What are the different approaches to fitness based care?

What are the different approaches to fitness-based care? So right now the fitness-based approaches to myeloma care are really have just been investigated based on consensus guidelines. National organizations, which are primarily based in Europe, have product guidelines on how to make these dose adjustments. We are currently awaiting the results of one study in particular that is looking at this fitness-based approach to care called the fitness study based in the UK. And what they will employ is really a proactive arm in which patients who are considered frail or intermediate frail will have upfront dose adjustments of their therapies. And so looking at this in clinical practice right now, we do not have the existing data from large trials, but what we do have is these expert opinions that really help to guide how to adjust these medications. And I will say the other thing that is very useful when you think about adjusting medications is really looking at the inserts or even using things like up-to-date. Oftentimes they will give recommendations for care of the geriatric patient, along with the NCCN guidelines on older adult oncology often gives recommendations, maybe not on specific drugs, but just about caring for older adults in general and when you need to consider dose adjustments for therapies. Is fitness-based care another part of precision medicine? Yes. So we definitely think of the same way you think about precision medicine where we are targeting various genes with different drugs. We are basically using fitness as our precision medicine. So we are using fitness to then ascribe therapy to make sure that the patients who need more intensive therapies receive them and the patients who are at the other end of the spectrum where they are considered to be frail, that they are not being over-treated and then put being placed at risk for increasing toxicities.