Speaker 2: Useful, is if the data that they.
• 16:36
  Speaker 3: Are trained on are innately accurate, clean and harmonized.
• 16:40
  Speaker 2: And so that's where I feel very strongly.
• 16:43
  Speaker 3: That we need to invest in the data generation side,
• 16:45
  Speaker 3: and I think in order to do that that does
• 16:48
  Speaker 3: require shared collaboration and know how amongst many different parties.
• 16:52
  Speaker 3: So CRI of course is a player in this, but
• 16:55
  Speaker 3: we need to be partnering with the data generation vendors.
• 16:58
  Speaker 3: So we're talking about MNAs and ten x's of the world.
• 17:01
  Speaker 3: We need to be partnering with the data hosting folks.
• 17:04
  Speaker 3: We're talking about the awus's of the world. We need
• 17:08
  Speaker 3: to be partnering with the analytics folks. We're talking about
• 17:11
  Speaker 3: the open ais and deep minds of the world. So
• 17:13
  Speaker 3: that's a very different way of collaborating than how organizations
• 17:17
  Speaker 3: like CRI has collaborated in the past. Right, So mostly
• 17:20
  Speaker 3: our ecosystem today is academic health centers, research hospitals, and
• 17:25
  Speaker 3: clinicians and researchers. These are new categories of people for
• 17:29
  Speaker 3: us to engage. That's on sort of the innovation side.
• 17:32
  Speaker 3: On the other end of the spectrum is the equity
• 17:34
  Speaker 3: and adoption side.
• 17:36
  Speaker 2: So we know that for some of.
• 17:37
  Speaker 3: These biologics like ki Truda, the patent cliff is coming
• 17:41
  Speaker 3: in twenty twenty eight and when that happens, what we
• 17:44
  Speaker 3: expect to happen as well is that there should be
• 17:46
  Speaker 3: more biosimilars that will hit the market, which should decrease
• 17:50
  Speaker 3: the price of immunotherapy and increase the axis. But if
• 17:55
  Speaker 3: we don't actually invest in the adoption, there's base ticket
• 18:00
  Speaker 3: standards that your community and cologists needs to understand I.
• 18:05
  Speaker 1: Guess there could be, and why patients need to go
• 18:07
  Speaker 1: in eyes wide open to ask the right questions.
• 18:10
  Speaker 3: Absolutely, so there's a couple of things. When a person
• 18:13
  Speaker 3: is approaching this topic area, a patient should always recognize
• 18:17
  Speaker 3: that they are an equal participant in that conversation. The
• 18:21
  Speaker 3: oncologists in the room certainly has the knowledge and expertise,
• 18:24
  Speaker 3: and they're going to make recommendations, but ultimately it's a
• 18:26
  Speaker 3: patient's decision on what they do. So there are some
• 18:29
  Speaker 3: very important questions to be asked here. One is what
• 18:32
  Speaker 3: are the side effects that you might expect to experience. Two,
• 18:36
  Speaker 3: what are the lifestyle changes that you might need to
• 18:39
  Speaker 3: make during the time that you're on treatment. Are there
• 18:42
  Speaker 3: any existing drugs that you're taking today that you need
• 18:46
  Speaker 3: to stop during the time that you're on immunotherapy? And
• 18:49
  Speaker 3: then also how is that immune therapy getting combined with
• 18:51
  Speaker 3: the other therapies that you're on, whether that's radiation or chemotherapy,
• 18:56
  Speaker 3: and what's the combination of that going to look like
• 18:58
  Speaker 3: in terms of side effects? And then very importantly, what
• 19:01
  Speaker 3: does treatment look like? How many times do you need
• 19:05
  Speaker 3: to undergo treatment? Is it going to be an infusion,
• 19:08
  Speaker 3: is it given orally is in an injection? How much
• 19:11
  Speaker 3: time are you going to be down after each treatment?
• 19:13
  Speaker 3: How many times do you have to go to the clinic.
• 19:16
  Speaker 3: These are super super important questions to ask, and I
• 19:19
  Speaker 3: think a lot of patients when they come to speak
• 19:21
  Speaker 3: to a provider, they kind of just do a lot
• 19:24
  Speaker 3: of the nodding and the receiving of information. But it's
• 19:27
  Speaker 3: really important to be a participant in that conversation as well.
• 19:29
  Speaker 3: And these are the questions that you should be asking.
• 19:31
  Speaker 1: Oh yeah, I mean, it's a team sport, I have
• 19:34
  Speaker 1: found because these things are so new, they're just coming
• 19:38
  Speaker 1: online in many cases. The combinations in particular, that a
• 19:42
  Speaker 1: lot of these oncologists and surgeons and they all work
• 19:45
  Speaker 1: kind of in silos because everything's referred around.
• 19:48
  Speaker 3: Yep.
• 19:49
  Speaker 1: I wouldn't say that they just don't have all the
• 19:51
  Speaker 1: answers and they don't know everything, and we can just
• 19:53
  Speaker 1: it's just unusual right for us. We always think the
• 19:56
  Speaker 1: doctor knows best and knows everything.
• 19:58
  Speaker 3: Yep.
• 19:58
  Speaker 1: Not always the case.
• 20:00
  Speaker 2: Yeah, totally.
• 20:01
  Speaker 3: And the things to be aware of, you know, is
• 20:04
  Speaker 3: often when you do experience side effects, the places where
• 20:07
  Speaker 3: you want to be really careful is around kidney and
• 20:09
  Speaker 3: liver health. These are the two places where often you
• 20:11
  Speaker 3: can get overwhelmed if you're having a combination of therapies
• 20:14
  Speaker 3: being given at the same time. So that's something to
• 20:16
  Speaker 3: be asking about right away. Is this is going to
• 20:19
  Speaker 3: be something that's going to be really hard on my
• 20:22
  Speaker 3: liver or kidneys, and how healthy are my liver and
• 20:23
  Speaker 3: kidneys today?
• 20:24
  Speaker 2: And how well will I tolerate this therapy.
• 20:27
  Speaker 1: Let's talk a little bit about early detection, diagnosis, and prevention,
• 20:32
  Speaker 1: because obviously it's harder to treat a further this cancer.
• 20:36
  Speaker 1: Any answer is along, you know, it's journey.
• 20:40
  Speaker 2: Yes.
• 20:40
  Speaker 3: So I think what's really important to recognize and understand
• 20:43
  Speaker 3: is a lot of the advances that we've made in
• 20:45
  Speaker 3: terms of cancer outcomes and survival over the last I
• 20:48
  Speaker 3: would say fifty years, a lot of those improvements and
• 20:53
  Speaker 3: outcomes actually are attributed more to better screening and prevention
• 20:56
  Speaker 3: than necessarily.
• 20:57
  Speaker 2: To better drugs.
• 20:59
  Speaker 3: What means is that we know that cancer is a
• 21:02
  Speaker 3: disease that the earlier stage we can catch it, the
• 21:05
  Speaker 3: better we can treat it. There's sort of a very
• 21:07
  Speaker 3: first order reason for this, which is that the earlier
• 21:10
  Speaker 3: stage that you can catch it, if it's a solid tumor,
• 21:13
  Speaker 3: the smaller the tumor is, the more well defined it
• 21:17
  Speaker 3: is so it can be surgically removed. And then by definition,
• 21:21
  Speaker 3: it has not yet spread to other parts of your body,
• 21:24
  Speaker 3: so it hasn't metastasized.
• 21:26
  Speaker 2: So what that means is that we can do a.
• 21:27
  Speaker 3: Much more precise job of going after that cancer. Surgery
• 21:32
  Speaker 3: becomes a huge part of that equation versus when we
• 21:35
  Speaker 3: are looking at later stage. Now surgery becomes not such
• 21:38
  Speaker 3: a great option because we might be talking about metastases
• 21:42
  Speaker 3: that have spread to other parts of the body and
• 21:43
  Speaker 3: at that point, surgical intervention is not.
• 21:45
  Speaker 2: Going to help.
• 21:47
  Speaker 3: And that's where you really do need these additional chemical
• 21:50
  Speaker 3: agents like chemotherapy and immino therapy.
• 21:53
  Speaker 2: To help you.
• 21:54
  Speaker 3: So early detection is key, and I think what we know,
• 21:58
  Speaker 3: for example, in breast cancer, if you can get a
• 22:01
  Speaker 3: detection of the breast cancer at stage one, you're looking
• 22:05
  Speaker 3: at a ninety nine percent survival likelihood and that's a
• 22:08
  Speaker 3: great outcome. But if you let a progress to stage four,
• 22:12
  Speaker 3: you're talking about like a fifty percent survival rate.
• 22:14
  Speaker 2: So there's a real difference, and.
• 22:17
  Speaker 3: I think that's where it's really important to understand that
• 22:19
  Speaker 3: sometimes we feel like we're a passenger in our health.
• 22:22
  Speaker 2: But we can be a driver.
• 22:24
  Speaker 3: And this is an area where it's really important on
• 22:26
  Speaker 3: the prevention side, because of course, in order for prevention
• 22:29
  Speaker 3: to work, you need to catch things before you have
• 22:31
  Speaker 3: any symptoms, and so you.
• 22:33
  Speaker 2: Have to be really proactive.
• 22:34
  Speaker 3: You're going to be feeling great. You have no reason
• 22:36
  Speaker 3: to necessarily go in for a test or to go
• 22:37
  Speaker 3: into the doctor, but you have to be proactive about that.
• 22:40
  Speaker 3: And I think that's something that's really important with in.
• 22:43
  Speaker 1: My own personal experience with late diagnosis and denial, I
• 22:47
  Speaker 1: feel like there's really almost no downside. That's my message
• 22:51
  Speaker 1: to people whenever I'm asked the real question is is
• 22:53
  Speaker 1: what can you do about it? Are we closer to
• 22:56
  Speaker 1: achieving precision and cancer care than we think? Are there?
• 23:00
  Speaker 1: Or I think the ability to design a vaccine is
• 23:04
  Speaker 1: here and now and probably only increasing. You know, we
• 23:07
  Speaker 1: saw headlines in the UK for what they're doing West
• 23:10
  Speaker 1: vaccines out of the National Health Service and Maderna and
• 23:14
  Speaker 1: others retooling what they did for COVID for cancer. Do
• 23:18
  Speaker 1: we need to change the name of vaccines for cancer?
• 23:22
  Speaker 1: Because I don't know that they're really truly properly vaccines anyway, Right,
• 23:25
  Speaker 1: they're not.
• 23:26
  Speaker 3: Actually, they're not vaccines in the way that we think
• 23:28
  Speaker 3: about vaccines being sort of prevention. I think of them
• 23:31
  Speaker 3: as sort of that their immune system priming agents, but
• 23:35
  Speaker 3: not vaccines in the way that we think about like
• 23:38
  Speaker 3: the flu vaccine.
• 23:39
  Speaker 1: Right, I think that's important to point out is that
• 23:42
  Speaker 1: a thing now that we're going to see in the
• 23:44
  Speaker 1: next few years become mainstream, I hope.
• 23:48
  Speaker 3: So I think this is a very promising area of development.
• 23:50
  Speaker 3: So this concept of the cancer vaccine is really interesting
• 23:54
  Speaker 3: because the idea here is that if we can extract
• 23:59
  Speaker 3: very union markers from a patient's specific tumor, and then
• 24:03
  Speaker 3: we can use those unique markers that don't exist in
• 24:06
  Speaker 3: the normal cells and only exist in the cancer cell,
• 24:09
  Speaker 3: if we can use those unique markers to activate your
• 24:11
  Speaker 3: immune system to go after that specific signature, now you're
• 24:15
  Speaker 3: cooking right now, you're saying, okay, I'm going to go
• 24:17
  Speaker 3: and use the immune system to go after the specific target.
• 24:20
  Speaker 3: So as a category, as a concept, it's very promising
• 24:23
  Speaker 3: and we have seen some great outcomes in some of
• 24:25
  Speaker 3: the clinical trials. Ultimately, the larger the tumor burden, the
• 24:29
  Speaker 3: more you're asking from the drug or the immune system
• 24:33
  Speaker 3: to go and clean up.
• 24:34
  Speaker 2: That's a lot to ask.
• 24:36
  Speaker 3: And the interesting thing about cancer drug development is that
• 24:39
  Speaker 3: typically when we come up with a new biologic or
• 24:42
  Speaker 3: a new category of therapies, the only way for us
• 24:45
  Speaker 3: to test them at the beginning is to test them
• 24:47
  Speaker 3: on stage four patients who have failed every other type
• 24:50
  Speaker 3: of therapy. These patients usually have pretty progressed disease a
• 24:55
  Speaker 3: very large cancer burden. Now we're this is sort of
• 24:58
  Speaker 3: a last ditch effort. It's not surprising to me that
• 25:02
  Speaker 3: cancer vaccines have not been super successful in that stage
• 25:05
  Speaker 3: of disease because simply at that point, there's just too
• 25:08
  Speaker 3: much to be done and you're asking your immune systems
• 25:10
  Speaker 3: to go after all of that.
• 25:12
  Speaker 2: I think it's very.
• 25:13
  Speaker 3: Important that during COVID we learned about the delivery mechanisms
• 25:18
  Speaker 3: that are going to be quite effective. So these lipid
• 25:20
  Speaker 3: nanoparticles which we all used and received as part of
• 25:24
  Speaker 3: our COVID vaccines, we know they were and the FDA
• 25:27
  Speaker 3: has approved them and said that they are safe. And
• 25:30
  Speaker 3: they have done this thing which is unprecedented, which is
• 25:32
  Speaker 3: they've allowed with the boosters to also get approvals without
• 25:36
  Speaker 3: having to go through the entire clinical trial again. So
• 25:38
  Speaker 3: instead of treating the boosters for COVID as a new therapeutic,
• 25:43
  Speaker 3: they've said it's the same drug as the original vaccine,
• 25:47
  Speaker 3: and I think if it has same suitcase, different package inside.
• 25:51
  Speaker 3: So because of the precedent, the FDA has set around
• 25:55
  Speaker 3: COVID initial vaccine and then subsequent boosters.
• 25:58
  Speaker 2: There's a real now.
• 26:00
  Speaker 3: For somebody like Moderna or biointech pvisor to take these
• 26:05
  Speaker 3: cancer vaccines and get them through a different sort of
• 26:08
  Speaker 3: more accelerated approval.
• 26:09
  Speaker 2: So I think on the regulatory.
• 26:11
  Speaker 3: Side there's a real pathway there. Then on the development side,
• 26:14
  Speaker 3: I do think we have to try it in earlier
• 26:17
  Speaker 3: stage tumors.
• 26:19
  Speaker 1: True, well, I think we'll probably see more and more
• 26:22
  Speaker 1: on that as the individualized much like we did in
• 26:25
  Speaker 1: CARTI and cell therapy. I mean, I guess that'll follow
• 26:28
  Speaker 1: us similar model. What are your last thoughts and what
• 26:31
  Speaker 1: do you want our listeners to consider about supporting cancer
• 26:35
  Speaker 1: research Institute.
• 26:37
  Speaker 3: I think the goal for CRI is to maximize the
• 26:40
  Speaker 3: impact of the dollars that we receive, and what that
• 26:43
  Speaker 3: means to me is that we are going to be
• 26:45
  Speaker 3: examining deeply what are the transformative challenges and bets that
• 26:50
  Speaker 3: we need to make in order to help accelerate the field.
• 26:55
  Speaker 3: And sometimes those are going to be things that we
• 26:57
  Speaker 3: can do ourselves, and sometimes those are a problems that
• 27:00
  Speaker 3: we have to solve in partnership with others.
• 27:02
  Speaker 2: But what I would say is I.
• 27:04
  Speaker 3: Think as a nonprofit with importantness that we do the
• 27:08
  Speaker 3: work that nobody else is incentivized to do because we
• 27:12
  Speaker 3: can afford to do that. And what that means is
• 27:15
  Speaker 3: some of the work that we do is not necessarily
• 27:16
  Speaker 3: going to be the most sexy.
• 27:18
  Speaker 2: Groundbreaking drug development work.
• 27:20
  Speaker 3: Some of the work that we're going to be doing
• 27:21
  Speaker 3: is some of the in the trenches, getting all the
• 27:24
  Speaker 3: infrastructure set together, building a data platform, writing a policy
• 27:29
  Speaker 3: white paper about adoption of standards, convening together thought leadership
• 27:33
  Speaker 3: in the world around how do we think about biomarker
• 27:37
  Speaker 3: selection for patients. These are not the most headline making initiatives,
• 27:41
  Speaker 3: but they are the ones that are necessary to unlock
• 27:45
  Speaker 3: the next breakthroughs or the next adoption cliffs that are coming.
• 27:50
  Speaker 3: And so that's the thing about CRI is that the
• 27:53
  Speaker 3: money that gets done into us will be used to
• 27:56
  Speaker 3: solve what I believe, with the transformative step function problems
• 27:59
  Speaker 3: to be solved, even if those actual problems are not
• 28:02
  Speaker 3: the most sort of headline making problems. And so that's
• 28:06
  Speaker 3: how I want to focus us as an organization.
• 28:08
  Speaker 1: Well, didn't the research of the prior of seventy years,
• 28:11
  Speaker 1: didn't it lay the groundwork for what we have.
• 28:14
  Speaker 2: Today one hundred percent yes.
• 28:16
  Speaker 3: And as a result of the work that we funded
• 28:18
  Speaker 3: over the last seventy years, we were responsible for that
• 28:21
  Speaker 3: first FDA approval of immunotherapy that was ippiluminum BMS. That
• 28:27
  Speaker 3: was the true translation from bench science through to the
• 28:31
  Speaker 3: development of a drug, and Ceri was there at every
• 28:34
  Speaker 3: single milestone. One of the key things that we did
• 28:37
  Speaker 3: during the development of IPPI was to recognize and show
• 28:43
  Speaker 3: that you had to change in clinical.
• 28:44
  Speaker 2: Trial design and your end points.
• 28:47
  Speaker 3: And so it's really interesting there's actually this bake off
• 28:50
  Speaker 3: that happened. I think it was IPPI with BMS. There
• 28:52
  Speaker 3: was another immunotherapy or CCLA four inhibitor, I think it
• 28:56
  Speaker 3: was GSK that was developing it or some other drug maker.
• 28:59
  Speaker 3: They had almost it's the same sort of biologic mechanism,
• 29:03
  Speaker 3: but the difference was that BMS recognized and understood because
• 29:06
  Speaker 3: of work that CRI was involved in that when you
• 29:10
  Speaker 3: do immut a therapy, the curves actually state the same
• 29:14
  Speaker 3: for about four months before they start to deviate from
• 29:19
  Speaker 3: each other and the unpacking about survival curves, and so
• 29:21
  Speaker 3: for four months you're looking at the curves and you're
• 29:24
  Speaker 3: seeing that patients in the trial arm versus the standard
• 29:27
  Speaker 3: arm look exactly the same. If you are not patient enough,
• 29:31
  Speaker 3: or you didn't set your endpintes correctly, you would expect
• 29:34
  Speaker 3: this means that you haven't gotten the outcome that you wanted.
• 29:37
  Speaker 2: BMS, because of the help.
• 29:39
  Speaker 3: Of cri knew that this was what they should expect
• 29:41
  Speaker 3: from the preclinical data, so they set their endpoint differently.
• 29:44
  Speaker 3: They said, I expect for the first four months, nothing's
• 29:48
  Speaker 3: going to happen. I'm going to start reading out at
• 29:50
  Speaker 3: the four month cliff and then reading out for the
• 29:53
  Speaker 3: next twelve months after that, and that's how they proved
• 29:56
  Speaker 3: the efficacy of their drug. GSK didn't do that, and
• 30:00
  Speaker 3: so as a result, they actually canceled their filout four
• 30:02
  Speaker 3: months because they didn't see a difference. And so CERI
• 30:05
  Speaker 3: has been there at the sideline of these very important
• 30:08
  Speaker 3: moments throughout history. That's not a sexy thing to tell
• 30:11
  Speaker 3: you that the curves don't separate until four months, but
• 30:14
  Speaker 3: it was crucial for that particular approval.
• 30:17
  Speaker 1: You said, up before you know, it grows before it shrinks.
• 30:20
  Speaker 1: This is the mechanism, right, which is a little different
• 30:23
  Speaker 1: than what we're used to. So many of the things
• 30:26
  Speaker 1: we work with blow the thing up, but blow every
• 30:29
  Speaker 1: other sell up too, So that's very different. So really
• 30:32
  Speaker 1: cool way to put that. It's a very exciting time.
• 30:36
  Speaker 1: We both know it. We're both dedicated and involved here,
• 30:39
  Speaker 1: and I like to end a little bit on some
• 30:42
  Speaker 1: nice personal stuff. So I like to ask questions of
• 30:45
  Speaker 1: my guests, what's your guilty pleasure and what you're not
• 30:48
  Speaker 1: so guilty pleasure?
• 30:50
  Speaker 3: Okay, so my guilty pleasure is I really enjoy getting
• 30:56
  Speaker 3: on whatever Netflix trend there is in terms of TV
• 31:00
  Speaker 3: shows and movies, very topical. But I'm a huge musicals fan,
• 31:05
  Speaker 3: so Wicked is like all in my head right now.
• 31:08
  Speaker 3: So I'm listening to the musical soundtrack, I'm listening to
• 31:11
  Speaker 3: the movies soundtrack. Might not so justly pleasure. What I'm
• 31:14
  Speaker 3: really interested in doing right now and where I spend
• 31:16
  Speaker 3: a lot of my free time is I'm playing a
• 31:18
  Speaker 3: lot of tennis. And then my husband has decided that
• 31:20
  Speaker 3: he's a distance runner. He just decided this, and so I,
• 31:25
  Speaker 3: as his running partner, have also started running distance and actually.
• 31:29
  Speaker 2: I find it very therapeutic.
• 31:31
  Speaker 3: I think a lot of these initiatives that we've talked
• 31:34
  Speaker 3: about today, I came up with while while trying to
• 31:36
  Speaker 3: run five six miles, and so I actually think it's
• 31:39
  Speaker 3: a productivity hack is going on long distance runs and
• 31:43
  Speaker 3: having an opportunity to think, Okay.
• 31:44
  Speaker 1: Well, we hope you go on a lot more rots.
• 31:48
  Speaker 1: That's for the next breakthrough, Alicia. So we're going to
• 31:51
  Speaker 1: talk desert islands. If you're caught on a desert island,
• 31:55
  Speaker 1: what's the album you bring?
• 31:56
  Speaker 3: I'm a huge edge Shearon fan of his album was My.
• 32:00
  Speaker 2: Favorite is Equals, which.
• 32:02
  Speaker 3: Is his not last album, but of second to lapse album.
• 32:05
  Speaker 1: Awesome. I don't think I've never heard anyone say I
• 32:07
  Speaker 1: don't want that's good and unique. Well, look, it's been
• 32:11
  Speaker 1: a blast just talking to you a little bit less
• 32:14
  Speaker 1: formally than we normally do. Yeah, in the way things are,
• 32:18
  Speaker 1: you're doing a fantastic job. Thank you for joining CRI.
• 32:22
  Speaker 1: We look forward to many, many years of innovation. And
• 32:27
  Speaker 1: I know you said not so exciting, but I think
• 32:30
  Speaker 1: it will be exciting research and development that will change
• 32:34
  Speaker 1: the course of many people's lives, which is I know
• 32:36
  Speaker 1: why you do it. So anyway, thank you for doing.
• 32:40
  Speaker 3: Thank you so much for having me.
• 32:41
  Speaker 2: This is last.
• 32:42
  Speaker 1: I agree. I learned a lot.
• 32:43
  Speaker 3: By the way thanks, yeah, of course.
• 32:51
  Speaker 1: Hey everyone, thanks for listening in today. The Get Real
• 32:54
  Speaker 1: with the Chairman podcast is a production of Real Chemistry.
• 32:57
  Speaker 1: I want to thank my team, led by execut to
• 33:00
  Speaker 1: producer Kate Voss, audio engineer Nick Murphy, and composer Matt Lipkins,
• 33:05
  Speaker 1: and special thanks to Danielle Clark Brown and the amazing
• 33:08
  Speaker 1: team of Real Chemistry. If you like what you're heard,
• 33:11
  Speaker 1: don't forget to review our podcast on Apple, Spotify, or
• 33:14
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• 33:18
  Speaker 1: you don't miss an episode. Again, thanks for listening and
• 33:21
  Speaker 1: we'll see you on the road.