Everybody having a good day so morning so far? Yes. Kind of, kind of, I don't know which way to turn. Right. My back. So I have an awesome panel who I love. They're my friends, and, I'm gonna introduce them. You guys come on out. So this is-- Go ahead, sit. I can't fit up there, so I have to stand over here. this is Dr. Regina Hampton. She's my doc. This is Latoya Boldes-Johnson. She's my bestie. And this is our-- my new friend, Phoebe Daniel, who's from Amgen. And this is my dear friend, Clayton Yates, who is an am-amazing researcher at Johns Hopkins. And I love your title, right?

Clayton is the, is the endowed-- the John Lewis Endowed Professor at Johns Hopkins, so pretty cool. So he does a lot of research stuff. I'm happy to be here with you, and, and, I'll just start by saying I am really alive because of a clinical trial. Hey, how are you? I had Stage Three A triple negative breast cancer. I did all the stuff, surgery, chemo, all the things. It came back in exactly a year, and I fought for myself to get a clin-- to do a clinical trial, and I'm here. My doctor gave me two years to live. I'm on fourteen. So this is my God job. This is my God job.

And we can do all the things and help people with cancer and do all the advocacy, but unless we change the science and advance the science, we're gonna keep dying for all these diseases, right? And so what does that mean? That means we have to participate in clinical trials. So you guys, let's le-- I'm gonna let you guys all just in-- kind of do quickie introductions, and then we'll sort of get into the questions.

But these are all my people. Hello. hi. I'm, Dr. Regina Hampton. I'm a breast surgery oncologist with Maryland Oncology Hematology, here locally in the Maryland area. Hi. Good evening or good afternoon, everyone. My name is Latoya Boldes-Johnson. I am a breast cancer survivor, Stage Three C triple negative breast cancer. I'm also a physician assistant and mom and thriver. Hi, everyone. I am not Dr. Osa Isley. I believe she was on the screen a little bit earlier. But my name is Phoebe Daniel. I am the strategy and data insights manager on the Representation of Clinical Research Arise team over at Amgen.

And our team is really focused on ensuring that disease burden is matching the clinical trial populations over at, in our studies. So I'm really excited to be here today with our other panelists to continue this conversation. Hi, I'm Clayton Yates. I'm at Johns Hopkins, as, Ricky said. I'm the John Lewis Professor of Oncology and Pathology, but also serve as Director of Health, Translational Disparities, as well as Global Health Equity. And for almost nineteen years now, my lab is run a basic science research lab, has exclusively focused on molecular targets and why disease is so aggressive in individuals of African ancestry.

And I'm really proud that we're now translating some of those basic discoveries into clinical trans-- interventions. Actually, I was at Tuskegee University for seventeen years, and I moved to Hopkins about three years ago because I felt it was time to implement these into people in the clinical trials.

And so we're now designing trials at Hopkins that are intentionally designed to target molecular targets in people, with African ancestry and African Americans. So we'll talk more about that in a second. So, a few years ago, I wanted to understand. I'm a marketing person by trade. I worked at Coke, and so I wanted to understand why Black women aren't participating in trials. Like, why aren't we, right? And everybody wanted to blame it on Tuskegee and Henrietta Lacks and all the science stuff. But the research didn't show that. Those were kind of clouds in the atmosphere, but the main reason why Black women don't participate in trials, and I think it goes across the board for all people, is what?

Anybody know? Not asked. Not asked. Doctors don't invite us. We are not asked. Why is that? Oh, it's bias, racism, whatever the things are. They don't wanna lose a patient, but that's the number one reason. Equally as important was another reason. Anybody know that one? Fear of the unknown. I'm gonna get the sugar pill and die. I don't wanna be a guinea pig. So that said to me, as a marketing person, people just don't understand what a trial is and how it works, right? They don't understand it. I mean, if you called somebody on the phone right now and said, "Do you know how a clinical trial works?" To anyone in your family, would they be able to answer the question?

Right. So we figured that we had to break down the science and explain it to people in words they can spell. Hello, from a voice of trust.

And so we launched a campaign four years ago called When We Trial, and we've now signed up over thirty-three thousand Black women into our clinical trial portal. But that's not enough. That's not enough. We all You know, we talked about generational health. We all need to be talking about clinical trials at the kitchen table with our families 'cause that's the only way it's gonna get better. So let's start with you guys. I think, you know, you guys, do you, do you think there are any other misconceptions besides those? I mean- No. Really. Really. And so, you know, what do we think we should be doing about that?

So, so do you think trust is a fa- I will add to that. Yeah. I think also, some of the institutions that, perform these research, these trials don't reach out to community physicians because a lot of times patients of color will come to community physicians, and I am one, but a lot of times they won't partner with us where the people are coming to. They're not always going to university- Right institutions. So there needs to be more partnership with providers in the community. Great. Great. Great, great. Oh, I echo that. I, I'm at Hopkins, and I've been advocating for that as well, coming from a small institution like Tuskegee since I've been there.

You know, w-sometimes the academic sort of industry sort of lead sponsors go to because of the, the research part of it. But most, a lot of people are still being cared for in the community, and they're just completely missed.

So I call it, like, we don't know what's out in the real world when we do these trials, so we can actually translate it to the larger population. I absolutely one hundred percent agree with that.Um, Toya, tell your story. Yes. well, as I stated, I am a stage three C triple negative breast cancer survivor. I was diagnosed at age thirty-six in twenty twenty-one with no known family medical history while I was breastfeeding. I felt my own lump. my doctor ordered mammograms, sonogram. From the very beginning, I had to fight, and I'm fighting as a healthcare provider. the radiologist did not want to perform the mammogram, saying that I was too young.

Had the mammogram and sonogram, fought it for it anyway and fought for it anyway. I was misdiagnosed. I was misdiagnosed as having a galactocele or a benign milk cyst. Repeat sono in thirty I mean, sixty to ninety days. gratefully, there was a chief radiologist who performed the overread, thought that it looked suspicious, had a biopsy. it was a Friday when I had the biopsy. I was told I would get a call Monday or Tuesday with the pathology report. Well, instead of receiving a phone call, I received a text message on my cell phone while I was at work, working with patients in the ER that showed that I had a triple negative invasive ductal carcinoma.

By text? By, by text. By text. Text message. Yes, ma'am. Yes. I had to leave work. I was just-- My world was just rocked. I thought it was a, a mislabeled specimen or something of that nature.

the next morning, I received a phone call from a radiologist who was very nonchalant, no compassion whatsoever. "Yes, this is your diagnosis. You'll get a phone call from a nurse navigator." I, I was just in a state of shock. I had three babies. I nursed every one of them. I was still lactating. So it was just My world had turned upside down. fast-forward, I'm starting all the things, neoadjuvant chemo, followed by, you know, mastectomy, radiation, and more oral chemo and immunotherapy. But during the neoadjuvant phase, I started looking for clinical trials myself. I also found out that my doctor withheld immunotherapy from me, Keytruda two.

He did not prescribe immunotherapy for me. When I asked him why, he turned to me, turned to his screen, and said, "Oh, it's not on my NCCN guideline checklist. That's the reason why you didn't receive it." In addition to that, I had been sending him my own studies that I had been finding on clinical trials. I knew the importance of it, but I also knew in that moment that if I'm fighting for this, I can't just imagine with someone without a medical background and the, the hardships that they're facing in, in this navigation. So I fired him. I got another doctor. I was enrolled in a clinical trial here, right here at Georgetown.

And, I needed to be enrolled in the clinical trial because I needed to understand why I was being faced with such a, a deadly diagnosis at thirty-six years old with three little girls who will have boobs one day. So this was my way of building my medical trust fund for my children.

It's no different from building your five twenty-nine for your children. I needed my Black body to be studied. I needed to understand why this was happening to me. I needed my biological data to be deposited somewhere so that my, my genes can be studied, so that one day maybe we can get to a preventative measure for my three girls who will have boobs. So, you know, I say all that to say that y-you-- it's-- I tell I had to come forward as a patient advocate. This wasn't something that I set out to do. It just allows me to serve a dual perspective, to be able to speak to clinicians, but also advocating for patients because it made me see things from a different lens.

But now I've been out of treatment for two years. I participated in the clinical trial, and I just have to live every day to the fullest. And she does. And she does. And her little girls are precious. Clayton, do you want to talk about, what we talked about earlier, just what, what you guys are doing and how you're looking at research differently now and how important that is? Absolutely. so, over the past, I think at least my career over twenty years, there was an explosion of not only trying to understand the access to care as well, but also what are the basic biologies.

So if we start thinking about drug development, it actually starts in the lab, right? With the question of what is driving that disease. Those questions are really important because as we fast-forward through the research continuum all the way to a clinic, those t- those questions actually end up into what drugs are being targeted.

So as a basic scientist, we think it was really important for us to actually ask those basic questions early as we're developing the biology. Are there differences between we-well cells from an African American, African ancestry individual respond differently to certain therapeutics? So fast-forward twenty years now of basic science discovery, right? It's time for us to take that knowledge. There's a collective body of knowledge in the literature. I do cancer, prostate, and breast cancer, so I'll focus on those. That we now think that we have targets that pharma can exploit.

For example, inclusion criteria for a certain drug. We now know if that gene is overexpressed, right, in a certain population, that should be an inclusion criteria for that particular patient, right? And then as we're discovering new drugs, right, based on new targets, then we fast-forward those as well. And so, my role at Johns Hopkins is to do just that. So I've been there three years. there was a really-- I thought it was a really cool study for prostate cancer patients, at Johns Hopkins being pioneers, called high-dose testosterone or BASH study. So in prostate cancer, it's driven by testosterone, right?

Just like we talked about hormonal therapy. And, and so hormonal therapy is the standard of care. However, at Hopkins, they actually-- When men stop responding, they give high dose, super physiological levels of testosterone. It does almost just as good as taking away the testosterone, it's the standard of care.

No Black patients were being enrolled in the trial. We mirrored that those patients who respond better to that Black therapy have gene signatures that are more prevalent in the Black community.And now we're opening up in our first trial and, high-- over-enrolling African Americans for this very life-saving study that is going on at Hopkins. And so that's just an example of matching biology, 'cause we know we're in the, in the, in the era of precision medicine, with what we already have available, and making sure the people in our community receive the best and the standard of care, the best possible care, care as possible.

Excuse me. Thank you. Incredible work. Dr. Hampton, and, we, you know, we know also that Black people tend not to get genetic and genomic testing. They don't get biomarker testing. It's very-- I think it's about forty percent. And that dictates all the precis-precision medicine that we need in cancer. So Dr. Hampton, I know that you just did a study on genomic testing, and can you talk to that a little bit? Yeah, a great point. you know, I really believe I've treated mostly African American and Latino women in my community. I'm, in Prince George's County. and so genetic testing has always been at the forefront.

I still find that a lot of us in our community don't wanna get genetics. We're afraid of where that information goes. But I think when the, the counseling comes from someone that looks like them, I think it can be-- make a big difference. And not to say that my White counterparts can't do it, I just think it just, it, it comes differently.

'Cause I can sometimes be like, "Girl, get it together. This is what we're doing." Versus my White counterparts can't really approach a patient in that way, but that's how I'm able to get them. I have been doing, a, a registry trial, called the Flex trial. And my goal, just as everyone else, is really trying to get more Black tumors in there. And what we are starting to find is the difference, and I'm starting to get an aha moment in that our tumors tend to be what's called Luminal B, even when we are estrogen and progesterone positive. So in breast cancer, when you have an estrogen and progesterone positive tumor versus unlike what Latonya had, those patients are eligible for a hormone type of treatment.

But what we're finding is that in Black women, many times our estrogen receptor is not that functional, and so you have to add chemotherapy on top of that in addition to the, endocrine therapy. So, I think this work is exciting. I'm excited to get more Black tumors in there so we can try and find these answers. They're also starting to look at triple negative tumors as well. A lot of genomic testing won't allow triple negative tumors to be s- to be in these or even to be tested. And so we're starting to find that not even all triple negatives are the bad actors. But can we try to figure out, well, who are the bad actors and who are the ones that we need to We can say, "You're gonna get your treated, you're gonna have a good response, and we know you're gonna be okay for the next twenty years of your life." So a lot of exciting things.

But again, I think patients have to be asked, and we have to get the right clinicians who are involved to partner so that those patients can be asked. Vivi, can you speak to-- Thank you, Dr. Hampton. Thank you. Vivi, can you speak to what Amgen is doing with your Rise project and just in clinical trials, trials in general? Yeah. Thank you, Ricki. And thank you so much, Latoya, for sharing your story, and also for all the work that's been done prior to when clinical trials already come into focus. as I frame this discussion, I really wanna say to begin, seventy percent of clinical trials are run through industry.

So really, it's a public health imperative when we say there's an underrepresentation in clinical trials. And so the Rise team here is a step after what you were describing, after we find those biological markers, after we figure out what that is, after we build that database specifically for the people that we're talking about here today, and how do we get, like you were saying earlier, these people into our clinical research sites? And one of the things that we talked about earlier today in this panel is actually how a lot of the s-studies that are running right now are in large academic centers.

And the primary goal of our Rise team right now is currently figuring out how we can transfer that or link them to community-based sites. How do we link them to the community health physicians who see these patients on a daily basis, who see these patients, just regularly, who have access to these patient populations?

And so we are really excited to be launching this program called Research Expansion and Access to Community Health Sites, our Am- our Amgen REACH program. And this is specifically partnering with community health centers, partnering with them to see if they have the logistics to basically offer sites to community members. And if they don't, how can we support that infrastructure? How can we support that capacity building so that these community members have access to these clinical research sites? And with this, we're really hoping to improve that access because like you were saying, Ricki, it's not really an issue of are they willing to participate, it's are they being asked?

Do they have an ability, a facility to go to that's not three miles away, I mean, that's three hours away or four hours away? Because, I mean, GW's a great campus, but it's an hour twenty away from me. It's two hours away from you. And so it's not like it's feasible every single time for someone to come here for their clinical research treatment. And so at Amgen, we're really excited to be launching this program in partnership with our community health physicians to really improve that access, improve that availability of these trials to community folks, across the spectrum.

That's great. That's great. One of the things that we're doing, at Touch is, helping companies like you, all the pharma companies, develop the marketing materials, I call them marketing materials, for trials because most of them suck.

Sorry. I have to tell your baby's ugly. And most of them are very scientific and not very user-friendly and don't embrace patients. And guess what? I wear p- hearts a lot because we're in the love business that clinical trials are about love. Patients don't do clinical trials because they want their molecules tested. Patients don't do clinical trials because they want to advance science. They may have that sort of as an altruistic goal, but they do trials because they wanna have another birthday. They wanna see their kid graduate from college like I did. They wanna ha- to have, you know, take care of their babies.

And so we have to think about how we talk about it, how we talk about them, and where we conduct them. And it's really, really important to think about the people that are involved here, that we're, we're talking about people and their lives. We're not talking about science. And it's, you know, we've gotta approach it differently. We also provide navigation to our patients in the trials, and we have, a twenty-four/seven navigation team, and all of our navigators are Black women. They're twenty-four/seven, meaning you can call them anytime. When the cancer cl- center closes at five o'clock, you can call our navigators, and they all are survivors of the disease.

And so we're now expanding that actually to all diseases because it's so important for a patient to be able to pick up the phone and not get that thing, "Oh, if this is an emergency, call nine one one," and then wait to be triaged for ten minutes before they can talk to somebody.

So we provide that service. So Latoya, you were gonna say something? I was just gonna say that I have been trying to focus, and whenever I get a chance to, I think that, you know, there has to be some retraining to the ACPs as well, because, I know for myself personally, even I was sending, like, NCT study numbers to my oncologist, and I was still being dismissed. So, yes, I was not asked, but for someone like me who's, like, showing interest, and I'm still being dismissed, I just think that there has to be some type of retraining, and remodeling, you know, just probably from, you know, getting the young doctors, you know, medical school level and onward because y-y- I think there has been, assumptions made all the time.

yes, I had to drive about an hour away, but I was willing to do that. And but don't always assume that, okay, they're not gonna drive, or they don't have childcare or whatever it may be. I think you just the first step is just to ask. You know, we-- it, it needs to be like a vital sign. Whenever they're being triaged, it needs to be a vital sign. Whatever it may be, and clinical trials are for so many different disease subsets. Like, just ask. And if there's, if there is, you know, a lack of comprehension about it, then that's when you have a multidisciplinary team approach to educate that patient about w- the importance of clinical trials and just breaking down those barriers because there may not just be full understanding of the trial.

I think clinical trials need to be a upfront consideration.

As soon as you're diagnosed with anything, that should be an option, right? So we need to make that happen. So you guys, what can we do? We're in this mess. we need better science. We need better drugs for Black people. How can we fix that? I mean, I think we're all doing pieces of it, but is there something we could all be doing together to communicate better? And I mean, you know, thank God for Black Doctors platform to be able to talk to a lot of people. And so we're here. Let's, let's figure out what, what can we do? What can we do? Anybody wanna go? Go, Clayton. All right.

I'll take it, I'll take it two steps. so from my point of view, in fact, and, and Rick and I, we've had this conversation where he said we need new drugs. I actually think we have a number of drugs, but we don't know who and when to target those individuals appropriately, right? So mirroring the science with the clinical translational data we have, understanding genetic backgrounds in our precision medicine era, I think is really key for us. And then the second piece, I think where you mentioned, we have to be able to communicate that to our community, right? it's essential that the community gets that there are people out there, such as everyone on this panel and pretty much everyone in this room, that are trustworthy, right, and are looking out for you.

And to be able to have those resource hubs where people can go to get that trusted information so they can help guide their care. I cannot tell you how many people from our community, I think it was a person on the panel be-before, that come to me because they were confused by what their doctor said, and I'm not even involved in their care.

And it's happened at GW, it's happened at Georgetown, it happens always because it-- because I've tried to become a trusted member or participant in the community to help explain what has happened in care. So I think those two translations will help disseminate as well as be able to design therapies that, that are, that are more effective in our communities. Awesome. Anybody wanna go? Go ahead. Go ahead. Go ahead. Okay. I, I can, I can go second. and it's actually building really heavily on what you, you were stating, but from an industry perspective, right, we don't have the best track record of trust.

And so a part of this, right, for us is communicating directly with the trust makers of the community, communicating directly with the community physicians that are trusted with these patient populations, and understanding what these gaps are so that we can really identify where we can step in to be the greatest resource to you and to provide that access for you and the patient populations that you serve. And when I think about this, I think about all the different things that we talked about today, how everything is kind of in silos. And so in a lot of ways, we're all doing this work to propel this piece of representation, this clinical research to the communities that need it the most because comm-- again, like Ricky, you were saying, clinical research should be a core tenet of our health care.

And a part of making sure that that is a possibility is understanding that there are organizations that do this work across the continuum, from the beginning to getting those drug targets to the actual clinical research care delivery model.

And so I believe there was a colleague here from Novartis who was talking about the community engagement and community liaisons in two different communities. Amgen has that too with our Rooted program. And so as we're thinking about how we can do thisIt's really understanding that so much of this work is already being done, and individually, there's this quote, "Individually, we are one drop. Together, we are the ocean." And so as we're propelling this forward, it's understanding that and communicating across the continuum, this is the work that is doing, partnering across the, this continuum to make sure that the changes that we are pushing forward are actually seen by the patient populations that we are trying to reach.

Yeah. Well, I'll just keep it simple. Ask, don't assume, offer to everyone, and make it very relatable in plain language terms. Awesome. That's what I got. Awesome. Yeah. I think, a, a grassroots approach, I think there's two things, one on the patient side, one on the provider side. I think on the provider side, I think it's, you know, reaching out to community providers, helping them to get, you know, NCI, get them a- an NCI investigator license, which is pretty easy to do. But I think, you know, many clinicians, if they're busy taking care of patients, they don't really know to do that.

And I think if we can help them to do that and provide the resources for them to be able to do the research, I think that can go a long way. Then I think on the patient side, I think it's kinda walking them through.

I've found that because I've been able to get patients into a registry tri- registry trial where we're studying their tumors, not necessarily studying them, and they don't have to take a medicine. You know, once I get them into that, when they go to see the oncologist, they're more open to wanna get into a trial. They're like, "Oh, well, I'm already in a trial. I'm in, I'm in the blah, blah, blah registry trial." So then they're more open, and their ears are open. So I think it's a two-prong approach because I think we stef- definitely need to get more of these Black tumors studied to then help industry to be able to come up with medications that will work for these tumors.

That's awesome. That's awesome. we just started a program, with pastors, and, we developed like a toolkit for pastors. After you pray, what do you say? 'cause the first thing people do, women do when they go get c- diagnosis, go to their pastor. "Can you pray with me?" But then they don't know what to say. So we've developed a toolkit all about clinical trials and to direct them to clinical trials. And Black Doctor has a great resource on the website to find clinical trials. We have two websites that we, where you can source trials on, whenwetrial.org and navtrials.org, if you wanna find a trial or help people find a trial, and we do whatever we can to help get them into the funnel and then navigate them through the process.

But I think it's just sitting down with your families, sitting down, understanding your family her story, your family history, talking to both grandmas on both sides or whoever's, whoever's around, and understanding your family history, what you're up against, and knowing that, you know, we are all at risk.

Everybody has a cancer story. Everybody has a heart disease story. So we can't, you know, we're not gonna change anything until we all take this responsibility to do it ourselves. Our tagline for this is, "We are the science we've been waiting for." We in this room are the science we've been waiting for. We have to make it happen. So thank you. Anybody? Go ahead. I think, helping to get patients' history. You know, guess what's coming up? Reunion time. Yes. Everybody's family gonna have a reunion. Yes. And everybody's going wherever. Yeah. You know, get index cards. Black Doctor- Yes y'all could do this.

Get some index cards- Right and hand these out. And I tell my patients, "Y'all take index cards to the cookout, collect them," and you don't even, they don't even have to put their name on it. Somebody take that. Somebody put it all together, and AI can help you do that, and then distribute it to the family so at least people know, oh, three people have hypertension. Four people have been diagnosed with colon cancer before the age of 40. I think these are simple grassroot things that we can put in people's hands so that the cookout, then we can use that to get the his and her story.

Yeah. Yeah. Great. Anybody else say anything? Oh, we have a question. Can we take questions? Are we allowed? Okay. Go ahead. Come up here so we can hear you. First of all, I wanna say thank you. Thank you for your story, and thank you for fighting. That's one. my name is Dr. Carmen Saunders Russell.

I'm an associate professor at Cal State University Northridge, and I'm a pracademic, a researcher, and a scholar. And I am also a mammographer. And I am angered and hopeful by the story. Angered that you got a text message, angered that you got it, on a Monday without anyone speaking to you. I would never ever do that as a mammographer. Happens every day. I, I'm saddened by that. What I'm hopeful about is that I currently teach undergraduate and graduate students in health administration, and I think that those are the people that are left out of the conversation right now, the leadership.

Those are the individuals we need for buy-in to bring those programs into the forefront and put them as accessible to the community. So I think, and I would love to speak to anyone to see what kind of curriculum I can hopefully bring in to that aspect of programming so that now that those future leaders and administrators that are out there working with patients can now also empower them when they go in to speak with their doctors, 'cause it's the interdisciplinary approach that we need. Yeah. And I wanna be a part of that. But thank you for the fight. Awesome. We will definitely follow up with you because the more we can communicate, the better.

You know, in my ideal world, if I had a lot of money, I would build a beautiful Victorian house in every Black neighborhood where you walk down the street, you open that wrought iron gate, the beautiful Black grandmother meets you up the, meets you at the door.

She takes your three kids into the playroom, feeds them spaghetti. She takes you into the treatment room. She sits you down in a cushy chair, gives you a cup of tea with mint from her garden, and she gives you the-- turns on Luther Vandross and gives you the shot. Because we have to bring the love to this. We have to have a different conversation. We have to bring it to our people. We can't expect them to come to it, 'cause they're not being asked.So whatever we can do. I think we have a few more minutes for questions. Anybody else? Oh, coming over. I don't have a mic but- Here, come to this one.

Come on. Move it a little bit? Yeah, come on. Okay. Oh. Thanks so much for that excellent discussion. My name is Isoma Fergus. I'm a cardiologist in New York and a member representing Association of Black Cardiologists. This is so important. The clinical trials that are out there are very, sparse when it comes to the representation of Blacks and browns. And when you look at the demographics in this country, about thirteen to fourteen percent of us are Black, but when you look at most clinical trials, you're seeing five percent or less. So a lot of times, how can you actually state that these medications and these treatments actually work for our, our communities at large if we're not represented?

But one of the issues is that we need to have more people engaging in clinical trials. And I, actually happen to do clinical trials, but I'm at an academic institution. We need to get out into the communities where people are practicing and seeing the patients, because I'll tell you one thing.

You talk about trust and mistrust and the Tuskegee. There's still a lot going on out there that people don't feel comfortable enrolling in clinical trials. Look at how that young lady was treated. That is abominable. Right. So, people are gonna feel more comfortable, enrolling in clinical trials with their primary practitioners in the community. So it's an opportunity for organizations such as the blackdoctors.org to, you know, engage, and ABC, 'cause we've done that as well, to engage with, you know, companies that wanna do the clinical trials and then support the people in the community to be able to enroll more.

So I'm just putting that out there. This, this panel is important. It's an excellent opportunity and very timely to get involved with the organizations helping to support some of these, you know, primary practitioners to do the studies. Thank you. Yeah. any chance anybody has to educate at the kitchen table, at Starbucks, wherever you are, who was saying, "What's your PSA?" I ask people that all the time , "When was your last mammogram?" But we all have to do it. We are the science we've been waiting for. Any other questions? Over here. Yeah, thank you. I think the idea of bringing the research closer to the community is probably a really big opportunity, and I'm wondering if there's a way to have partnerships where community centers, CVS, clinics, can work with sponsors of clinical trials to find a way to make these local sites inve-- you know, research sites.

Even if they have to partner with the big institutions, but to find a way to bring in those diverse communities into our trials.

There are models that have been done where a big academic center has, you know, satellite clinics, and they incentivize the doctors to enroll on clinical trials. But they make it idiot-proof, where you just have to click a button, click, click, click, and they provide them with the resources. So I would really encourage us to try to find those types of opportunities. Everybody can't go to Hopkins or Emory or Children's National. Right. Right. We live in our little community, zip code. We have to find a way to get what we need closer to our homes. Thank you. Right. So I just wanted to comment on that really quickly.

So I think that is a new sort of, emphasis for many apps. We are having those conversations at Hopkins now. We cannot see everyone in the clinic, right, in the, in, in the hospital. It also costs too much, for its cost. And so we're having those conversations of how we translate it. We're actually recruiting faculty now who are specializing in bringing clinical trials to the community in the home as well. And so those conversations, I know Mayo, Hopkins, and all of those, we're, we're, we're forming a tripartite collaboration to have those. So we're thinking about those.

But I also think it's an opportunity for this organization here to sort of be a part of that- Yeah because all of those conversations don't necessarily reflect the complexities of our community when these are being designed. Yeah. It goes up, it boils down to design. I know, and Dr. Hampton's a community doctor doing it in the community, so we just need more and more and more of it.

But also, we need to be talking, talking, talking. Is that it? We're good? All right, so check the breast that you love. I know you have a pair. Oh.