Head of Research Division of @GustaveRoussy , @myesmo President
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Thank you to the @myESMO community to have elected me President. Digital / molecular tools to optimize care & integrating science to medical decision will be the main pillars of the vision, with the aim to improve outcome, decrease tox and decrease healthcare disparities. 1/3
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V happy to become Head of Research @GustaveRoussy : 500 staff, 10 highly cited researchers, 8 NEJM / Nature in 2019 as lead author.
Le Pr Fabrice André est nommé Directeur de la Recherche de @GustaveRoussy par la Ministre des Solidarités et de la Santé @agnesbuzyn et par la Ministre de l'Enseignement supérieur, de la Recherche et de l'Innovation @VidalFrederique, pour cinq ans.
▶️gustaveroussy.fr/fr/le-pr-fa…
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Argentina won the world cup (deserved) but the two teams together won the title of best game ever in a world cup. Thanks to them !
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The new Impact Factor @annals_oncology is 32. It means the papers we publish are highly cited and, given our Editorial scope, probably impact patient's outcome. Remember that all articles are free for @myesmo members ! Thank you all for your contributions !
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I'm very honored to receive the 2021 Outstanding Investigator Award for Breast Cancer Research from the American Association for Cancer Research @AACR at SABCS21.
Helen Piwnica-Worms, PhD and Fabrice André, MD, PhD are the #SABCS21 recipients of the @AACR awards for their contributions to breast cancer research. See more at our blog. sabcs.org/2021-SABCS-sup-sup…
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New Impact Factor of @Annals_Oncology is 18.2. This means our articles are more and more cited every year. Thanks a lot to all the Authors, Staff, Editors and Reviewers to make our journal better. High quality publication and dissemination ultimately improves patient management
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The presentation: "Sotorasib versus docetaxel for previously treated non-small cell lung cancer with KRAS G12C mutation: CodeBreaK 200 phase III study" has just been added to the Presidential session III of #ESMO2022 First randomized trial testing a KRAS inhibitor in NSCLC
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This is the best review I ve read so far in the field of AI applied to cancer pathology. If you have few minutes, you should read it at rdcu.be/b7LqP . As always with @NatRevClinOncol , the figures are outstanding
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After 5 years, it’s time to leave the position of Editor in Chief of @Annals_Oncology . Call for applications is now open for the next EiC
Tks to everyone, esp authors & reviewers. The journal has a now clear Editorial line & we are confident that we help improving patient care
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.@GustaveRoussy ranked 5th oncology hospital in the world by @Newsweek
We all know the limitations of these rankings and that all big centers are very similar, but it probably means we are doing a good work for pts and research newsweek.com/worlds-best-sp…
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we are very pleased to announce that papers published in @Annals_Oncology are now free for patients. thanks @myESMO and @ELS_Oncology . To get a paper; go to annalsofoncology.org and request it thanks to the link mentioned below
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we have been AGAIN forbidden to share our genomic data on open portals, because of the "per-project re-consent" of GDPR. Frustrating for pts, clinicians and researchers who want to share their data to generate societal advances. Claim for open science is not compatible w GDPR
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Metastatic cancers should be classified as much as possible based on their biology, and agnostic of organ of origin
To reach this vision, new statistical tools are needed to claim that drugs work across multiple cancers
TY @Nature & @lucy_os for the opportunity to write about it
The conventional way of classifying metastatic cancers according to their organ of origin is denying people access to drugs that could help them.
We need radical changes in how medical oncology is structured, conducted, and taught go.nature.com/3SEB7vb
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To authors who submit a paper @Annals_Oncology ; there is a procedure for presubmission inquiry. you can get a quick answer without formatting your paper. it's waste of resources if brains who should focus on research & care spend hours to format ms rejected without review.
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In the next 10 d, I m going to comment 10 important papers published in @Annals_Oncology in 2020. before starting; Annals has an editorial line: "driving innovation in oncology". it defines the journal's identity and the frame of acceptance. 150 original papers are published / y
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Tk you @Thelancet for taking this question seriously. Academic clinical trials should be evaluated mainly based on their IMPACT on pts, not only on innovation. Too many grant committees give too much weight to innovation vs impact , when it’s about funding clinical trials
On our cover this week ⬇
A Viewpoint on the need for pragmatic, affordable, and practice-changing real-life clinical trials in #oncology: bit.ly/495NtC6
Full issue in thread 🧵
ALT Cover of The Lancet January 27 issue. The quote reads, “As clinicians and researchers, our aim is to help patients with cancer live longer and better lives; thus, the primary endpoints of the trials should be overall survival and quality of life improvement.”
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I'm very happy to co-chair with @CharlesSwanton the Scientific Program @myESMO Annual Meeting 2022. More info soon about Editorial Line & preliminary program. The scientific committee is outstanding. We look forward to see you in Paris on sept 9th 2022 esmo.org/meetings/esmo-congr…
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I have the task to animate a live discussion about a drug that gives HR:0.28 and is not toxic. 😬 Can anyone help me finding conversation piece about it ?? or maybe we take the opportunity to discuss about things since there is no controversy here; just give the drug #ESMO2021
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Targeting cancer complexity is going to be tough. I see three options: treat cancer before it becomes complex , discover the molecular roots of complexity, treat different compartments separately (ADC could help). #AACR22
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we have now implemented a Plain Language Summaries of @Annals_Oncology for patients, students and in general for everybody who want to learn without going deep.
Thanks to the Pt Advocacy and Young Oncologists WG of @myESMO
annalsofoncology.org/content…
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.@myESMO is launching a monthly virtual journal club. 3 papers discussed during 1h by the best experts. The goal is to update all colleagues about the latest advances wherever they are in the 🌍. First session on May ! Stay connected ! esmo.org/about-esmo-meetings…
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DAISY trial (TDXD) @NatureMedicine :
29% OR in pts Her2=0 but only 4 months PFS
Her2=0: pts w ultralow ERBB2 by RT-PCR present ORs
No uptake of TDXD by tumor in Her2=0 vs uptake in Her2+
No quantitative change of immune cells drg TDXD
Uptake of TDXD in 4/6 samples at resistance
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This is an incredible paper. I can just imagine how many hours authors have spent to write it and to draw the figures. outstanding effort. Obviously anyone involved in BC care and translationel research should read it
📢Proud to present our manuscript 'Treatment landscape of triple-negative breast cancer — expanded options, evolving needs' which has just been published with @SpringerNature in @NatRevClinOncol
If you are intrested read here: rdcu.be/cA5e5
#bcsm #TNBC
@OncoAlert
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The 1st @myESMO guidelines on metastatic breast cancer have just been published with some important messages about the positioning of tdxd , palb2 mutations, alpelisib , IO and adc in tnbc... under the great leadership of Alessandra Gennari annalsofoncology.org/article…
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Cannabis extracts seem effective to prevent chemo-induced nausea and vomiting. I love the conclusion: "participants preferred cannabis to placebo" 😅 annalsofoncology.org/article…
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6 month improvement in OS in late line. HR:0.48 for OS. Sacituzumab govitecan is going to substitue chemo very soon in all settings, including (neo)adj of TNBC #ESMO20
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JD Flaysakier etait mon etudiant en these et une aide precieuse pour la dissemination scientifique. Une boite a idee, un vrai chercheur en cancero. Son projet c’etait de connecter questions simples et rigueur scientifique. On rigolait svt, il est parti avec ttes ses anecdotes...
Nous apprenons avec tristesse le décès du Dr Jean-Daniel Flaysakier, grand journaliste #santé et vulgarisateur hors pair. Il nous avait rejoints en 2018 pour participer à des recherches sur le cancer du sein et préparer une thèse.
Toutes nos pensées à sa famille et à ses proches.
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CDK4/6 inhibitor to prevent ... neutropenia (!!!!) induced by chemo. A randomized trial. I m lost with this drug family: it induces neutropenia as single agent and prevents neutropenia when given with chemo 🤔 academic.oup.com/annonc/adva…
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We know how will be the next Research Building @GustaveRoussy (Q1 2027)
32 000 m2 , 60 research teams in 15 Centers, 15 core facilities, 1400 staff. Each floor will include 10 teams of biology that will surround Data Science / Epidemiology teams. We are welcoming new teams !
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v proud to be author of this paper. A work done with large number of colleagues and friends. Tks to Editors and reviewers who improved it a lot. special mention to pts who accepted to receive a biopsy for research and to donors who funded this work through charities (and taxes🤷🏻♂️)
The #genomics of metastatic breast #cancer: analysis of 617 patients demonstrates sheer complexity as tumors evolve and spread nature.com/articles/s41586-0…
@nature by @FAndreMD and collaborators
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Pooled ctDNA analysis of MONALEESA -02, -03, -07 trials. >1000 pts analysed. ANO1, CDKN2, RB1 and high TMB associated with lower sensitivity to ribociclib. annalsofoncology.org/article…
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.@PrismCenter selected to receive 30-40 M euros to build a Precision Oncology Center. Vision: to classify pts based on biology. Scientific strategy: bottom-up approach to model cancer biology in each pt (fig 2) for early cancer or relapse detection, & tt optimisation (fig 3).
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v proud to have been nominated Chief Editor of @Annals_Oncology . thanks @myESMO . @jsoriamd did an incredible job
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The 5 year OS wall has been broken by Ribo for pts with endocrine sensitive stage IV BC . A milestone in oncology. When I saw the data first time, it came to my mind the very low 5 y OS I was learning when I was student #ESMO21
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Tumor Mutational Burden predicts sensitivity to anti-PD1 .... only in cancers where CD8 T cell infiltration correlates with tumor neoantigens. No association between TMB and anti-PD1 activity across tumor types (n=1500 and 1900) (cat I/II: CD8 infil 👇🏼) annalsofoncology.org/article…
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To attendees of #SABCS21 ; I m very sorry for not having been able to make the presentations SAFIR02 and AACR award (friday) in person, but a member of my close family was tested covid+ on saturday (everything OK); so I was not allowed to travel. I hope it's OK by virtual
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I'm not comfortable with the terminology "Virtual conference". It's a real conference that is digital. can't we call it "Digital conference" ? virtual would mean that all what is presented does not exist... like when my team beats barcelona on Nintendo Switch... #ESMO20
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Tonight I had the opportunity to diner with Bob Pinedo, a Legend of Cancer research. A lot to discuss: cisplatin developt by Cvitkovic, 1st bone marrow transplant by Mathe, his developt of azacitidine. Also how 70-80’s were driven by creativity rather than technology. #ESMO23
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Pembrolizumab improves EFS, and clearly reduces the rate of metastatic relapse in patients with eTNBC, irrespective to PDL1 expression. A transformation for future patients. We hope this drug will be accessible very quickly for the patients who need it
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A BIG thanks at @partitadelcuore , @FilippoMontemu1 and Ms Agnelli for having invited me to this incredible event. Continue donating at 45527 for Cancer Research ! First time ever Ronaldo-Pirlo-Totti-Nedved in the same team !
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SAFIR02 breast trial: benefit (HR:0.41) of using genomics in pts with ESCAT I/II (Condorelli, Ann Oncol + Tung, JCO). No detectable benefit ESCAT >I/II (small size). This ranking could be used in clinics, and amended stepwise when new targets come 1/3 nature.com/articles/s41586-0…
Warming up for #ESMO22, online at @nature: “Genomics to select treatment for patients with metastatic breast cancer” by @FAndreMD and colleagues nature.com/articles/s41586-0….
With our brand new #clinicalbriefing nature.com/articles/d41586-0…
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T-dxd improves PFS compared to treatment of physician’s choice in pts with Her2-overexpressing mBC resistant to TDM1. Median PFS: 6 > 17 months (HR:0.36, 0.28-0.45) (DESTINY-B02). Evidence that an ADC can reverse resistance to another one. In @TheLancet authors.elsevier.com/c/1gxxv…
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18% of pts included in PALLAS did not receive adj chemo. What happens in the brain of an oncologist who considers that a pt has a risk high enough to receive a CDK4 inh for 2 years... but does not give adjuvant chemo ????? #ESMO20
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Petite pensee a @kinkybambou , patiente qui a fortement contribue a developper la Vision de @PrismCenter labellisé IHU ce jour. @kinkybambou est malheureusement decedee il y a quelques semaines. Elle aurait tellement aime cette nouvelle
« Le Centre national de médecine de précision #PRISM entre dans une nouvelle dimension en devenant un Institut Hospitalo-Universitaire »
📰 Lire le #CommuniquéDePresse ⤵️
gustaveroussy.fr/fr/le-centr…
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. @jsoriamd is the new general director of @GustaveRoussy ! roadmap and vision expected for Q1. (👇🏼w george mathe )
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very proud to be in this list with 10 colleagues and friends. these 11 account for >10% of the highly cited researchers working in life science in 🇫🇷 😳. @GustaveRoussy is an outstanding institute.
🏆11 médecins-chercheurs de @GustaveRoussy figurent dans la liste 2018 @clarivate @webofscience des chercheurs les plus cités au monde, une performance pour une structure française !
Pour les découvrir 👉gustaveroussy.fr/fr/onze-che… #HighlyCitedResearchers #HighlyCited2018
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A cancer patient from @GustaveRoussy presenting a symptomatic covid infection, treated with an anti IL6R antibody. could be useful to some (not all) patients. prospective trials will inform us about predictive markers of efficacy. @AlbigesL @MichotJM annalsofoncology.org/article…
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Aside trials testing Innovations, there is a need for trials testing pragmatic questions in oncology. These trials must ↘️↘️ the nb of data collected & bureaucracy. This is 1 of the 4 pillars of clinical research strategy @GustaveRoussy 1/2 thelancet.com/journals/lance…
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incredible emotion when we visited the @royalsociety w the faculties of MAP2019. we had access to the original "principles of mathematics" (Newton), the 1st edition of the origins of species and others. these books have transformed the world. vertiginous. tk @CharlesSwanton
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PI3K inhibitors are finally coming of age, by @CellsigL . everything you need to know about PI3K inhibitors : 377 references !!!! and nice illustrations nature.com/articles/s41573-0….
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1st large prospective study looking at PRO before / after breast cancer. n=4 000, 1st set of CANTO (n=12 000). Key msg; Endocrine therapy dramatically alters PRO (more than chemo in post-meno pts); there is an urgent need to de-escalate ET : biomarkers ! academic.oup.com/annonc/adva…
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Synthetic control arms are coming in oncology. It will allow pts to get quicker access to innovation and avoid randomisations. One of the 1st examples (post-hoc) is now published in @Annals_Oncology ,comparing APT trial with external controls. @stolaney1 annalsofoncology.org/article…
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we must find solutions to make careers of clinician scientists more attractive. CS are the ones translating basic concepts and innovation to patients. need for action @esmo @aacr @ASCO . V proud to sign this paper w @LoiSher @CRUKresearch @CharlesSwanton nature.com/articles/s43018-0…
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How a failed clinical trial led to an important discovery, in @Nature
PI3K delta inh ↘️ T reg infiltration in tumor (1), particularly an ST2-like T cell pop (pop 8 in 2). T reg ↘️ induces colitis. Intermittent schedule ↗️ results.
rdcu.be/cOuLD
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2nd trial showing that fecal transplant overcomes resistance to anti-PD1. The proof-of-concept is now done. next step will be to transform this into a therapeutic strategy. drug-bacteria or fecal transplant ??? science.sciencemag.org/conte…
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Some patients treated with anti-CD20 antibody present a very severe chronic COVID infection requiring long stay in ICU, due to lack of B cells. It's absolutely crucial to avoid COVID infection in these patients.
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In @JCO_ASCO ; Guidelines for the use of biomarkers in pts with early stage BC. A huge work done with @VeredStearns , coll and pts.
Key msg: only oncotype in premeno pts, Ki67:✅ in some situations, no biomarkers in >3N+, tnbc, her2. ascopubs.org/doi/abs/10.1200…
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🚨🚨⚽️⚽️V Happy to take part in @partitadelcuore . May 27th, 8pm @juventusfc stadium and @RaiUno . coach: M Platini 😍😍. tks @FilippoMontemu1 . Part of the benefits will go to Fondazione Piemontese Ricerca Sul Cancro. pls give at 45527 !!! I trained hard dg the last 2 months!
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Single Cell Atlas of Breast Cancer. A must read. @gustaveroussy is v proud to have contributed to this International effort through our expertise in myeloid cells (@cadutertre & @FGinhoux). Identification of Lipid-Associated Macrophages in Breast Cancer👇nature.com/articles/s41588-0…
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In a few weeks, I ll no longer be Editor in Chief of @Annals_Oncology. In this Editorial, some reflections about this period and how the journal was transformed. tks to authors, readers, editors, reviewers, @ElsevierConnect , @myESMO , lewis & @jsoriamd
sciencedirect.com/science/ar…
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Ballot for the esmo tournament has been done today by @CharlesSwanton , the Chair of @myESMO scientific committee 2022 ! And some groups are tough 😰
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tres triste, @kinkybambou a monte avec nous le dossier de Centre de Medecine de Precision PRISM (en evaluation). Son experience a ete cruciale pour definir la vision: « les cancers doivent etre definis et representes par leurs mecanismes biologiques » et la partie pt engagement
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The paper that everyone was expecting; role of Tumor Mutational Burden as biomarker for IT, written by the key people of the fiel; @peters_solange @CharlesSwanton @squezadd T Chan .... v comprehensive, nice fig. key msg: read it ! academic.oup.com/annonc/adva…
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The Annual meeting of @myesmo 2022 will be in Paris. Given the burden of innovation in oncology, it's expected to have an outstanding program, full of hope for patients, doctors, nurses, researchers and the whole community ! esmo.org/meetings/esmo-congr…
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Detection of ctDNA at the time of cancer diagnosis: 99.5% spec & 51% sens. promising in pancreatic cancer. 88% prediction of tissue of origin. the test is now available in US.
next step: evidence it detects some cancers earlier than standard of care ? annalsofoncology.org/article…
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.@Annals_Oncology has reached a new milestone. While the Editorial policy is to publish <10 articles a month, the nb of downloads has dramatically increased to >1 M per month drg several consecutive months. This means that papers we publish are read by a large number worldwide
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ADCs are substituting chemo step by step. Here, the 24-month findings from the trial of enfortumab vedotin vs chemo in pts with advanced urothelial carcinoma. The big question in this field is the impact of ADCs in pts with early stage cancers annalsofoncology.org/article…
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.@myESMO reco for NGS
1. Public health: NSCLC, cholangio, prostate, ovarian Kc: ✅ + TMB in 5 add cancers. Optional CRC
2. Clin res centers: any pt eligible for trial
3. pt centric (outside 1): ✅if pt aware of v low benefit and no cost /public HS annalsofoncology.org/article…
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Pembrolizumab plus chemotherapy as neoadjuvant treatment for high-risk, early-stage triple-negative breast cancer: 60% pathological complete response, high TILs and/or PDL1 = higher pCR. by P Schmid, @LoiSher and coll annalsofoncology.org/article…
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to my colleagues researchers and +++ reviewers and editors; a paper showing that Cas9 itself mediates tumor rejection by T cell. A MAJOR source of biases in immuno-oncol projects. tandfonline.com/doi/full/10.…
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Merci a tous les soutiens pour mon #SemiParis au profit de @GustaveRoussy . Le parcours est genial mais la fin est hyper dure a cause des crampes 😩🥵
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serum detection of tamoxifen: 16% non adherence at 1 year; associated with relapse. In this study, it s estimated that non-adherence could contribute to around 20% of relapses. A study from CANTO project by @BarbaraPistill2 and @inesvazluis ascopubs.org/doi/abs/10.1200…
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I was v happy to receive the San Salvatore award, especially one year after @CharlesSwanton , but I felt even more happy when I received so many 👍🏼💪🏼👏🏼🤙🏼♥️after. thanks ! I feel like the @riouyoann of oncology
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Primary endpoint of 5 phase III randomized trials will be presented during @myESMO 2020, including 1st ADC in TNBC and 1st adjuvant trials testing cdk4/6 inh.
🚨Less then 🔟days before the start of virtual #ESMO20 and 2⃣weeks before the start of the science weekend, besides looking forward to our #YoungOncologistCommittee track, i'm eagerly awaiting so many new exciting data in #breastcancer
My top 10 selection🤗 👇@OncoAlert @myESMO
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I would love to see an ImpAscent trial that would combine anti-TROP2 ADC and anti PD(L)1 antibody. According to what we know about biology (Ag release, immunogenic cell death, Lymphocyte sparing by ADC), it should transform TNBC. #ESMO20
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<5 years from 1st patient dosed to @FDAOncology approval. Beside its efficacy this drug probably opens an era of translational research in the field of intracellular trafficking to understand how payload reaches its target
Today the FDA granted accelerated approval to fam-trastuzumab deruxtecan-nxki (ENHERTU®, Daiichi Sankyo) for patients with unresectable or metastatic HER2-positive breast cancer who received two or more anti-HER2-based regimens in the metastatic setting go.usa.gov/xpA4h
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Without disclosing what will be presented, #ESMO22 will be for sure a conference that colleagues will remember 20 years after , given the wealth of innovation + new concepts on the clinical trials side
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I was so proud to have met @EmmanuelMacron that I sent a pic to one of my sisters. here is the answer 🙄
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For those who want to play football, we organise a game on monday 6 pm during @ASCO conference. Pls send me an e-mail.
NB: @DrChoueiri being out of shape , he will not attend 🧸 😏
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Effect of containment: +46% paper submissions to @Annals_Oncology in March...😓
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Very important paper showing high sensitivity to anti-PD1 single agent in patients with >90% PDL1 NSCLC.
Need for an additional biomarker (TMB ? CD8 ?) to reach outlier sensitivity, and withhold chemo. work in progress.
tks @DrMarkAwad for having chosen Annals to publish it !
How do patients with NSCLC & very high PD-L1 levels ≥90% do with 1st-line pembrolizumab? Multi-institutional collaboration led by outstanding Elizabeth Jimenez Aguilar & Biagio Ricciuti now online @Annals_Oncology @BiagioMD @Elizabethjimag @DanaFarber academic.oup.com/annonc/adva…
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We have now a cute vegetable garden @GustaveRoussy . It’s like an Oasis in the middle of Buildings hosting sad human stories. I can see colleagues taking care of it sometimes when they want to breath a little bit
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.@myESMO recommendations for the use of NGS is published in @Annals_Oncology . >200 references ! Breast cancer is one of the new indications. A special mention is done for tumor-agnostic indications. A big work from @fermosele and the precision medicine group of ESMO
Now available #OpenAccess in Annals of Oncology, recommendations by the @myESMO Precision Medicine Working Group for the use of NGS for patients with advanced cancer in 2024
🧬Expanding indications
🧬CUP & tissue-agnostic situations
🧬Best practice
annalsofoncology.org/article…
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One of the most robust study on clinical utility of assessing residual disease by ctDNA . >500 patients with bladder cancer from adjuvant Imvigor trial rdcu.be/cmHvg
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Concluding remarks of #ESMO22
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.@myESMO virtual plenary is clearly the way to go: 1h session during the lunch, original data with some suspense, update on a key topic, no need to wait months before seeing data and implementing them. It will be the standard soon
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21h; les chercheurs de @GustaveRoussy sont mobilises pour identifier des cibles therapeutiques dans la maladie a covid19. Cytometrie de masse pour caracteriser la reponse lymphocytaire a l'echelle unicellulaire.
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Because there is NO reason why simple clinical trials would cost a lot 💶; @GustaveRoussy F & @criscancer start the «Real-Life Trials in oncol Prog».
1.5 M to fund several simple 🇪🇸🇫🇷 clinical trials answering questions that impact pts 👇 gustaveroussy.fr/en/real-lif…
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So sad Jose Baselga is dead. Beside he was very inspiring, we had a lot of fun. Our last jokes were these FIF19 @FCBarcelona / @ogcnice virtual games trying to hit as many goals as possible. let's try to score more than 100 goals jose !
José Baselga, MD, PhD— revered AACR Past President, Fellow of the AACR Academy, and an internationally renowned expert in the development of molecular targeted agents— has died at the age of 61. We offer heartfelt condolences to his family, colleagues, and friends.
#AACRFellows
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A selection of 10 papers related to breast cancer published in the last 12 months in @Annals_Oncology . thanks to the authors for trusting us to disseminate their research.
With #ESMOBreast20 just around the corner, Annals of Oncology has prepared a collection of most read #BreastCancer articles. Free access using this link: annalsofoncology.org/content… #bcsm @myESMO
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This is a very very sad news. Angelo was an incredibly nice person. Always quiet, smiling and helpful. I learnt a lot from him during our work @BIGagainstBC . Also, he was so elegant and charismatic
(credit photo: BIG , Brussels 2012)
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.@GustaveRoussy launches its center for early cancer detection, led by S. Delaloge. For participants with high risk of cancer; individualized intervention + inclusion in a research cohort to discover methods of cancer detection (plasma, feces, imaging...). 1st step: n=10 000 pts
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key findings of the below paper in the context of other important works (mskcc, dfci, erasmus, aurora):
RB1 mut> enriched in hr+ mBC, poor outcome, resistance to cdk4. 1500 pts from 3 randomized trials analyzed in the paper. soon a level I marker👇🏼 nature.com/articles/s41586-0…
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