Chordoma Research and Treatment Panel

Really, your great files and labor of low stones. We just had a really energizing, incredible couple days talking about the latest research advances, latest advances. And so this is really kind of, uh, certain multiple verses an opportunity for our research position to abstain the latest line, but Also to exchange kind of new ideas, um, that are gonna change the next steps of around research and care. So we have a, uh, an absolutely, um, extraordinary panel that's been kind enough to stay with us on Saturday, um, to share some of the highways and key takeaways things that they're excited about in Canada, the comments also to kind of give us a sense of what you've seen in terms of So I'll very briefly introduce the, uh, the panelists, and I'm telling you, you know, I'm not going to do nothing at all to their, uh, the rain metal acknowledgments, but, um, uh, we're very lucky to have the doctor that had the same from professor who is the, uh, same acknowledgement, uh, doing a lot of really important work. Understanding talking from interaction with the computer system, and I have a huge understanding development there, which was close to, uh, multiple disciplinary products there. We, uh, heard that college doctor and I got who is a, uh, leading media photologist as much. Uh, Dr. Ifani, who is a, uh, continuing neurosurgeon as different, as well as a Uh, the laboratory researchers work on a number of, uh, therapeutically oriented, uh, projects to, um, focus on self out of business one day, um, and uh, then, uh, to, uh, his Dr. Joe Schwab, who likewise is the research and scientists working with self out of business. So, uh, Dr. Foundry works at top of the spine, and here's Dr. Schwab works. Uh, bottom of the line, uh, um, so uh, Dr. Bob is now in Montana Care Sinai. Uh, many of you may know him from the line here in Mass Central, uh, where, uh, he spent, uh, many years as part of the, uh, the Harris Center, uh, disciplinary from the center here, uh, National Central. Um, and speaking of which, uh Uh, last and not please Dr. Greg, who is currently a part of the multi disciplinary center center here, uh, and one of the leaders of that center, uh, focused on Cordova. Um, and Greg is a medical oncologist, uh, led, uh, clinical trial, and so here working extremely closely with our team, uh, And hopefully soon launch, um, a new platform file that is going to pave the way for many more trials, uh, coming coming. Um, so again, thank you all so much for being here. Uh, really engaging conversation. I'm gonna start with a couple questions because we've also, um, had this question submitted, um, by you all, but um, I hope it's just the kind of a Engaging live conversation. So if you have any questions, feel free to raise your hands. I think we have some members for the name staff that we'll run live over to you. So I think just to start off, we'll go down the line and, uh, maybe Greg can start. Um, so, uh, Greg coming out of the, uh, the program research works on the period. They're calling that you are that you found most notable and then you're most excited to off a month. Uh, yeah, support, uh, for support here on the basis. Uh, so we'll get into a little later when I issue for construction. We are trying to find a base, uh, cultural development First days that, uh, you present, uh, you know. Yesterday we heard so joining all the text really basic science working on that five basic part of things. Thinking about how to draw and really particularly especially Um, I was trying to think, you know, one one of the things that we, uh, the presentation for the advances, this general advances in the science. I expressed that to thinking about clientists. And I, I started thinking about, uh, including the knowledge that was, it was, you know, the knowledge of understanding technology. I started that here. And I thought, well, how do you explain that? So Ashley called a explorer actually that washes, so the figures that they cost the arguments He was a professor of author who was explored photography. So he would go into the territory, Marks and all the races, carry the survey, surveying equipment, and survey these mountain areas to the rural areas. And then he was this air yard, he would get into a airplane and take pictures, throw these airplanes, kind of map out how He was top flight for the topics, right? And look, we learned a lot about what was going on in the world because of him. Now, fast forward, how do we, style, much minor points of the rat, older rat washman work, which was great, but they made it much, much better. I think that's what a lot of scientists are doing. First of all, it's more three million of the year for your questions. I think from my point of view, you know, I'm concerned in scientists, I'm most excited about I think I mean, and I think that's closer to day than it was at the same time for sure. Um, and that's because first and foremost, we have new technology for analyzing each of us in a way that we've never done it before. We're looking not just at the thing for tele resolution. At the hotel in the tumor, but we're also using sort of in the RHIP, like that to do catalyze, right? You look at the tumor and zoom in and understand the difference between this tumor, that tumor, and why this tumor responds better to treatment and not. Um, and and for that, we, we are developing such chemical bio, like understanding why from patients. We saw that our new treatment, uh, and the treatment means surgery means the AMP treatment that do we have available right now, or we may have in the future. So there's any objectal argument individual different biology rather than sort of using a one that gets all, um, I think it's very important. So that's that's one aspect very excited about. Going with technology to analyze equity or tumor. Um, the other side is also maybe to to take ew tumor and analyze it, uh, not just in the lab, but then coming back to the patient. So, um, the writing is something that we call tumor, taking information from the operator, mixing to the lab, and then testing hero for the policy. And so the other aspect that I'm very excited about, and the most excited I'm talking about the fact that people are not collaboration, we're not isolated, we're not working, uh, supplying, we're collaborating in the community mostly that the Corona Foundation is all together. Conferences like this, they're emailing, uh, putting people together, and that's very important because it's a rare tumor. Um, tissue is sparse, so it's very difficult to, to, uh, make, like, generalizable discoveries on three patients, right? So this is huge, in my opinion, and it's gonna change the way treatment. Uh, and then finally, uh, what I was a very, um Surprise about and positively surprise about is that we're using very different ways of treatment. Uh, even just the knowledge. We're attacking it from the alien system side of things. We're attacking it at the tackle side of things and the genetic side of things. So we're coming at it from very, many different angles. And the answer is we're not gonna treat it with one room, we're gonna treat it with, with a combination of therapies where we just support So yeah, I, I think and I hope that in a few years, uh, I'll just hopefully myself out of business happy small sooner with the company for the following, uh, and I've got it. Uh, thank you very much. Uh, two things I would say. One is that professor about hand, sir, K, she's coming to the super excited about an observation that we brought up in technique, which is the five development in full room. It's almost like the set of this walls three microscope. What K is about is That's actually the problem as way of speaking. Fascinating, and never even connected this way. And is there a way we can break down those walls and how they consistently five thousand? So I'll understand that we understand. Second piece of TVS. I was really grateful for this lockdown. Last July, uh, where a whole bunch of Cordova sessions all across the world came together on in 1918. Really talked about Cordova programs, and it was so much fun because we learned so much. I think everyone share my perceptions, the each of the obvious process, all that stuff. Help our growth, I learned so much learning all around the world who were able to teach me how I can take share on it. And then we created sentences so unique and such a rare tumor that we're able to publish and hey, this is how we in the current state should manage a road. So if you think about that, how challenging that is to get a production To great customers to fly thousand minds into the to the summer heat of field and actually bring their minds together to come up with best practices currently to take care of patients. I think that's a good most major constraints I had mission discussion. Uh, uh, spending more of the day on that, uh, this afternoon and, uh, beautiful talk more about those, uh, those guidelines, but, uh, it's really a huge consequence. So grateful to all of you for being part of that. Um, okay, uh, we should say. Uh, he gave the honor to speak To really, uh, start controlling in education project. So I was very clear how I am just, I am not in association, I am So that's where it's not trying to interact with analogy construction is when how our body can be born to fight nature by the change, but infection by our So with, um, now in what we operate and decide the relationship relationship, um, people are freely advised on moment my law and you know, um, we are now to just that extra place we have Um, in the how we can this type of research which is and how a case a non case for notation The, uh, cheese, we might want to be a very common. The very first time And I regret the abstraction participate on the mission, all the things to start. And what is happening? And I'm like, okay, well, it's a short term that when I'm looking at the case of the same. All three, they are taking notes, not And then I'll do that all dependent shop because of that issue. And show each part of many our only that we need to quite first because it's actually extremely clear in the came up name after In all the five years now by all the things We are with, I think we are now in front of now. We, um, you know, can we not keep my change, right? Even up there are just Um, number and then we have all channels we are over the children actually how much um I think it's going to be launched And we can talk to you. So this is my touch thing without taking out the show, uh, in about to have we are saying, uh, with we actually power Now, for me, you have to talk. But you just talk to the show. I did, I understand. I don't mind anything. I think that you just scratch the service. So I think that, uh, I think comment comments. Our understanding of Roman biology, this idea of looking at, uh, the tumor finer finance solution, understanding that, uh, keep patients tumor different in the tumor that even different self-deployment, uh, how interacts with the use system, all these things are kind of even up towards the future of So we're starting to see that and I'll talk a little more about that later. But at the moment, Forever's largest still with certain age, and also, um, in parallel with the answer science and answer Or, uh, systemic therapy growth there is also seeing in surgery and radiation. So, um, reference to the, uh, the surface radiation problems on, on the panel, uh, you started, uh, um, uh, with government flow. In the last several years, we think it's changed the most for how you I think the greatest change is that the, the, uh, the bi spectrum is, uh, kind of variation. The web circuit does agree. I think that's general we use radiation, and many people do not agree with that. The SNEC entered group really was pushing a load. At the time, they were starting to do what's called separation surgery and between that, uh, Symmetry surgery. And they had the energy results at the same time, uh, the carbon eye centers came in Japan, but also Europe were starting to show positive effects with radiation from the carbon eye. They were patients, but we're using protocol. Alone, and in, in some cases, that works. And so, you know, the idea there actually for me, the conversation with patients has has changed because there's a lot of vision with surgery alone, and so surgery can work, but it doesn't work all the time, and it's certainly side effects. And so to be able to talk a little bit more about surgery in some cases. Um, and these radiation, some cases these radiation will, some cases called the surgery, morbidity is acceptable. And that's really the key discussion with patients. What is the expected morbidity from this surgery? Is that acceptable or is it not? And really being honest about what the results are because I think that the, there's something which don't know. Is it involved in the whole process? discussion is evolving, but it's a different discussion than it was 20 years ago, where really they be the first cancer discussion now is evolving. Survey is still very important, but I have to take a dialogue issues as probably a lot, uh, we want to apply it to some, uh, how to involve it. Yeah, in public is actually the opposite. We're, we're moving away from trying to weight every single patient, and we're trying to understand better which patients require weighing and which patients do not. Um, the qualities cordon are very close to very important structures like, um, raise that, cranial nerves, important blood fat mold. Um, everything you do in putting surgery, um, it's dangerous in that area. So you have to, essentially, you have to really balance that risk benefit, uh, before you make a decision. But now we have some tools from higher orders where we decide after surgery which patients require relation, which patients we can just hold off and wait and see how the killer behave. And I think we're making good progress in that field. That is important, we know we do these surgeries, they are very complex surgeries. It's not just taking up the tumor, but then how do you, fix everything? Because it's just a giant hole in the base of the salt. That needs to heal. The patient needs to heal. The patient needs to recover before you decide on, uh, starting radiation. Um, and that gives us a little bit of time frame to to analyze tumor psychology and sort of the time which patients require radiation based on that rather than based on, um, just humans. And the other thing that we're doing, you know, uh, we're trying to be as aggressive and aggressive in a positive manner as possible with surgery. Thankfully, we will begin with our technology has evolved, we, we have better We have, uh, better instruments, we have better technology that now allows us to get into places that we didn't maybe five years ago, such as the capital science, uh, let's say five to ten years ago, but we thought about removing tumor and the capital science, but now we're measuring there because we know that the more you reset, and not just the tumor, something that's called super marginal recession, where everything that the Slightly different than design where we try to remove the block and do that with mobile adjustments to the realities of that building. It's really interesting, you know, converted traffic and the spine signal that is the integration playing a larger role. Uh, use all based perhaps a, uh, more limited role, but I think it's both into, uh, the experience in the past no one was surgery call variegation now much more, uh, varied individualized temperature. So again, metal's your job, uh, a little bit more, uh, intellectually demanding. So, uh, how are you seeing? Uh, it's statement on that might have you, uh, yeah. So, um, to address that question and I'll speak for that, you know, I was much earlier that multi-disciplinary collaborations so that you was bad for patient energyosis survey, there should be some That surgeon in creation of how is the national sound great transition that actually called sense of the other showing the image of the team to serve something. So we can think that that should be utilization once there is profiles that small nuance and and to to take point the idea is pretty gonna be unnecessary for certain types of question to ask but where we are afraid that why it is in some cases increasing technology so much better and match for continuity Type technology efficient years was no worse in five years. We take every tool that we have created reduced in which treat a lot more publication so much more. All across the world, so much more there. And obviously, I use protons. Protons, there's so much more. There's so much more to change. So I used that slide, I can photo on top of the slide. You're trying to flip call on the ring. Got a, you know, hazard over here, you've got a sand track over there, water over here. And if you want to understand the variation of conference because much more safe, just for one second, and because of a better surgery, you know, you may not need to push the dose regularly. That's a lot of sugar in there. So really much more dead than when I started. So, um, part of the role of way of those matters and, uh, lots of growth is that I think, uh, Alex and this as well not just about extending life, but we call it like so, um, yes, uh, it goes back to, uh, some general, um, point that you see in So a lot of our mind is going to have to do the current currents. And sort of that is another major challenge. So one of the things that, uh, are emerging that, uh, current, uh, And other things that are founding that maybe help reverse, uh, uh, the impact of the, export is. So, uh, I don't know how to do, uh, that was hard. You know, I think further, this is not. That ground rating that we're using a lot more, we have the soft issue in terms of treatment with something like green situation validation value in the circuit. Because what much point value is certainly especially that it's much, much more difficult to first of all follow the circle, I'm not able to do that, and in all structure is there's a hard time to do that so that a target system I hope is that my life is interested in development therapy but they be local delivery of cell there's bad use of people not there yet we're hoping for that in the future so we don't have this So basically, when you, when, uh, you're going to push this, you offer the environment. So there is a need of integrated lamps, or I see the radiation, the realism. They see lamps, they see And then they release, in this case, they release hard on gas and iron gas increases. That freezing flows to, uh, the name that you get three, three or three small cycles will go through the same. And that can be an effective way of continuing. Now, you can also freeze nerves. You can also freeze valves. But that's that concept. And and so because there are worry about how you have to worry about errors, that's what I hope is if we do some other less conflated features like cell cell errors and same up there, things like the few cells inject those way things. That's that's complex. Uh, I'll speak to them very So if you expose a certain tissue tissue to radiation, there's a percent share. Here is not the and so Because what we're trying to do now is we're trying to take the priority years decades previously. Now we're trying to think what is the current value and how much major income should be or can be situations and how is that translated? There are software will be to possibly allow you that to that so much better than reducing a lot of functional solutions. And this again is a model spare discussion. And it's part of Discussion, I've already kind of quantified in my fifty percent share is going to happen. And balancing that how successful easier was concerned. Then for that short information, what are other alternatives? Seven francs discussion involved to say it was Allows those tissues to prepare themselves across the key service. So this understanding soft both respect allows us to be a problem. Quality of life is very long for FB10s because it's a slow range where, uh, employee benefit is for a very long time. So we need to focus on this, and we're very mindful of hope that we are made not just mainly, but also not made locally or enclosed properly to it. So what we've done over the past Very good point. And quality block mobility so now you can go through the jones. Very frequently get new things for the jungle that isn't Used to, uh, maybe ten years ago, maybe five years ago. So that is better for her for a lot of cases that the business is called. Uh, and also, of course, we are very mindful of financial, um, quality of life because there are just a lot of individuals. So all these things we take into account So, uh, new advances in, uh, enabling surgery energy point in the place, for example, to address tumors of way that preserves or, uh, and minus impact on quality of life. Um, where you see drugs type that is getting into this Next, um, now I think we'll continue. I think it's pretty much so, so right now I'm medical therapies. We have to see these pretty models. So we will still help them, they still work, but there's no benefit. We're not like big residents. Now I see a patient occurrence, we still apply all human side, and we pull all tools in the hands of swelling situation. There's also some patients have the parents that actually was possible. Part on that. So that's where we are now. Uh, it's not hardly better in the future, and the future products are we start the executive prior jobs working. So you can make sure that we use I think as our surgery runs all, we're gonna start seeing a strength will happen to get there. Um, it's really important to specify the Lowers on your hands for most of your husband cultivation nice and actually workable for systemic method compared to really interesting Uh, topic of discussion, I think that we're in America, so I think we're gonna talk a little more about that, uh, this afternoon. Uh, I think the expansion, uh, you know, we can get conventional wisdom, uh, that therapy are reserved for, um, so occurrence is a great deal, but that's really it. Uh, to set as we can go up the non activity for. Um, okay, so some of the similarities of projects in this room continuously, um, are, uh, some unit therapies of, uh, chain deadline. There's been a lot in the news recently about microphile seasons, uh, for example, uh, the headline, uh Last one, uh, really, really big steps of calculation. That's just one type of, you know, therapy. There's a tackle that are, uh, the same adults. But, um, that's interesting, uh, what do you see as the likely, um, potential future for a you know therapy And it's one of you know learn, and so you see that we are happy to bring those enhances that are happy to be able to do sure. Yes, there was no, it's no idea how much we ever My last staff and family, okay? And, um, when we should be on the chain and stop, um, she's been all that And, um, I do not make the actual mark. So the map is a cheaper. And to the function on the original We have same as we show, uh, there are patients in natural chain or payments once they success from the So, uh, now they are all the children that they do not have to go to the bottom of the seas because they are not patient for anything. Um, in the game, I have this or not the client That keeps us that we can do now give us a half, and one of the patients that And I think that should make it possible. I think here the mangoing That means everything else just needs to find way for them to overform Number of variables. The one of the biggest parts top of the organization shouldn't be an effect of this number. Should we argue from the commission? Okay, to get help all the shows to that keeping the name of the net. So now we are going to have that. I think that we are not in that position that you see. Um, but we are, but we need to go first the bio and we have an initiative. So I think we are gonna do this. Thank you. Uh, really important, uh, reminder of my understanding biology of each individual tumor type is so important that you can't just necessarily apply and again You're also working on your lab that is developing health therapy. Um, where do you see that going, and what do you see as the energy area comfortable? I think there's two major areas. One is great And the good news about that is there are, uh, CART therapies that are that Google used to in my city, therapy, that are closely. So that may be just going to work that decision. Um, but then when it comes to CART therapies, CART therapy basically works And then you're modifying them to see they have antibody on the surface of themselves that target protein. And you check that back in the patient. And the idea is that the butt, um, as, as pointed out, and there's shown, there, there's showing There is a center matrix. The tumors themselves are actually very higher pressure and very low. So it's not a number, uh, a minimal environment per cell. And so how do you get those cells into the tumor? And so, uh, that's something that we have to consider talking about cell terms. So it may be that we're talking about trying to, um. Soften up the tumor in some way so enzymes directly in the tumor and then inject, uh, uh, the cells afterwards. These are all things being developed, and they have to be common for saying biology and science, uh, soft. I think that's a takeaway that there are multiple difference, uh, even there, just talk about a couple of them, there's, uh, a whole menu of different terms that we applied. Um, so I think more that we can talk about now, but I just want to see if there's any questions that, uh, anyone has, uh, hang on. So if you raise your hand and we'll pull that up. Yeah, I'll go over the great. So that's done by radiologists. These types of procedures should be done in multi-disciplinary sessions. People like us, plus another radiologist, and the radiologist is the tumor. Can you like this? Can you freeze that? What that is by can you do this? Is it next to the valve? Is it a set valve? If you done safely, then the radiology goes to the radiology. And just all on the FTCs would be the same thing on the CD scan. And during the FCT on the check scan, there'd be radiology, and there's seeds into the C group based on what the TTC. And that's where they, uh, in this case release. So you don't create usually might be in a situation, but in some cases you're underway with out issue. There are some really nice badges relationship with value. So I'm pretty sure that there are like popular types of cancer type. Um, I'm sure there's a lot of involved to study this particular type of cancer care, mostly the doctor too. Not carried on until Um, add those. I'm just wondering what possible. I, so I, I recommended, and, um, I my started, you know, With energy costume, but the adoption do not, um, and such a key rate, um, and I remember five days. And lastly, that the whole quarter is okay. I cut one, and then the next time One response at time. I'm going to start that issue. Just hope that you're supposed to And the things that I'm, uh, track of central goal over there such a Thirdly, that's But I could finish out issues a lot that is part of the study of the church. I think And are not revolved. There's no longer formation that comes complication. There is the fact that we need to do better formations and papers We should also persevere. So that's why I think, uh, it's very important not just for the operating room or inflation, but also back to the lab and trying to make it. Uh, and sorry when I was interested, uh, my mentor was at a surgeon, uh, for example, and and to the audience, uh, almost practice Um, and I just construct the flashbacks surgeries. Um, and in our clinics, so many patients functionally survived for a long time, but they're living lost opportunities, especially, um, it was very different than the other clinics for treatment. Yeah, for me, it was also very trained. You know, I, I, uh, I was very senior development, especially now, and Uh, so fellowship with patients or common cancers is very long-lived to be on trials with not the patients being patient. CBR200 cancer. So, uh, to get that out of that, you're quite interested in real motivation. We are at all that you've dedicated your time and efforts. Everything that is just individual things. I in my office are nothing I have to take in there. Um, that is that we have so it being very clear. Um, much go there and several coats on the rest. Um, um, what is that on the So it's not closer. And, uh, so there's a person from my all here, and then we're just trying to follow the efforts that we're trying to certainly call the operating like five. Um, I keep questioning Um, um, my question is what does it happen which form of the cash change characteristics, and what that is is kind of third education And I'm gonna think of that later, but I'm curious how much second whether it be wash, uh, sounds I say patient. So there's two there. So maybe they're being controlled. It's hard to get if those just not. So the question I ask when I can search for Down size reduced reduces, reduce that yourself carry across the treatment yourself. But then there's a nice conversation situation on our I like this. So where is it for that? And I think that all is a discussion. But if there's a goal for certain decided to use perhaps avoid everything. Save my highest. Second point about relativity to the point. Yeah, five percent. So I have a situation where there's a very high ship on standards. So there is a high response. I have set that percent to yourself. And so easily but also get decisions in the margin design as well. If you have one cost on the back of the day, Oh, along the line. I've wrote that question. Direction that it's a problem. Uh, you can flip over, um, diagnosed twenty nineteen called five, and then design I think not so much has changed. Um, I've been told that the new How the group is more awareness of what it forms depending on why in the house, why it manifested in some people in this group as opposed to others, because we all have itself in the economic stage. As is in any research as to why it doesn't manifest in That's a great question. We, we, the answer is still. We still don't know why competitions get it. We don't know if there are any environmental factors to it. We know there's a lot of genetics involved in that we don't understand. Uh, much like with any other cancer, you know, sometimes the patients don't worry, and there the bottom is, uh, uh, follow Even the live include, uh, from, uh, uh, so would it be involved then in it to have AMB members and that? Yeah, that's a great question. So we don't have these for the ones that are generally not doing that children, uh, siblings Uh, they're not accomplished supervision, um, revenue that happens, um, and generally, should they come itself that's something that we can happen. Uh, you know, the committee gets a little more comfortable here, and we want to make sure we stay on track of the day and give all the parents conference today that I think a lot of They sure can take and help us get on.