My first clinical Trial: 5-ALA & Glioblastoma re-irradiation

For the first time, investor Guy Spier steps outside the world of finance to share a deeply personal conversation—with the doctors who treated him.   Recorded at the University Hospital Münster, this discussion with neurosurgeon Dr. Michael Müther and radiation oncologist Dr. Niklas Pepper explores the frontiers of brain cancer treatment, focusing on glioblastoma and a groundbreaking clinical trial combining 5-ALA (Gliolan®) with radiotherapy.   Topics covered:   What glioblastoma is and why it’s so difficult to treat The Stupp protocol and why recurrence is common How 5-ALA fluorescence surgery helps surgeons “see” tumors The role and evolution of radiotherapy and re-irradiation A new approach: radiodynamic therapy (5-ALA + radiation) How clinical trials work (Phase I, dose escalation, safety focus) Why patient participation is critical to medical progress   The conversation also explores the human side of medicine:   Should patients deeply engage with their disease—or not? The role of mindset, movement, and psycho-oncology How doctors balance research, clinical care, and uncertainty   This is a rare, candid look at how modern medicine advances—from lab to patient—and the people behind it.   Chapters: 00:00 Introduction 03:10 What is glioblastoma? 06:00 5-ALA and fluorescence-guided surgery 12:37 Radiotherapy explained 17:39 Re-irradiation and treatment evolution 23:50 The new clinical trial (radiodynamic therapy) 35:48 How clinical trials work (Phase I, dose escalation) 45:39 Collaboration in cancer research 53:32 Why Germany leads in this field 59:03 Patient involvement in research 01:01:41 The psychology of disease 01:06:32 Final thoughts   Transcript to the whole episode is available here: https://aqfd.docsend.com/view/5gbyupsrddq9ieda   Disclaimer: Nothing contained herein constitutes or should be construed as medical advice. No representations or warranties are made regarding the accuracy or completeness of the information, and it should not be used as a substitute for consultation with a licensed healthcare provider.

In this episode, Guy Spier speaks with Ritavan and Paaras about how businesses can unlock real value through data—not by chasing trends like AI or cloud, but by leveraging data purposefully. Ritavan shares insights from his book Data Impact, discussing how legacy companies often fall into the trap of tech commoditization.Learn how to:Use data leverage for outsized returnsPrioritize high-impact “leverage tasks” like dynamic pricingAvoid wasteful tech adoption and focus on differentiationApply real-world examples from Walmart, Octopus Energy, Bajaj Finance & more Full transcript available here: https://aqfd.docsend.com/view/sqgp7wsixsgvevsk Contents:(00:00:00) Introductions and First Impressions(00:05:25) Ritavan’s Journey and Cultural Insights(00:17:52) Writing “Data Impact” and Global Examples(00:29:18) Data Strategy for Legacy Businesses(00:41:32) Big Bets and Data as Leverage(00:50:30) Content Strategy and Power Laws

What happens when a thoughtful investor sits down with a contrarian academic for a free-flowing, two-hour conversation? In this wide-ranging episode, Guy Spier reconnects with his former professor, Amar Bhidé, who’s the Professor of Health Policy at Columbia University Medical Center, for a dialogue that blurs the lines between economics, storytelling, philosophy, and life itself. They begin by reflecting on paths taken—and those deliberately left behind. Professor Bhidé shares how a winding career through finance, policy, and academia has shaped his unconventional views on business education and the role of theory. At the heart of the conversation is a simple but profound distinction: risk versus uncertainty. But this is no dry academic discussion. Instead, it opens into a deeper exploration of how we make decisions, how we explain the world, and why models often fail to capture what matters most. Stories play a starring role—stories in business, in investing, in life. The two explore why narratives move us, how they can deceive, and what they reveal about human nature. From entrepreneurs to generals, from investors to doctors, Professor Bhidé argues that judgment and imagination remain our most vital tools. There are digressions, of course—beautiful ones. Into mythology and scripture, literature and logic. Into why certain minds captivate us, and why what we choose to read says something about how we choose to live. This isn’t a podcast about one big idea—it’s about many. And the spaces between them. It’s about learning to see and finding meaning—quietly, sometimes stubbornly—just beyond the known. Full transcript available here: https://aqfd.docsend.com/view/g2vwrtr7yiq9cwnp (00:00:00) Setting the Stage: Uncertainty, Progress, and a Life’s Work  (00:06:21) A Distinction That Matters  (00:14:46) The Power of Plausibility: How Investors Use Stories to Decide  (00:22:20) Data Can’t Dream: Why Judgment and Imagination Still Rule  (00:28:34) First Principles, Human Realities: Rethinking How We Know   (00:47:55) More Than Facts: How Stories Shape Action and Identity  (00:55:49) Duty Without Reward: Eastern Philosophy Meets the Business Mind  (01:03:27) Happy with Small Takes: Reflections on Power, History, and the Self(01:10:36) Books, Minds, and Conversations That Stay With You  

In this conversation between Guy Spier and Eric Schaanning, the discussion revolves around the intricacies of asset-liability management (ALM) and interest rate risk, particularly in the banking sector. Eric shares insights from his experience, explaining key concepts like the economic value of equity (EVE), DV01 (the sensitivity of a bank's net present value to interest rate changes), and various risk management techniques used by banks.The conversation explores how different banks, depending on their lending structures (e.g., fixed-rate vs. floating-rate loans), manage interest rate risk. Eric discusses the role of macro and micro hedging, highlighting that while macro hedging is used to offset risks from a portfolio of loans, micro hedging targets individual debt issuance with specific interest rate swaps. The conversation also touches on the concept of "equity term out," referring to how a bank's equity is handled from an interest rate risk perspective.Guy draws a parallel to value investing and mentions how understanding banking risk management, such as interest rate risk, is valuable for investors, especially when evaluating financial institutions. He mentions the importance of having a clear understanding of how these risks could impact stock prices and the economic health of banks.The discussion ends with reflections on how understanding these concepts can enhance an investor's decision-making, particularly in evaluating the risks and opportunities in the banking sector. Eric emphasizes the importance of thinking about balance sheets over time and how these insights apply not only to banks but also to individuals managing their own finances. Finally, Eric shares resources like LinkedIn and his personal Google site for further learning.

In this engaging podcast, Howard Marks, co-founder of Oaktree Capital, and Guy Spier, founder of Aquamarine Capital, share invaluable investment wisdom with Roi Lipovetzky, a former MBA student and current investment professional at Oakmount Capital.The conversation explores key principles of successful investing, such as mastering market cycles, second-level thinking, risk management, and the importance of long-term, contrarian positions. Howard reflects on his experience through major market events, while Guy emphasizes the need for emotional discipline and unconventional thinking.A key theme in their discussion is the importance of being true to oneself, especially in a world that often values conformity. Both Howard and Guy highlight the value of making independent decisions and staying grounded in one’s own principles, rather than trying to please others or follow popular trends.With years of collective experience, Howard and Guy provide deep insights into the mindset needed for lasting success in investing and life. Full transcript available here: https://aqfd.docsend.com/view/2nv2iqixj8rm7bb7  Contents:(00:00) A Journey of Learning: Insights from Howard Marks, Guy Spier an Roi Lipovetzky (03:20) Focusing on Excellence: Howard Marks on Building Oaktree for the Long Term(07:19) Writing for Investors, Not for Entertainment(18:09) Honesty, Risk and Purpose (27:23) The Value of Fun: Howard Marks on Enjoyment, Work, and Investing (33:38) Risk, Resilience, and Staying True to Your Principles (41:12) Closing Reflections: The Power of Truth and Clarity 

In this gripping segment, Eric Schaanning and Guy Spier delve into the complex world of interest rate risk, revealing how seemingly straightforward banking practices can quickly turn into high-stakes dilemmas. Schaanning breaks down how banks forecast deposit behaviours, merging historical trends with expert judgment. He explains that as interest rates fluctuate, customer preferences shift dramatically—rising rates lure them into term deposits for better returns, while declining rates send them back to the safety of site deposits.But the intrigue doesn’t stop there. The duo uncovers the hidden layers of behavioural modelling in assessing credit risk, identifying subtle signals that may indicate a customer’s financial distress. Changes in spending habits and payment timing can serve as critical warning signs, shedding light on the delicate balance banks must maintain to safeguard their portfolios. Spier interjects with essential advice for individuals grappling with financial strain, emphasizing the power of communication and proactive payment management.As the conversation reaches its climax, Schaanning reveals a shocking twist: a seemingly lucrative fixed-rate loan could morph into a devastating loss due to unexpected interest rate spikes. With banks grappling to adapt in an ever-shifting economic landscape, the stakes are higher than ever. This tantalizing cliffhanger sets the stage for their next discussion, where risk management strategies and survival tactics will be put to the test in the face of looming financial uncertainties. Full transcript available here: https://aqfd.docsend.com/view/jtbtn9zjhaebq9ehHere's a link to the presentation: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5007032 Contents:(00:00:00) Why banking Regulations Matter: A Dinner Table Explanation(00:08:50) Calculating Net Interest Income with a Simple Example(00:14:22) Fixed vs. Floating Rate Loans: Cash Flow Dynamics(00:22:19) Balance Sheet Management: Shifting Between Income and Capital(00:29:47) Interest Rate Swaps and Market Liquidity (00:37:57) Exploring Risk Measurement and Gap Profiles in Banking (00:40:52) Navigating Liquidity Risk and Redemption Dynamics in Investment Funds (00:48:24) Understanding Interest Rate Risk and Behavioural Modelling in Banking

In this episode, we continue our exploration of financial risk management with Eric Schaanning, a thought leader in the field. Following his dynamic insights from the previous discussion, Eric delves into the intricacies of treasury functions within major banks and their critical role in risk management. Together with Guy Spier, they unravel how a small treasury team, despite its size, manages significant financial risks compared to the larger pool of relationship managers.  Listeners will gain a clear understanding of complex concepts like yield curves and risk spreads, as Eric adeptly explains their implications in today's banking landscape. The duo examines the Basel Committee on Banking Supervision (BCBS) scenarios for interest rate shocks, pondering whether current banking models can adequately address extreme interest rate fluctuations.  As they venture into discussions on net interest income (NII) and the economic value of equity (EVE), Eric shares his expertise on how these concepts can be applied to personal finance, making the conversation relevant for individuals navigating their own financial landscapes. With an engaging blend of practical knowledge and theoretical insight, this episode offers valuable perspectives that push the boundaries of traditional risk management. Tune in for another captivating dialogue that not only expands your understanding of financial systems but also equips you with practical tools for managing your financial future! Full transcript available here: https://aqfd.docsend.com/view/dyu45ikdqvarwf5pHere's a link to the presentation: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5007032 Contents: (00:00:00) Navigating Interest Rate Risks: A Deep Dive into Bank Balance Sheets(00:08:57) Measuring Interest Rate Risk: Insights into NII, EVE, and Bank Profitability(00:17:09) Banking on Transparency: The Impact of Regulatory Frameworks opn Financial Institutions  (00:31:18) Gap Risk in Banking: Insights from the Delta EVE Measure and Silicon Valley Bank(00:39:56) From Crisis to Regulation: The Evolution of Interest Rate Risk Management(00:53:52) Balancing Act: Large Banks, Regulation, and Operational Challenges  (00:59:21) Bridging Capital and Growth: Perspectives on Modern Banking  (01:23:55) Treasury Functions Unveiled: The Backbone of Risk Management in Banking  (01:29:02) Understanding Interest Rate Shocks: A Comprehensive Look at the BCBC Scenarios

Eric Schaanning is a dynamic figure in financial risk management, known for his innovative approach to navigating the complexities of market and valuation risk. Leading these critical functions for Nordea Group, Eric blends a wealth of experience with a forward-thinking mindset. His career spans impressive roles, including overseeing risk management for UBS and Credit Suisse in Zurich, where he dealt with the high-stakes world of managing risk across massive deposit and loan portfolios. Full transcript available here: https://aqfd.docsend.com/view/bxtu77b955d6grcy  Here's a link to the presentation: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5007032 Contents:(00:00:00) Asset Liability Management & Interest Rate Risk in the Banking Book  (00:06:03) A Case Study in Interest Rate Risk and Asset-Liability Mismatches(00:14:24) Liquidity, Insolvency, and Interest Rate Risk  (00:20:15) The Mechanics of Bank Balance Sheets(00:32:24) Bank Balance Sheets, Loan Reporting, and Equity Capital  (00:49:28) Exploring the Dynamics of Fractional Reserve Banking, Interest Rate Risk, and Regulatory Frameworks(01:03:30) From Pillar One to Pillar Three: Regulatory Safeguards and Banking Risk

Simon Kold is a Danish entrepreneur and investor who’s making waves in the financial world with his firm, Kold Investments. Before founding Kold Investments, Simon spent over a decadeatNovo Holdings, a powerhouse investment firm managing around €150billionin assets. His approach to investing is anything but ordinary. Simon runs a single-strategy, concentrated public equityfirm that focuses on companies with network effectsandscale advantages, a strategy that sets him apart from the crowd. He’s all about finding businesses that have the power to grow and dominate in their sectors. Full transcript available here: https://aqfd.docsend.com/view/akcftczb463rhcam Contents: (00:00:01) Stand-Up, Fall Down, Get Back Up: Lessons from Comedy and Life(00:13:47) From Stand-Up to Stocks: The Unlikely Path(00:30:30) Falsification, Not Verification: Rethinking Investment Strategies(00:53:30) Tattooed in Business: The Long-Term Rewards of Relentless Commitment(01:02:57) The Evolving Landscape of Business: Insights on Leadership and Network Effects(01:20:47) Demutualization: Unlocking Hidden Value in Financial Infrastructure(01:26:07) Network Effects, Brand Identity, and the Global Shifts Reshaping Investments(01:37:33) Investing in Relationships: Timing, Goodwill, and Business Success

Tobias Carlisle, an Australian investor and founder of Acquirers Funds, LLC, also shares his personal journey—from his beginnings as a corporate advisory lawyer in Australia to his transition into investing inspired by Warren Buffett. His career spans roles as an activist hedge fund analyst and general counsel, leading up to his authorship of Deep Value, Quantitative Value, and Concentrated Investing. Full transcript available here: https://aqfd.docsend.com/view/ziv6die4mhrta2ud  Contents:(00:00:01) The Journey from Australia to the States (00:03:20) A Career Start in Law(00:07:01) The Transition to Investing(00:14:46) Exchange traded Funds vs. Mutual Funds(00:27:31) The Important of Risk of Ruin(00:31:12) On Tobias’s Books(00:36:33) The Disciple of Writing(00:45:26) Tobias on His Portfolio Construction(00:58:17) Historical Fictions