Q4 2022 Immunocore Holdings PLC Earnings Call
Speaker 1: I like some music.
Speaker 2: Greetings. Welcome to the Municor 2022 Financial Results and Business Update Call. At this time, all participants are in a listen-only mode. A question and answer session will follow the formal presentation.
Speaker 2: If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. BLANK
Speaker 2: Please note this conference is being recorded. I will now turn the conference over to your host, Clayton Robertson, Head of Investor Relations. Thank you. Thanks for joining us today.
Speaker 3: Thank you, Daryl. Welcome to our Q4 and 2022 Financial Results Call.
Speaker 3: Before we begin, I would like to remind you that this call will contain 4 different statements within the meaning of the safe harbor provision under the private securities. Litigation reform Act of 1995.
Speaker 3: These include expectations and plans concerning future events, prospects, and performance, including with respect to commercialization, clinical development, and trials, regulatory approvals, and financial results. Actual events may differ materially from those indicated by these forward-looking statements.
Speaker 3: As a result of various important factors, including those disclosed in our filings with the SEC. And such statements represent our views only as of the date of this webcast. And should not be relied upon as representing our views as of any subsequent date.
Speaker 3: We specifically disclaim any obligations to update such statements. I'm now pleased to introduce a Munich or CEO . Dr. Bajesha Jalal
Speaker 4: Thank you, Clay. Good morning and good afternoon, everyone. We're very happy to share an overview of our 2022 performance.
Speaker 4: With me today are Ross Torbay, our Head of Commercial, Ryan DiDonato, our Chief Financial Officer and Head of Strategy, and David Berman, our Head of Research and Development.
Speaker 4: We will be happy to take questions at the end. 2022 was a momentous year, one that established immunocore as the leader in PCR therapeutics.
Speaker 4: It is not every day that a company can achieve the first, which makes it even more meaningful to have delivered three firsts with the launch of Kintrak.
Speaker 4: And we will not stop there. We will stay true to our mission to radically improve outcomes for patients with cancer, infectious disease, and autoimmune conditions and were never satisfied with incremental benefit.
Speaker 4: And I'm extremely proud of how our teams had advanced this mission in 2022. So let's take a look at the highlights from 2022.
Speaker 4: ChemTrac is the first and only approved treatment for anoreceptical or metastatic UV melanoma. It is now approved in more than 30 countries, and we have treated more than 500 patients since the end of phase three trial with ChemTrac.
Speaker 4: We have revenues of just over $140 million with 25% quarter over quarter growth.
Speaker 4: For a biotech of our size, what the team has achieved is amazing.
Speaker 4: Ralph will provide you with more details about our launch performance as well as our plans to launch in more countries and make him track available to even
Speaker 4: Our research and development teams, having successfully passed the battle for ChemTrac to the commercial and medical teams, have delivered substantial progress with our pipeline.
Speaker 4: Starting with tevantafax, we are screening patients with advanced melanoma in phase 2-3 trial.
Speaker 4: We presented initial data with our mTAC therapy targeting PRIM-AO2 at ESMO showing three things.
Speaker 4: resist responses, reduction in circulating tumor DNA across multiple solid tumors, and most importantly, durability of response.
Speaker 4: Our focus now is increasing the trial footprint for the PRAME AO2 Phase 1-2 trial across multiple tumor types, as well as in combination with standards of care.
Speaker 4: In addition, we have announced three new candidates in our pipeline.
Speaker 4: The first two expand our prime a prime franchise with impact therapies targeting frame a 24 and frame to have life extended. The third one is an exciting one is the first in class novel immunotherapy targeting.
Speaker 4: P.Will has the potential for patients with colorectal cancer and other GI tumors, which are so far insensitive to checkpoint inhibitors.
Speaker 4: Confirming further the potential of our mTACS platform, we presented the first safety and pharmacodynamic activity with our mTACS in HIV just last week at CROI. With these HIV candidates and our HPV therapy, we presented data last year.
Speaker 4: Our aim is to evaluate their potential as a functional cure. As you can see, we had a very busy and productive 2022.
Speaker 4: We are well placed to deliver these ambitious goals with our projected financial runway taking us into 2026.
Speaker 5: I will now hand it over to Ralph. Thank you, Bahija.
Speaker 5: I'm delighted to be here today to provide you with an update on what was a very successful launch here.
Speaker 5: With approvals in over 30 countries and the launch of the same track, we have strongly delivered against the promise of radically improving outcomes for patients living with metastatic uveal melanoma.
Speaker 5: This has been recognized with Kim Trekk's inclusion into the ASCO and NCCN guidelines, recommending it as a standard of care for patients with MUN and through the prestigious Innovative Therapy Award from the Fundatio Ngaria in France and the best-viewed drug award from SCRIP. Our teams have executed flawlessly.
Speaker 5: launching KimTrack just days after approval, achieving reimbursement in the US, Germany and France, transitioning all EAP patients to commercial supply within weeks, and importantly establishing KimTrack as the most prescribed medicine for HLA-0201 positive metastatic
Speaker 5: across all countries that we've launched in. In 2022, we recognize $141 million in net sales of Chemtrac, primarily in three major countries.
Speaker 5: Our Q4 net sales of 51 million represents approximately a 25% quarter over quarter growth.
Speaker 5: This was driven by strong demand in the US including a one-time increase in year end stocking at our specialty distributors and single digit demand growth in Germany and France. Let's now look at our progress in the US and what to expect
Speaker 5: The outstanding execution by our US team delivered Kimtruck to 240 new accounts in 2022.
Speaker 5: We believe these capture approximately 50% of the patient potential and we plan to continue increasing the number of new accounts, especially in the community.
Speaker 5: Our focus on enabling first-line patients
Speaker 5: We closed the year with 60% of Kim Track share in first line.
Speaker 5: Being treated closer to home is important for patients and the future of our therapy.
Speaker 5: At the end of 2022, one out of two patients were being treated in the community. I'm pleased to see the efficacy and tolerability of KimTRAAT reported in our Face-Free Clinical Trials playing out in the real-world setting.
Speaker 5: While it remains early to confirm the average duration of therapy, our commercial persistence models indicate that Kim tracks duration of therapy is tracking to a mean of around nine months which is The
Speaker 5: While it remains early to confirm the average duration of therapy, our commercial persistence models indicate that Kim Trac's duration of therapy is tracking to a mean of around nine months which is broadly in line with our expectations. From an access perspective
Speaker 5: Our teams have done a tremendous job in securing formal policy coverage for over 90% of all potential patients in the US. And last year, we saw 99% of prescriptions covered. We continue to work hard towards our goal of supporting access for every single patient who needs KimTrack through our KimTrack Connect program. Let's move on to Europe .
Speaker 5: job in securing formal policy coverage for over 90% of all potential patients in the US and last year we saw 99% of prescriptions covered. We continue to work hard towards our goal of supporting access for every single patient who needs KimTrack through our KimTrack Connect program. Let's move on to Europe who have had a fantastic
Speaker 5: With over a hundred accounts treating patients with Kimtrak across Germany and France, we are capturing nearly all potential patients with MUM in these key markets. The European team are dedicating their efforts to increasing patients treated with Kimtrak in first line by working to expand our treatment footprint into office-based physicians in Germany and with dermatologists in France. The patients recognized in Germany
Speaker 5: the GBA with a considerable added benefit rating. This is particularly important as Kimtruck becomes one of only three orphan oncology products in the last 10 years to have received a strong rating which will support our ongoing
Speaker 5: we expect to reach a negotiated price by the first half of the year. This negotiated price will apply retroactively and we have started accruing for this potential discount in our German net sales as of November 2022. In France we have received an ASMR
Speaker 5: and an SMR benefit of importance. With no restrictions and no relevant clinical comparators, this strong rating will enable us to begin pricing negotiations in the second half of 2023 with an agreement expected in the first half of 2024. 2022 was certainly a historic year.
Speaker 5: Looking ahead, we expect to launch ChemTrack in one major European country around mid-year and in up to five additional countries by year-end. Across countries where reimbursement is not yet available, we continue to offer ChemTrack to nearly 200 patients through
Speaker 5: We remain focused on our ambition of making ChemTrac available to over a
Speaker 5: With that, I want to thank the team for an excellent 2022. Thank you for your support and I'll invite Brian to take you through our financial results. Thank you, Ralph. Today we will focus on the financial highlights in the fourth quarter and year-end 2022 and provide some insights into 2023. Please refer to the press release we issued this morning.
Speaker 3: and our SEC filing on Form 20F later today for our full financial results. Comparisons discussed are versus third quarter 2022, using US dollar convenience rates unless otherwise stated. On slide 14, you see a summary of our financial results. I'm excited to report that our teams continue to execute and to deliver Kim Track to patients in the United States, Germany, and France with impressive site expansion and seamless reimbursement. I'll continue to expand our global early access program.
Speaker 3: new countries currently treating nearly 200 patients. In Q4 we increased biosales in both the US and Europe . Total fourth quarter net revenue as Ralph mentioned was $51.1 million when converted to US dollars, an increase of 25% over Q3.
Speaker 3: In the U.S., we saw a 50% increase in Q4 net sales, in part due to some one-time year-end stocking and a year-end adjustment of gross to net, with reduced 340B to Medicaid assumptions.
Speaker 3: In Europe , even with an increase in vital sales, net revenues decreased to 12.2 million due to new reimbursement accruals for Germany, which started on November 1st, and will continue until final pricing agreement expected in Q2.
Speaker 3: On the expense side, SG&A increased to $52.1 million in Q4, partly due to a currency loss of $15 million on U.S. dollar reserves when it's translated back to GBP. R&D expenses for the quarter increased to $32.8 million and are expected to marginally increase throughout 2023.
Speaker 3: we expand and accelerate our clinical development portfolio. The company is capitalized with over 400 million in cash and cash equivalents at year-end. With projected Kim track revenue, this provides a runway into 2026 with the convert current development plans including our
Speaker 3: I'll share with you some of the key drivers for KimTrack looking ahead. On slide 15, it summarizes some of these insights as we head into 2023. In Europe , a key dynamic will be formal reimbursement agreement in Germany and France, as well as the expected launch of commercial KimTrack in one additional major European country by mid-year.
Speaker 3: and expected five additional new countries by year end. In the U.S., one opportunity for growth is new community oncology accounts, which tend to be lower density than academic centers, which may lead to lower U.S. growth rates as we move into 2023. Globally, it's still too early to know real-world creation of treatment.
Speaker 3: However, currently we are approaching the nine months as observed in the clinical trials. Another consideration in the U.S. is the 2021 Refund Act. The Act requires drug manufacturers to rebate CMS for discarded drug amounts.
Speaker 3: Starting in Q4 2023, CMS may request a rebate of a portion of our CMS sales for KimTrack. We plan to seek an exemption from CMS as we follow FDA and USP guidance regarding required fill to ensure patients safely and consistently receive 68 micrograms of KimTrack.
Speaker 3: Given the number of moving revenue targets in 2023, it is still too early to accurately provide sales guidance for the year.
Speaker 3: The team and I are extremely pleased with the commercial team's execution and bringing ChemTrack to patients globally, and we look forward to continuing to help and support patients with metastatic uveal melanoma.
Speaker 5: I will now turn the call over to David who will review our portfolio updates. David. Thank you very much, Brian . We are very proud to have brought ChemTrac as the first approved medicine for metastatic uveal melanoma. GT100, which is the target of ChemTrac, is also expressed in other melanoma types including cutaneous melanoma. All of the efficacy signals we observed in early trials for TEBBY in MUM are also replicated
Speaker 2: And with PRAME, we have the opportunity to go to other solid tumors. And based on the strength of the Phase 1 data, we have invested in building a franchise around this target.
Speaker 2: The lead program F106C targets a preem peptide presented by HLA A02. At ESMO last year, we showed that F106C induced durable PRs in eugil melanoma, cutaneous melanoma, and ovarian carcinoma, and our focus now is to expand the trial footprint globally and enroll hormone therapy extensions as well as combinations. We expect to have efficacy data by the first half of 2024.
Speaker 2: In January , we announced that we will be bringing two new PRAME impacts to IND in the next 18 months. P119C targets a PRAME peptide presented by HLA-824, and this will expand the potential addressable population by 30%. In Japan alone, for example, 60% of patients are positive for A24.
Speaker 2: P115C targets the same HLA-AO2 peptide as the LEAD program, but has an extended half-life.
Speaker 2: We know that our current platform with a standard half-life is very active with durable PRs in multiple solid tumors and for Tabentafest a dramatic survival benefit.
Speaker 2: Nevertheless, given our enthusiasm for PRAME, we are also investing in an HLE version which could enhance patient convenience. Our discovery engine has a pipeline of unique targets where we will push the boundaries of using TCRs to unlock solid tumors. And here, I'm delighted to present a novel TCR target called P-WILL-1. We understand a wide array of things for a flux of calories and levels. And we anticipate investments in StadiumWeek,callings,Only have orie
Speaker 2: P1 has several features reminiscent of PRAME, one of which is that it's a negative prognostic marker suggesting it has an important role in tumor progression. P1 has broad homogenous expression in about a quarter of colorectal cancer patients. NCRC historically has been insensitive to check points reminiscent of uveal melanoma.
Speaker 2: We believe the addressable population is 35,000 patients per year and an IND is planned for fourth quarter of this year.
Speaker 2: Our T cells scan for cancer, but they also scan for virally infected cells. And therefore, it was logical to apply our technology to attempt functional cure in HPV and HIV. Both have viral reservoirs where current therapy cannot remove or eliminate the residual virus.
Speaker 2: The goal of our TCR by specifics are to eliminate these risk related Park. 1
Speaker 2: 113B, our HIV impact, is potent at killing HIV-infected CD4 T cells and works by recruiting the cytotoxic CD8 T cell to punch holes in the infected T cell.
Speaker 2: We opened a single ascending dose portion of the HIV trial last year and had very strong enthusiasm in enrollment of people living with HIV who are stable on antiretroviral therapy. The primary objective was safety and to identify a dose for the multiple ascending dose portion. We identified 15 micrograms as a dose that was well tolerated.
Speaker 2: with no clinical cytokine release syndrome, but induced IL-6 in the blood. We have found in our oncology programs that IL-6 is a sensitive downstream biomarker of T-cell engagement and redirection, and this consistency from oncology to infectious disease is striking to us.
Speaker 2: provides reason to move to the MAB.
Speaker 2: We have now opened the MED portion where participants living with HIV will receive three months of 113D on top of
Speaker 2: The primary endpoint is safety and to determine a phase two dose, but we are very keen to also look at antiviral activity, including stopping VMTAB, 113D and the anti-reprobiological treatment after three months to see if we can affect, slow or decrease the kinetics and magnitude of HIV viral rebound.
Speaker 2: We believe this trial should provide early POC for a functional care. I'll now hand back to Vihica. Thank you, David, Brian , and thank you Ralph. As you have heard, 2022 was an amazing and transformative year for the company.
Speaker 4: We have definitely written the next chapter in oncology treatment as we pioneered and now launched the track. This pipeline reflects the large potential that our IMTAX platform can offer to patients across many cancer types and, as you just heard, also infectious diseases. Given the breadth and depth of our pipeline, we need to...
Speaker 4: In addition, we are eligible to receive development of commercial milestones if Genentech advances the major for AF2 therapy.
Speaker 4: This is a robust pipeline based on which we will continue building immunocore as the growing leader in PCR therapeutics.
Speaker 4: So officially, In Middle Court is now a commercial stage biotech company.
Speaker 4: I'm very proud to report such revenues for Q4 and 2022 and a cash runway into 2026 that will allow us to continue delivering against our commitment as we have done to date. Our performance is even more significant in the context of what has been another challenging year for the biotech sector.
Speaker 4: So as we wrap up our remarks, I'm excited for the year ahead. So if 2022 was a transformative year, 2023 will be a year expanding on those successes.
Speaker 4: Our priorities are clear. We are focused on launching and growing Kim track and enrolling the putaneous melanoma trial. For our program frame program, we are investing in increasing the site footprint and enrolling patients in multiple tumor types as well as in combination with standards of care. We are also expanding the frame size with an eye towards multiple eyes.
Speaker 4: and also antiviral activity that could lead to a functional cure. Along the way, we will continue to focus on cost and cash discipline the way we have been every step of the way.
Speaker 4: So as we enter 2023, we do so with same drive, determination and sense of urgency to radically improve outcomes for patients.
Speaker 4: For that, I want to thank every single employee at immunocore. I want to thank you as our investors and shareholders for your support. But most importantly, I want to thank our patients and their families.
And now, I'd be happy with the team to take your questions and we'll open the call for questions. Thank you. Thank you. And I'll be conducting the question and answer session.
If you would like to ask a question, please press star 1 on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star 2 to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star key. One moment please while we poll for your question. Thank you.
Our first question comes from the line of Michael Yee with Jefferies. Please proceed with your question. Hey guys, good morning and thanks for the update. Congrats on a good year. On two questions, on the Kim track sales in US, there was a very strong number there and then you mentioned that there was some one-time positive impacts like gross to net and also some mandatory. What are you doing against Giants personal with numbers that, ne in domestic
Could you just help us understand what the underlying number of demand there was in the fourth quarter so that could help us get a good run rate going into 2023 and describe what you think the growth rate looks like throughout 2023 for the US? And then a question on PRAME maybe for...
David, I know you're enrolling the phase two or phase one B expansion cohorts. Can you talk to us a little bit about how you think about the bar for lung cancer and the expectation for lung cancer, given what you've seen previously, and just help right size us for what is good lung cancer data? Thanks. Thank you.
Okay, thank you Michael. Great questions. Brian you'll take the first one and then David. Yeah, so Michael some more specifics around those two increases in Q4. Together they're about five million dollars that we saw for increase in stocking and
a reduction of gross to net, mostly 340B assumptions that we use, we're probably a little bit conservative. So about five million dollars. So U.S., instead of being 38 million, was probably around 33 million in real end demand. So that's probably a pretty good number as we move into Q1 for benchmarking. As we mentioned, as we have saturated or have...
now penetrated most of the academic centers and we're moving in community growth. You should expect growth to be slower in 2023 in the US. The other dynamic is we'll have another month of German discount for Q1 versus Q4 so that'll reduce it a little bit more as well from a benchmark perspective. Yeah, Michael, I guess I would answer it in two ways. The first is that you know lung is lung is a very complex tumor. So we need to study different
Is there the opportunity for response rate or PFS? And so I think those are the two levels of activity that were that we're looking at
Thank you. Our next question comes from the line of Jessica Farr with JP Morgan. Please proceed with your question. Hi, this is Nick on for Jess. Thanks for taking your questions. I believe today you mentioned that you're about 650-60% of patients on therapy in the first line setting.
How does that does that hold true across the US Europe or is one region more heavily weighted towards first line or second line versus the other? Great, you can take that one.
Nick, thank you for the question. So look, in the U.S., we are seeing 60% of the KimTRAQ patients in first line. So the remainder of them are in second line plus. In Europe , specifically in Germany and France, we're seeing around 45% and that's where we're focusing on increasing because our focus is first line. That's where we see OS, that's where we see the duration of therapy.
we're focused on increasing that to as high as we can get it. Thank you. Our next question has come from the line of Tyler Van Buren with Cowen. Please proceed with your question. Hi, good morning. This is Tara. I'm for Tyler. So, when you say that the PRAME dose expansion data are affected by the first half of 2024, is there a chance that it could come later in 2023, maybe at...
Specifically with Timtrack revenues ramping while multiple programs continue through development and these new programs emerge, I'm wondering if you can discuss the focus for capital allocation in the next year and beyond, particularly as it relates to balancing the focus on R&D and pipeline development with the potential eventual pivot to profitability. How do you balance these priorities and when might the company achieve profitability? Yeah, thank you. Thank you for the question. I'll start and then Brian , you know, really our focus is.
So we don't expect that to change dramatically. What will change and will scale as you would expect would be the development costs as we move an advanced PRAME. And it'll really be driven in the large part by how many large pivotal trials we need to run for PRAME. So that's that's where we're focused. We have those in the budget now. You'll notice that we did opt out of the co-development co-funding of MAJE as we focus on the PRAME expansion. And however, we still appreciate the collaboration with Genentech and will still be in a collaboration with them and be able to receive milestones and royalties from MAJE A4 if they move that forward.
Thank you. Our next question comes from the line of Justin Kim with Oppenheimer. Please proceed with your question. Hi, good morning. Thanks for taking the question. With regards to the movie and treatment duration, does the team have any insights on how physicians are managing patients through situations of potential super progressions? And are there any tools to observationally compare how the experience might be additive to the clinical trial experience, perhaps benchmarking against HLA-02 negative patients? Great, Justin. I think you can talk about this VOT and where we are comparing clinical trials. Go ahead. Oh, great. Thank you.
Okay, it's really great when we launch a new medicine and we see the experience in the clinical trial being replicated in the real world because that means that the safety and efficacy that we've seen in the clinical trial is true and physicians are able to really use the medicine the way that is intended and the patients are seeing the benefit and physicians are seeing that the patient's benefit. So from a median perspective, we're at six months and from a mean we're tracking to nine months. And if you recall, that's what we saw exactly in the clinical trial. As that relates to the progression, we keep educating on that aspect or treatment beyond progression. We keep educating on that aspect, of course.
Today, we see treatment patterns very similar to what we're seeing in academic accounts, which is why we're also seeing this mean duration of treatment at track in tonight Thank you. Our next question comes from the line of Justin Zell, the BTIG. Please proceed with your question. Thanks for taking a question and can grassen the results here. Maybe just to follow up on the prior question, just on duration of therapy, you know, do you expect that the duration of therapy will kind of thick and the results seem thus far mirroring the clinical trials in the real world? Or do you think that it's possible that you could see extension with more follow up here?
So, that's what we expect. We expect to see so far what we've seen in the clinical trial. And if you look at our clinical trial to a two clinical trial, you see the median staying somewhat the same and then the mean growing not significant. And that's driven mostly by the tail. So we do expect that the longer we're on the market, if physicians keep treating the way they're treating, we do expect the mean to be growing. Now, not significant being, I think you can use the clinical trial as a benchmark to see where this is going. Thank you. Our next question comes from the line of Peter Lawson with Barclays. Please proceed with your question. Right. Thank you. I guess we'll follow up here just around where you think that duration of treatment could eventually settle for Kim Trump.
The half-life extension, is that for patient convenience, or do you think that could help with durability as well? Yeah, great having a relative to take the duration and maybe save it on the half-life expectancy extension. So I think the best answer I can give you is that we're going to be providing an update of our three-year overall survival, which will include duration therapy and PFF at an upcoming conference. So I invite you to take a look at that so you can see where we expect the mean duration of treatment to go. David. Peter, you know what's remarkable with Kim Track, with the plasma half-life of eight hours, we saw survival benefits with the Hazaryship 0.51. So we know that our current platform is of course very highly active. I think it's an open question about whether a half-life extension will have any improvement. And if it goes to your durability, we'll have to just be data-driven on that. Thank you. Our next question comes from LeLon of Jeff Hunt. With Morgan Stanley , please proceed with your question. Thanks for giving my questions. For advanced melanoma, can you talk about why you're using...
CTDNA in Phase 2, and how predictive do you think that is for survival on point in Phase 3? And then for Prame, how do you think about treating multiple HLAs and what needs to be done to get there? Thank you. Great, great question. So for the advanced melanoma, the dual endpoints for the Phase 2 are both CTDNA and overall survival. The reason we're doing CTDNA is because that gives us the earliest fastest read so that we can make the decisions for the Phase 3, i.e. drop one of the arms, repower it. We also designed it though because CTDNA is not yet completely validated in CTDNA's melanoma. We realize that. It's going to give us a directional look. We designed it also to have a survival look.
We realize survival won't be mature at that point, but we will have enough power to Get an estimate about whether survival is trending. So that's that's really the reason for the CT DNA with regard to the second question I think you're asking about some different alleles for pram. Is that correct? Yeah, so so after a to the most attractive HLA allele for pram is 824 and that's why we announced that we are Pursuing this HLA 824 and we'll take the learnings from the HLA a to allele and apply it to a24 to make it develop Faster we estimate this will increase the opportunity 30%
from a patient population opportunity. Thank you. Our next question comes from the line of Nick Gallop with Goldman Sachs. Please proceed with your question. Looks like we lost Nick. I'm gonna bring through the next questioner. Our next question comes from the line of Azu Demir with Lattenberg-Dalman. Please proceed with your question.
Thank you very much for taking my question and congrats on a good quarter and a year. My first question is on TeamTRAC. Could you maybe provide more color on discontinuation rates and treatment beyond progression in the real world? Great. Thank you. Rolf, do you want to? Great question. So we are seeing the treatment discontinuation to be in line with what we expected in the clinical trial experience. In fact, we look at closely the reasons for discontinuation and they are really tracking very well. We are not seeing any surprises which is always great to see when you go into the real world.
question and congrats on a good quarter and a year. My first question is on Team Track. Could you maybe provide more color on this continuation rate and treatment beyond progression in the real world? Great, thank you. Ross, you want to? Oh, great question. So we are seeing the treatment discontinuation to be in line with what we expected in the clinical trial experience. In fact, we look at closely the reasons for this continuation and they're really tracking very well. We're not seeing any surprises, which is always great to see when you go into the real world.
When you're going to, we regard the treatment beyond progression, what we do is we ask physicians whether they are comfortable treating beyond progression and then obviously that's part of our conversations that we have from a medical affairs perspective with physicians. And so far we are seeing that level of comfort. Of course as we go into the community more education needs to be had and that's what we're Yeah, I think it's a really good point because in the academic centers there, the investigators are the ones who actually saw that there is benefit beyond progression. So I think there is more work to be done when we go into the community, but that's where the MSL and the education and the science will come in. Thank you. There are no further questions at this time. I would now like to have a call back over to Buzz Zizr Zilal for any closing remarks. Yeah, so thank you so much for your questions and thank you. Thank you for your support and we're going to now close the call. Thank you. Thank you. This does conclude today's telecomference. We appreciate your participation. May disconnect your lines at this time. Enjoy the rest of your day.