When should I consider a clinical trial?

When should I consider a clinical trial? MDS treatments, let's take low risk first. So low risk treatments, so if we have low risk patients, the goal here is quality of life. So if you don't need treatment, standard treatment, then I would not go on to a clinical trial. Like you don't need any treatment, including a clinical trial. If you have symptomatic disease, then there are some treatments that might work. One is giving growth factors, another is giving other chemotherapies. And so I think you have to balance out what is actually being studied versus what are standard therapies. And how well do the standard therapies work and do you think you can do better by being on a clinical trial? So with low risk, that is oftentimes the pivot is like, should I treat this person at all? Because I'm not going to treat them all, I'm not going to put them on a clinical trial. If you have high risk disease, right, high risk disease is difficult to treat, there are not many approved therapies. And so I think that the standard therapy that we use is something called a hypomethylating agent. So if you are getting a hypomethylating agent, that's the standard. If you can add something on top of a hypomethylating agent that might improve things, I think that is a good trial, right? I think that even if you have randomized trials where they have a hypomethylating agent with or without something else, I think those are good trials. So I think with high risk disease, it's good to think about a trial when you're diagnosed. It is, I think, really good to think about a trial if you've relapsed because there are very few effective therapies after you relapse from the initial hypomethylating treatment. So relapsed patients with MDS, high risk MDS, I think those patients should really consider a clinical trial. For MDS, we always encourage clinical trials for almost all of our patients, whether they're low risk patients or high risk patients. Unfortunately, we don't have a lot of treatment options available in MDS, and so we really need clinical trials to help us know what is the best treatment and get us new treatments that can help our patients fast. Clinical trials are available for MDS patients throughout their treatment spectrum, starting at the beginning at their first line of treatment, second line, and all throughout their treatment course. We're always looking for clinical trials to improve the outcomes for our patients with MDS.