 So next, we're hearing from Sandra Swain and Bill Powell. I think you're doing a duet from the Society for Clinical Oncology. Right. So thank you very much. And I'd really like to thank Gene Passamani particularly for organizing this. And when we had the discussions, he said the main goal was about education in this area. And I think already we're all educated about what each of us are doing. And I think you've achieved one great goal. From what I see and what I hear, we all have a lot of similar issues that we're working with. So if we can do, as some of us suggested, work together on the guidelines. And it's interesting hearing this discussion about guidelines and the heated remarks at our board meetings, probably that causes more discussion than anything else. So it's clear that, you know, all of us need to do more work in that area and figure that out. So Cantor, I think, is a little different as a specialty than some of the other diseases in that five to 10% are, at least as we know now, are caused by mutations in specific genes. But most of the cancers are caused by somatic mutations of genes. So most oncologists certainly, you know, deal with it on a daily basis and do learn about it in their fellowships and their training. And I really especially liked what Tom Nazca said that it's going to be changed in the future. It's going to be part of the fabric of what everyone knows. And I think that that's critically important. It'll be, I like what he said a lot, that it's going to be the pathophysiology or part of the pathophysiology for everyone. So just, and I think that, Bruce, you already showed this example, but I'm going to show it again. The example, the big one for us from the lab to the clinic is a matneb. And the Philadelphia chromosome was discovered in 1960. It's almost 50 years ago now in chronic myeloid leukemia, just to show you a little bit of genetics. You said genetics were important, but they're interesting anyway. It's a translocation where the BCR-ABL fused cancer gene is formed and becomes an abnormal growth of white cells or CML. And the treatment that was discovered was a matneb, approximately 30 to 40 years after the Philadelphia chromosome was discovered. And it caused a lot of excitement, FDA approval and accelerated approval in 2001, and even a Time Magazine cover, as you, I'm sure, are all familiar with, calling it the magic bullet. It's really been the poster child for targeted therapy for cancer treatment that we've all heard about. And later on, it was also found that it affected other genes, C-kit, and is used for other diseases like GIST. So I just show you this as an example for us in our field. It took 50 years now to have a treatment for GIST, and it's changing a lot. We have the alkygine and lung cancer. That took about four years to go from the laboratory to the clinic. So the rapid dissemination of this information from the laboratory to the clinic is really happening, fortunately, because our patients can't wait this long anymore to find the cures for them. So I think you all are probably familiar with all of this, as the major challenges in completing the cancer molecular map are sequencing the exomes, and we can change. I misspelled that. It should be, I guess, H-O-L-E, genomes. Thank you, Deborah. And differentiating between what the driver and passenger mutations are, because there are thousands of mutations and we need to really sort out what's what and what's important, because the tumors are very unstable and they do change over time. So even if you biopsy at one time, it may be different later on. We do have a lot of mutations integrating these data across platforms and then finding solutions when you have multiple testing of all this massive amount of data. So how do we get from the research to the clinic? You've got the multiple targets and these tumors, as I said, they continue to mutate. They don't always tell you how the cancer is going to act. The genomic discovery has been very, very rapid. I mean, tons and tons of information has already been said, but the therapeutic agents really have not kept up with that. So are we going to be able to deliver? And I think that's one of the reasons for this meeting, too, and the meetings you've had, the last three or so meetings, is to try to sort that out. Quality diagnostics, Deborah commented on that already. At the community level, as you probably know, about 85% of patients with cancer are treated in the community. I think that that's a really important point to remember, and we're all talking about embedding geneticists. It can't happen for 85% of people in the community as a person. Cannot do that. I mean, that's just not going to be physically possible, so we have to find other ways to really get our message and the education to the community. And then how do we help the general oncologist really keep up with the massive amounts of information? I think what's really important is that the paradigm is changing from being at the bedside and saying, you know, what's your differential diagnosis, doctor, for these 10 things for this patient? I mean, people can look it up now, and that's okay. It's all right to look it up. You know, we have, our fellows are all in there with their smartphone. They're looking everything up. I mean, that's okay because the information's accurate. There's good evidence. So we need to incorporate those kind of things into how we work. So we have a leadership development program, and I think Debra mentioned it, too, that you also have one in pathology. And we started this several years ago, and unfortunately, Dr. Nelowoski, who was supposed to be sitting here from Mayo Clinic, was Rochester, was not able to get out because of the weather. And so he wasn't able to be here. But he is one of our trainees in our leadership development program. And they chose, as this area of genomics and genetics and what resources that our membership of about 30,000 members need, did a small, focused, not really survey, but they interviewed people, community medical oncologists, academic medical oncologists, people in the leadership, surgical oncologists and pathologists, to try to determine what was needed for education in this area. And they just came up with the same things that everyone else has said here. There's overwhelming amount of data. It's coming very quickly. And I really like what, I can't remember what your name was, said that, you know, we just have to assume it's going to be there because it's there. Patients are coming in with their genetic data now. They want to know, Dr., what do I do with this information? So there's no standard resources available. We can use the path reports and drug device reps to tell us what to do, but obviously doesn't seem to be the right thing to do. So they came up with these recommendations that they're simple, searchable, clinically relevant, updated, user-friendly, patient-friendly things should be available. Not a laundry list. It should be in the guideline format, again, guideline. What is a guideline? We do also have vigorous discussions about this because in oncology we have the NCCN guidelines, which are consensus-based. And those guidelines, only 6% are really on level one evidence. And that's not because they didn't find the evidence or they didn't look it up. It's because that's what exists. You can't have level one evidence on absolutely everything, the hundreds of decisions we as practitioners make every day when we're treating our patients. So they came up with it, was going to be most effective, was a website, and they wanted to be able to find it quickly, bookmark it, use it, or a mobile device application. And then decision supports tools embedded in the EMR, which has already been mentioned already today. So what is ASCO doing in trying to answer all the questions that Gene handed out to us in education and training? We have ACGME program requirements for medical oncology, which we've been active in working with ACGME for. And these are just, I'm not going to read the whole thing, but I think it kind of goes with what you would expect, the things that people should know. And that was effective on July 1st, 2012. We have an ASCO self-evaluation program, which includes chapters on molecular biology and biologic therapy. And at our annual meeting, because I felt like this, this was actually even before Gene, you contacted me, felt like it was such an important topic because of what I see in my patients coming to me with, you know, 23andMe or whatever, they're, you know, coming to you with this data or wanting to get their cancer gene looked at by Foundation Medicine. So I felt like it's overwhelming for people in practice to figure this out. So I organized, and William Powell is one of the co-chairs for our annual meeting in June, a course for genetics and genomics for the practicing clinician. It will be one and a half days. And these, we had these last year, we just started doing these last year, these kind of pre-annual meeting courses, very, very successful. And they were basically oversold. I mean, people really wanted to come to them. And it will be CME as everything that we do pretty much in ASCO is CME. So the main thing that I was really interested in, and I put practicing clinicians on the steering committee, is it's got to be something that's, when a practicing clinician goes home to their community that they have some tools to work with, or they understand what they don't have and what they need. So I'm really looking forward to that. And it's interesting that a lot of you all are doing similar things. So I think it would be great if we can put all the stuff on the website that Dr. Green mentioned and learn from each other on that. We have several 75-minute educational sessions at our annual meeting on lung cancer, for example, on bridging science and clinical practice, how to use molecular markers and brain cancer, and then barriers and expanding access to genomic information. We have what we call ASCO University, and this is again all based digitally. It's e-learning center. It hosts online, digital, and app-based educational products. We also have tumor boards. And I know some people, at least in the oncology field, are now having these multidisciplinary genomic tumor boards. And that might be something that we will do in ASCO University, too. I know at least two or three centers are doing that now. We have CME accredited courses, the cancer genetics review, molecular oncology, and genetic testing in oncology. And then getting into guideline development process. We have chosen as a society to be evidence-based. And because we are evidence-based, we only have about 23 guidelines. When you're evidence-based, you have to review all the literature. It takes forever. It takes two years. You go back and forth about, is this really evidence? Is that really evidence? They're very non-Nimble documents. But we have done it, and I think people really appreciate those and do use them. However, we just can't do it for everything. So that's been our struggle, too, is to how to go forward with guidance or guidelines and how to incorporate that into our practice. So we have a formal consensus development process used when there's insufficient evidence, so we haven't done a lot of that. And now the whole goal will be to focus on evidence that informs the clinical utility of the genomic assay results. As Deborah already mentioned, we had collaborations with CAP for the HER2 testing and the ER testing, which I think have been very successful and very important because as oncologists, we work extremely closely with our pathologists as colleagues. So to show to the community that we're working together, I think, was very critical and to have the expertise both there sitting there at the same time. And then also, more recently, the Association for Molecular Pathology with the Colorectal Cancer Markers guideline. So the policy on the release of the joint guidelines is that there's concurrent posting, publication of joint guidelines and respective websites or journals, coordination with sister societies about press releases. All these things are really important because everybody puts a lot of effort into this. So we really want to make sure that we get along and we do these appropriately for all the different societies that we work with. So next, I'm very excited to talk to you about this because I've heard a lot of people really wanting what I'm going to talk about now. And our board a couple of years ago had similar discussions to what we're hearing in here today. And as a practicing oncologist, care is fragmented all over the place. I get a lot of patients for second, third, fourth opinion. They could have had their path report at one place. There are three things everywhere. It's just kind of scattered. Then you give an opinion, it's in your EHR, and it's really problematic to kind of get that information everywhere. Plus, you don't have outcomes. Only 3% of our patients in oncology that have cancer go on clinical trials, 3%. So 97% of the patient's information for treatment that I give or other people give is lost. We have no outcomes. The data is totally lost. So you're talking about with genomic data having a problem. We have a problem with clinical data and that we're not utilizing it to the fullest extent. So based on the Institute of Medicine's rapid learning system ideas, which they have put forth over the last few years and they've put out several documents on this, we decided to take on a very ambitious project, the rapid learning system, which we have called Cancer Link. And what we will do and what we've done, it's actually the prototype has been very successful. We were concerned that there would be many hurdles. One, just getting people to give us the information because it's data on patients. It's not anonymized data initially. And we have now decided to do a breast cancer prototype in the last few months. And we have gotten clinical records on 130,000 breast cancer patients. So this is like the biggest amount of data, clinical data is available anywhere. Work through all the issues of the different electronic records. And actually right now, 30,000 of those records are dumped into one network system. The whole idea is that there'll be a central knowledge base. As shown here, you have data that's going to come in patient data. Then you have provider data, also research data. And all of these things will be able to generate knowledge. So there's several aspects of this Cancer Link. One is that it will help the physician right there at the point of service. And I don't have all the slides to show you what we've done in the prototype. But at the point of service, embedded in that are our guidelines and our quality oncology practice initiative, which is something we've worked on for several years. So physicians can look and see if they, for example, give herceptin for patients who have her too positive or negative disease, which is the wrong thing to do. So that will pop up and say, you shouldn't do that. Or give Tamoxifen to a patient who's had a DVT in the past. It'll pop up and say the guidelines say, no, you shouldn't do that. And so far, it's actually working, as I said, in 30,000 patients. We have another 100,000 to put in there. And this is just the prototype. A lot of what's been done is using open source computer software. So it's an expensive project. So we'll see how that goes in the future and the ability to do it. But we're very excited about it. Everyone was concerned about whether we could do it. But it really looks like we're definitely going to be able to. And be able to do a lot of the things you all said, embed. You can embed the genetic recommendations and the guidelines that you have. And it will be helpful for physicians. So our next step for ASCO or recommendations to ASCO from the Leadership Development Program that I mentioned to you about what they're going to recommend that we do, incorporate the genomics into our rapid learning system or our cancer link plans, discussions with other societies, not just pathologists. But I hear a lot of people here are doing similar things and would be really delighted to talk to anyone about this and involvement and follow up, certainly from today's meeting. So I wanted to, I was going to give a couple minutes of my time to William Powell. Because I think what he's done is really pretty remarkable already in helping generate information for practicing oncologist. So he's going to talk for a few minutes about that.