Advertise on podcast: Mendelspod Podcast

What is the value of someone’s genome over their life? Is a genome today what it was 10 years ago? How does the adoption of genomic testing compare to other areas in medicine, such as imaging or electronic health records? Today we take a pretty comprehensive look at genomic testing in practice with Damon Hostin, Head of Market Access, Clinical Solutions at Illumina. Damon brings a rare perspective to this conversation. He’s been in the field since the Celera era, when sequencing was helping define modern genomics, and he’s also worked on the front lines in a large community health system, CommonSpirit Health. At Illumina, he speaks regularly with payers and other stakeholders. Across oncology, rare disease, reproductive health, and pharmacogenomics, Damon describes a field that has clearly moved into standard of care in key areas—but is still very much in the phase of identifying the “eligible but under-tested.” Adoption is real, but it’s incomplete. Chapters: 0:00 Genomic medicine arrives4:51 Genomics, imaging, and the EMR11:23 Oncology—from diagnostics to decision-making18:16 Rare disease and reproductive genetics28:51 The lifetime value of a genome36:03 Cost, quality, and what a genome is A central idea running through the podcast is that the genome is no longer a one-time diagnostic. Its value compounds over time as databases grow, variants are reinterpreted, and new therapies emerge. At the same time, even the basic notion of what a “genome” is, is beginning to shift. With the rise of multi-omic data—transcriptomics, proteomics, methylation—the question is no longer just cost per genome, but what kind of biological insight we’re actually measuring. “A genome isn’t a genome isn’t a genome,” Damon says. He ends with a line that neatly reframes the entire debate around cost: “When you look at the cost of healthcare . . . the cost of the genomics is almost nothing.” Genomic medicine is here. We’re now wrestling with how to scale it, how to use it earlier, and how to make it part of the everyday infrastructure of care. Note: For more discussion and analysis on this topic, check out this upcoming Virtual Roundtable Discussion at GenomeWeb. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Fei Chen of the Broad Institute describes the original problem simply: genomics gave us powerful inventories of gene expression, while microscopy gave us structure—yet the two lived in separate worlds. “You could either have your structure or you could have gene expression, but you couldn’t have both.” In this conversation, Fei walks us through how Slide-tags—now commercialized as Takara Bio Trekker technology—set out to close that gap. Instead of mapping gene expression onto a grid, his team flipped the problem: barcoding the cells in place, then reading them out with single-cell sequencing. The result is something closer to a GPS system for cells. What this unlocks is not just better maps, but better biology. Better questions. In cancer, Fei describes the discovery of local immune “circuits” that determine whether tumors respond to immunotherapy. And more broadly, spatial data turns tissue itself into a kind of experiment itself. Is this the biology of the future? “The spatial context is a natural experiment that has happened.” Chapters: 0:00 The problem: structure vs gene expression1:36 A GPS for cells8:59 Immune circuits and cancer response20:04 Tissue as experiment26:24 New questions for biology Across applications, Fei emphasizes that the real shift is conceptual. Spatial biology is not just about adding location to sequencing. It’s about learning how to ask new questions—ones that treat cells not as isolated units, but as participants in research. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Peptides are having a moment. But beneath the market excitement and the GLP-1 headlines, something more interesting is going on. A field that for years seemed technically promising but perpetually constrained is becoming wide open. To see into that open terrain, we’re joined by Charlie Johannes, founder of EPOC Scientific and president of the Peptide Drug Hunting Consortium, along with Tomi Sawyer, a founder of the Consortium and founder of Maestro Therapeutics. We asked them for a high-level look at a field being reshaped by advances in chemistry, screening, delivery, and by a growing sense that peptides may be uniquely positioned to open up biology that other modalities have only partly been able to reach. And yet both are clear: the field is not mature. AI is accelerating biology, which still depends on existing knowledge. Prediction remains limited, especially with non-natural chemistry. And the core challenge may now be human—how to turn an overwhelming amount of data into real innovation. As Johannes puts it, “Turning knowledge into innovation is the real challenge.” Chapters: 1:31 Why peptides are suddenly hot again6:10 Between small molecules and biologics10:14 Oral delivery, screening15:45 AI, automation, and the limits of prediction32:17 The Consortium and where the field is heading This is not a finished revolution—it’s a launch. The field, Sawyer says, is “in the Artemis II rocket right now heading towards the moon.” The peptide story is now much bigger than obesity drugs. Where does the field stand today? What has changed, and what remains difficult? This episode is the first in a new partnership between Mendelspod and Peptide and Protein News, a media platform covering peptide and protein drug development. You can see what they’re up to at peptideandprotein.com. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

It was the biggest story in sequencing last year: Mark Kokoris, head of SBX sequencing at Roche and inventor of the technology, joins Mendelspod to talk about how Sequencing by Expansion (SBX) works and why it may redefine the limits of genomics. * 0:00 A long journey inspired by PCR * 7:20 What is sequencing by expansion? * 14:00 On scale and accuracy * 19:40 Multi-omics vision? * 24:40 What will be the killer app? * 30:00 Biggest challenge for launch Kokoris recounts the long path from co-founding Stratos Genomics in 2007 to Roche’s acquisition in 2020, when his team’s “wildly ambitious chemistry” finally found its match in Genia’s high-density nanopore platform. “Our approach to efficiently sequencing DNA,” he explains, “is to not sequence DNA. We rescale the problem—expand the molecule about 50-fold—so we can read it with much higher signal-to-noise.” The result is astonishing speed. Working with the Broad Institute and Boston Children’s Hospital, SBX delivered whole-genome results in under four hours, with the sequencing step itself taking only about 15 minutes. Kokoris attributes the achievement to a confluence of chemistry and compute. SBX’s duplex mode achieves Illumina-level accuracy (F1 > 99.8 %) while maintaining single-molecule simplicity. Its tunable flexibility lets small labs run a handful of samples in hours or large centers run thousands per day. Kokoris describes it as a technology built on impatience and rule-breaking, designed to give scientists options they’ve never had. Looking ahead to the 2026 research-use launch, he’s characteristically bold: “For me, success means SBX becoming the new standard in sequencing. Innovation can’t stop—it has to keep evolving, because biology is complex and we’ve got a lot more to do.” This show was originally published Nov 11, 2025. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Why do some animals live ten times longer than others? That question opens today’s interview with Steve Austad, Distinguished Professor at the University of Alabama at Birmingham and one of the leading thinkers in the biology of aging. It quickly becomes clear why he’s been such an important voice in bringing aging research from the margins into the center of science. As he puts it, the field was once “where scientists went to die,” but with modern genetic and molecular tools, it has become one of the most active areas in biomedicine. Steve’s approach, laid out in his book for the empiricist (I’m an amateur), Methuselah’s Zoo, is deceptively simple: look at the animals. From birds and bats to clams that live for centuries, he shows that lifespan follows a clear evolutionary logic. Safer, more stable environments favor slower aging. “If it’s unstable and unsafe… it makes sense… to reproduce fast,” he explains, while protected environments allow organisms to invest in long-term maintenance. It’s a framework that turns curiosity into theory—and theory into something testable. Chapters: 1:31 Where scientists went to die4:11 The opossum problem8:00 Air, land, sea14:23 The longevity quotient33:30 Not forever, just longer What makes Steve such a compelling guide is his tone. He’s low-key, almost amused at times, but unwavering on the science. Aging, he reminds us, isn’t programmed for our benefit—“evolution does not care how long you live.” That doesn’t mean we can’t intervene. The field is now moving into human trials, even if key tools like aging clocks are still imperfect. He has little patience for talk of immortality—calling it “completely delusional.” Still, he’s optimistic. Adding a decade or two of healthy life—not forever—is the goal today. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Molecular residual disease, or MRD, has been part of oncology’s vocabulary for decades. But knowing something is there and being able to measure it precisely are two very different things. In today’s show, we explore how MRD testing moved from a long-standing clinical suspicion to one of the most consequential tools in modern oncology. Joining us on the program are Chris Hourigan, Director of the Fralin Biomedical Research Institute Cancer Research Center (DC) at Virginia Tech, bringing the academic and clinical AML lens, and Gary Pestano, Chief Scientific Officer at Biodesix, offering the industry and diagnostic development perspective. Hourigan reminds us that MRD itself isn’t new. What was missing were the tools. From counting cells under a microscope to flow cytometry and now highly sensitive molecular techniques including droplet digital PCR, MRD has evolved into a quantitative, actionable signal. Coming from the side of commercializing and scaling assays, Pestano underscores the central challenge of distinguishing meaningful signal from background noise. “There is a lot circulating in our blood. The key is what is meaningful, what is not meaningful,” he explains. Sensitivity alone isn’t enough. Target selection, bioinformatic filtering, validation at scale, and real-world reproducibility all determine whether MRD can truly guide care. The field is very much still work in progress, say both. Looking ahead, they point toward quantification as the next frontier. MRD is no longer just about detecting what remains. It’s about deciding what happens next. “We’ve been talking about MRD as if it’s a binary concept” says Hourigan. “I can imagine in the future, there’s going to be windows, and we will tune therapy to what comes next.” Thank you to Bio-Rad for sponsoring today’s show. Bio-Rad is your trusted partner for absolute quantification and reproducible results in oncology research. Bio-Rad helps you move from data to confident decisions. Learn more at bio-rad.com/oncology. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

This is a free preview of a paid episode. To hear more, visit www.mendelspod.com For two decades, tests like Oncotype DX have helped oncologists decide which early-stage breast cancer patients should receive chemotherapy. But those tools were designed mainly to predict early recurrence, leaving physicians with far less clarity about the risk that cancer might return years later. For today’s program, George Sledge, Chief Medical Officer at Caris Life Sciences, discusses new findings from the TAILORx trial showing how multimodal AI—combining molecular sequencing, digital pathology, and clinical data—can improve long-term prediction of breast cancer recurrence. Sledge explains that breast cancer recurrence may actually reflect two different biological processes unfolding over time. Molecular signals captured through RNA analysis appear most informative for predicting recurrence in the first five years, while computational analysis of digital pathology images becomes especially powerful for predicting recurrence later in the disease course. “The best results come from looking at multiple omic levels,” Sledge says, describing a shift away from single biomarker tests toward integrated biological analysis.

We began this podcast back around the time the ENCODE project announced that much of the genome was biochemically active. The big science project was undoing the tidy idea of “junk DNA,” and not without controversy. But activity is not the same as purpose. On today’s show, we move past the question of whether the non-coding genome does something and ask a more ambitious one: why has evolution retained so much genomic material unless it carries adaptive potential? Theral speaks with Sudhakaran Prabakaran, computational biologist at Northeastern University and founder of NonExomics, about his provocative new book, “Eclipsed Horizons: Unveiling the Dark Genome.” Drawing on his lab’s work cataloging more than 250,000 non-canonical proteins, Prabakaran argues that regions outside traditional gene definitions are constantly generating novel open reading frames—previously unrecognized proteins that may shape adaptation, speciation, and disease. Chapters: (00:00) Identical Genomes, Wildly Different Fish (04:00) The Dark Proteome Wakes Up (10:00) Protein Pop-Up Shops (20:00) Homo Minimus and the Space Thought Experiment (30:00) Precision Medicine Beyond the Exome From rapidly diversifying cichlid fishes to human accelerated regions (HARs) of the human genome linked to schizophrenia, he makes the case that protein birth and death is continuous, cheap, and exploratory. In his framing, the “dark genome” functions less like debris and more like a flexible evolutionary sandbox—capable of producing latent biological parts that can be deployed under stress or even extreme environments like spaceflight. The book goes beyond ENCODE’s demonstration of activity and asks what that activity is for, crossing into that taboo in biology, teleonomic analysis. Weaving together proteomics, evolutionary biology, information theory, and even speculative extensions into space biology, Prabakaran suggests that genomes may be structured not just to preserve past adaptations, but to enable future ones. For those of you staying put on the ground, the implications are very tangible for precision medicine. His company NonExomics is using non-canonical protein signatures to stratify cancer patients and refine difficult diagnoses, arguing that the next wave of biomarkers may lie outside the exome. Provocative? Certainly. Grounded in emerging proteomics tools and real clinical cases? Also yes. This conversation probes directly into that mysterious future of biology. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

“We have been talking now for 15, 20 years about the diagnostic odyssey. That shouldn’t exist anymore. The new odyssey is the therapeutic odyssey.” That’s Stephen Kingsmore, president and CEO of Rady Children’s Hospital (he just announced his retirement), explaining the impact of a new genome mapping technology from Illumina. Whole-genome sequencing has transformed diagnosis, but some of the hardest pediatric cases persist because the structure of the genome has remained difficult to resolve. Today on Mendelspod, we cover Illumina’s newly launched proximity mapped reads, showing how long-range genomic context can be captured directly on existing Illumina sequencers and integrated into the lab workflow. The conversation traces how this added structural clarity is already improving diagnostic confidence and, critically, enabling highly precise n-of-1 therapies such as antisense oligonucleotides (ASOs). Olivia Kim-MacManus, a pediatric neurologist and ASO trial leader, shows how the new diagnostic precision directly feeds therapeutic design. “All of these genetic therapy approaches hinge on precise diagnostics,” she notes, emphasizing that allele-specific and haplotype-aware targeting is essential for ASOs and other emerging gene-based interventions. From the product and workflow side, Ali Crawford joins us as Senior Director of Science Research at Illumina, detailing how the technology works without requiring new instruments or complex workflows, eliminating the need for separate library preparation steps. “You just order the kit and go,” she says, highlighting how preserving spatial information on the flow cell unlocks variant calls and structural insight that were previously inaccessible with their standard short-read sequencing. When genome structure comes into better focus, treatments are no longer theoretical. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

This is a free preview of a paid episode. To hear more, visit www.mendelspod.com CareDx is a company on the move. For years, they have been a bellwether in molecular diagnostics. Their early bet on gene expression testing in transplant medicine, their bruising fight over Medicare coverage, and their pivot into cell-free DNA monitoring have all reflected the growing pains of precision medicine itself. Now, under CEO John Hanna, the company looks less like a single-test diagnostics firm and more like a clinical ecosystem. Hanna brings an unusual vantage point. He began his career in health insurance before moving into molecular diagnostics—giving him insight into both innovation and reimbursement. That dual perspective shaped CareDx’s recent evolution: focus tightly on a defined clinical niche—transplantation—while expanding horizontally into the tools, software, and services that surround it. Today, CareDx operates across three segments: lab products (including high-resolution HLA typing kits using PCR, NGS, and nanopore), a growing software and patient solutions business, and its flagship genomics portfolio led by AlloSure, its donor-derived cell-free DNA assay. What distinguishes the company now is its “solution selling” approach—engaging transplant centers not just with a test, but with workflow software, quality reporting tools, specialty pharmacy, and EMR integration. “Our solution selling strategy is working,” he says today. At the scientific core remains the effort to replace invasive biopsies with molecular monitoring. AlloSure’s innovation—detecting donor-derived cell-free DNA without requiring donor genotyping—made routine blood-based rejection monitoring scalable. Yet adoption is not purely technical. “The biggest challenge with our space is building belief that molecular testing can replace tissue biopsy.” Clinician education, clinical trials, and guideline inclusion remain central to shifting standards of care. CareDx has leaned heavily into this, hiring medical leadership specifically to translate data into practice. The company is also layering AI on top of its molecular assays. AlloSure Plus integrates genomic results with EMR-derived clinical variables to generate a rejection risk score. CareDx’s operational mantra has been to put the burden of complexity on the company, not the clinician.

Large-scale genomics is back — and this time, it’s global by design. In this episode of Mendelspod, we return to the kind of ambitious, shared genomics project that helped define the field a decade ago. The Global Parkinson’s Genetics Program (GP2) has now genotyped more than 100,000 participants worldwide, with roughly one third of samples coming from historically underrepresented populations. That scale and diversity are already reshaping how Parkinson’s disease is studied — and how it may eventually be treated. My guests are Andrew Singleton, co-lead of GP2, and Ignacio (Nacho) Mata, a geneticist at Cleveland Clinic and founder of the Latin American Research Consortium on the Genetics of Parkinson’s Disease (LARGE-PD). Together, they describe how globally representative datasets are not a political aspiration, but a scientific necessity — especially in an era of precision medicine. Singleton explains that studying Parkinson’s across populations doesn’t just broaden participation; it increases scientific power. “The more we learn about individual populations, the more we understand about disease as a whole — and the more chances we have to come up with treatments for disease as a whole,” he says. Mata brings a complementary perspective from years of building Parkinson’s genetics infrastructure in Latin America. He emphasizes that without inclusion in genetic and biomarker research, entire populations risk being excluded from the next generation of molecularly targeted therapies. “If we don’t have our patients studied for genetics or biomarkers, then those patients will not have access to the new treatments,” he notes, adding that GP2 is designed to narrow rather than widen existing health disparities. We explores how GP2’s open-science structure has been key to its success and could serve as a model for other global research projects. GP2 has invested heavily in training and infrastructure so that researchers around the world can lead analyses locally, rather than simply contributing samples. As both guests make clear, this is only the beginning. With hundreds of thousands of samples committed and a new generation of globally distributed investigators, GP2 is laying the groundwork for biologically defined subtypes of Parkinson’s and for more precise diagnostics and disease-modifying therapies. When genomics gets big enough — and inclusive enough — scale itself becomes a discovery. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

What if the hardest part of scaling cell therapy turned out to be a materials problem not a biological one—and the solution looked like a sponge? On today’s show, Theral speaks with Yev Brudno, Associate Professor in the School of Pharmacy and also the Department of Biomedical Engineering at the University of North Carolina at Chapel Hill, about a deceptively simple technology that could dramatically accelerate manufacturing and lower the cost of cell therapies. Brudno’s lab works at the intersection of chemistry, biomaterials, and cell biology, with a focus on removing the manufacturing and scalability barriers that have kept powerful therapies like CAR-T out of reach for most patients. At the center of the conversation is a dry, porous biomaterial sponge—developed initially by accident—that boosts viral transduction efficiency from roughly 10% to as high as 90% by forcing cells and viral vectors into intense, highly efficient contact. The sponge works across multiple delivery systems, including retroviruses, lentiviruses, AAVs, and even lipid nanoparticles, effectively functioning as a low-cost, scalable alternative to complex microfluidic systems. Brudno explains how this discovery reframes genetic modification as a physical- and materials-science problem rather than a purely biological one. The discussion goes beyond mechanism into real-world impact. Brudno describes how these sponges—now commercialized for research use by Takara Bio USA—could compress weeks-long CAR-T manufacturing workflows into hours, enabling bedside or community-hospital cell engineering without the need for $100-million cleanroom facilities. The episode closes with a broader reflection on the future of cell therapy. Once again, some of the most transformative advances might come from curious bench science and happy accidents rather than prediction alone. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

For today’s show, we return to discussing the exciting new Cellanome platform. Joining Theral are Pier Federico Gherardini, VP of Computational Biology at Cellanome, and Matthew Spitzer, Associate Professor at University of California, San Francisco, whose lab is using Cellanome’s CellCage technology to study immune cells in dynamic, interactive contexts. 0:00 From static snapshots to observing cell function in real time 4:45 Pairing phenotype with function like we never could before 7:30 Can see cell-cell interaction 19:40 Early applications Rather than relying on static single-cell snapshots, the Cellanome platform enables longitudinal observation of live cells—tracking division, interaction, and function over time—before pairing those behaviors with transcriptomic and molecular readouts. As Gherardini explains, “This creates essentially a new data type where you observe cells over time… and then you can pair all of that functional information with the molecular readouts that you get from sequencing.” For Spitzer, that shift fundamentally changes what can be known. Traditional approaches often force scientists to infer function indirectly, correlating phenotype measured in one experiment with behavior measured in another. With CellCage, his lab can finally measure both in the same individual cell. “Now we have measured the function of the cell and the phenotype for the same exact individual cell,” Spitzer says, “and this allows us to really understand how those core characteristics are linked in a much more detailed way.” For Spitzer, a major advance comes from observing cell–cell interactions as they unfold. Where previous methods could show proximity in a tissue section, they could not reveal outcomes. Using Cellanome, Spitzer’s team can now watch whether a T cell activated by a dendritic cell actually proliferates, produces effector molecules, or kills a tumor cell—and then trace those outcomes back to specific molecular programs. This has already revealed surprising heterogeneity within supposedly uniform cell populations, identifying rare but highly potent immune cells that would have been invisible in bulk assays. Looking ahead, both guests see immediate applications in cell therapy development, target discovery, and functional CRISPR screening—areas where measuring what cells actually do matters more than what they merely express. We close with a sense that cell biology is entering a new phase—one where function, interaction, and time are no longer inferred, but directly observed, measured, and modeled. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Half of oncologists in the U.S. are now ordering MRD testing, according to Adam ElNaggar, MD of Natera — but the other half, he says, “are still figuring out how to use it, or that it even exists.” In this episode, we talk with ElNaggar about the rapid rise of ctDNA-based monitoring and how it’s changing the very rhythm of cancer care. From Natera’s “tumor-informed” SignateraTM assay to its new “tissue-free” LatitudeTM test, the company is reshaping oncology around the molecular traces that cancer leaves behind. “ctDNA-negative patients have an extremely low likelihood of showing disease on imaging,” he explains. “So rather than scanning every few months, we can tailor follow-up to when it’s actually needed—and spare the anxiety and cost that come with it.” The conversation also covers Natera’s EmpowerTM hereditary cancer panel, which has expanded testing to all patients with ovarian and endometrial cancer, and a new Hereditary Cancer Alert program that nearly doubled testing rates among eligible patients. ElNaggar describes how hereditary and MRD testing now reinforce one another, helping clinicians catch missed cases and close the loop for families. We finish with a look ahead: a future where ctDNA status becomes a staging element, where clinical trials are shortened by molecular endpoints, and where multi-omic assays—combining DNA, methylation, and protein—push oncology toward truly personalized medicine. “We’re reaching the point,” says ElNaggar, “where staging won’t just be about pathology—it’ll be about biology.” Note about trials mentioned: IMvigor010 compared adjuvant atezolizumab to observation (surveillance) in an unselected muscle-invasive bladder cancer (MIBC) population IMvigor011 prospectively randomized only ctDNA-positive MIBC patients to atezolizumab versus placebo See all SignateraTM Publications here. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe

Aging may be the last great frontier of precision medicine—not a single disease, but the slow re-patterning of immunity, metabolism, and resilience that determines how well and how long we live. In this wide-ranging and genuinely mind-bending conversation, Alan Landay and Tom Blackwell make a compelling case that aging itself is finally becoming a legitimate—and testable—target of medicine. For Landay, the path into aging biology began decades ago through HIV. Antiretroviral therapy transformed HIV from a fatal disease into a chronic one—but something didn’t add up. Patients were surviving, yet developing cardiovascular disease, neurocognitive decline, and metabolic disorders years earlier than expected. The immune system recovered on paper, but inflammation never fully resolved. That realization led Landay to view HIV as a model of accelerated aging, and to ask whether the same inflammatory processes drive aging in the broader population. As he explains, “we realized that persistent inflammation was the driver—pushing comorbidities forward in time. That’s when HIV stopped being just an infectious disease and became a window into aging itself.” Over the past decade, Landay has brought the full toolkit of systems biology to that question—proteomics, metabolomics, glycomics, microbiome analysis, and epigenetic clocks—to understand why some bodies grow frail while others remain resilient. A central theme is the gut: age-related changes in the microbiome weaken the intestinal barrier, allowing inflammatory signals to leak into circulation and quietly accelerate biological aging. Blackwell approaches the same problem from the clinic. As a geriatrician, he sees that most people ultimately die from one of three conditions—heart disease, cancer, or dementia—and that aging is the common denominator behind them all. His bold question is not whether we can treat these diseases individually, but whether we can slow the biological aging process that gives rise to them. That question underpins his ongoing clinical trial testing tirzepatide, a GLP-1–based therapy, not for weight loss, but for its potential to slow aging itself. “ “There is no drug in the world proven to slow aging,” Blackwell says. “We haven’t proven this one either—but we’re finally running the experiment that can give us a real answer.” At the heart of the discussion is a shared fascination—and healthy skepticism—around aging clocks and biomarkers. Both researchers are using advanced epigenetic and proteomic clocks, including the DunedinPACE measure, to track whether interventions truly change the rate at which people age biologically. The clocks are powerful, but not yet definitive. The episode also explores how geroscience has moved from the fringe to the mainstream: NIH-wide initiatives, ARPA-H funding, repurposed drugs, and growing FDA openness to aging as a trial framework. Rather than chasing immortality, both guests emphasize healthspan—more years of mobility, cognition, and social engagement. “Our vision isn’t to live longer in a nursing home. It’s having a lot more 98-year-olds who drive themselves to clinic, go on dates, and still love their lives,” says Blackwell. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.mendelspod.com/subscribe