brought to you by lung cancer research advocates. We are very excited because we are going to have a wonderful session. The IASLC STARS Program is a global program with global audiences that will provide interpretation of different languages such as Chinese, French, German, Greek, Japanese and Spanish to allow interpretation to continue on Zoom. Please follow the instructions shown on the slide, Choose the world interpretation button, choose your language and turn off so that the webinar remains in English. Then mute the original audio so that you only hear the webinar in your own language. Use your guides in the offered languages that are accessible throughout the link or chat link. We want to thank our sponsors and partners for their support of this year's IASLC STARS program. The goal of the IASLC STARS program is to help lung cancer patients evolve into patient research advocates. Program goals include maintaining a network of LCPRAS, educating about the science of lung cancer, research, effective forms of the model to be able to communicate science and research and identify opportunities. We have some logistical notes in this webinar. Questions will be asked by the panelists during the question and answer session at the end of the session. To ask your questions, use the question and answer window. The interpretation user guide is posted in the chat. Please, this chat feature is not allowed for attendants and send a message in the Q&A window if you are experiencing technical issues. This webinar will be recorded and available for later viewing in all languages offered. We have four presenters and a moderator who will be sharing their insights and expertise with us. This is a rare occasion, as the presenters are mentors for the STARS program and our moderator is a co-founder who helps develop the program. Our mentors are the milestone of this EASCL STARS program and their dedication, knowledge and support have a great impact on the growth and development of patients. We want to take a few moments to briefly introduce them. Dr. Upal Basurroy is Executive Director of Research Longevity Foundation and forms the group of lung cancer patients in the United States, trained as a cancer biologist and a public health researcher. You can also advise for more than a decade. Upal is a champion of the power of communities. Andrew is associate director of clinical research at GO2 for lung cancer. He was originally a cancer researcher in the laboratory. He earned his doctorate from Baylor College of Medicine in Houston, Texas. and did his research at other institutes focused on understanding resistance biology for different types of cancer. He discovered new therapeutic targets in cancer cells and his experience became interested in how to achieve better clinical research, focus on patient care and be able to control the disparities that lead to this. Jill Feldman became involved in the fight for lung cancer in 2001, after losing his father, mother, aunt and two grandparents to lung cancer. And then the Longevity Foundation started this. In 2009, at the age of 39, with four children, Jill was diagnosed with EGFR-positive lung cancer. And after being this researcher for 13 years, is committed to understanding and promoting all of this. In 2017, Jill co-founded the EGFR Resisters, or COPD, and she is one of the original mentors of this IASSL-START program. Dr Anne-Marie Baird is an experienced cancer molecular biologist with research interests in inflammation, immune mediators, metastasis cascade, drug resistance and disease biomarkers. Currently, she is a senior researcher at Trinity College, Dublin, Ireland. Anne-Marie became involved with lung cancer patients in 2012, starting with their participation in lung cancer social media. And she is one of the founding members of the Irish Lung Cancer Community and president of Lung Cancer Europe. Janet Freemant-Staley will moderate the Q&A. Today, Janet is a retired aerospace systems engineer, freelance writer or also a metastatic lung cancer patient and activist diagnosed in 2011. His focus is on translating the experience and science of lung cancer for others. She serves as a researcher for oncology research programs. In all these different programs he has collaborated, in an investigation of educational projects with non-profit lung cancer, also published research papers scientific articles and co-founder of LCSM Chat on Twitter, Rose Seeders in the LSFA patient group Hope with Answers. And our experts have a wide range of perspectives for our discussion today. So, starting today, I leave you with Dr. Upal Basu Roy, who will introduce you first. Thank you very much to all of you and thank you for the opportunity to talk to you about these investigations that we have had. We have these talks about the results that are on the front line, with these chemotherapy and target therapies. Many of you have seen this slide and it comes from our great friends, with these incredible mentors and, of course, they also have these points of how we can look at this thing that is lung cancer, How can we see this that is so incredibly complex. And we, as cancer counselors, have conducted research to understand these opportunities. and how we can induce this information to see all this. So we are going to see the current discussion of all this. When we talk about the projects that were founded here, these projects, we see that at the national, international, In all parts of the world, we see that this is also observational. What do I mean by observational? Well, that is, the studies that have to do with all this. And this particular study gives us some of the fundamental questions. Can one of these lines of therapy impact the patient's experience for this point of therapies? So this is a very important question that came out of the lung cancer community. A few years ago, the average patient diagnosed with lung cancer I was going towards two lines of therapy and this was the situation. And then in 2021 or 2022, the majority of people diagnosed with lung cancer They had access to three or four lines of therapy. So when they moved to a line of therapy, they were experiencing the disease with different situations. So that's why we are trying to have an impact on the studies. And what we can see here on the screen are the different questionnaires that have been used and what we are going to be talking about currently. And we also see these investigations. So these two investigations have been validated and are used regularly with the results that we routinely use. And here we have, for example, These studies not only have to understand this, but we can also compare this data and the patients with our own clinical studies. But this is the very important part. Therefore, we have to tell them why these studies are important and how we take the basics into account. Well, now I'm going to talk to you a little about, first, how these investigations, these studies, were developed, both in the United States and patients outside the United States and collaboration with other actors. And these surveys or these studies, They came from these points that it was quite important for it to be similar and international to be able to see all this. So this is a study that actually originated in the lung cancer community and patients competed and completed their baseline after 11 months of surveys. So today I'm going to be talking very specifically about those patients who were diagnosed with stage 4 diseases that were used to do these analyses. They started with 174, it's a total population. And about half of these patients, which are more or less 84, were diagnosed with this first line of treatment. And the other half of the patients, which were about 90, were in the subsequent second line of treatment. Next slide, please. So, this gives us an overview of the demographics of the participants, of the patients who were 174 participants, including a time analysis. This study continues all these samples, that is, about 86% of the population are women or those identified. I apologize, rather. And they also have an average age range of 55, from 29 to 75 years old. They also have an average age range of 55, from 29 to 76, which is a good reminder of the demographics, even the diagnosis that we saw internationally in Europe, Australia and Asia. On the right side of the table, we see the education level of the patients. And this is very important for the panelists. So now let's move on to the next slide so we can really get into the data. This is truly looking at the quality of life based on these treatment line points. And we see the different points, the physical functions, the emotional function, whether happy, content, social functionality, role functionality. Can I do the things I should be doing? Well, the role I play in my house, the role I play as a doctor, etc. Cognitive functioning, am I mentally well? And also the state of global health. This has to do with all patients. And again, these questions were standardized and we have to see these points here in the table. So these are the average scores, that is, the average of these points. So we see here that this typical performance is a score of basically 84. The blue numbers are the numbers of the second part and the subsequent line that are like 90. And we see this dominance, the average scores are much lower than the previous ones. So we see a clear decrease. This slide uses these questions and shows us very clearly that the first line and subsequent line of treatment experienced an increase in quality of life. Now let's move on to the next slide, please. Next Please. I apologize because the lyrics are very clear. So this is a question of fundamental importance. And we are seeing here, for example, if there is any result of the physical condition or medical treatment. We also have the points of financial difficulty and the current line, the first line and subsequent second line of treatment. How has lung cancer impacted you? For example, 27% do have some financial problems caused by this physical condition and medical treatment. We see here the subsequent parts of therapy and we see that these are increased aspects. We see this line of questions that as a result of these conditions and lung cancer They have enough money, for example, to buy basically all of these foods and dressed despite the expenses you have. Well, here we have that some have some difficulty. And well, let's see the last point here. Have they borrowed money or sold their personal belongings? Well, in the first line 11%, in the second 20%. In the first line 11%, in the second 29%. So let's continue with the last slide if you would be so kind. Well, here in the conclusion we can see the impact of lung cancer treatment which is cumulative as seen by the decrease in quality of life and also the increase in financial toxicity. I hope you can see both sides, the quality of life and also the increase in financial toxicity. And we as advocates of this, we have to move and continue with this in our heads because this type of data has to be included in both education and in making decisions. And doctors should have these discussions with their patients to tell them that well The treatment can be very expensive and in second-line therapy we have to talk to them about how they feel, what impact it had on them, etc. And all this is cumulative as I tell you. So again I thank you very, very, very much for allowing me to present this work and more than anything it is a privilege for me to be the voice for be able to carry out these studies. Thank you so much. Thank you so much everyone. I'm Dr. Andrew Zupik, and I'm going to present to you some of the work I've done on biomarker testing reports facing the patients. So, well, in increasing these target therapy options they have made these biomarker tests more inclusive as an essential part in the selection of lung cancer treatment from these companies that are carrying out these results, these tests. So, it is very important to see how these third-party tests are widely used and it has been suggested that providing accessible evidence summaries to patients, for example, the likelihood of appropriate initiation therapy, etc. We have this opportunity to have the right type of therapy initiated. Therefore, we have to see a patient's desire, for example, to work and to have preferences on these summary reports to have an inclusion with these test results standard. So, the way we look at this is with focus groups with patients and health caregivers and their differences are associated. And our interviews are focused on groups covered, for example, by companies, on how well they understand the industry reports. We also ask them about their educational needs, about the lung cancer mutations, your education on treatment options. And finally, We asked them about their preferences to see which markers they had to include and what this type of information and elements were in the report. Then, from These interviews, we identified some formats, some templates and reported and we finalize through multiple stakeholders and a supplier feedback council, of the companies and the people themselves to be able to see what they really They were interested. Also regarding the focus groups that were carried out, we had We must recognize, for example, that in the first group, lung cancer patients or their caregivers they didn't have a non-actionable mutation test running through all of this. The people in group 2, for example, lung cancer patients or their caregivers They had an actionable mutation. And here, in this group, we saw that if they had, as I repeat, the actionable mutation and we had to see whether or not they were involved with a base group in Patient-driven mutation involved in group like this. In group 3, we saw patients who have actionable mutations through these tests and the mutation with based on patients. Here, we can also see the feedback from the group of current focus and reporting. Group 1 told us that they were a little confused, including because they had a lot of information that they did not understand, it was not clear to them what mutations were non-actionable items listed that were relevant to them. And specifically, because they wanted to see that these non-actionable mutations that generated this mutation were not relevant to them. group 2 was confused about the importance of these non-actionable mutations, especially in the progression, and had treatment options that appropriately addressed these mutations actionable. Group 3 was familiar with and understood the reports, but many of them They felt that other patients did not feel the same. So, we saw the desires that they had, for example, to be able to reach these results in the reports. So, with this in mind, we continued with these report preferences to see what exactly it was that they had regarding these problems in these focus group reports. Which What we see here, for example, are the report preferences, the level of information. In the third, for example, group 1 and 2 were focused in a high way that could be linked with the report. Also group 2 and group 3 of the reports could contain too much information. The next thing was about the inclusion clinical trials and group 1, well, Well, he informed us that yes they should, they preferred if they could be recent and relevant regarding this situation. Group 2, not so much, especially in TKI resistance, They were focused on what to ask the doctor and group 3 said that the information was outdated very quickly and could cause hyperfocus on inappropriate trials. So this, for example, the patient information carried by the mutation groups, group 1 said it was not useful, group 2 said yes and group 3 said yes, it was very important. And the last one was how they could present actionable mutations. Well, group 1 had no information, group 2 included the treatment related to these options and group 3 also included the history and mutation genes. The conclusions then were that the patient-centered summary reports of a page, for example, it was understandable both an entire sheet of the front and back part in length, minimize health literacy requirements and also descriptions that were actionable for treatment options and provide background for the gene itself. Then they also had the specific clinical trials that were not listed and the diversity given in preferences in some areas and a template that favored allow design for individual situations. So, in this report we had to see what was important to be able to implement these barriers. The preferences of report differ between patients, but there are common elements that can be identified patient desire to have a summary of lung cancer patients, demarkers that were tested with the actors who should collaborate to develop it. They must also do more studies to see the effects of reporting provision and the results implemented the barriers that exist. And now I thank you very much for your time. That was my collaboration and I would be happy to share with you if there is time for questions and answers, more points. So, thank you very much for your time. Hello everyone. First of all, I just want to thank IASLC for the opportunity to present this work to all of you. Our studies were on early adopters of this non-stigmatized language of the IASLC WCLC 2022 with lung cancer, and like many of We know, stigma is very very important. There is also an undeniable way of culture in lung cancer and these holistic points. I am truly regretting that I cannot do a lot to achieve all this. However, I believe that lung cancer is very, very important and this is quitting smoking. This is important and these are some questions that we must take into account, but of course it gives us very significant consequences in these implications. Research shows that we see everything with our family members this, including the barriers, etc., and all the support that we are having. Cancer type 1 lung disease is very important, therefore, the treatment itself has a stigma and a judgment opposite. So, yes, words matter. Not only is it a simple truth, but it is a simple and profound truth. So recognize the urgency of having all this with these points of the cancer disease. We associate these lines created with collaborative efforts I have, for example, that the word smoker was investigated. It was carried out in the slide decks of 519 presentations from different organizations. Also the guide is important. We have this to mention and in fact we saw that it was taking the point to be able to raise awareness and promote all this. So this was approved in 2021 through the ALC council. Our study analyzed and while it was created specifically for the abstract and presentations, really our goal was for the entire community to start using this type of language. And that our study looked at certain presentations from the 2022 world conference, after the language guide was approved to evaluate adoption of non-stigmatizing language for that first year. And we wanted to see if there were correlations with this and with the characteristics of the presenter. So, we focus in the term smoker, because it is the first word on the list of the agenda of the guide of the stigmatizing language. The smoker is labeling patients by their behavior and the completely dehumanizes. So we did some research on their usage and presentations and also explored their presenters and their information. 177 of 519 slides They talked about smoking status and 43% used non-stigmatizing language. As you can see, we were able to find that non-stigmatizing language was embraced much more by those with doctorates and other categories, including patient advocates. But Well, the most important thing to take from this is that all groups exhibited positive change. Therefore, if we also see that there was not necessarily a statistical significance In the other categories, again the diversity in continents and specialties showed promise and whether it sustained a change in the people who were talking about lung cancer. And well, this language improvement guide had made an improvement in our community as I showed you, but it's also gaining some traction beyond our community. And Let's think one of the most important impacts is established in the influence outside the community, outside our cancer community or in the cancer center network. And they've recently created a language guide that actually cites the language guide. Therefore, NCCN serves as the primary resource for physicians and insurance companies to determine care pathways. So, it is definitely a super reinforcement important and significant and in essence should be the game changer, but obviously Change comes with challenges and we recognize that. Also old habits don't really stick They die very easily. We know that language is static, it is not static, but the guide of the language is not static either. We are trying to work on these second interactions to address some of these challenges that we know about, research tobacco and present the data, tables, numbers, word limitation concerns. AND we started to start certain discussions about the dissemination plan and develop certain metrics to be able to measure success on a larger scale. You know, we recognize that this is a step crucial, but it is not the only step we should take. So we know that we are also trying to work on the way in which researchers report from top to bottom so that it is consistent, so that it is not subjective and so that in a certain way is reported in a way that patients and caregivers can also understand that at this moment we can understand, those of us who do not have doctorates or who are not doctors, that we can understand science in a certain way, right? Now, well, there are many people who They were involved in this. We are very grateful, but really the most important thing is that the fact that IASLC took the lead in changing the way we talk about lung cancer and change that focus from blame and affect to compassion and language without judge. And this medical language is quite large and historically used to describe cancer, But over time we have learned that some of the words and phrases hurt and hurt. to the patients. And many times patients don't go to lectures or necessarily read magazine articles, but now we do it and we keep each of the words and IASLC really recognizes this. Now, really when we talk about lung cancer, you know? It is how we need within the community to also promote dignity, respect and first the person, language focused on the person. So I, and well again I am very grateful for everyone who was involved in this and we are going to We are doing a lot more work in this area and our goal was to document how people do it. are seeing and we were really very grateful with what we found up to this point. So thank you so much. And last but not least, I'll turn it over to Anne Murray. Thanks, Jill. It's wonderful to be here with all of you and I hope this worked out correctly. So, I'm going to show you a little bit about the presentation that we have as part from the cancer conference and lung cancer barriers to care in Europe. And thank you all very much for being here. Unfortunately Mario couldn't, he was part of our lung cancer council, passed away last week and it was a very very difficult week. So well, for us I just wanted to mention it. With this, the project that we What we really did was try to look at the path of lung cancer care and each It's getting a little more complex than the different treatment options and there are so many things to eliminate in this care path that really the care path that is very difficult to navigate and particularly from the European perspective there are certain limitations and certain problems that this journey has affected us and we want to focus on the person specifically. Our goal is to explore the experiences and preferences of the trajectory of Be careful and also go more in depth in the European countries, since we do not have much data And I would like to share the data with you. So in terms of our methods, really this was extensive literature to review and we developed an online survey on SurveyMonkey. And well, this organization is an organization and most of the topics came from our members and we create working groups. There are many people working in these groups. I work to be able to develop the different projects and in this case it was no different. The people actually participated in the survey and wanted to see if we always prioritize certain questions, we checked if the language was correct in the questions for the survey and obviously We also want to try to work in as many languages as possible so that we We could have the survey actively in 17 languages. So just a quick overview of the main characteristics of our participants. The majority were women and 55 to 64 years, they were between 55 and 64 years old and it is something that we have seen in previous surveys. However the Age range typically varies from 25 to 75 plus. Most of our participants also were in stage 4 disease, primarily with adenocarcinoma and 57% had some positive molecular marker. I wanted to mention that from the data we could see that there was like 26% of those who participated actually didn't even know if their tumor had been tested by biomarkers or had been positive for some type of biomarker and that in a certain way the Most of our respondents were also from urban areas and had low education as well. I also wanted to mention that 50% of our respondents came from France, Germany, the United Kingdom Kingdom, Poland and Greece. So, initially we start to see the data of the diagnostic part of the trajectory because we developed different portions and there was really a lot of this that that patients mentioned to us regarding the problems of early diagnosis and in Europe, screening is implemented in different countries and we can see that the screening programs really It is the problem in most of the participants. There was also a lot of data that was showing that people had to go to their care, to their primary care doctors to see the different types of education and many times the doctors did not give them the opportunity. information and this we also needed to help them how to reduce waiting times and educate the general public regarding lung cancer and also see the priorities. The diagnosis and this way again the waiting times were what affected the most and many times what we could be managing because it was the different numbers of people that was really very important help and have people with a primary contact to see if they had any problems and also give them different paths to see if they had any problems and give them a map a general idea of what could be happening next and all of this could improve the education and priorities too and this could focus us on better communications, empathy, clarity and messages for education about side effects and how to reduce the risk of complications too. Looking at the treatment and the treatment trajectory there were different areas that were not specifically addressed by the health care teams. health and that we should really consider all the emotional, physical and personal experiences that each one was having and also the most difficult part of the treatment in the trajectory was anxiety. The anxiety that there is a lot in the expected treatment but also when we were talking about surgery in particular there were many difficulties regarding pain associated with surgery and also the difficulties of radiotherapy, medical treatment and difficulties in terms of fatigue, weakness and again stress, anxiety and everything that people were feeling and other problems identified that these were the key problems for each of them. In terms of priorities during and after treatment it was also like this guide of what people could do in terms of the complications. People wanted support to be able to manage the side effects, particularly in terms of pain management, but this also It meant that we needed to ensure that we had allied health care professionals and that they gave them paths, that also gave them certain references and that they also had their own way of educating themselves and managing, self-managing their illness and as we mentioned before, that they have a point of contact, who have accessibility and who can speak. Again we talk about communication information and the different needs that are needed in each of the sections and it was really to make sure when we particularly make a treatment decision, if we want to have shared decision making and understand what the available treatment options are, the advantages, the disadvantages of those options and what are the potential side effects associated with those different treatment options that are available. There was also some information for support needs that were missing, follow-up and the care phase, which we are also looking at some of the symptoms and recurrence that were already having, perhaps, the long-term consequences of the disease and the treatment. And again Access to information or quick access to health services is super important to have in mind in the care trajectory and there was also information needs. In terms of treatment pathways, treatment pathways, and in terms of clinical trials, many of the people felt that there wasn't enough information on this and these social and emotional issues, again that people felt like they were obtaining too much information and that the participants also interviewed, surveyed, selected the need to have information regarding the advanced care planning and that many times perhaps they were forgotten along the route as such. And another thing I wanted to mention here about the data is which was about informed consent, which our study showed that 47 percent of our participants felt that they had not received all the information they needed before they actually started signing their informed consent forms. So really this kind of Information and communication has to be addressed. The most important points in this study, again from the European perspective, It was entirely to ensure that the implementation of lung cancer screening in European countries was in some ways the need for quick reference and to have improved information and communication for each of the people and this really impacted so many different things in terms of the trajectory, the route itself and the people and what they felt and experienced. With that I would like Turn the floor over to Freeman Daley to moderate the questions and answers. Thank you Anne-Marie. I invite all our speakers to come back again. Thank you all for sharing the important work on the results. I have some questions about how people get involved in these projects and how they get started. So how did you guys get involved with your projects? individuals and what was their role? Well, how did this project start with lung cancer Europe? It was that all the members have and come at different times from the moment in different priorities that they need and what is needed for them is to see each of the projects and in this sense we have other work regarding the social impact of lung cancer and that members felt it was important to provide follow-up and experiences and a path of care. My role was just to help in terms of the work group, getting people together, but a lot of these things you also need experts, so we are very lucky to have the working group also to and to have all the literature to review and to be able to have everything together for the different translations that had to be done. And well, in some ways seven languages is too many. Yes, it's too much, but hey, some way we could have one person who could handle everything it. Thanks, Andrew. Well, I think the reason we started focusing on this question is two things. One is that the data that What we've seen from many of the health care systems, including the US Oncology Network and others, is that not all of them were having the testing of biomarkers and also many of the people were having these biomarker tests, they actually started with a very appropriate therapy late and that was a very important problem. Not getting certain feedback from people who needed support services patients and how they did not have access to the companies' current biomarker reports. So, we decided to focus on this and asked, did the question of why no one was really trying to do a friendly biomarker test and that this could be brought to bear for the partners of the industry so that we could take it and start informing as to what the community will need specifically in the project in the that I have worked very closely with the organization. I focused more on designing the questions we were going to ask and how we were going to contact people for information and the suggestions we got also to reflect the patient experience and really We could connect with patients. Again, it's like a partnership of more than nothing. Yes, take a whole team correctly. So Jill, what do you think? Well, me and this started from a personal experience obviously with my family history starting when I was 13 years old and well it was probably About 10 years ago I started to see some division in the lung cancer community as well and well words matter and I tried Actually 10 years ago I had a person calling me a professional who told me sticks and stones. Others tell me you are being too sensitive, sentimental. So, well, I believe it was fall of 2019 when IA SLC split into patient advocacy committees. I was proposing a language guide and a of them was simply knowing that it was a work in progress but that I was just starting with the language used and the information of research and presentations and was also working with the national lung cancer stigma roundtable and task force and this Synergy really was bringing everyone together and other different disciplines and people and organizations as well. And well, I think people were ready to listen at this point. So it really was a labor of love and as Cristianito mentioned, many hearts and hands that were laid. And yes, well, that, thank you, thank you. Whoop? What do you mention? Well, our project started in 2019 with the society from EGFI and Jill and the different people and this project was looking at the experience of people in the EGFI community and this project in particular was the bases of the project and the data that we present today. And that is really embedded in the needs of the patients and their community and I would say like the questions that are established in the patient's community, but there are no companies that have and can understand the experience of patients without through different kinds of therapy and research and well the advocates in mainly who can mention and Be aware of the research. But another part that is also research by patients and patient advocates as well They need to bring other actors into this project, because we can have projects by ourselves, but if the data is being used in other actors and if other actors do not fit into this project, well it is a failed experiment. So we can work together with the FDA as I mentioned before, because there are pieces of this project that if we compare the patient experience in a clinical trial situation in the that we collect the data with a real life experience, well it's different is how this project started and that's how we started bringing the value proposition to the broader community. I'm hearing a very common thing that was a credible idea, but in order to have the project It required coordinating many people to ensure that we could do it. That being said, how long did it take from when the initial project was conceived until we were able to have all the data? No, I have realized that they do not have the exact months, but more or less. Let's not go back in time a little to see? Well, I do have the exact number, of course. The priority of the project began in 2019 and Ivy and Jay presented it to different parties regarding the investigation of project priority and different places in 2020, 2019, 2020 and 2021, how good in a certain way the project is how it was developed. So It is in 2019 and 2023 that gives us a manuscript phase. And well, the PIER project started in 2021 and finally we present the discoveries in the 2013. This year we present a little more detail of what we found. So, I think that patients and persistence is quite key because We are doing a rigorous study that we are asking and asking the different actors to be part of and that takes time. Andrew, yeah, well, We've had these conversations for quite some time, but well, talking a little about the project started six months before we actually started the project. The people helped us do the different analyses, plan the project and have resources of financing also to do so. But from the beginning of the project to the end It took about a year for us to collect people. We started having interviews with people and analyze the results to generate the reporting template. Thanks Jill. Well, if you could tell me all the years you were thinking about that before from when it started. Well, for this particular one specifically, for this particular project it really was a few months. Which, well, because it was there. us nothing more We need to see the entire presentation from 2022. So, it took maybe three or four months to really look at everything for the purpose and we were very happy with what we found and we hoped that might be the case. It could have gone the other way, but we are starting at this moment to go deeper. Henry. Well, for us they were like 12 months because, well, it was collecting people, getting people to help us and Well, it's team work as Janet mentioned and definitely peer review and read the data publication. That's what took the most time. Well, we have a couple of minutes, So I would like to have feedback from each of you. What do you think a person who is involved in the lung cancer community as an advocate? What could Is it so that he is involved in projects like these? What could be the first steps, Jill? I would like to start with you. Well, I think there are different things you can do. One of the things is talking to other people. I like to ask a lot of questions and if I am going to contact to different people, defenders and people, because if I am really very interested in something and well, just a very quick example that I just did with something else than what I'm very interested at this moment is the doses, right? And I spoke with a researcher who started talking about certain things and we started brainstorming. So Janet, well, you know, I talked to this person in Oregon about the PROs and well, I just try to be persistent like this form and I have to tell you that these are very willing to talk and see the different things. Andrew, what do you mention? I would like to talk about the importance of societies that we could have it. That it is very important that we are not afraid to share with others, you know? And what is the most difficult. We can do it alone, but many times the projects that I start I have a couple of ideas, some ideas and I really don't stop pursuing them, but I I get involved in other parts, with communities and other things to share ideas and well, I kind of talk to someone and they say, you know what? It's a very good idea and eventually I'll start to make connections to do it. So I tell people and well, have the different community members really is very, very important. I would love to continue doing this he asks, but we're already out of time. So thank you very much to our speakers for presenting the present day. Thank you to everyone in the audience for being with us today. See you next time. Thank you and see you all later. Thanks and see you later. See you later.

lung cancer research

advocacy

treatments

quality of life

biomarker testing

patient-friendly results

barriers to care

improved communication

patient involvement