Transforming Cancer Care: The Hollings Cancer Center

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Ray DuBois

Now there are vaccines being developed for pancreatic cancer and other types of cancers. I think that to me is very exciting and may set up the idea that for certain cancers we may even be able to just take a vaccine and prevent it from happening as well.

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Kevin Smith

Welcome to the Innovatively Speaking Podcast, a podcast brought to you by the Medical University of South Carolina. In each episode, we dive into the origins of the next big things. The who, the why and how we explore ideas that are changing what's possible here at the Medical University of South Carolina and in some cases all across the world.

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Kevin Smith

My name is Kevin Smith, and I'm here in the MUSC podcast studio with my co-host, the Chief Innovation Officer here at MUSC, Dr. Jesse Goodwin.

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Jesse Goodwin

Good morning, Kevin.

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Kevin Smith

Good morning to you. All right. Now, Jesse, cancer is never a fun subject to talk about, but innovative prevention measures. Now, that's some exciting stuff that someone can get behind.

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Jesse Goodwin

It is exciting. Cancer touches everyone. I don't know anyone who hasn't been touched by cancer in some way, shape or form. So I think anything that we're doing and any conversation we can have about how we can prevent it or new treatment methods is always exciting.

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Kevin Smith

Well, our guest today is Dr. Ray DuBois, and he is head over at Hollings Cancer Center, correct? Tell me about why he's a good guest for us today.

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Jesse Goodwin

back in the mid, maybe around: 2006

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Jesse Goodwin

So today is going to be a really good discussion.

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Kevin Smith

I'm excited. Let's dive in. Dr. Ray Dubois, good morning. Welcome to the Innovatively Speaking Podcast.

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Ray DuBois

Good morning.

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Kevin Smith

All right, so we're here to talk about some research. You're doing this really exciting, but can you maybe give us a kind of a lead in to how you got into cancer research to begin with and what's your passion in that area?

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Ray DuBois

Sure, sure. So it you know, that happened some time ago during graduate school. You know, I was working on a Ph.D. in biochemistry at the Southwest University of Texas Southwestern University in Dallas. And I was mainly focused on metabolism. But one of the things that happens in the liver is can convert certain compounds or carcinogens to a cancer causing agent.

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Ray DuBois

And so that really started piquing my interest in cancer research from a very early stage and that just continued to develop through, you know, medical school training and postdoctoral training and all of that.

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Kevin Smith

And what was your connection to the Charleston area?

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Ray DuBois

My wife is originally from South Carolina, and so I drug her all over the country to Baltimore, Houston and in Dallas. And Arizona. And finally on this move, she said it was time to come home to take care of her mother. So that really was an attractant. But also MUSC I think was a place we were really excited to join.

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Ray DuBois

And it's been a great run for us here in Charleston.

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Jesse Goodwin

When you first came, you came in as the dean of the College of Medicine, and then you've since transitioned over to leading the Hollings Cancer Center full time. Can you talk about a little bit about that transition and what your goals are for Hollings now that you're in the role?

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Ray DuBois

Sure. And that was a bit of an unusual transition. What had happened was during the pandemic, we lost our director of the cancer center for, you know, one reason or another. And, you know, that caused some concern, especially from somebody who's so interested in cancer I had sort of been leading the the College of Medicine for six or seven years.

00;03;51;17 - 00;04;13;28

Ray DuBois

And so I did both of these jobs for about a year and a half and then decided that was too much. And I told our senior leaders, I've got to do one or the other just to make sure that I can take care of all the business needed and so I chose to do the Hollings Cancer Center as we were emerging into a competitive renewal for the CSG grant.

00;04;13;28 - 00;04;34;18

Ray DuBois

And so we kind of switched roles there. Terry started took over as dean of the college. He's doing a fantastic job, and I focused my efforts on Hollings, and we just got through our five year review and I think things went really well. We won't get our score for a couple of weeks, but the team pulled together and we did a fantastic job on that.

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Jesse Goodwin

So one of the things I know MUSC is proud of is that we're the only NCI designated cancer institute in the state but we're moving towards comprehensive status. Can you share a little bit about the difference between designation and comprehensive status and what we need to do in order to get there?

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Ray DuBois

Sure. So the NCI designation is important because it identifies us as a cancer center, that has a fairly large research component, fairly large clinical activity with all of the accouterments that people expect for a, you know, an academically oriented cancer center the the comprehensive designation is a step above that. And it requires us having a very large community outreach and engagement effort, which we we are building.

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Ray DuBois

And I think we're going to be in good shape for that. But also the clinical research arm has to be having some innovative clinical trials underway that are accruing a lot of patients, a larger number than we currently have in our trial portfolio. And then two or three areas where we're making a national, international impact. We already have that in tobacco cessation and some of the other areas that we can talk about.

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Ray DuBois

But clearly, we were just not quite at that level during this previous review. And we have mapped out all of the sort of action items we need to to work on to get to that next higher level. And I think it's totally achievable, very confident that we're going to be able to get there.

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Jesse Goodwin

And I think it's exciting for the people of South Carolina because more areas of international sort of recognition and more clinical trials means more potential cures for the people here that we're serving. So to me, it's really exciting just from a population standpoint as well.

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Ray DuBois

Sure. And one action we've already taken was to get some philanthropic support to develop our own Phase one clinical research unit. Believe it or not, Hollings has never had one of those before. It's an area of the Hollings where we designate six to eight infusion chairs just for research purposes. And that makes it a lot easier to conduct these trials and get patients enrolled when we know we have a space for them reserved to give them these innovative new drugs.

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Jesse Goodwin

I think that's really exciting.

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Kevin Smith

Well, cancer is a pretty broad topic, obviously. Let's let's pivot into talking about some of the research you're doing right now. What's some of the things that's on the front burner for you right now?

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Ray DuBois

Well, I've always been interested in how to prevent cancer in the first place. And, you know, there are a lot of things going on that are aimed at doing that. You know, screening, early detection. It's a bunch of new diagnostic blood tests for detecting cancer early. I'm really focused on colorectal cancer, and that's a really good model for early detection because there are some pre-cancers or pre malignant lesions that develop into colorectal cancer.

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Ray DuBois

We can detect those easily with endoscopy we can study them in the lab and examine what's going on. And many of those pre-cancers don't develop into anything. But there's a small percentage, probably less than four or 5% that do go on to develop into cancer. So our whole role has been to try to understand which ones are going to develop and what we can do to stop those from going on to a cancerous state.

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Jesse Goodwin

I'm a little bit embarrassed to admit that I had to look up what you do in your lab because for a good number of the faculty that that we have here, I familiar with what they study in their labs because I filed patents for them back when I first started here. But I met you when we were both in more administrative roles.

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Jesse Goodwin

So as I was sort of preparing to do this podcast, I was reading your bio. I knew that you were internationally known and have, you know or have this really illustrious career behind you. But I was like, I wonder what exactly you study? It's like, but one of the things I found really fascinating and and very relevant to me, because we have a very high incidence rate of colon cancer in my family was that you back in the nineties discovered the link of Cox two with colon cancer and the role that anti-inflammatories can play.

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Jesse Goodwin

Can you talk a little bit about that? Because I was actually unaware that I think of aspirin for heart disease. Yeah, I hadn't really thought about it in terms of colon cancer prevention.

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Ray DuBois

Yeah, that was surprising. And what happened was we were right when I moved from John Hopkins to Vanderbilt, we were cloning a lot of genes that were turned on in these early adenomas that I discussed. And one of the major ones was this COX2 gene and so it's really a pathway that's involved in inflammation and other areas of medicine.

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Ray DuBois

And it was quite surprising to find that it was so highly elevated, especially in these early pre-cancerous lesions. And then about that time the epidemiologists published a lot of work showing that people who take aspirin and other NSAIDs on a regular basis more than 16 times a month have a much lower risk for colorectal cancer, decreases by about 50 to 60%.

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Ray DuBois

So we thought the two might be connected and it turns out that they were and we just mapped out how by inhibiting that pathway with those anti-inflammatory drugs blocks the progression of some of these early cancers and it's led to some other discoveries for other targets in that pathway that we're also very excited about. It turns out that the lesions that progress are the ones that have aberrations in the immune system and makes the the pre-cancer makes the immune system look like a cloak or cloaking device.

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Ray DuBois

It can't be attacked by your own immune system and then deleted. So we figured out exactly how that works and we've come up with a couple of possible ways to target that. We've teamed up with a biotech company in San Francisco, and they've developed a new drug that inhibits the pathway with far fewer side effects than some of the other NSAIDS and they do work in a preclinical model, and they're now already in phase one trials through the company in San Francisco.

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Ray DuBois

So we're excited there's been some responses in early trials and you know how drug development works. It's always a few advances and then some retreats. And until you get to the right drug and everything.

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Jesse Goodwin

You know, but it's exciting that you're pushing the field and in that direction. And maybe that leads to my next question, which is sort of looking on the horizon about preventative vaccines. And do you think that we're marching towards that? Do you think it's going to be feasible?

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Ray DuBois

That's a great question, Jesse, because there is a lab at University of Washington in Seattle, and the doctor discusses the head of the vaccine center there. And she and I work together on a committee at the NCI. So we get to know about one another's work. And she has developed a vaccine for Cox two and administered it to these preclinical models in mice, mouse models and other preclinical models.

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Ray DuBois

It really prevents Pre-cancers from developing pretty significantly. Even better than the NSAIDS do, probably because it sort of blocks the whole pathway just with the vaccine. The I think the next step in that is to see if there's any side effects of doing that or any anything that, you know, would be preventing that from being used in humans.

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Ray DuBois

But she's sort of marching forward using the vaccine approach.

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Jesse Goodwin

That's really exciting. And that pathway, you know, as we discussed, is has a role in colon cancer. Does it have a role in other cancers that are harder to detect by by screening?

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Ray DuBois

It does have gastric and esophageal. So it's really seems to be focused on the GI tract. There's some data in breasts, but it hasn't been developed as well as the GI studies. So, you know, I think that what I hope can develop here and we're doing a bunch of single cell sequencing on these lesions at different levels of progression.

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Ray DuBois

We can come up with the sort of class of targets that if we combine efforts on, those could could be more effective and blocking that development of a pre-cancer into a cancerous lesion. And that's created this whole new field of cancer interception that people are talking about. If we can intercept the process in a way that, you know, it's not too damaging to the person, but also prevents them from getting the disease, that would be the probably the best way to deal with some of these.

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Jesse Goodwin

It's really exciting what's out on the horizon and I think when you look at the sort of expansion of the data and the single cell sequencing, the NIH has pushed to make data more open and accessible between sites. And it leads me to, you know, sort of the next question, which is always a hot topic, which is the role of artificial intelligence in this, because it is a vast quantity of data that that we're generating as a scientific body.

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Jesse Goodwin

And do you think that artificial intelligence can help to sort of comb through the data and help us make more progress more quickly?

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Ray DuBois

I definitely I think that is probably one of the most acceptable and best roles for A.I. because it you know, it can really in a comprehensive way tell differences and patterns and other things that could really tease out what the best targets are. It's also being used to design drugs, you know, based on protein structures and other things and get that initial sort of in silico look at, you know, what drugs might be effective.

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Ray DuBois

It... you know, just from a clinical perspective, it's already is helping with X-ray studies to tell if there's an abnormal thing or if it's normal because the radiologist have to read so many of those so quickly. Sometimes they miss some details. It doesn't miss any details. So it's really good for that. I think it will be good for pathology as well.

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Ray DuBois

Eventually, once all the paradigms and algorithms are set for that. So it's very exciting in health care, in medicine for A.I., there's a lot of concerns about other ethical and moral issues where it might take over the world or something. But certainly for now, we're using it in our research and in clinical practice as well.

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Kevin Smith

Can you talk a little bit about the prevention side of things? Especially when I was doing some research, I was really interested in the inflammation connection. Can you talk a little bit about that? Maybe give a layperson a little bit of information on how that works?

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Ray DuBois

Yeah. You know, what most people are familiar with is when you have a wound or a cut in your skin or some sort of trauma initially you get a lot of inflammatory response to that. The body's trying to keep out all the viruses and bacteria, but trying to heal the damage to the tissue and that's all a really good process because it usually goes up and then comes back down and resolves, you know, as things get better in cancer, it turns out that, you know, areas of the body that have what we call chronic inflammation or so the inflammation never sort of gets turned off is a bad thing because it can damage DNA

00;16;03;11 - 00;16;48;06

Ray DuBois

that can lead to cancer. It can set up a situation that sort of is what we call a wound that never heals. So it's just a constant process and there are ways we can modulate that with new sort of immunotherapy treatments. The checkpoint inhibitors are a good example of, you know, these checkpoints are important so that, you know, the immune system doesn't overdo it or, you know, cause damaged tissue in the cancer uses those to evade the immune system and grow unchecked without, you know, being attacked by those cytotoxic T cells or macrophages or other immune cells that are present so and one thing we have learned is that people who have obesity or high

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Ray DuBois

body mass index, they have a chronic inflammation in their body. If you measure in the bloodstream or other tissues, they just have all of these chronic inflammatory mediators and their risk for cancer goes up pretty dramatically for a number of cancers. And it's probably related to that chronic inflammation. So there are ways to modulate that with exercise and diet and, you know, avoidance of toxins and carcinogens.

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Ray DuBois

But, you know, we're we're also interested in deep molecular understanding of how we can stop those processes from developing.

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Kevin Smith

Well, Hollings Cancer Center has seen a lot of growth over the last 30 years, including now specialists from all over the country is that helping grow more diverse and innovative ideas for you guys?

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Ray DuBois

Yes, we you know, we have been recruiting a lot of people from all over the country and the world to come to Hollings. And just since I started, you know, about three years ago, we've recruited about 35 new faculty, including research scientists, and clinicians, and we plan on recruiting another 50 over the next five years. And we're just not doing this to get bigger.

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Ray DuBois

You know, there are certain areas we want to cover but for example, we recruited immuno oncologists from University of California, San Francisco. Leo Ferrara. Leo is trying to reprogram T regulatory cells to attack tumors and he's making some progress. We, we really never thought of that doing that here with the people that we had. You know, he trained with a prominent immunologist there and sort of those ideas came out of his postdoctoral work and he's already gotten lots of funding from the outside.

00;18;34;29 - 00;19;06;17

Ray DuBois

He's really energized that whole idea and concept. And I think having somebody like that from across the country come in, you know, it's it's very energizing and he's certainly doing a great job. We've recruited a CAR-T cell engineer from Vanderbilt University. He's trying to engineer immune cells to attack tumors more effectively with basically many of the larger medical institutions we've been able to recruit from.

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Ray DuBois

I think Charleston is a delightful place to live. And people you don't have to twist their arm too hard to come here, especially earlier on in their career when they're a little bit easier to recruit.

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Jesse Goodwin

I agree. And, you know, we mentioned that clinical trial enrollment will need to increase for comprehensive status, as well as really demonstrating expertise in a few key areas, tobacco cessation being one where we're already really strong in. Can you speak a little bit about your where you see us going with with this some of the other areas and where we're really going to double down?

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Ray DuBois

Sure. So we we have already sort of applied to the FDA for approval for use of our own car t cells that we generate here. And we're in the final, final glide path for that. As you know, there's always a few little hitches in getting that FDA approval. And and one of the cytokines we use to culture the cells, they were worried that it might have a toxin in it, but we've done all the studies and shown that it was pure and worked well.

00;20;08;10 - 00;20;37;22

Ray DuBois

And so I think that'll come really soon, any week now. We want to continue to create those here because if you buy them commercially, the cost is around $500,000 or treatment for an individual and we can generate those for about $25,000. So it would save the state. A lot of money enabled us to treat more South Carolinians who couldn't naturally afford, you know, that level of cost to to get a car t cell therapy.

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Ray DuBois

So we're going to push that as hard as we can and also create our own new car t cells here that we can use that might be more experimental but eventually be something that we could use for patients with different kinds of cancer. We have, as you know, a drug development program. And Nate's done a great job of sort of guiding us I think we would we would like to develop that a little bit more and generate some expertise in screening libraries and things like that.

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Ray DuBois

On the early end of things where we could have our own sort of homegrown compounds or things that we patent right here and belong to him. You see we're in meetings now talking about how to best do that, whether we collaborate with somebody else who's already got it going or try to develop some more of that in-house yeah.

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Jesse Goodwin

And I think that's exciting. And as Nate Dolloff who has been a guest on this podcast previously and I think it is exciting you know, we were fortunate as an institution to have a compound library donated to us two, actually, one from a faculty member who had his own proprietary library and he gave it to us as he retired and one that came from an industry partner who was sunsetting its own internal R&D work and gave us their compound library but it never seems like we've had enough robust sort of boots on the ground people to really maximize their the work that's being done in those spaces.

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Jesse Goodwin

So it is exciting and and collaboration is always good if, you know, depending on because drug discovery can be pretty expensive.

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Ray DuBois

Yes it is.

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Jesse Goodwin

So coming up with some good partners.

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Ray DuBois

Yeah. You know, I think those compounds have been very helpful, certainly in developing leads that look quite exciting. Dr. Howe has developed a new drug against this. E3 ubiquitin ligase and triple negative breast cancer looks very interesting. And he's getting into the SBIR and SCTR phase of that. And so we're very excited that he's been able to take it that far and see if it's going to work in humans eventually.

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Jesse Goodwin

So as you mentioned, so Nate has his own company and how does as well where do you see for for Hollings the role of entrepreneurship and innovation and with it and what you're hoping for from faculty development for those in your group?

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Ray DuBois

Well, that's another that's a very good question, Jesse. I mean, it's also important for us to show that some of our science works out so well that we can take it into clinical use. And so and you can't do that without entrepreneurship. As you know, there's always this valley of death where you do the basic study. You find that there's a pathway and a mechanism to inhibit it.

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Ray DuBois

But if you can't get it to an actual drug that you can give to a patient, then, you know, you can't really show that you're making the best use of your science. And so for comprehensive, they usually look for a few examples of that. And we have a few. And, you know, we want to have more to show that we can not only do the basic work, but we can get it across the finish line.

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Ray DuBois

And that's very important for an academic medical institution and the Hollings Cancer Center.

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Jesse Goodwin

I agree. And you've always been a great partner in terms of pushing those initiatives ahead, by the way.

00;23;56;19 - 00;24;06;23

Kevin Smith

Well, let's let's look to the future now. Let's let's talk about maybe what you're what you're seeing coming down the down the pipeline here in the next, I don't know, 5-10 years. What are you getting excited about?

00;24;07;05 - 00;24;31;24

Ray DuBois

Well, you know, this immunotherapy is really taking off. And like you mentioned earlier, people are developing vaccines not only for prevention. They're you know, clearly, we know if we give vaccines for cancer causing viruses or other things, prevents those people from getting cervical and head and neck cancer. Through the HPV vaccine. But now there are vaccines being developed for pancreatic cancer and other types of cancers.

00;24;32;17 - 00;24;57;18

Ray DuBois

And a study was just published not too long ago, showing there's a pancreas cancer vaccine developed at Memorial Sloan-Kettering using the MRI technology that did have an impact on response rates of individuals to treatment. So I think that to me is very exciting and may set up the idea that for certain cancers, we may even be able to just take a vaccine and prevent it from happening as well.

00;24;57;27 - 00;25;28;21

Ray DuBois

Like the Cox two vaccine that I discussed that's in pre clinical trials, we did just recruit a new person, Bill Hawkins from Washington University in St.Louis, and he has got three or four studies underway right now on pancreas cancer vaccines. So he'll bring those here to Hollings and we'll start doing those studies here that'll increase our clinical trial accrual but also serve the people in our state if this does work out, we'll have that treatment available right here in Charleston.

00;25;29;18 - 00;25;49;13

Jesse Goodwin

Obviously, running a cancer center is probably a very costly endeavor and I know we get funding from the federal government through research grants and then there's some, you know, care related payments that we get from the treatment of patients. But how else do you help support financially the growth of your center?

00;25;49;28 - 00;26;17;17

Ray DuBois

Well, we've been extremely lucky. And just, you know, the last few years where the state of South Carolina has a legislated funding from the state budget in the amount of around $10 million extra dollars per year. And that's really helped us in some of our developing some technology, recruiting individuals and beefing up our clinical trials. Office that is setting us up to get the comprehensive status.

00;26;17;17 - 00;26;45;12

Ray DuBois

So I have to thank the South Carolina state legislature. They've really come to the rescue there and this is an annual amount. So it keeps coming every year. And I think it will enable us to be in a position to compete very effectively for comprehensive status that we've never had in the past. So that support, I have to thank the state and thank all those legislators that worked hard to get that bill passed and get that through the state house.

00;26;45;12 - 00;26;47;17

Ray DuBois

It's it's just been a lifesaver.

00;26;47;25 - 00;26;50;16

Kevin Smith

Sounds like government working the way it's supposed to work, you know?

00;26;50;17 - 00;27;16;15

Ray DuBois

Yeah. And well, we do treat a lot of family members and others related to people all over the state. So I think they see it as a resource. And we are expanding our reach to the regional health care centers in Florence and in Columbia and in the upstate eventually. And so that really helps us. It puts us in a position where we can offer treatment for people closer to where they live at home so they don't have to drive all the way here.

00;27;16;15 - 00;27;26;12

Ray DuBois

And, you know, we have problems with parking and other things so they can avoid that and get their treatment efficiently. Effectively and then just stay close to home where their social support networks are.

00;27;26;19 - 00;27;52;27

Jesse Goodwin

I think that's really exciting and really meaningful. And I agree it's wonderful that the state has given so much support to not only Hollings, but to the people of the state of South Carolina in terms of advancing their own care. I agree one of the other ways that Hollings in recent years has been fortunate to get support is one of my favorite fundraising activities in terms of the LOWVELO bike ride.

00;27;52;27 - 00;27;58;11

Jesse Goodwin

Can you describe for the audience what LOWVELO is, what it aims to do, and how we participate?

00;27;58;24 - 00;28;30;17

Ray DuBois

Sure. I think LOWVELO was started about well before the pandemic, actually. And, you know, we did run into issues during the pandemic because those kinds of things just weren't possible. But we've rebounded and there's a lot of interest in riding in the it's called love below for, you know, low country bike ride, basically. And it's raises money that we use at the cancer center to support pilot and seed funding projects that aren't quite ready to be funded by the NCI or the federal agencies.

00;28;30;17 - 00;28;57;12

Ray DuBois

So the CAR T-cell project is one. We started off funding with available funds. We do support our trainees, our post-docs and students with it as well. We have an annual LOWVELO symposium, and we've been lucky in the last three years. We're going have two Nobel laureates that come and talk to our students and trainees about their, you know, how they were successful and try to teach people the right path to go on that.

00;28;57;12 - 00;29;27;04

Ray DuBois

So we're getting locals and statewide individuals to sign up for the ride. That money raised is, like I said, is manna from heaven. George Hincapie, who it was a Tour de France rider in Olympic bicycle, has been very supportive. And Mr. Bean tomorrow is really helped get this bike race off the ground and bike ride. And we've expanded it and we're really excited about the one coming up in November.

00;29;28;05 - 00;29;39;17

Ray DuBois

Most of the courses will go over the Ravenel Bridge, which is an exciting, breathtaking view, and then end up on the idle ponds or have a celebration and really celebrate the whole process.

00;29;40;17 - 00;30;08;07

Jesse Goodwin

I have ridden in it every year since it started. It's one of my favorite activities for the year. It actually is what got me to ride a longer distance. I had done a triathlon and then decided to do the 50th the first year, and I know you ride a lot as well as a cyclist, but one of the things I like when I get there and sort of see the other bike riders is that they span decades of ages, a huge sort of variety of athletic ability.

00;30;08;08 - 00;30;35;07

Jesse Goodwin

You have cancer survivors and children, and some people are there on their beach cruisers, you know, you know, up to and including individuals like Mr. Hincapie, who comes, you know, and clearly is going to lead the charge on 100 Mile. But I think it's just a really wonderful way to sort of see the mix of individuals and everyone being there to celebrate and advance it together.

00;30;35;11 - 00;30;57;06

Ray DuBois

Yeah, it's a tremendous event. I think one of the things we did actually was to open up a ten mile ride, island ride, where you could use your beach cruiser to have your kids go along and allow more people to participate. They weren't quite in the tip top, you know, triathlon shape because they've been having cancer therapy or other issues, aging and other things.

00;30;57;06 - 00;31;10;05

Ray DuBois

So, you know, it has expanded to a much larger group and it is really a fun event, but also inspiring to see all these people out there doing what they can to help support cancer research.

00;31;10;13 - 00;31;19;10

Jesse Goodwin

Well, I'm excited to try it again this year, and I'm hoping for good weather. It's it's more fun when it's not raining hard. You although that was fun, too.

00;31;20;29 - 00;31;38;05

Kevin Smith

Well, sounds like there's a lot of energy building behind this push that you guys are making right now. So we're excited about that. And we're very thankful that you're a part of this organization and we're thankful that you're a part of this podcast today. So, Dr. DuBois, we appreciate you very much and we look forward to talk to you again in the future.

00;31;38;11 - 00;31;38;26

Ray DuBois

Thank you.

00;31;39;02 - 00;31;39;16

Jesse Goodwin

Thank you.

00;31;42;10 - 00;32;03;08

Kevin Smith

You've been listening to the Innovatively Speaking Podcast with the Medical University of South Carolina. If you enjoyed this episode and would like to support the show, leave a rating and review to hear more innovative ideas and to share your own. Subscribe to the show or visit us on our web page. Web Dot MUSC Dot edu slash innovation.

00;32;03;15 - 00;32;06;11

Kevin Smith

And remember, don't hesitate to innovate.