What testing is done prior to CAR-T cell therapy to make sure that the patient can receive this therapy?

What testing has done prior to CAR T-cell therapy to make sure that the patient can receive this therapy?

So typically, the testing we do prior to transplant and really CAR-T is called vital organ testing, as the name suggests, you're basically testing your vital organs, your important organs to make sure that things look okay before you undertake this type of treatment. So commonly, the testing that we will do truly for both procedures, we commonly will get a PET scan that's more of to measure disease burden to see if we have myeloma anywhere else. We will get a bone marrow biopsy as a marker of, again, how many myeloma cells are in the bone marrow and we will get blood testing. That's just a look at myeloma protein and similar with urine testing on top. In addition to this, we commonly will get cardiac testing. So that involves an echocardiogram to make sure heart function is okay. And we will get an EKG to assess for any abnormalities of heart rhythm. We commonly will also do what's called pulmonary function testing. And just to look at the pulmonary system and the rest is just blood testing. Just to look at, for example, are kidneys. Okay. Are the liver numbers okay.And we do infectious testing. So we check all of our patients for any, you know, potentially infections that could cause problems. So we check for hepatitis B and C, and we also check for HIV amongst some other viruses. But it's a very thorough testing and it helps us identify any other preexisting problems prior to whether it be transplant or CAR-T, So to to undergo an autologous transplant, there's a wide array of testing that's done to assess if patients can receive high dose intravenous chemotherapy. For CAR-T, most centers have tried to replicate, at least in part, some of the safety testing done on some of the original pivotal trials for both back and CARVYKTI. These generally include the assessment of heart function, looking for infectious disease parameters, looking at standard blood, doing a bone marrow biopsy. These are pretty common. I think it's less common to do some of the things that you do for autologous transplant, such as pulmonary function tests, etc., as that's not been thought to be a good predictor for side effects.