I'm

going to talk to you today about ICANS, immune effector cell-associated neurotoxicity syndrome.

So, related to CRS and that what ICANS is, is what inflammatory cytokines make the blood-brain barrier more permeable and allow cytokines into the CSF causing inflammatory neurologic changes.

ICANS is really poorly understood and as you can tell from Stephanie's talk, there's sort of limited things we can do and it's mostly supportive care that we treat it with and dexamethasone.

It is also really a diagnosis of exclusion because it can look like so many things, right? You know, somebody even maybe with CRS who's a little bit confused or lethargic.

Is it the CRS? Are they elderly? Have they been in the hospital a long time? Do they have brain mets? Is it leptomeningeal disease? There's so many choices.

that it could be, so a lot of it is figuring out what exactly is going on.

It either works or it