Dr. Azadeh Nasrazadani, MD Anderson Department of Breast Medical Oncology,

Dr. Nasrazadani (Dr. Ozy) shared her career journey from biochemistry to clinical oncology at MD Anderson, where she focuses on inflammatory breast cancer research and treatment. Terry and Dr. Ozy discussed the challenges of academic research, including financial struggles and the need to balance clinical obligations with research efforts. They explored the progress and future directions in IBC research, emphasizing the importance of patient involvement in studies and advocacy initiatives, including the MD Anderson Boot Walk.

Transcript

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Terry Arnold: Hi! I'm Terry Arnold, and welcome to Talkivc, and I am so thrilled to have one of my favorite doctors at Md. Anderson with me today, and because I know I'm going to butcher her name, I'm going to ask her to say, but we affectionately call her Dr. Ozzy. Please pronounce your name.

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Azadeh (Ozy) Nasrazadani: Good morning, Terry. Thank you so much for having me and having me in your living room. How fun it is to do this! But my name is my parents thought was an awesome idea to name me that in the eighties. And you know, Louisiana, because why not? But for hopefully obvious reasons. I go by Ozzy, Dr. Ozzy, which my friends and colleagues affectionately call me so. You are welcome to call me as you wish.

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Terry Arnold: Well, I guess I just got stuck on the Dr. Ozzy, and I hear that so much now. I don't get to hear your full beautiful name, but I'm so glad to have you here, and for those of you who don't know you, you are a clinical oncologist researcher at Md. Anderson in Houston, Texas. I'd like to have you tell them a little bit about your background, how you landed at Md. Anderson, about your family, anything you want to share, but also

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Terry Arnold: kind of always like to know why you pick the tough world of inflammatory breast cancer? Because that is not an easy

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Terry Arnold: apple to Peel. Shall we say so? Where would you like to start.

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Azadeh (Ozy) Nasrazadani: That's a pretty loaded question. But let's see, I'll try to organize my thoughts in a way that answers all that. But how I kind of started off. Well, my dad's a scientist, he's a he's a university professor, although in engineering. And so when I was growing up, I thought that every little girl had to grow up, go to college, get a Phd. And then become a princess. So that's what my trajectory essentially was.

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Azadeh (Ozy) Nasrazadani: So I actually didn't want to be a doctor at the beginning. I I wanted to be a scientist, but somehow, you know, life shows you your path. I ended up. I did my bachelor's of biochemistry at ut, Austin, you know. Hook them horns have to make a plug there

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Azadeh (Ozy) Nasrazadani: and then, I, you know, doing rotations in graduate school. I kind of fell into a breast cancer research lab with Carla Vandenberg, with the College of Pharmacy at Ut Austin. And I really resonated. I really found that that was what I was meant to do, and you know I have to say with them at the time I was like a 21 year old.

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Azadeh (Ozy) Nasrazadani: with the, you know, whatever the frontal development of a 21 year old is at the time. But it really it really shaped a big part of what it was, and I really felt like I was doing something that mattered. It was a lot of of course, bench experiments, you know, perhaps we should talk about animal models. But you know, bench research and

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Azadeh (Ozy) Nasrazadani: my project specifically focused on advanced breast cancer specifically underlying signal transduction pathways, and really to say it simply

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Azadeh (Ozy) Nasrazadani: You know what the biology, you know, aggressive biology in these breast cancers. And it was just so fascinating to know that your body, you know, to troubling Nerd out, to know that your body can do these things, and it really gives you an appreciation, for you know what what our bodies are capable of. Essentially, you know, cancer cells. Being kind of these. To quote Dr. Mukherjee, and that was it.

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Azadeh (Ozy) Nasrazadani: One of his books. I hope he forgives me. But he said something to the nature of cancer cells or scrappy versions of ourselves.

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Azadeh (Ozy) Nasrazadani: And that's that's just so, you know, spot on right. So just being really fascinated by that. But as I was getting closer to defending my thesis and graduating what I really kind of found myself gravitating towards was trying to go more at the clinical trial space and kind of going from that bench to bedside, and us being in Austin every year that really afforded us a chance to go to San Antonio. And I'm telling you as a grad student when you're like stuck in the lab, and you smell like anger and like, I don't know, like

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Azadeh (Ozy) Nasrazadani: all kinds of you know, lab things. And you get to go to see all these cool things happening like really clinical trials, talking about hundreds and thousands of women, you see advocates, and it really just shifts your understanding of what's happening, and what it really means to be at the bench, and what, how, where things get started. So I have to see that that really inspired me. And it really kind of changed my trajectory.

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Azadeh (Ozy) Nasrazadani: So that's why I knew I was like, I want to be a breast cancer doctor, and the reason for that being that all the jobs I wanted to pursue? You know, specifically, for you know.

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Azadeh (Ozy) Nasrazadani: being in the clinical trial world, necessitated having an Md. Interestingly enough. You could have a Phd, but you needed to have that. Md, so really, that's what I decided to do. I said, Okay, I want to be a breast cancer oncologist, and that's what I did. So at the time my husband

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Azadeh (Ozy) Nasrazadani: was.

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Azadeh (Ozy) Nasrazadani: and see how I ended up in Pittsburgh. I'm trying to make that link now. So we I applied to a couple of different programs Med school. And then for Residency fellowship. I did a physician, scientist pathway, which was more geared towards people who are more you know, academically inclined, and my husband at the

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Azadeh (Ozy) Nasrazadani: husband still at the at the time, and still my current husband. He! He!

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Terry Arnold: Still your husband.

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Azadeh (Ozy) Nasrazadani: Yeah, that was very successful. Marriage. We're good. He's a.

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Terry Arnold: Good.

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Azadeh (Ozy) Nasrazadani: He was in Pittsburgh, and so it was very desirable for me to want to go there. They have a wonderful Residency program, and there's a combination internal medicine

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Azadeh (Ozy) Nasrazadani: Hemont Fellow Residency fellowship, physician, scientist, research pathway. And so it was a wonderful experience. I spent about 7 years or so roughly at Pittsburgh. I had wonderful mentors. I got to work with Stephanie, really amazing people who continue to help invest in me and to help me be who I want to be. But you know, as I had my

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Azadeh (Ozy) Nasrazadani: my second kid, and as you know, things happen, and, as you know, career choices, and just with family, all kinds of, for a variety of reasons

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Azadeh (Ozy) Nasrazadani: that I think you know. Variety of reasons. You know, looking for you know what the next step was so at the time I was a clinical instructor in Pittsburgh. And actually, Dr. Tripathi reached out to me and said, Hey, I heard you're looking for a job.

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Azadeh (Ozy) Nasrazadani: And at the time I had been also talking to Jenny Tank at Methodist, and I just was really excited to come back to Texas. So A big believer in destiny. And I think it was just so wonderful to get to meet so many amazing people and have the opportunity to come back to Md. Anderson, which I just really thought was

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Azadeh (Ozy) Nasrazadani: in my wildest dreams. So it's been really an honor and a privilege to get to work with so many amazing people here being at Md. Anderson. But to kind of answer your question, why inflammatory breast cancer as part of my research. A big part of my project was focusing really on the really bad cancers, the really bad breast cancers being essentially triple, negative. And some of the projects I'd worked on with Dr. Bruvsky. One of them specifically was looking at

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Azadeh (Ozy) Nasrazadani: long-term survivors of metastatic, triple, negative breast cancer, which, as you know, are really rare birds

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Azadeh (Ozy) Nasrazadani: and trying to move that project forward, although it hit Covid and other fun challenges. But all that to say is that I really wanted to pursue something that was really tough, you know, like, really wanted to do something that was like really worth doing, and as hard as it is to see patients deal with these things. It's knowing that we're doing this together and kind of trying to figure out, how can we raise the bar? And once again in my life. I kind of fell into that opportunity as I fell into, you know, a breast cancer lab so many years ago with Dr. Vandenberg.

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Azadeh (Ozy) Nasrazadani: Dr. Wayno. You know very well known Wayno, just an amazing person, researcher physician.

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Azadeh (Ozy) Nasrazadani: He was one of my mentors, and how incredibly grateful I am for that! But somewhat shortly after I joined he was offered the position to be the cancer center director in Hawaii, and so he was moving on, and with that there was going to be a big void in clinical needs. And you know other specific needs and members of the Ibc program. So Dr. Bolero members, they approached me, and they said, Hey, I think this is going to be a really great opportunity.

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Azadeh (Ozy) Nasrazadani: It's completely up to you. We realize this is a really hard gig. Would you like to do this?

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Azadeh (Ozy) Nasrazadani: And it just felt like an amazing opportunity. And somehow I felt like, Oh, my gosh! This is my chance, you know, I had actually been recruited to do more hormone receptor, positive breast cancers, which you know in many cases, can be resistant, aggressive. And I had actually spent a lot of time doing research on invasive lobular carcinoma which we talked about a little bit in the past.

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Azadeh (Ozy) Nasrazadani: And so it's kind of carving my niche in that regard which we still continue to do here, as we're gearing up also to open a center of excellence, which I'll I'll plug a little bit later, but all that to say is that I really felt like, Oh, my gosh! This is going to really help me. Kind of go back to my roots of what I really wanted to do. So it has just been an amazing.

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Terry Arnold: I'm gonna interrupt you there for a second.

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Terry Arnold: I will say, I remember when

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Terry Arnold: excuse me, got a phone with her. When Wayno told me he was going to be leaving. I'm like you just said it's going to leave a big void because he had his fingers in a lot of things and was very well loved on top of it. And also he brought a unique element as a two-time cancer survivor.

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Terry Arnold: his patients really connected with him. And so there was a little pushback in the Ibc community about him leaving, and everybody say, but wait, there's more. Wait. You meet Dr. Ozzy. She's amazing. And he talked to me about you.

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Terry Arnold: and and I was able to pass that along to people who were concerned. And I can tell you I've got nothing but really positive feedback, and and they were nervous because you had some big shoes to fill.

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Terry Arnold: But I think you filled them well, and I also appreciate something I'm hearing from you is the passion about doing something hard.

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Terry Arnold: Everybody that I know is in the Ibc world is doing something hard. And one thing I was. I say this all the time

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Terry Arnold: is, I want patients to understand what your life is like, because I know when I got involved with breast cancer world. I assumed academia just literally. And I say this all the time, gave you guys a bucket of money and said, Here, go study it.

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Azadeh (Ozy) Nasrazadani: I know.

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Terry Arnold: No idea how hard you had to fight for grants, how much time, how hard it was, how the limitations on what you'd even apply for or how many times you could apply. That's why we started. The Ibc network foundation to our main goal is to fund research was because I saw the challenges you guys are up against, because when I felt like I needed to do something to help, people said, Well, you could pay people's light bills or do whatever I thought. No community can do that. Churches can do that. But getting into the research part

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Terry Arnold: is where I wanted to give support, because that's where I saw there was a huge void. So I would like you now that we're here, and you're trying to do all these big things to talk about. You know what you're seeing. That's a hurdle. What's an obstacle? How patients can help what is coming down the pipe for patients to know about to take care of themselves medically, because you were really in that clinical space.

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Terry Arnold: And there's a lot that you want to do. So. I'm glad that you're here. I'm glad that they found you.

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Terry Arnold: I'm glad you're wanting to do the hard stuff, because I tell people this all the time

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Terry Arnold: Academia is not private practice. You guys look at all the education you got. You guys be making double triple bank

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Terry Arnold: in academia or pharma. You can make more money working at a Botox clinic, I promise.

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Azadeh (Ozy) Nasrazadani: That is also unfortunately true, but I know this well, so thank you so much Sherry, for bringing this up. I'm so glad that you did. And it's really funny that you say that I think it's kind of a big, mysterious box with regard to kind of academia and research in general, and even my own husband every single day in the internship, fellowship, he would say, private practice, right, private practice, right? So he still continues to

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Azadeh (Ozy) Nasrazadani: to wonder and try to comprehend my career choices, but I joke he gets it. But just to kind of take a step back and talk a little bit about in very simplistic terms of what that means and how we are distinguished. So in private practice. Really, that means that physicians really focus on clinical care, which is a lot more straightforward kind of once you know how to treat patients and what the standards are.

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Azadeh (Ozy) Nasrazadani: and of course, staying up to date on things that are changing. You're good, you know what to do. You know how to take care of people, and it's boom, boom! But for and inappropriately, or rather, as people presume. Yes, that is something that can be very well compensated to varying degrees, particularly in private practice. But for academic physicians, in order to justify not spending your entire

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Azadeh (Ozy) Nasrazadani: time on clinical obligations. You actually have to find a way to support yourself and to buy that time. So the hospital and or entity that pays. You can allow you to do that, because otherwise they can be, you know. Of course, it's all about helping people, but the they're employing you for a reason. They want you to take care of business. So how that funding comes about.

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Terry Arnold: But I might interrupt here, because cancer treatment is not so straightforward. I mean, it might be what they say, the simple cancers. Okay, you do this. This this you know, but when you're in a place like, you know, Md. Anderson, or Dana-farber, or places are bringing in the harder ones, where, like, especially Ibc, it's constantly morphing and changing. And you're like, Whoa, that treatment plan works on 85% of patients. It's not working on you. It's not like you're just given a prescription for a cold. You are constantly.

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Azadeh (Ozy) Nasrazadani: You need to know that there are new things coming. But where do those things come from? They come from somewhere, right? So we really have to foster and really nurture those efforts that are coming from all the way down from the bench, the research to the different varying degrees of drugs being studied, and where all that happens. But that really requires academic efforts. And so to kind of, you know, build on what I was saying is.

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Azadeh (Ozy) Nasrazadani: it's very surprising that even to do something that you know, one would think would be important. There's not a whole lot of it doesn't make a ton of money to do that, because many times for anyone who's been in grad school or done research, you realize that for every 20 failed assays you're going to get that one result that you can, you know, kind of

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Azadeh (Ozy) Nasrazadani: and think, okay, this is what we need to be propelling forward. It's beyond just knowing having a good idea to start with. You know what are the good ideas, where the knowing, having the sense to know, or you know, the the skill, the art of knowing where the important questions lie.

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Azadeh (Ozy) Nasrazadani: funding it as it's a whole arena. And I remember one time I was trying to explain to my son. Actually, last year I was trying to put in a grant and my poor children that they've only ever known. You need to go to sleep. Mom has more work to do. And I was trying to explain to him, Mom, he's putting them this grant, and he's like, Oh, what's that? And I was trying to explain to him how it

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Azadeh (Ozy) Nasrazadani: I don't know why I was trying to explain to a 7 year old what it means to put an Nih grant and to ask for money. But I said, it means that mommy is asking the government for money. So I can do research because he's all excited about being a scientist now, and he's like, Oh, you can do that. They'll do it like, yeah. But it's really hard work. You have to prove that you have to, you know. Put something in. You have to. What you're proposing has to make sense.

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Azadeh (Ozy) Nasrazadani: he basically said, Oh, so you can do that and just spend all your money on toys. It's like, Oh, wow! Absolutely not. You have to justify every cent of what you're asking for. But I think one thing that people don't realize is that it actually is. It's very hard work, because it's increasingly, it's become very difficult to fund research. And because it's just for a variety of

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Azadeh (Ozy) Nasrazadani: reasons that you know socioeconomically, but the political climate and everything. Where where our priorities lie, as far as what we're funding. But there's just not a ton ton of money for research, and it's very expensive. It's not just about the the agents. It's the space. It's the the people, making sure that you're within the regulations and ethically doing all the right things. So the

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Azadeh (Ozy) Nasrazadani: so it may be very surprising to people to know what those costs are, and the fact that indeed it pays significantly less than you know. Were you to basically do just

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Azadeh (Ozy) Nasrazadani: private practice.

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Terry Arnold: One thing that got me going was I met a researcher, and I hate repeating myself on things. But maybe somebody will hear this relation to you that hadn't heard before is a researcher showed me a paper, and he said I got a perfect score, but they wrote on here. They're going to pay, if and what it was is they pay if they still have it. At the end of all the other things they paid, and I found out that rare diseases get put at the bottom of the list.

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Terry Arnold: And so, even though we had a perfect score, he didn't get the funding because they want to go for the bigger bang for the buck. So I want people to understand that so they can get behind the researchers because we are trying to help ourselves. I mean, I am standing on the shoulders. My wellness is because of people like you before me, and and patient advocates before me who those essays led to something that made me. Well.

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Terry Arnold: now I know people got the same treatment I got and didn't beat. Well, so there's something unknown in our bodies that we're not hitting, maybe what they knew hit my targets, but didn't hit that next person next to me with the same exact diagnosis.

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Terry Arnold: because there's some unknown factor we want to get to. So that's where I get very passionate about what's going on the science. And we're recording this in June of 25. And there's a lot of unknowns right now. So because they're unknowns, we're just going to that alone. But can you talk about some science that you think is merging, that you would like to share with our patients that listen or their families listen, or also

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Terry Arnold: just to let people see there is science coming because some people think science has come to a screeching halt, and I don't think that's really fair for them to feel that way, but they don't know what's going on.

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Azadeh (Ozy) Nasrazadani: Sure, and it's easy to feel discouraged or feel like things are, you know, are not moving fast enough. I can say that it is overall an exciting time to see so many approvals and things happening faster. But it's still the unmet needs remain, and it's just not fast enough. But as far as things to be excited about and things to kind of know things are happening, I can tell you. Aside from private practice and academic medicine, the pharmaceutical industry. They are

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Azadeh (Ozy) Nasrazadani: going at a ridiculous speed. But the thing is, they are testing things all the time, and just because we don't see it, there are many things that don't quite meet the hurdles, and thus they're not pursued. But it's a really exciting time, you know. In recent years we have Inher 2. We have Tritelby, other such things. And now we are talking more about these Adcs. The antibody drug conjugates. And I know that Dr. Limborah, she's working with multiple pharmaceutical companies and

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Azadeh (Ozy) Nasrazadani: trying to push projects forward. We have trials opening for Ivc patients. So which is just really exciting.

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Terry Arnold: I'm going to interrupt you real quick, having you say the word trials open for Ibc patients. You say that so casually, but for me as a patient. I remember back when I was diagnosed, and it was 17 years ago they precluded us from being in the trials. So the fact that there's actually a trial written. Not only

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Terry Arnold: that, let us in that are written for us. Can you? Can you slow down on that one for just a minute, because I don't think you realize the listeners right now are cheering at that thought.

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Azadeh (Ozy) Nasrazadani: And we cheer with them. I think it is very challenging, as you know, in clinic, when we see these very tough cases of wanting to do something beyond the standard agents, we still have this issue. We still have issues where many patients are excluded, and many times when we are able to participate in conversations. We are making a plug of always saying, Hey.

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Azadeh (Ozy) Nasrazadani: is there? Are Ibc patients excluded? Can you explain why? And sometimes you're successful at changing the opinions of the powers that be. And sometimes you're not. But it is absolutely a big deal. And I think that as we're all appreciating that even if it's increments of improvement.

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Azadeh (Ozy) Nasrazadani: there is value there. And so that's kind of one way of being able to really convince people who have drugs or the support system, as far as like funding whatnot to be able to do that. So it is a big deal, and that is not lost upon us either.

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Terry Arnold: Now, what do you see coming down the pipe that you feel hopeful for treatment? Care for someone with inflammatory breast cancer.

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Azadeh (Ozy) Nasrazadani: So I don't know that I'll talk about a specific drug. But I can tell you one really amazing thing that we've been able to do which has been, thank you. To every single Ibc patient, specifically, who has been a part of our registry is, it has really allowed us with strengthen numbers. So what was about 2 years ago? Remember, Terry, we had our milestone, 1,000 patient event, and how amazing that was. So if you think about.

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Terry Arnold: Have a second to tell people about the milestone. What was that? Because

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Terry Arnold: I know I was patient number 97.

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Azadeh (Ozy) Nasrazadani: Amazing. Yeah, I thought you were patient. 10.

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Terry Arnold: I was patient number 97.

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Azadeh (Ozy) Nasrazadani: Oh, that's amazing. So just for our listeners. registries specifically like, you know, at least like research registries, are are basically kind of like databases that allow us to collect information on a select population. So within the Ibc department we have this Ibc registry, and we collect a very comprehensive amount of information samples

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Azadeh (Ozy) Nasrazadani: very comprehensive. But what that allows us to do is it allows us to, instead of having kind of a smattering of, you know, case reports here and there. Things in literature is really put everything together and take a step back so roughly. About 2 summers ago we got to our 1,000th patient that was enrolled into this Ibc registry.

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Terry Arnold: It's an incredible milestone, 1,000 patients. It was years of work.

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Azadeh (Ozy) Nasrazadani: Years of work, and and really again, thanks to each patient for believing us and allowing us to to use this information, but what it allowed us to do is not.

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Terry Arnold: Again interrupting, because one thing I tell people all the time, even if you're happy with the care that you're getting locally, try to get close to the research. Try to get your data in there, because we don't know that our data is not shared. And I tell people try to get close to the research project if if you can, in some way, even if you're doing things well, you know, because it can matter. So continue on. So what happened with your.

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Azadeh (Ozy) Nasrazadani: I promise. But it's just very exciting about that. But the nice thing is because then you don't put everyone in one big bucket. When you Google, you know, look for prognosis of Ibc. There are terrifying things on there, but that's because everyone is in one big scary bucket. But the truth of the matter is at the end of the day. There are many different ways that we characterize breast cancer. It matters whether or not it's

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Azadeh (Ozy) Nasrazadani: triple, negative, or her 2 positive or hormones that are positive. And each one of those have distinct biology still. And so there are still things we need to understand of where, what's working, what's not working and what is unique to each group, so that we can justify the interventions we're trying to make. Yes, we want to be very aggressive, but you have to make sure that you're not over or under doing it for any one person. So what's been very interesting.

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Azadeh (Ozy) Nasrazadani: it's been kind of allowing us to take that step back and really dive into the research which has been a big part of what I've been able to do since kind of taking on that initiative. And one of the things that we're seeing that, you know, has been very startling, but yet not surprising, considering what we see in clinic, is seeing the really surprisingly disproportionate rate of brain metastasis. And I think that's been something that has.

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Terry Arnold: That's man. That's my hot. That's my hot button. Crazy, hot button is that? It keeps me awake at night, and I've talked to Wendy Wood about this many times that we see women going along. They're beautifully well.

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Terry Arnold: And then, all of a sudden, they've got full blown brain, Max, that's what keeps me awake at night, and she said, that keeps her awake at night, too.

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Azadeh (Ozy) Nasrazadani: Absolutely. And it's very hard to see that I can think of multiple people that come in front of my eyes, that I think of. And really just, they're not being a good way of being able to predict that at present, and to predict, to predict, to prevent. And really, what we're doing is really heavily reliant on local therapies as far as radiation or surgery impossible. So that is a major unmet need. And it's absolutely terrifying.

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Azadeh (Ozy) Nasrazadani: Patients who are getting Pcrs right? They're having complete, you know, their cure achieving cure essentially and by all means, having, you know, favorable prognostic features. We are still falling into this and really not knowing it's a very dark area. So that specifically, has been a really big interest for me, and especially in the past. Since that time when we came to, you know, report on this

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Azadeh (Ozy) Nasrazadani: has been a lot of focus on how can we do better? Specifically to prevent that from happening.

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Terry Arnold: Well. And one thing I want to say here, if someone's listening to this and they've got brain meds, I don't want them to think that they're toast, shall we say? Because I know if I was 1st diagnosed, and someone said, You know, I knew that cancer could go from the breast to the lung or breast to the bone. But Ivc behaves so differently. Sometimes it goes straight brain, and that would scare the devil out of me. I've seen amazing things. I've seen women be perfectly well

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Terry Arnold: after a metastasis to the brain, and so I don't want people to ever think there's not hope and give up. But again, what we're seeing is, women are doing well, well, well! And all of a sudden there's this massive

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Terry Arnold: yes.

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Azadeh (Ozy) Nasrazadani: It's very discouraging, because otherwise you really want to kind of make. Do give everyone that optimal outcome. But those are things that it's it's, you know, we won't downplay right. It is discouraging to see something, you know, involve an area that is so sensitive. But please, for all the listeners absolutely that is correct. There's many things that are done and can be done, but it's just a matter of kind of wanting to make sure that we are being doing as much as we can to kind of

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Azadeh (Ozy) Nasrazadani: giving you the rest of your life back right? And that's a little bit harder when you have something that requires a little more

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Azadeh (Ozy) Nasrazadani: stuff to happen.

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Terry Arnold: So. So what do you see coming down the pipe that people should be paying attention to, and also hit you with a couple of questions, what would you like? Okay, obviously, patients. First, st job is getting well and taking care of themselves. But if someone has the bandwidth along the way

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Terry Arnold: to help or do, or be involved in advocacy. I'd like you to tell them you know what's coming down the pipe to be excited about and and what can they do? And you are very welcome to put in a plug for Md. Anderson's boot walk, which is this fall? You're very welcome to put in a plug for the they're going to do a town hall.

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Terry Arnold: I want people to get as close to research as possible. It doesn't mean they have to end their local relationships. But we are all doing better

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Terry Arnold: because of someone before us. And so I think it's it's very natural that we can find some kind of way to pay it forward at some level. So what's coming down you're happy about? And what do you want people to know about in other areas.

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Azadeh (Ozy) Nasrazadani: I think, building on the success of drugs like Inher 2 and tradelvy. It's been really exciting to see, especially clinically, we have patients who kind of do really poorly on many chemotherapies, but somehow seem to have a very good response to these. This mechanism, which has been very reassuring, and it's been very exciting of being offered being able to offer these things. So I'm very excited. I know, working with our phase one team at Md. Anderson. They have a lot of these types of Adcs and just nationally.

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Azadeh (Ozy) Nasrazadani: So I'm really excited about that specifically of knowing that we have a new class, not just, you know, before hormone blockers, or her 2 positive, you know, directed agents or immunotherapy. But this really has become its own kind of thing, and the fact that for whatever reason now, while we continue to understand the biology of Ibc, this seems to be very effective, and so that I'm very excited about, as far as our listeners. I want to encourage you. Just number one.

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Azadeh (Ozy) Nasrazadani: It doesn't mean that you have to, you know, start calling every Congressman or really crazy things, which, if you do, we would love it. But even just as a 1st step, I want people to appreciate the value and the efforts of research, please, at least just be open to knowing that the research matters. It's what eventually makes the difference

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Azadeh (Ozy) Nasrazadani: down the line. So there is value there. And to just acknowledge that. But even having a voice, your voice matters. We want to hear from you. We it is we want to do all this together, and and as we do it together, we're stronger together. But being a part of initiatives like the boot walk, and you know, standing together, it's hard to go through these things. And so it's very.

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Azadeh (Ozy) Nasrazadani: It's wonderful to get to come together at these events, like the boot walk we we really get to boast about having one of the most successful teams Ibc wranglers. We have so much fun, and it really speaks to the advocates. Terry, like you and everyone who rallies behind the team.

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Terry Arnold: About the boot walk in case people don't know. Md. Anderson started the boot walk. I think it's maybe been 10 years ago, and it is a walk.

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Azadeh (Ozy) Nasrazadani: The 10th year. This year. This year is the 10.th

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Terry Arnold: Okay? Well, what they did when they started the boot walk. What it is. It's a walk that patients can participate. But also the different clinics can also put together a team, and the way it works is I could decide to raise $500. It just goes to the greater good. But if a department makes a team they have to raise at least 25,000, I believe, or maybe it's 20. I think it's 25, and if they raise that much they can spend it on whatever they want

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Terry Arnold: into that. And I'm on the committee at the Md. Anderson boot Walk. That helps decide how that money spent and it and it goes to things in that department that are really wonderful. And you can talk about that, too. But people don't have to feel pressured to raise a lot of money, but I think the participation is is extremely important, and we can walk with you and hang out with you, so I've got your ear for it's about an hour and a half walk and or maybe an hour walk. It's an honorary walk.

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Terry Arnold: But I want people to come and see, because I think it's very exciting, because one thing I get push back from people sometimes. They say, you know

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Terry Arnold: they got the cure for that disease. They're just not telling you, and you're just being a sucker, and I'm sorry I cannot believe it when I see the passion of you people.

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Terry Arnold: and how hard you pour your lives into this. You cannot convince me there's a cure out there hidden. I just I just can't believe it.

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Terry Arnold: I can't, and and everybody loves somebody, and somebody would let out the secret if it was really there, because I've seen. I remember one day going down a hall, and I heard something fall.

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Terry Arnold: and I heard a wail.

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Terry Arnold: and I went running down the hall, and it was one of the doctors. When one of her patients died she literally collapsed and was in a puddle of tears. The love and the passion is real.

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Terry Arnold: so I always tell people you don't know what you're talking about, but I would love to have them get close to you at the boot walk, or come to one of the town halls, or maybe consider being an advocate on a grant where they help write the letters to the Government. Can we talk about that? Because I tell you what, when you get to be an advocate on a grant, what people don't understand is you get to hang out with those researchers. You get to go to their lab, you get to hear what they're studying.

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Terry Arnold: and it is super crazy, cool.

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Azadeh (Ozy) Nasrazadani: And it's it's very helpful, because again, your voice means a lot. Your support means a lot, and it helps reviewers say, Oh, there's a face behind that this matters to somebody, but absolutely to really to speak to your point, patients who have Ibc their family members are going through the absolute scary times, right for that person. But what?

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Azadeh (Ozy) Nasrazadani: Just on the other side of that, we're walking that journey with you and with every single patient. So day in and day out. It's, you know, that it really does, even though we're not the one with the diagnosis. We are part of that journey, and it's just it would be.

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Azadeh (Ozy) Nasrazadani: It's impossible not to be affected by that. So if there were some magical cure out there, I cannot tell you how much it affects me when I see that young woman with a very aggressive diagnosis. I know what that trajectory is going to be like, you know. I can tell you. I hug my my kids a lot harder every night when I get home, perhaps because I see it. It's a constant reminder of the fact that that could be me at any minute, so I assure you I don't think I if there was something there, I don't think I could sleep at night knowing that I'm just watching people go through this.

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Azadeh (Ozy) Nasrazadani: So so yeah, hopefully, people believe that that's not what's happening.

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Terry Arnold: One of the things about people don't understand about being an advocate on a grant, let's say, like you used to be, you had to have one advocate to write a letter of support

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Terry Arnold: to the committee, and I hear that some of the Grants are now wanting. 2 advocates, which is harder to get one advocate. And so I'm an advocate on a lot of grants. And but we need more advocates, especially now that they're wanting more. And one thing patients don't realize is they don't want you to have any advocate. They want somebody who's got skin in the game. They don't want it to be somebody who just cares about cancer. They want to be an Ibc patient. So that's again, where their story can matter. They help explain the science to you. They help you write your letter, and then you can bring in.

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Azadeh (Ozy) Nasrazadani: Right goes under their personal.

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Terry Arnold: Sometimes. Those things, then, can lead to invitations like, I've been a reviewer on the Dod, which is Department of Defense, and what was a little scary for me as a layperson. I'm in a room with all these really important people, and my vote on that Grant

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Terry Arnold: was equal.

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Terry Arnold: You really do have a place at the table. You're not just a token thing, so it can open up opportunities to be on the decision end of it, too. But I think a lot of patients are hesitant to be an advocate on a grant, because they think it's going to be over their head. Now, there's a lot of patients out there that are crazy smart with Phds and or scientists themselves and things. But I want to really encourage people if they have interest to contact you.

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Azadeh (Ozy) Nasrazadani: Because you can hold their hand and educate them.

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Azadeh (Ozy) Nasrazadani: It is, I agree, I think sometimes it's you know, people think for anything they have to do like everything or nothing. But sometimes it really is a lot simpler than that. And but again to your point, writing a letter, especially if there's templates, or, you know, mentors like yourself that could say, Hey, this is really all they're asking. It's really just kind of putting weight against someone saying, hey, I'm there. I stand with this person. I think I believe in their research that matters to me. So that's really that simple. And so I think that for sure, that that makes a lot of sense.

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Terry Arnold: Yeah, well, is there anything you want to cause with.

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Azadeh (Ozy) Nasrazadani: I think.

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Terry Arnold: You've done a great job covering a lot of things.

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Azadeh (Ozy) Nasrazadani: Terry, you and I talked fast, and we we always have a lot we want to talk about, because you and I are.

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Terry Arnold: I know, I know.

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Azadeh (Ozy) Nasrazadani: But thank you. Thank you for having me in your home. It was so wonderful to hopefully get to connect with listeners, and just to kind of let them know that there are a lot. There's a lot happening. There's a lot happening behind the scenes, and it may not feel like it or look like it. But we never want to be dismissive. But we really are trying to kind of balance all the things and move the field forward, but it really can't happen without you. Each person's voice matters. Please continue to engage with us. Please come to the boot, walk, walk with us.

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Azadeh (Ozy) Nasrazadani: Really you are the reason this is happening and that we're stronger together. So I really hope that everyone realizes that, and to really place the value in research and in their own voice. So, thanks Terry.

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Terry Arnold: That's an absolute, perfect ending. Thank you, Dr. Ozzy, for being with me today. We're going to put this on spotify and different apple channels. It will be on Youtube, too. We'll send you the link later. And you can share it with your friends. And I hope you encourage other people to do podcasts with us. Because I like you said, we're stronger together. And I appreciate that very much.

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Azadeh (Ozy) Nasrazadani: The many more things that we have constantly talked about so hopefully, many more things to get to do together.

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Terry Arnold: Oh, I'm sure we could tease this down to a lot of topics. So thank you again. And I'm gonna stop recording now. And so let's give it a second.