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Our goal is really to get out all the cancer, says Dr. Arvind Bakhru. In the operating room, the gynecologic oncologist relies on sight and feel to help identify the cancerous lesions hell remove. But at the Arizona Center for Cancer Care Gynecologic Oncology, where Bakhru practices, there has been another tool at his disposal for the past year. Flicking on an infrared light at the end of his laparoscopethe thin surgical tube that helps surgeons see inside the body during minimally invasive procedures cancerous lesions start to glow green. Its a striking difference, Bakhru says. This fluorescent glow allows surgeons to see exactly where lesions are located, making removal easier and more preciseall courtesy of a medication called Cytalux. Its still relatively new, but the physicians using it and the company that produces it, On Target Laboratories, say its already having a big impact for some cancer patients. [Image: Cytalux] What is Cytalux? Cytaluxadministered via IV up to nine hours before surgery for ovarian cancer and up to 24 hours before surgery for lung cancerworks by attaching molecules of highly fluorescent, but harmless, dye to receptors that bring folate into cells. Because folate, a nutrient found in leafy greens and citrus fruits, supports cell growth and divisionand cancer cells are always growing and dividingfolate receptors are often over-expressed in tumors. The result is that cancer cells shine brightly under infrared light, while other cells stay dim, helping surgeons remove cancerous masses while sparing healthy tissue. The U.S. Food and Drug Administration first approved the medication in 2021 for use in ovarian cancer surgeries, following a successful clinical trial that saw Cytalux identify known cancerous lesions and, in over 30% of patients, additional lesions that hadnt previously been detected. In 2022, it was also approved for lung cancer surgeries. Since it became commercially available in September 2023, Cytalux has been used in over 1,000 surgeries for lung and ovarian cancersmost of which occurred just this year. Bill Peters, CEO of On Target Laboratories, says there are many more potential use cases for Cytalux. Because it has such an affinity for all different types of folate receptorswhich unfortunately are represented by 85% of cancerswe are in the very early days of our ability to treat patients, he says. [Image: Cytalux] Making surgeries more precise In lung cancer surgeries, Cytalux is a more precise alternative to dyes that can be applied to cancerous areas during the surgery itself. While these traditional dyes are effective at marking which areas need to be removed, it can be challenging for surgeons to avoid leakage and overlap when applying dye to multiple lesions in the same area. Cytalux gives the surgeon a lot of comfort, says Ryan Levy, chief of thoracic surgery at the University of Pittsburgh Medical Center. It increases surgeons confidence that theyve removed as much of the cancer hidden in the lobes of the lung as possiblewhile sparing the healthy tissue and lung function of their patients. To take a specimen out and then not be 100% sure that the lesions are in the specimen and then have to go back in and take out the rest of the lobe, thats sort of the nightmare scenario, Levy says. [Image: Cytalux] Catching issues early Beyond tissue-sparing surgeries, Levy says the drug is already playing an important role for patients who are referred to him with small, potentially cancerous, lesions on their lungs. The last thing a patient wants to be told is, Oh, you have a five millimeter spot, and were not going to be able to find it, and you just have to wait until it gets bigger, Levy says. Now we have a way of localizing stuff like that. Being able to find even the smallest spot of cancer is also pivotal in ovarian cancer surgery. Bakhru says patients with ovarian cancer tend to have vague symptomssuch as bloating, bladder issues, and just not feeling quite rightuntil the disease has progressed and the tumor is large. However, he notes that the past 15 to 20 years of research has pointed to removing even small, not yet symptomatic, lesions as being crucial for a good long-term prognosis. For now, Cytalux is the only product of its kind available, and Peters says no other drugmakers have completed the clinical trials needed to apply for FDA approval. Bakhru sees it as “the lead example” of multiple potential products that will help surgeons identify and remove cancer with increased precision. I think its important for people to know that the quality of your surgry and the completeness of your surgery really matters in terms of survival and keeping that cancer from coming back, Bakhru says.
Category:
E-Commerce
Design is the main differentiator in the age of AI, Carl Rivera says. For months, Rivera, Shopify’s chief design officer, has been reorienting his team around this idea. And now, with a new acquisition, he’s doubling down on his thesis. Rivera announced that Shopify just bought Molly, a small Brooklyn design studio known for its inventive work with brands like Apple, Google, and Nike. Shopify declined to share financial details of the deal. With the acquisition, Mollys seven-person team will become the new Shopify Product Design Studio, Rivera says, reporting directly to him and serving as an in-house Navy SEAL squad tasked with reimagining the next era of commerce from the ground up, powered by AI. Rivera explains that Shopify is buying Molly for the way they solve problems as a unit. He believes the new team will serve as a template for how the rest of the Shopify UX design structure should work, which focuses on centralized, flexible teams. Mollys role, he says, will be to inject vision, strategy, and future-forward design across Shopifys most critical and experimental projects, helping other teams visualize and build UX breakthroughs instead of siloed features. It comes at a time when Shopify as a whole is pouring resources into being AI-first. Rivera says Molly will be the prototype for this new operating model in which the organization is not centered around departments like payments or shopping carts but around challenges that span across many departments. Were flattening the organization, he says, with expert teams that can be deployed against different problems. Why Shopify is betting it all on design Riveras vision for the AI era is a refreshing challenge to Silicon Valley orthodoxy. In this sort of AI war that we find ourselves in, the companies that are building the foundation models are at the forefront and fighting over talent, he says. But second only to researchers building foundation models, the most valuable talent in the entire market right now are the designers. In that way, he is framing the studio buyout as a strategic land grab. While the rest of the tech world chases PhDs and model benchmarks, Riveras bet is different. He describes it as arbitragea moment for design to win disproportionate value before the rest of the market catches on. The problem of the engineering-first perspective is that the current AI interaction paradigm is extremely stone age, extremely naive, and kind of obviously wrong, he says. Most products still treat AI as a bolted-on feature, not a core experience, which is why UX designers are so important. Rivera believes that most companies in Silicon Valley are ignoring the real arms race, which is happening around the form factor, or the way users emotionally connect to products. I believe so deeply, so strongly, that the thing that will set companies apart, like when anyone can create anything and all products can be generated at will, the difference between one that is functional and that is memorable is the form factor, he says. Its the thing that makes it click for you. The real innovation will be driven by designers who discover and define AIs lasting form factor. Rivera also believes that this UX revolution will happen in New York. If San Francisco built the models, New York will build the experiences, he tells me. Shopifys design ambitions, and dollars, will flow through the citys creative arteriescreating a hub that attracts the worlds best designers to produce the best work of their careers, defining the future interaction patterns of AI. The Molly template Rivera didnt just want to hire any designers. He wanted a very special team, he says. One that would serve as a model for how Shopify should work because the old organization modelisolated specialists attached to siloed teamswasnt made for AI. AI doesnt give an F about the boundaries, he says. It forces you to break up how you work as a company. Founded just two years ago, Molly had previously worked with Rivera on several projects, including Demo Nights in their Brooklyn studio, and collaborations with brands like Apple, Google, Nike, and AirPods. Seeing how they worked, Rivera realized they were the ideal team for that: I had seen that work. I was very inspired by that work. And then, to be honest, I went out to dinner with them . . . You know how you sit down and have a conversation and things click. Yeah, it just clicks. In their site, the Molly team describes their practice as a creative labwriting experimental frameworks, dissecting UI paradigms, and exploring the API-ification of everything. As their announcement of the sale puts it, weve built a deep library of frameworks and strategy, not only for the process of how we work, but in our theory for how products and the web should interact, behave, and disclose content. They see Shopify as the natural next step for deep impact: The studio model excels in a lot of relationships, but one thing its not ideal for: long-term, deep impact across an entire organization. And this is exactly what Carl Rivera and Tobi Lütke approached us about. New studio, new operating model Now, Riveras plan is to turn Molly into the Shopify Product Design Studio. Theyre going to stay as a team, seven people, deployed against some of our most important, most strategic investments, he explains. To that end, their work will be both practical and theoretical. Rivera says they will join product teams to inject vision and clarity about what the next 18 months could look like. That’s not an arbitrary amount of time; Rivera believes thats the maximum you can plan into the future. Meanwhile, the teams will work on taking the necessary steps to making that vision real in a two-week timeframe, working backwards to build it now. Rivera believes Mollys example will spark a shift company-wide: Instead of trying to fit people into process, you have to build process around the people that know how to navigate this time and age. Thats the theory, at least. Now they need to walk that talk. If they dont produce work that is outstanding and that represents the vision Im proposing, then this whole thing falls flat, he laughs.
Category:
E-Commerce
A hundred years ago, it wasn’t easy being a reader. Books were expensive and libraries weren’t common, so it was hard to get your hands on your next read. In 1926, a magazine editor, professor, and book publisher tried to solve the problem with a mail order company called the Book of the Month Club. The men would read upcoming books, select what they considered the best, then mass-produce them, thereby driving the price down. For decades, thousands of readers across America relied on the catalog to discover new literature. But by the early 2010s, when Blake Orlandia recent Harvard Business School graduatestumbled across the company, it had lost its luster. Consumers had no shortage of places to buy affordable books, from Amazon to Barnes & Noble to their local indie bookstore. Book of the Month had sunk to offering books at bargain-basement prices, but even then, it was quickly shrinking. “Amazon did everything that Book of the Month was purporting to do, but better because of technology,” says Orlandi. “The company was basically hollowed out.” [Photo: Book of the Month] Still, Orlandi couldn’t get Book of the Month out of his mind. The legacy company seemed to have so much potential, if only it could be reimagined for the current reading landscape. “Consumers today have a paradox of choice,” he says. “Book of the Month’s original mission of curating books suddenly seemed compelling again.” Along with his business partner, John Lippman, Orlandi bought the skeletal remains of the Book of the Month Club. In 2016, in the midst of the direct-to-consumer boom, they relaunched it as a subscription business targeted at millennialsand particularly women, who make up the majority of its customers. Every month, the club offers a selection of only five recently released hard cover books, largely fiction with the occasional memoir. Since the company acquires the right to publish each title with a “Book of the Month” logo on the cover, it can price these books cheaper than you were to get them at a book store. Members pay between $13 and $17 a book, depending on their plan, but they can skip anytime. Growth mode Orlandi is now the brand’s CEO. Over the past nine years, Book of the Month has grown to 400,000 members. It generates money from subscription fees and is profitable. It has lower margins than a traditional bookseller because it publishes the books itself. “We have a very different business model than a bookstore that pays the publisher for each book it sells,” Orlandi says. “We publish a small number of titles and we’re highly incentivized to make sure we sell all of them.” Book of the Month is now a powerful player in helping to put books and authors on the map, along the lines of celebrity book clubs, like those founded by Oprah Winfrey, Reese Witherspoon, and Jenna Bush Hager. V. E. Schwab says when her novel The Invisible Life of Addie LaRue was selected by Book of the Month Club in 2020, it exposed her work to a new audience. Until that point, she had been largely seen as a fantasy author, but the club introduced her work to fans of literary fiction. [Photo: Book of the Month] Book of the Month’s success is particularly impressive given that the percentage of Americans that read fiction is actively declining: In 2017, 42% of adults read fiction, and in 2022, that had gone down to 38%. A 2022 Gallup survey found that Americans read an average of 12.6 books a year, three fewer books than they read in the early 2000s. But over last nine years, the company has gained deep insight into the habits and identities of millennial and Gen Z readers, what makes a successful book, and how social media is transforming the reading experience. “There is this narrative that reading is dying because we’re glued to our phones,” says Brianna Goodman, Book of the Month’s editorial director, who runs the team that selects each month’s five books. “But that’s not what we’re finding. People seem to be turning to books precisely to escape being online.” [Photo: Book of the Month] What Women (Readers) Want Over the years, Book of the Month has zeroed in on the demographic of people who still continue to read for pleasure. It found that more women than men are reading on a regular basis: a quarter of men read fiction while for women, that figure is roughly half. “We didn’t have a clear sense of the target market when we bought the company,” says Orlandi. “But we quickly began to figure it out.” Book of the Month’s most devoted members are college-educated women in their early to late twenties, who read one or more books a month. Orlandi says that this age is the sweet spot when people are no longer reading for school, but don’t yet have kids. When the brand relaunched, it tried to make the brand enticing to this demographic of millennial women. Much of its branding was similar to millennial-oriented startups of that era, like Glossier, Away, and Warby Parker. The website and app were clean and minimalist, with playful fonts, and saturated in a sophisticated blue color. In contrast to Amazon’s overwhelming volume of books, Book of the Month focused on curation, spotlighting the five books available that month. In the early years, when social media marketing was still affordable, Book of the Month advertised on Facebook, Instagram, and YouTube, targeting women with ads that portrayed reading as part of a chic lifestylesomething you did with wine, in an attractive apartment. Over time, when the brand hit a critical mass, it began to grow by word of mouth. Members get a free book for every person they get to sign up. The physical books themselves have become home decor, with members often posting photos of them on their bookshelves. “Our members seem to like the idea of books as objects,” says Goodman. “So much of our life is digital, and there’s something satisfying about seeing a physical pile of books you’ve read and loved.” Now, Gen Z is just hitting the late twenties prime-reading age. But that doesn’t mean that older readers aren’t still valuable. Orlandi says there’s a certain kind of woman who self-identifies as a reader. It’s not just an activity, it’s how they see themselves. Often, it comes from positive childhood experiences with reading, or growing up in a family that valued books. These are the ideal Book of the Month customers and the company spends a lot of effort trying to bring them into the fold. It targets them on social media and rewards customers who get their friends to sign up with free books. “We’re a subscription business, and ideally, we want to have members with us for decades,” says Orlandi. (Readers can pause the service for months or years at a time with no penalty.) “Readers may go through phases when they don’t have time to read, but they will eventually come back to books, and we want to be there to help them find the right one.” It’s All About Curation While cool branding and targeted marketing are important, Orlandi believes that the success of the business hinges on how well it can curate books. If a member has a bad experience with a book, they may quit and never come back. (The company has Reader’s Guarantee that allows a member to get a new book if they don’t like the one they picked.) If they find an unexpected book that they can’t put down, there’s a good chance they will be a lifelong customer. For many readers, trying to pick the next book is overwhelming, given the pace of publishing. This is also hard for authors, who are struggling to break through. But Book of the Month can help cut through the noise. Take V.E. Schwab, whose book The Invisible Life of Addie LaRue was a Book of the Month pick in the fall of 2020. “As a fantasy author . . . I’d rarely shown up on the shelves of those who preferred more grounded/realistic work,” says Schwab. “But thanks to Book of the Month, my audience not only grew, but so did some readers’ concept of the shapes and scope that fantasy could take.” Goodman, who oversees a team of seven editorial assistants, says picking books is not an exact science. The company hires people they believe have good taste and instincts. Every month, they go through hundreds of books that publishers send their way, and they choose five to seven. Their goal is to choose the very best book in a number of different categories, from romances, to fantasy, to literary fiction, to thrillers. “It’s hard to say exactly what makes it a right pick,” Goodman says. “It needs to feel fresh, like we haven’t read something like this before. The author needs to be doing something original with words.” As experts have analyzed the decline in reading, they argue that screensfrom social media on our phones to video-streaming servicesare edging out reading in our leisure time. Goodman says that part of what her team is trying to do is to get readers hooked on books that are exciting enough to entice them away from their smartphone addiction. This is why pulpy page turners always have a place on the list. Goodman believes that people are also getting tired of being online. They turn to Book of the Month to return to a slower, more analog pace of life, and the company’s curation team takes this responsibility seriously. “People have limited time, and they’re looking to books to get away from their troubles,” she says. “We want to make sure their time is well spent.”
Category:
E-Commerce
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