The Genetics Podcast

This week on The Genetics Podcast, Patrick is joined by Lindsey Wahlstrom, Co-Founder and Chief Momatologist of Rona’s FUN LAB, Jimi Olaghere, sickle cell disease patient advocate and early CRISPR gene therapy trial participant, and Rachel Smith, Vice President and Head of Rare and Genetic Diseases at Parexel. They discuss the realities of developing and delivering advanced therapies in rare disease, how funding models, regulation, and trial design shape access and outcomes, and why embedding patient experience early is critical to building therapies that are not only effective but scalable, accessible, and meaningful for patients and families.

Show Notes: 
0:00 Intro to The Genetics Podcast
01:00 Welcome to guests and what Rare Disease Day means to them
08:09 Balancing hope with funding, pricing, and access in advanced therapies
11:48 Why patient access must be built into drug development from day one
14:20 Patient engagement, community readiness, and the realities of trial participation
17:49 Why early patient input is still inconsistent and often treated as a checkbox
23:20 Designing trials around what actually matters to patients and families
26:53 Navigating regulators, payers, and trial design constraints in rare disease therapies
36:02 Redefining success in gene therapy around access, scalability, and real patient benefit
43:27 Closing remarks

This week on The Genetics Podcast, Patrick is joined by Dr. Suzanne Schindler, Associate Professor of Neurology at Washington University in St. Louis. They discuss how blood-based biomarkers like p-tau217 are transforming our ability to detect and stage Alzheimer’s disease, how “clock models” can estimate when symptoms may begin, and how combining biomarkers with clinical phenotyping could improve trial design, prognosis, and patient care.
Show Notes
0:00 Intro to The Genetics Podcast
00:59 Welcome to Suzanne
01:35 Neurobiology of Alzheimer’s disease and how it differs from dementia
06:22 Presymptomatic changes to phosphorylated tau (p-tau) in the brain
07:36 The role of the APOE gene in Alzheimer’s
09:07 Differences in neuropathology in women vs men with Alzheimer’s
10:19 Rare cases where amyloid and tau pathology do not align in Alzheimer’s
12:37 Using plasma p-tau217 trajectories to estimate when Alzheimer’s symptoms may begin
17:30 Using p-tau217 to select clinical trial participants and predict progression timelines
20:59 Overview of therapeutic strategies in Alzheimer’s disease
24:24 Why APOE effects may not appear in p-tau217 measurements
26:30 Combining biomarkers and clinical phenotyping to understand disease progression in Alzheimer’s
30:08 Early-onset vs late-onset Alzheimer’s and differences in clinical presentation
31:45 Expanding beyond p-tau217 to proteomics and multimodal biomarkers for predicting symptoms
33:52 MTBR-tau243 as a more specific marker of tau pathology and Alzheimer’s symptoms
37:31 Expanding biomarkers beyond Alzheimer’s and bringing blood tests into clinical practice
38:49 Closing remarks
Find out more:
Phosphorylated tau217 study

MTBR-tau243 study

This week on The Genetics Podcast, Patrick is joined by Derek Ansel, Global Vice President and Therapeutic Strategy Lead for Rare Disease and Oncology at Worldwide Clinical Trials. They discuss how contract research organizations design and run rare disease trials, the challenges of selecting endpoints and patient populations, and how emerging approaches like n-of-1 therapies, regulatory flexibility, and AI are reshaping clinical development.
Show Notes
0:00 Intro to The Genetics Podcast
00:59 Welcome to Derek
01:38 The role of Contract Research Organizations (CROs) in clinical development
02:41 Why endpoints are the hardest problem in rare disease trial design
05:24 How Derek’s team chooses and operationalizes endpoints in rare disease trials
08:14 Balancing patient selection, signal detection, and trial feasibility in rare disease
11:55 How the FDA’s new guidance for personalized therapies could accelerate rare disease drug development
14:20 Patient engagement, genetic counseling, and decision-making in genetic trials
19:30 Patient and clinician dynamics in genetic subtypes of common disease
23:05 What needs to change to make n-of-1 therapies scalable and accessible
26:12 Where AI is delivering real impact in clinical trials today and where it is heading
31:24 Operational bottlenecks, risk tolerance, and the limits of AI adoption in clinical trials
34:55 Derek’s path from early clinical research roles to genetic counseling and rare disease drug development
38:51 Key areas driving progress in rare disease over the next five years
41:42 Closing remarks
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This week on The Genetics Podcast, Patrick is joined by Dr. Tim Jobson, consultant physician and gastroenterologist at Somerset NHS Foundation Trust and Medical Director of Predictive Health Intelligence (PHI). They discuss the rising burden of metabolic liver disease and how routine clinical data can be used to detect disease earlier and prevent late-stage presentation. They also discuss the LiveWell study, a collaboration between Sano Genetics and PHI, and what it reveals about layering genetics and other data types to improve risk stratification and clinical trial recruitment. 
Show Notes
0:00 Intro to The Genetics Podcast
00:59 Welcome to Tim
01:50 The rise of metabolic liver disease and worsening mortality trends
04:35 Motivation and goals behind the Somerset Liver Improvement Program to address late diagnosis
09:13 Where genetics is already used in liver disease and where it’s still emerging
13:17 Current tools for staging liver disease and the challenge of predicting progression at scale
18:48 How the LiveWell study could improve risk prediction and reshape trial recruitment in liver disease
23:58 Applying longitudinal risk detection beyond liver disease to cardiometabolic and other chronic conditions
26:35 Using subtle changes in routine blood tests to identify cancer risk earlier
28:09 Using existing health data to drive earlier intervention and maximize patient impact
30:05 Expanding beyond liver disease, scaling early detection, and advancing precision medicine
32:18 Closing remarks
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This week on The Genetics Podcast, Patrick is joined by Dr. Glenn Cohen, Professor at Harvard Law School. They discuss the evolving legal and ethical landscape of reproductive genetics, why regulation in areas like embryo selection remains limited, and questions arising around the use of AI in healthcare.
Show Notes: 
0:00 Intro to The Genetics Podcast
00:59 Welcome to Glenn
01:35 An overview of the courses Glenn teaches at Harvard Law School
02:29 Glenn’s areas of expertise across biomedical ethics
03:20 Ethical considerations around reproductive medicine and polygenic risk scores
10:37 Regulatory uncertainty and limited oversight in reproductive genetics
13:18 Liability, regulation, and real-world implementation challenges for AI in healthcare
14:52 Risk–benefit framework for evaluating AI use in clinical settings
17:19 Glenn’s experience contributing to landmark Supreme Court cases in biotechnology and health law
20:09 Glenn’s perspective on mitochondrial replacement and its regulatory divide between the UK and US
22:20 Closing remarks
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