Tocilizumab

And so we succeeded in a, in a big way, and that product's probably yielded some of the most, uh, impressive clinical data that I've ever seen.

And then other equally big swings, like the, the bladder cancer work that we did, where we had a localized delivery of a medicine by an implantable device in the bladder for early stage bladder cancer, um, Darzalex, uh, the T-cell engagers, Tocilizumab, Tociliza-- I could go on.

But there's so many different medicines that I feel we took big swings and succeeded, and those are the kinds of medicines I think that are, you know, if you're, if you're mission-oriented in life, are worth working on.

There was the nasal spray ketamine, the Spravato, that, that happened too.

After reaching his lifetime limit of Cytoxan, he was still experiencing symptoms.

Tocilizumab, uh, tocilizumab, targeting IL-6 from a very small trial at Duke failed, so he was trialed on azathioprine, which does seem to work.

I know this is different than long COVID, in particular his severity, but even in AE, many have low severity but dramatic responses to the same treatments nonetheless, Khadija.

P.S.

Regarding Tarlatamab, we should interrupt until the event improves to a CRS of grade 1 or less and then we are able to resume Tarlatamab at the same dose level but if CRS does not resolve to grade 1 or less within 7 days, then we need to discontinue Tarlatamab.

For grade 3, of course, apart from other supportive measures, we need to consider antidote administration, either Tocilizumab or Siltuximab, and patient needs to be carefully monitored for subsequent adverse events.

And again, Tarlatamab should be interrupted.

And of course, for grade 4, this is a life-threatening situation.

Um, luckily, I think we know a lot more about how to manage ICANS and treat it right away.

Um, with steroids, we know that Tocilizumab is probably less effective, uh, for ICANS than it is for CRS.

So I think we need to have a little bit of learning to do with how to use this and see if it's a real signal for DLBCL.

We didn't see it in the follicular patient population.