Chapters Transcript Video Identifying Neurotoxicity Earlier in CAR T-Cell Therapy we are now able to identify in certain patients the development of neurologic toxicity or ICANN's early in the course of therapy and develop interventions to treat this during the course of Carty. Cell therapy for human logic malignancies. My name is Dr Phillip McCarthy, and I am a transplanted socio therapy physician at Roswell Park Comprehensive Cancer Center I Cancer, a Munif actor sell associate. Neuro toxicity is a serious complication of car T cell therapy, and if it's allowed to progress without intervention, it can lead to significant neurologic dysfunction. Patients would normally be evaluated for neurologic function. There are some scoring scales that we utilized, and what they found is that patients would pass these, but then would have subtle differences from day to day and their ability to do more complex tasks. As an early sign of this ICANN's and so that led us to develop a strategy for earlier intervention for treating Icann's. It was, uh, put together by making her one of our epidemiologists and, uh, Renee Mackenzie Hillary Jacobson, representing physical therapy, and Laura Marquel, representing nursing. We all put this together a za group with my other colleagues to war in the community that this is something that we really need to account for. This is, we think, a strategy that will allow us to a identify toxicity earlier, be treated and see. Avoid long term complications of glucocorticoids treatment. So we're really beginning to see major differences and how we treat our patients, adult brains and pediatric brains. They're just behave differently in Children who are being treated with Carty. Cell therapy. The pediatric hematologist oncologist who treat these patients will tolerate mawr neurologic dysfunction. Child has more plasticity and likely is able to rebound much more quickly than adults. And this, hopefully will allow us Ah, better approach identification of toxicity and management so that we only have short term issues and no long term problems. Ah, big struggle that we have this. Patients who've had prior neurologic problems often have more problems with car T cell therapy. So if we could develop a strategy toe, identify this toxicity earlier and then hopefully apply it to patients who have had prior neurologic problems, it would open up this treatment for patients who right now often are not able to receive it. The key take away is that we still don't understand the complete pathogenesis of neurologic dysfunction, or ICANN's after car T cell therapy if we can identify it earlier that will allow us develop strategies for early treatment. But most importantly, we need to understand the basis of this toxicity in the first place, and hopefully we'll be able to develop strategies that will prevent it from occurring in the first place. Created by