 When it comes to fighting against cancers like multiple myeloma, we know very well that the immune system of the patient has the capacity to recognize and destroy the myeloma cell. And in CAR T cells, the idea is to collect lymphocytes from the blood of the patients. These are the soldiers of the immunity. And once they are collected, they are going to be engineered and manufactured in the lab, in vitro, in order to teach them the way how to recognize the myeloma cell. And actually, they will be able to target an antigen, which is a sort of a marker expressed by the myeloma cell. And once they have been engineered and prepared, it's like you're preparing a soldier to be ready to kill the enemy, they are infused back in the blood. And actually, they are supposed to, and this is working like this, they are supposed to recognize the myeloma cell and kill it. During this ASH 2019 meeting here in Orlando, we had a lot of presentations about CAR T cells in multiple myeloma. And this is quite amazing because you have studies from many places from North America, from China, highlighting that these CAR T cells, when they are used in patients who have already failed, several lines of classical therapy are still able to respond and live longer, enjoy longer survival. So during the ASH 2019 meeting, we have different type of studies about CAR T cells. We had new studies, but also we had confirmation with longer follow up of the results of the studies that were presented in the previous years. Well, the Cartitude study is one of the important CAR T cells studies that were presented at ASH 2019. This is a very interesting study because it is using a CAR T cell that has been already tested in China and presented in another trial last year. And the idea of the study is to test this CAR T cell product in 30 have in 29 heavily pre-treated patients. They have received an average of five lines of therapy, including the monoclonal antibodies, the imid, the proteas and inhibitors, which are usually used in myeloma. And what is really fascinating about is this study also the numbers of the number of patients is still small. The follow up is still relatively short, roughly around six months. Nevertheless, all patients have responded to this CAR T cell product. And more importantly, we have a subset of patient who was able to achieve a very deep negative MRD, minimal residual disease. And this is crucial information because the patients who are able to achieve negative MRD are probably those patients who are going to enjoy extended survival and response. And this benefit has been achieved in the CAR T-tude trial without an excessive risk of toxicity or problems of safety because we know also very well that the CAR T cells do have some specific profile of side effects. And here the patient didn't encounter a significant number of severe side effects. So the balance between the efficacy and toxicity in this CAR T-tude trial was excellent. In general, when you use CAR T cells, whether in multiple myeloma or in lymphoma or acute lymphoblastic leukemia, we are now quite familiar with a certain number of toxicities that can occur. And I would say that two major toxicities that were already described with CAR T cells in general are the cytokine release syndrome, usually called CRS, and the neuro toxicity. And they are quite specific side effects because in severe cases they can threaten the life of the patient and death unfortunately can occur. So what is the cytokine release syndrome? This is a very complex reaction of the body when you infuse the CAR T cells to the patient actually they start to proliferate because this is the concept, the philosophy of a CAR T cell is that your lymphocyte will start to proliferate because you need more soldiers actually to fight against multiple myeloma against the disease. And during this proliferation process there is a sort of a big fire and there is release of what we call cytokines assuming it's like you're fueling the fire and this can lead to some very severe symptoms like very high fever, the blood tension will decrease significantly and this can lead the patient to go into the intensive care. And this is why the side effects needs to be recognized very early because we have effective treatments to stop it or to prevent it. And now we see that the severity of the CRS has been decreasing and in general in the multiple myeloma CAR T cell trials the frequency of CRS is relatively very low. The neurotoxicity is also another side effect which can be severe. Unfortunately we don't clearly understand why it can happen in some patients. Many symptoms can develop. One of the early symptoms is about what we call dysgraphia. So the writing of the patient the way you write will worsen over time and it can go from very mild gentle symptoms up to very severe symptoms with coma. And usually sometimes it goes together with the CRS and usually the treatment is more supportive care symptomatic treatment and hopefully things will settle progressively over time. CAR T cells are providing a lot of hope to the patient and to the myeloma community in general because this is a new way to deliver and to educate the immune system which is a very powerful tool against multiple myeloma. However we always need to be cautious. The results are very exciting they are very good but you need to be aware that they are not curative. We didn't see studies where the CAR T cells were able to eradicate completely the myeloma cell. So the patient who receive CAR T cells needs to be aware that the disease unfortunately can come back. Exactly like when you use the usual treatment where you can obtain a remission but sometimes you know relapse can occur and then you will need another type of therapy. Definitely there is hope but they are not 100% curative they are providing an additional tool which is extremely important especially for the patient who already used all the available other treatments. So definitely I'm very optimistic.