In what setting do you see immunotherapy being the most effective?

In what setting do you see

immunotherapy being the most effective?

I think that what we've learned so far

about how to treat these hematologic
malignancies is that immunotherapy

probably may be most effective
when the disease burden is very low.

Someone who has a lot of leukemia
in their body, it may not be safe

and it may not be effective
to give an immune therapy.

But someone who has just a small amount
of leukemia in their body, immune therapy

may allow own immune system
to clear that leukemia

and provide longer responses rather than
someone who has a lot of disease.

So perhaps the post-transplant setting
or someone who has what we call measurable

residual disease, this could be different
situations that could be more effective.

I think that in you know,
and this is to some extent

extrapolating from other diseases

because again, outside of a bone marrow
transplant, immunotherapy right now

is just very early, I would say
in most forms of acute myeloid leukemia.

But, you know, in terms of where it can be
the most effective.

So, first of all,

again, bone marrow transplants,
I think it was a for immunotherapy.

And that's a key component
of our curative therapy

for many of our patients
with acute myeloid leukemia.

And bone
marrow transplants are ideally best done

when the patient's disease
is under the best control.

So it's a difficult kind of situation
because from a patient perspective,

you know, if they if we are able
to get them into a remission,

ideally the leukemia blast cells are low,
the good cells are back.

They may actually be feeling pretty well.

They may say maybe I don't
maybe I don't want this,

you know, bone marrow transplant.

I really want to pursue this.

And actually, it's the time
when they're feeling the best.

That actually is usually the time

if they're going to pursue a transplant
to do it,

you want to pursue a transplant
when the disease

has absolute lowest levels
and when the patient is doing the best,

it can be very difficult
to do transplants.

And really even sometimes

knowing impossible
if a patient is already going in very sick

or if they have a very

high level of disease going
in, that just makes it very difficult

for the transplant to go well,
you worry about the disease, just come in

coming back very quickly.

So immunotherapy in general,
including bone marrow transplant,

is really best done
when the disease is at its lowest level.

You know, thinking forward about things
like CAR-T cells, for example,

we know from other data from, again,
the different leukemia, ALL,

that CAR-T cells work really
well when the ALL cells are just

at a low level,
you know, in the setting of,

you know, very low level disease
and immunotherapies in general

in other cancers often work
well in low burden of disease.

So I'm

I would imagine that that may be a place
where immunotherapy in the future for AML,

you know, hopefully could work well,
maybe even to eradicate

what we call minimal
or measurable residual disease.