Latest / The BioHub - by Avetix / Episode 199 - Miles Gerson - Partner at SV Health Investors and Co-Lead of The Dementia Discovery Fund

Transcript

Episode 199 - Miles Gerson - Partner at SV Health Investors and Co-Lead of The Dementia Discovery Fund · The BioHub - by Avetix

• 0:06
  Welcome back to the Bio Hub. Today, we're delighted to
• 0:09
  welcome Myles Garson, partner at SV Health Investors and Co lead
• 0:14
  of their Dementia Discovery Fund, one of the most important
• 0:17
  investment platforms focused on advancing new therapies in
• 0:20
  neurodegeneration. Prior to SV, he led to CADA
• 0:23
  Ventures, where he oversaw A broader life sciences investment
• 0:26
  portfolio and helped shape strategy across more than 60
• 0:29
  private and public company investments.
• 0:32
  What makes Miles especially interesting is the breadth of
• 0:34
  perspective he brings to the table, spanning venture
• 0:37
  investing, company building, business development and
• 0:40
  operating leadership across life sciences.
• 0:43
  He also brings a strong academic foundation with training in
• 0:47
  neuroscience, as well as IP and FDA law, which gives him a
• 0:50
  particularly thoughtful lens on how innovative science gets
• 0:53
  translated into companies and ultimately into medicines.
• 0:56
  Miles, it's great to have you with us today.
• 0:59
  Thank you very much. Appreciate being here and
• 1:01
  speaking with you. Yeah, no worries at all.
• 1:03
  I mean, just to begin with, Miles, you know, can you walk us
• 1:05
  through a little bit about your career path and how you got into
• 1:08
  venture capital and what really also LED you to focus so deeply
• 1:12
  on neurogeneration? Yeah, Yeah.
• 1:15
  I just had a conversation with another venture colleague about
• 1:19
  this and you know, for those looking to, you know, eventually
• 1:22
  get into this space or you know, rise towards, you know, being
• 1:26
  senior leadership within a fund, My comment is it was non linear
• 1:31
  in in the most extreme way. I think my background has just
• 1:36
  this extensive combination of good fortune to a degree,
• 1:41
  opportunities to expand skill sets and a willingness to take
• 1:46
  on challenges that I don't think I was necessarily prepared for
• 1:51
  at the time. But the, the nonlinearness adds
• 1:57
  a lot of skill sets that I can now deploy for our portfolio
• 2:00
  companies at the board level. So, you know, I, I started out
• 2:04
  as you mentioned in academia at the bench working on neuro
• 2:14
  related projects for my master's work, but really was interested
• 2:18
  in the protection of intellectual property around
• 2:22
  this space. So I went on to study in law
• 2:25
  school, but but very much realized that I was really drawn
• 2:29
  to the business aspects of developing novel technology and
• 2:34
  quickly added an MBA, which I was very fortunate to do at the
• 2:38
  time. And from there started looking
• 2:41
  at emergent science out of the technology transfer office at
• 2:44
  the University of Wisconsin where I was.
• 2:48
  So, you know, fortunately after consulting, you know, hanging my
• 2:53
  own shingle, helping small companies try to figure out
• 2:56
  their PNL, their project finance, all of the design of
• 3:01
  how they build a company. I was welcomed into a venture
• 3:05
  capital fund, but only for a very brief period of time when
• 3:08
  they then asked me to jump in as a first employee for one of
• 3:11
  their portfolio companies. So I was going to build a
• 3:13
  company and live that from there, moved into tech transfer
• 3:19
  at UCLA, moved back into private for a couple early stage
• 3:23
  companies and was fortunate to be drawn into a company that we
• 3:29
  pulled onto the NASDAQ in 2017, which was a tremendous
• 3:34
  experience. I actually operate as a general
• 3:36
  counsel and Head of Business development in that context and
• 3:40
  then joined Takeda Ventures. So all that sounds very linear,
• 3:44
  but it certainly was not. And the exposure over about 25
• 3:49
  years of different companies, different business models,
• 3:53
  different technologies, even ranging from medical devices all
• 3:57
  the way through to health tech exposed me to just a lot of
• 4:01
  different things that I that I try to deploy to the benefit of
• 4:04
  our portfolio. Yeah.
• 4:06
  And obviously neuroscience was a focus for you from the
• 4:08
  beginning. And what made neurodegeneration
• 4:11
  specifically a category that you wanted to spend time in?
• 4:14
  And why do you think now is a really, you know, important
• 4:16
  moment for the field? Yeah, now is really fascinating.
• 4:22
  So it's, it's a really difficult space for a lot of reasons.
• 4:27
  I, I won't spend a lot of time talking about the challenges,
• 4:30
  but I think, you know, pharma all the way down to, you know,
• 4:33
  early stage investors have viewed that, you know, running
• 4:37
  clinical trials for these type of patients and understanding
• 4:40
  the outcomes and trying to ascribe some sort of
• 4:43
  understanding to the responsiveness of drugs in the
• 4:45
  brain on an individual basis is a, is a compounding risk on risk
• 4:51
  on risk that we really hadn't had chance to interrogate or
• 4:55
  elucidate, you know, early on. And we were adding, we're
• 4:57
  standing on the shoulders of all of us who went prior and tried
• 5:01
  things. We're now arriving at a time
• 5:04
  where there's huge data sets, people have started to aggregate
• 5:12
  even biomarker work in healthy individuals for comparison
• 5:16
  against neurodegenerative. But because of these challenges,
• 5:21
  it has definitely created a hurdle for innovation across the
• 5:27
  industry to really get good footing.
• 5:32
  However, now I, I do see tremendous momentum and we've
• 5:36
  seen this, you know, through M&A, we've seen this in the
• 5:39
  public markets, we've seen this through funding where
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  undoubtedly there is deep interest in this white space
• 5:49
  that still you can, you can do tremendous things for patients
• 5:52
  with incremental improvements for disease modification.
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  We really just have not fully gone to the depths that other
• 5:59
  therapeutic areas have. Simultaneously the impact on
• 6:03
  society, families, patients of neurodegeneration is massive.
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  Dementia Dementia alone is one of the world's largest unmet
• 6:13
  medical needs and has branching impacts across societies and
• 6:17
  economies. Yeah, I mean it, it, it seems to
• 6:20
  be an area that's getting more and more attention as we as we
• 6:22
  go on. Obviously, you know, large farm
• 6:24
  Rex did for a while, but but it seems as though they're they're
• 6:27
  they're getting back into the swing of things, which is
• 6:29
  exciting, you know, for a lot of small companies, especially.
• 6:32
  Absolutely. Yeah.
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  And Will and a willingness to explore.
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  I think that that we've we've reached a point on a lot of
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  levels that I think investors too have more comfort in
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  exploring kind of early efforts because of again the data that
• 6:50
  we've generated over decades now of effort.
• 6:53
  Yeah, I mean, when when you look across the landscape nowadays,
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  what are the biological themes that both you and SV are most,
• 7:01
  most excited by at the minute? Yeah.
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  So one of the biggest challenges I think is a blood brain barrier
• 7:08
  for for a lot of these modalities, there's a lot of
• 7:12
  focus on brain penetrance. And I think there's some
• 7:16
  incredible efforts that are being made to examine how we
• 7:20
  take chemistry that we we probably understand and can
• 7:24
  manipulate really well. And that's small molecule, but
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  really understand how well the brain penetrant and and fine
• 7:34
  tune the the brain penetrant of those types of modalities can
• 7:41
  achieve. But secondarily, I think we're
• 7:43
  getting really good at Target deconvolution, target
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  engagement. The biggest challenge I think
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  you know, once your passive blood brain barriers actually
• 7:52
  distribution to the relevant brain areas that are sufficient
• 7:55
  quantum of the drug itself. So obviously we've gotten much
• 8:00
  better at understanding how how well we're engaging.
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  We're getting better even at surrogate, surrogate biomarkers,
• 8:07
  even digital biomarkers and understanding patient impact.
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  But this is actually, you know, blood brain barrier is a big
• 8:14
  challenge. Novel modalities.
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  We're looking at how one gets, for example, oligos into the
• 8:21
  brain, novel shuttles. There are some really, you know,
• 8:27
  brave and I think valiant efforts that have come to bear
• 8:31
  in terms of delivering to deep brain caudate and seeing the
• 8:35
  effects in patients which have been, which have been phenomenal
• 8:38
  to see. It's opening up areas for
• 8:41
  neurodegenerative patients who previously thought that it was,
• 8:45
  you know, almost virtually impossible for them to
• 8:47
  adequately treat their disease. So it's an interesting
• 8:51
  combination where, like, even the medical device world is
• 8:53
  starting to converge. But for me, the biggest
• 9:00
  challenge that I face in evaluating novel technologies
• 9:04
  now is what I consider moving targets as it relates to
• 9:08
  biomarkers. There's a number of kind of
• 9:11
  leading candidates for a number of diseases that we work within.
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  You know, our fund focuses on neurodegenerative, so it's, you
• 9:18
  know, Alzheimer's, dementia, broadly Parkinson's, ALS,
• 9:23
  Huntington's and you know, there's a variety of other
• 9:27
  diseases that fall into that context.
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  But, but we really do look deeply at biomarker effect
• 9:36
  because sometimes those are the only things that you can
• 9:39
  evaluate to to understand and assess drug activity.
• 9:44
  However, I think our understanding of biomarkers is
• 9:47
  vastly incomplete. I think each individual patient
• 9:52
  carries a bit of a fingerprint of biomarkers and to more
• 9:56
  complicate it more, it's actually on a time or even
• 10:00
  circadian basis. OK.
• 10:03
  So, you know, you may assess somebody, you may take ACSF
• 10:06
  sample at one time point, but it's really difficult to have
• 10:11
  repetitive Spinal Tap CSF samples and really get a sense
• 10:15
  for where these biomarkers sit not just on a time basis, but
• 10:19
  relative to each other. That's the biggest thing is I
• 10:22
  actually think biomarkers are moving up and down on a
• 10:25
  circadian basis, even on a environmental basis.
• 10:29
  You know, sometimes you bump your head hard and that can
• 10:32
  actually send some of these biomarkers in a different
• 10:34
  direction and all of a sudden what you thought was a read on
• 10:38
  your drugs activity is more an environmental effect.
• 10:42
  So a lot of my conversations relate to people who are really
• 10:48
  trying to find ways to chart and track and understand the
• 10:53
  relative movement of biomarkers and new biomarkers as well over
• 10:59
  time. In in some cases, this has been
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  a graveyard, to be frank, blood, blood biomarkers as it relates
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  to the brain, not an easy task, right?
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  And, and how do we deconvolute it?
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  Fortunately, I think we are at a compute time in our scientific
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  trajectory where we have tools that are particularly good at
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  searching, identifying patterns and providing potential insights
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  for us to consider. I don't rely ever 100% on these
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  types of insights, but I think we have a technological point.
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  Where we may. Be able to start exploring this
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  in more depth across these really big data sets.
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  So that's. That's where I look a lot at.
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  Yeah, within sort of neurodegeneration as a broader
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  category, neuro inflammation feels as though it's an area of
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  rising conviction. I mean, what, what are you most
• 11:53
  interested then there and what evidence do you really need to
• 11:57
  see to, to be, you know, to start getting excited about
• 11:59
  those areas? Well, yeah.
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  So obviously the evidence ties back to how well we understand,
• 12:06
  you know, differences in cognitive impact all the way
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  through to, you know, surrogate biomarker or not even surrogate,
• 12:14
  but just traceable biomarker as it relates to, you know, those
• 12:17
  important changes for patients. And depending on the disease,
• 12:21
  this varies. Obviously, neuroinflammation is
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  very interesting. It has been on everyone's radar.
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  So it's not, you know, absolutely brand new.
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  But again, this is one of those things where we have to stand
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  upon the shoulders of grates to get to where we're going.
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  But the reason I find it particularly interesting is
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  again, we have this challenge where we we talk about
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  entanglements, we talk about protein aggregates or just
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  aggregates generally in the the brain cells of these patients.
• 12:54
  And you do have to ask the question, because these these
• 12:58
  things happen over long periods of time, how do we look at
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  mechanisms that may be driving things earlier than we can
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  recognize? And I think neuro inflammation
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  falls into that space. It drives a lot of dynamics as
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  it relates to cellular activity with the brain that has to do
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  with repair mechanisms, even cellular activity that can be
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  deleterious. And so neuro inflammation from
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  my perspective, offers some interesting pathways that we
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  really do need to explore beyond just going direct towards the,
• 13:32
  the Physiology and trying to, you know, break up aggregates
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  or, or entanglements and try to intervene or find ways to
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  intervene meaningfully before these things start occurring.
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  I've heard other scientists make the argument that sometimes when
• 13:52
  we see aggregation, perhaps the, the horses have already left the
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  barn, so to speak, right. I don't know if that's 100% true
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  because I think there's some combinatorial effects.
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  It becomes, you know, a self feeding cycle.
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  Sometimes these aggregates may drive some of these mechanisms
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  as well. So it's something that we're
• 14:12
  starting to explore again, this, this goes back to how do you
• 14:16
  measure and what, what do we get confident in, in terms of
• 14:21
  neuroinflammation affect on disease modification.
• 14:24
  And that obviously goes back to biomarker strategy, patient
• 14:28
  enrichment plan. So we really can see within a
• 14:31
  unique group of patients on trial in effect and and have
• 14:35
  some understanding individual differences for these long
• 14:38
  standing diseases can be really challenging to you know
• 14:41
  delineate. Yeah.
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  And it feels as though within neuroscience as a whole, you
• 14:47
  know, conversations with more generalist investors around CNS
• 14:52
  opportunities are starting to happen more often.
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  And you know, it's sort of follows that theme of large
• 14:56
  pharma getting getting back into neuroscience and is, is that
• 14:59
  something that you're seeing too?
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  And what really do you think, you know, brings back that
• 15:03
  demand within that space? Yeah, without a doubt.
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  So I, you know, I, I think there's a number of human
• 15:12
  elements that are pushing this. We have a number of
• 15:15
  international communities that are facing aging workforce and
• 15:21
  declining population. Yeah, we we have a very good
• 15:25
  understanding of the impact on world economies as a relates to
• 15:31
  those effects. And in particular with
• 15:33
  neurodegenerative, you know, the, the impact of even dementia
• 15:39
  on the ability of not just one person, but all the caregivers
• 15:44
  in the, in the close circle around that one person and, and
• 15:47
  the healthcare system and the costs to really help these
• 15:52
  people. It, it's, it's a big financial
• 15:56
  number. And so when you look at
• 15:59
  generalists, what, how do they assess opportunity?
• 16:03
  This is a market that has huge potential, of course, for
• 16:10
  patient impact, huge potential for society impact, and huge
• 16:14
  potential for solutions that have not yet emerged.
• 16:20
  That combination sounds like a recipe for very good investment
• 16:25
  thesis. And, and I think that's why you
• 16:28
  see generalists looking at this. It is a white space.
• 16:32
  At the same time, I think there's there's encouraging
• 16:37
  scientific discovery and frankly clinical outcomes that are
• 16:41
  making people more comfortable to engage in finances because
• 16:45
  the numbers are quite large. If you're purely a financial
• 16:48
  investor, if you can make incremental improvements and
• 16:52
  really show impacts at a healthcare and patient level,
• 16:58
  there's a very good investment thesis.
• 17:00
  Yeah. And you know, the the upside
• 17:02
  potential is, is obviously huge, but but alongside that and what
• 17:05
  comes with it is it is obviously a massive area of risk.
• 17:08
  I mean CNS is, is one of the areas that that is, you know
• 17:12
  that arguably the hardest to to develop new drugs in.
• 17:14
  There are so many different challenges that are that are
• 17:17
  nuanced to CNS that you know, whilst there is massive
• 17:20
  potential upside, that there is also a much bigger risk of risk.
• 17:23
  Of failure. Yeah, I, I, I agree.
• 17:28
  And I think that's what also we're getting better at.
• 17:31
  I, you know, I, I mentioned this patient enrichment strategy, you
• 17:36
  know, really understanding disease dynamics and you know,
• 17:39
  each, each effort that is made adds to our knowledge.
• 17:44
  It's, it's extremely high risk, but in, in the same regard, we
• 17:47
  have to think about what these patients are facing.
• 17:51
  And so you have a very motivated, a clinician
• 17:55
  population, a very motivated patient population, you have
• 17:59
  families that are pushing very hard.
• 18:03
  And I think that combination really enables as long as it's
• 18:08
  thoughtfully done, safely done and logically done right.
• 18:18
  We, we have a, a convergence of many different aspects to
• 18:24
  address that risk. And I think that makes it
• 18:30
  tolerable from the risk perspective.
• 18:34
  You always have to think about risk tolerance when you're
• 18:36
  driving these things. We, we spent a lot of time
• 18:38
  talking about this within, within our group.
• 18:41
  How are we managing the risk? What are acceptable risks, but
• 18:46
  additionally, you know, what are risks that we should be taking?
• 18:49
  You know, the inception of the DDF was dating back to I think
• 18:54
  2015. There was a discussion that no
• 18:57
  one was taking these risks. And the driving force behind
• 19:02
  forming this fund was to to actually push forward science
• 19:06
  and technology in the dementia space.
• 19:09
  That just wasn't happening, but yet societal impact was being
• 19:13
  felt. You know, extremely.
• 19:16
  We've formed 11 of 22 companies. I mean that if you want to take
• 19:19
  out a risk forming a company from the start, being a very
• 19:22
  early investor that presents the least amount of information to.
• 19:26
  Yeah, Yeah, 100%. I mean, when when you are
• 19:31
  assessing these potential opportunities, weighing up, you
• 19:33
  know, risks versus rewards, what separates A genuinely investable
• 19:38
  neurodegenerate, neurodegeneration focused
• 19:40
  company from one that just tells a really good, you know,
• 19:43
  scientific story? Yeah, it, you know, this is
• 19:46
  something that we, we face probably every day, we, we
• 19:49
  discuss on, on a, on a different basis scientifically, the things
• 19:53
  that come to mind consistently. You know, we really do want to
• 19:58
  make sure we understand the mechanism of action.
• 20:02
  And that's a a tall order in this.
• 20:04
  Context. So being able to if, if, if
• 20:10
  someone comes to us and has done the work in both, you know,
• 20:16
  relevant models and have have gotten frankly, I, I this is not
• 20:20
  a requirement, but you know, non human primate data is, is really
• 20:25
  powerful, but but you don't have to get to that extent to
• 20:30
  necessarily understand the mechanism.
• 20:34
  But what where we get stuck sometimes is where there are
• 20:38
  leaps of faith that are too big and or we are looking at things
• 20:46
  that are so upstream and really just have pathway effect without
• 20:50
  ascribable impact down to at least a narrow set of actions.
• 20:57
  You know, if it's just too broad based.
• 20:59
  So we talked about neuroinflammation.
• 21:01
  You know, there've, there've been plenty of efforts for broad
• 21:03
  based anti-inflammatory, right. And what we're really trying to
• 21:09
  move more towards is precision medicine where we really do
• 21:12
  understand the impact we're having biologically.
• 21:16
  That's probably the first thing we we look at closely if there's
• 21:20
  anything in the clinic that has, you know, lessons for us if
• 21:24
  there's clinically validated pathways, but it's a non
• 21:26
  modality and we we do see that there's innovation on shuttles,
• 21:31
  there's innovation on different ways to hit targets.
• 21:34
  So clinically validated pathways is is actually, you know, a very
• 21:38
  helpful starting point trying to think what else you know makes
• 21:45
  it absolutely investable on front end.
• 21:47
  You know, we can go, you know, deep into, you know, how venture
• 21:50
  capitalists think about what is investable or not, but they
• 21:52
  don't think so. Enough time.
• 21:56
  Yeah, I, I think, I think 1 area that is probably slightly under
• 22:02
  represented or or at least, you know, not thought about enough
• 22:04
  is, is that around 70% of dementia patients are women.
• 22:09
  I mean, you know, how should investors and companies start
• 22:13
  thinking about this more seriously?
• 22:14
  But both in understanding disease biology, but also in
• 22:17
  designing therapeutics. This is a topic I have a number
• 22:22
  of friends locally here that I have this discussion with
• 22:26
  consistently. We have to be really aware of a
• 22:33
  population that I that has differential biology, right?
• 22:37
  It's just there, there are different factors at play.
• 22:42
  From a sex difference perspective, you're absolutely
• 22:45
  correct. I think the, the figure is
• 22:47
  somewhere between 60 to 70% of dementia patients are female.
• 22:51
  It's an, it's an interesting parallel, but something like the
• 22:54
  same percent, 70% of autoimmune patients are female, right?
• 23:00
  So we have to acknowledge that perhaps there is something
• 23:04
  differential that we should be paying not only paying attention
• 23:07
  to, but you know, if you're if you're being a thoughtful
• 23:11
  investor, you think about patient populations that you can
• 23:14
  be impactful for. And perhaps, you know, if we dig
• 23:18
  into the data and I actually think we are arriving at a time
• 23:21
  point where there's both increasing focus on this,
• 23:26
  there's the ability to, to striate and, and, and
• 23:30
  interpolate data on this basis. There may be some very
• 23:38
  meaningful druggable differences that we should be aware of, or
• 23:44
  at least from a perspective of a, of a, a protocol or a, a
• 23:52
  therapeutic regimen that varies that would be impactful between
• 23:57
  the two. You know, I think it's been long
• 24:01
  ignored, frankly. And you know, please, please
• 24:03
  don't laugh at this example, but it, it's, it's one that kind of
• 24:06
  shocked me. This is not my fact.
• 24:10
  This was shared with me. So apologies if someone proves
• 24:12
  it absolutely wrong, but I think it's accurate.
• 24:16
  You'll laugh. So the the United States at a
• 24:21
  certain time point not require that women be in clinical
• 24:24
  trials. Wow.
• 24:26
  It was not a legal requirement and not until the premiere of
• 24:29
  ATV show that I grew up watching Fresh Prince of Bel Air.
• 24:36
  That premiered. Before it was legally required
• 24:38
  for women to be in clinical trials.
• 24:41
  Wow. So that sets of like a stamp, a
• 24:45
  timestamp of, of, you know, how far away we were from evaluating
• 24:49
  us from a, from a broader time stamp perspective.
• 24:54
  It's, it's, I think an interesting opportunity.
• 24:58
  It's something we can't ignore. And, you know, I encourage
• 25:02
  others to engage in this conversation.
• 25:04
  I encourage, you know, scientists who are looking at
• 25:07
  these, these differences biologically because I, I do
• 25:13
  think this could be very meaningful for, for both sex
• 25:20
  base differences from both men and women, there could be
• 25:22
  differential treatment that's meaningful.
• 25:26
  So I think it's quite interesting.
• 25:28
  No 100%. And I think it's it's definitely
• 25:30
  an area that that firstly has to be considered, but, but also, I
• 25:34
  mean, looking forward to the future, if there are ways to
• 25:37
  differentiate between between treatments dependent on sex, it
• 25:40
  the benefits that come with it are astronomical.
• 25:43
  And if you're an investor, you have 51% of the population that
• 25:46
  is unaddressed right now. Yeah.
• 25:49
  Yeah, exactly. I mean, just to sort of wrap,
• 25:52
  wrap things up as as we typically do on on this podcast,
• 25:55
  I mean, if you could have dinner with any scientist or innovator,
• 25:59
  past or present, who would it be and why?
• 26:01
  Yeah. So I thought about this.
• 26:03
  I had some childhood scientist that I I really was impressed
• 26:07
  with. But you know what?
• 26:08
  This is a trick question in my mind.
• 26:10
  OK. Right.
• 26:12
  And maybe. That I I hope I'm not the first
• 26:15
  to think of this, but apology as if I'm a avoidant in my
• 26:18
  response. I actually don't think that we
• 26:21
  should be picking just one person who could be informative
• 26:27
  or exciting. Part of my job is talking to so
• 26:29
  many brilliant people across. The board.
• 26:33
  And the way I get better at my job, the way that I grow as an
• 26:36
  individual, the way that I get excited about things is actually
• 26:41
  having dinner or chatting with brilliant people over and over
• 26:46
  and over again. And so This is why I struggle.
• 26:48
  I say, OK, I could name one scientist, right?
• 26:51
  And I probably would have, you know, an amazing dinner, a
• 26:54
  conversation. But truthfully, I think the
• 26:58
  human condition requires us to talk to as many brilliant people
• 27:03
  as we can. And so my goal would not to be
• 27:07
  to focus on just one, it would be to seek out every single
• 27:10
  person I could talk to. So I it's totally avoided, but
• 27:15
  that's the honest answer. Yeah, complete, completely fine.
• 27:19
  Yeah, we'll have to book out, book out a pretty large room to
• 27:23
  be able to fit that one in. But it it takes a.
• 27:25
  Lifetime, right? And that's what we're here for.
• 27:27
  Yeah, 100. Percent, but like it's been a
• 27:29
  been a pleasure having you joining me today, Miles.
• 27:31
  I've really enjoyed our conversation.
• 27:34
  Super. Thank you for having me.
• 27:35
  Great questions. Again, this is, this is a very
• 27:39
  expansive and interesting space. I'm excited to be working and
• 27:42
  and look forward again to talking to everyone who I can to
• 27:46
  try to address, you know, the challenges these patients,
• 27:49
  families and communities face. Yeah.
• 27:52
  And thank you to everyone for for watching or listening along.
• 27:55
  Make sure you you drop a like and and subscribe for future
• 27:58
  episodes that are coming out. Thank you and goodbye.