[MUSIC PLAYING]

JASON PROSEK: So one of our research missions here is to collaborate with other onco-nephrology clinics so we can better leverage other institutions, as well as our capacity to learn things more quickly. For example, right now the standard for interstitial nephritis case secondary to a checkpoint inhibitor would be to pursue a kidney biopsy to confirm that diagnosis. Sometimes that might be limited by the patient only having one kidney, or maybe they have other contraindications to doing a kidney biopsy. We want to explore in urinary biomarkers if there's proteins that we can find in the urine that might predict or confirm a diagnosis without intervention.

So we have several questions that we were very interested in probing our vast database of patient experience here at the [INAUDIBLE]. For example, with bevacizumab, we know that there is some portion of patients who will eventually develop nephrotic range proteinuria and their treatment will have to be stopped. We have several questions to ask around this realm of, is there a threshold proteinuria, say 500 milligrams a day, that once it's exceeded, is this a predictor for eventual development of nephrotic range proteinuria? And if so, is there an early intervention we can make on these patients to treat them very aggressively upfront to perhaps decrease the incidence of nephrotic range proteinuria during their treatment, and perhaps lengthen the time that they can stay on bevacizumab.

So we're also collaborating with our bone marrow transplant colleagues to better understand the incidence of thrombotic microangiopathy, which can be a devastating complication of a bone marrow transplant. And we seek to better understand that. We're also working with our bone marrow transplant colleagues, again, with CAR T cell therapy, where we are helping understand who develops acute kidney injury during CAR T therapy and if there are any modifiable risk factors to prevent this from occurring.

So with the groundwork we've laid out of how to function onco-nephrology clinic with co-localization with other oncologists, same day visits, we're setting the blueprint for how other onco-nephrology clinics can be rolled out across the country. We'd like to be involved in helping other institutions develop their program.