Whiplash Injuries

Pictured: Hannah Wastyk/Background by Nicole Bean for BioSpace Hannah Wastyk was born in Jiangxi, China, and grew up with her adoptive parents in a small town in Pennsylvania. She grew up wanting to be a doctor, and had her first job in a cancer research lab during high school. That experience led to her being the first student at her high school to participate in a regional science fair, which she won. She took her project to an international fair, winning first prize in the molecular biology category and third overall. As a result, she was able to attend the Nobel Prize conference in Sweden in 2013, an experience that solidified her burgeoning desire to work in biological research. She got her undergraduate degree in biochemistry at the University of Delaware, then headed to Stanford for graduate school. During her third year in graduate school, a fellow PhD candidate, Will Van Treuren, asked Wastyk to start a company with him. That was the beginning of what is now known as Interface Biosciences, which is building an AI-enabled, metabolomics-based drug discovery engine for inflammatory disease. Wastyk didn’t know anything about startups at the time, so she borrowed the book Zero to One: Notes on Startups, or How to Build the Future and read it over winter break. She had always envisioned herself going into academia, but that winter, she reconsidered the impact she wanted to have. At Stanford, Van Treuren was building the very tools Wastyk had been waiting to use to find out how the microbiome and chemical language of its bacteria can be used to develop next-generation therapeutics. “It really was a perfect marriage there . . . his tools and then my vision," Wastyk said. "With the company, we could really go out there and try to make these therapeutics [and] use this technology for an application that would change the world. And I felt like we had a better chance of that in going out and start[ing] a company than staying in academia.” But stepping out of the lab at Stanford and into the biotech venture capital world, Wastyk, a 28-year-old queer Asian-American woman, had to learn quickly how to command rooms where middle-aged white men predominated. The Heavy Weight of Representation In 2023, companies founded solely by women garnered just 2% of the total capital invested in venture-backed startups in the U.S., according to a Pitchbook report, while startups with both female and male co-founders—like Interface Biosciences, of which Wastyk is CEO—doing only slightly better at 20.7%. “There’s a lot of women at Stanford, and there’s a lot of Asian women at Stanford,” Wastyk said. “I didn’t feel like a minority in that way as acutely as I did in pitch rooms and with venture capitalists.” In a January 2023 Substack post, Wastyk documented the pressure she felt: I was overwhelmingly surrounded by white men whose sole job was to judge me on the validity of my ideas and ability to make them money. Every day I feel the weight of representing women and proving we have what it takes to be successful. Every day I feel the weight of representing Asian Americans and proving we have what it takes to be successful. Every day I feel the weight of representing queer folks and proving we have what it takes to be successful. Every day I feel the weight of representing adoptees and proving we have what it takes to be successful. “There were times when I would pitch the entire company and then all of the questions would be directed to my co-founder, who’s a white man,” Wastyk said. “That was challenging. I had to learn very quickly to command respect.” Biotech venture capital, and venture capital as a whole, is a largely relationship-focused industry, Wastyk said. Having things in common, including shared identities like race and gender expression, can make it easier to form those relationships. Wastyk recalled a time when she pitched to a group of women venture capitalists and said she wondered why it felt so easy. Then it hit her: This is probably how it feels for white men pitching to other white men. “That rapport just comes really, really quickly,” she said. “That doesn’t necessarily mean it always translates to deals. . . . But being able to create that rapport so quickly with almost every single meeting that you’re in—the chances of it converting to a deal is much higher.” A Business Chameleon Wastyk thinks of herself as a chameleon. And while she said that identity grew out of necessity, she sees it as giving her an edge in business. “This is something that I’ve had to do my entire life,” she said. “Being in spaces where I’m pretty much always the minority, [I’m] good at adapting and can adapt to the mannerisms and the values that people are speaking to.” After delivering as many as eight pitches a day over Zoom to investors during the pandemic, she learned firsthand the truth of the age-old saying “confidence is key.” In graduate school, she noted, the approach is to look at the world as if you don’t know the answer to a research question and refrain from making blanket statements. But in business, investors want to hear sureties, a change in presentation style she described as “whiplash.” Yet she sees that confidence as earned, since “Really, when you come out of your PhD, you kind of are the expert in that domain, at least for a couple of years, because no one goes as deep as you go.” Wastyk said she conducts herself with command in every pitch she delivers, and it’s a practice that has paid off. As CEO she helped win $3 million in seed funding for Interface Biosciences in late 2023 despite a tough investing environment. “You want to have the confidence that what you’re doing is going to change the world, and that you are the only people that can do it,” she said. But her attitude has shifted a bit since last January’s Substack post. While she used to be afraid of failing, Wastyk said she now views failure as the expectation, as successful drug development is not the usual outcome. This gives her freedom to do good science, she said, because now she’s not afraid to try things that she thinks will work and adjust from there. “Business is the most tolerant to failure field in the world,” she said. “Failure doesn’t mean you’re going to be a failure forever.” For now, her priorities in building her company are defining her values, focusing on building up her employees and “protecting these people so that we can do the best science possible for as long as we possibly can.” Mollie Barnes is a freelance science writer based in Los Angeles. Reach her at mollie@100yearsco.com. Follow her on Threads and Instagram @shejustlikedtogo and see more of her work at molliebarnes.contently.com.

TUESDAY, June 6, 2023 (American Heart Association News) -- As rainbow flags flutter in the June breeze for Pride Month, many LGBTQ+ people will feel tension in the air. "It's been a really rough go for LGBTQ Americans" of late, said psychiatrist Dr. Natalia Ramos, an assistant clinical professor at the David Geffen School of Medicine at the University of California, Los Angeles. In the wake of universal stressors such as the COVID-19 pandemic and the economy, the news has been full of anti-gay and anti-transgender actions from the highest levels of state and local governments. "I think even for those of us that are not based in states that are directly impacted right now, it's hard to miss out on the extremely negative discriminatory messaging that's going on against LGBTQ people," Ramos said. Which means this year's pride celebrations could be an opportunity for LGBTQ people and those who love them to get a much-needed mental health boost from social companionship and public affirmation. But fittingly for an event that is associated both with exuberance and defiance, there's a spectrum of ways to approach it, experts say. Jessica Halem, senior director of Eidos, the LGBTQ+ health initiative at the University of Pennsylvania in Philadelphia, calls today's social and political climate the best of times and the worst of times. "I've been in LGBT health for 20 years," she said. "We've never had so much momentum, interest, support and public recognition," even as states enact laws that target LGBTQ people and some pride events are being shut down. "That's the part that gives us a little bit of whiplash," Halem said. "And of course, none of this is good for my heart health." Ramos, who is medical director of UCLA's EMPWR clinic, which emphasizes well-being and resilience in LGBTQ+ people, said toxic stress of the type caused by homophobia and discrimination can indeed be a health risk. "It's a weighty thing to be experiencing constant stigma and messaging against you and/or people you love." A 2020 scientific statement from the American Heart Association emphasized that stress is thought to be a significant factor in health disparities for LGBTQ people. They also are at higher risk for social isolation, which has been linked to issues with mental and heart health. Pride Month celebrations might, therefore, be healthy, Ramos said. "In general, we know that social connectedness, social cohesion and finding meaning in your identity and your values are all very positive experiences for our mental well-being and our physical well-being as well." Halem, who was the first LGBTQ director at Harvard Medical School, said "being isolated breeds shame. And shame is the internalization of stigma." It's impossible for an LGBTQ person to avoid hearing negative messages and absorbing their toxicity. "But you have to actively release it. That is why we dance. That is why we listen to loud music. That is why we sing. That is why we wear wacky clothes. We have to release that shame." Pride Month traces its roots to the 1969 Stonewall Uprising for gay rights in New York City. Over the years, it's been celebrated in ways both serious and silly. "You know, it's funny, because some of us old-timers probably started to take pride celebrations for granted," Halem said. "We were a little like, 'Oh God, not one more party. Not one more rainbow boa.'" Now, she's tuned in to the way those celebrations are a way to witness "the huge diversity of experience, expression and lives within the community." Halem, who has performed as a standup comic at pride events nationwide, said she'd felt the power of such gatherings firsthand. At pride celebrations large and small, she said, "you will always see an incredible range of bodies, couples, hairstyles and clothes. I mean, just to see how people live in their queer bodies, just to see people embody queer joy, to see transgender people, to see old gay people. It's just … "It heals," Halem said. Ramos said "there's an immense potential positive effect on well-being for folks that are marginalized" if they experience a sense of community. "Seeing ourselves in public discourse and public media in positive ways also is very helpful for mental health, even if you're not directly experiencing the pride events in person." But she said it would be naïve to assume that a pride month, week or weekend could counterbalance all of the negative social and political stressors people are encountering right now. People might also have safety concerns about large gatherings. "Realistically, a lot of folks think there's a kind of performative aspect of pride where it's confined to one weekend or one month, while all of these life stressors are never-ending," Ramos said. Some pride parties end up centered on alcohol in unhealthy ways, she said. Others focus on family and community or emphasize activism. So, in some areas, people can pick and choose the most comfortable setting for celebrating. Social connectedness doesn't have to involve marching in a parade, Ramos said. "Hanging out with friends, chosen family, in small get-togethers – whatever floats your boat – can be really meaningful." Halem said LGBTQ events, like LGBTQ people, come in all varieties. "Back in the day, we only had smoky bars and a couple of softball leagues. Today, you can find meetups in parks. You could find Dungeons & Dragons gay night. I'm going to a trivia night at a church basement." If your favorite type of event doesn't exist, it's easy to start something over social media, she said. Go to an online forum such as a local LGBTQ-oriented Facebook group, Halem said, and say, "'I'm looking for other introverts to do a gay puzzle night.' I guarantee you, you'll have 20 people show up." Pride activities also are a great way for friends and family to show support, Ramos said. People who aren't sure how to best be an ally can always ask. But, she said, "you don't want to just reach out to your LGBTQ friends during Pride Month. You want to be maintaining the relationships, checking in, being mindful and thoughtful year-round, especially when there's a lot of stuff going on around us." LGBTQ allies who want to show their support in person need to be thoughtful in choosing an event, Halem said. "You should go to a pride parade and cheer people on and hold a sign saying, 'Another mom for gay rights! I love my transgender kid!'" But after that, "you don't have to go to the dance club." Overall, she said, even small validations of LGBTQ people – including self-validations – matter. The world is full of loud, cruel voices, Halem said. "For me, the antidote, and the way to celebrate this month, is to practice love, joy and affirmation towards ourselves and others." Pride, she said, "sounds like an event I go to. But it's a feeling that I can cultivate in myself first." American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. By Michael Merschel, American Heart Association News Posted June 2023

Combining comprehensive genomic profiling like that offered by Illumina’s tests with targeted therapies—“identifying what is causing the cancer and treating it in a precise way”—makes for a “one-two punch” resulting in more efficient cancer treatment, according to Illumina's Kevin Keegan. A pair of studies Illumina researchers presented at the American Society of Clinical Oncology’s annual meeting in Chicago this weekend generated a feeling of whiplash: While one showed that using comprehensive genomic profiling (CGP) to guide treatment decisions can significantly improve outcomes for cancer patients, the other confirmed that between 50% and 80% of eligible insured patients don’t actually receive the recommended tests. Taken together, the studies highlight the urgent need “to democratize genomic profiling in cancer,” a core tenet at Illumina, according to Kevin Keegan, a vice president at the company and general manager of its oncology business. “Our data show that an enormous and even alarming number of patients are not getting genomic profiling when they get diagnosed,” he said in an interview with Fierce Medtech on Friday. “There are massive gaps; there are still unmet needs. Even here in the U.S., where we have probably more genomic medicine being used than anywhere else, there are still just massive, underserved populations in this country,” Keegan continued. “That’s one of the most important things that we have to wrestle to the ground.” Typically, he explained, after a patient is diagnosed with cancer, the plan of attack begins with surgery to remove the identified tumor. “For patients with localized cancer, surgery will cover it. But if you miss the margins or the spread or the metastatic disease, then you have a serious problem, because it’s no longer treatable with surgery. And now you need to understand how to treat it,” he said. “A lot of these patients just get blasted with chemo—and chemo works, and it helps—but if you can identify it in a targeted way to treat it, the outcomes are vastly better. And so this is what we’re missing here.” Indeed, combining CGP like that offered by Illumina’s tests with targeted therapies—“identifying what is causing the cancer and treating it in a precise way”—makes for a “one-two punch” resulting in more efficient cancer treatment, Keegan said. The outcomes-focused study saw Illumina partner with the Providence Health Network and set up a reflex testing protocol that automatically ordered no-cost CGP testing for patients as soon as they were diagnosed with advanced cases of cancer. Of the more than 1,400 patients who were included in the study—in whom the most common diagnoses were non-small cell lung cancer, colorectal cancer and breast cancer—the tests found actionable biomarkers in almost half. Only a sliver of those patients were then treated solely with chemotherapy—undergoing regimens of targeted therapies, immunotherapies and other combination approaches instead—while nearly two-thirds of those without actionable biomarkers did undergo chemo-only regimens. By the end of the study, which followed the patients for at least a year, one-year survival rates for the chemo-only group clocked in at just under 63%, compared to more than 70% for all of the patients treated with targeted therapies—whether they were biomarker-matched. In total, median survival for the two groups came in at 17 months and 25 months, respectively. Ultimately, the study proved that with a targeted-therapy approach to cancer treatment—which becomes easier to select when relying on CGP test findings—“the outcomes are vastly better than using chemo or radiation,” Keegan said, adding, “So if you don’t do broad-based genomic testing, you miss important, life-saving targeted therapies.” As for filling in the gap between the patients who should be receiving CGP testing and those who actually do, the Illumina exec was quick to highlight the company's choice of venue for the study: Providence is a standard community hospital system like those where most cancer patients receive care, he noted—in contrast to “state-of-the-art” facilities like the Mayo Clinics and MD Andersons of the world—and the study proved that routine CGP tests can be easily implemented into the standard of care at any institution. “Patients who are treated every day in these institutions that are not MD Anderson, they still need the same type of testing and treatment,” Keegan said. “So, we distribute tests all over the world that enable them to do that in their hospitals, in their community centers and in their health systems.”