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Earnings Call: Q2 2021

Aug 11, 2021

Operator

Hello, welcome to the Genmab Q2 2021 conference call. Throughout the call, all participants will be in a listen-only mode, and afterwards, there will be a question and answer session. Just to remind you, this conference call is being recorded. During this telephone conference, you may be presented with forward-looking statements that include words such as believes, anticipates, plans, or expects. Actual results may differ materially, for example, as a result of delayed or unsuccessful development projects. Genmab is not under any obligation to update statements regarding the future, nor to confirm such statements in relation to actual results, unless this is required by law. Please also note that Genmab may hold your personal data as indicated by you as part of our investor relations outreach activities in order to update you on Genmab going forward.

Please refer to our website for more information on Genmab and our privacy policy. Today, I'm pleased to present Jan van de Winkel. Please go ahead with your meeting.

Jan van de Winkel
President and CEO, Genmab

Hello, welcome to the Genmab conference call to discuss the company's financial results for the first half of 2021. With me today to present these results is our CFO, Anthony Pagano. For the Q&A, we will be joined by our Chief Development Officer, Judith Klimovsky, our Chief Operating Officer, Anthony Mancini, and our Chief Medical Officer, Tahi Ahmadi. Let's move to slide two. As already said, we will be making forward-looking statements, please keep that in mind as we go through this call. Let's move to slide three. Genmab has a science-focused and innovation-based culture, collaborations and partnerships have always been part of our DNA. During today's presentation, we will reference some of the products being developed under these strategic collaborations, this slide acknowledges those relationships. Let's move to slide four.

Reference from this slide are some of the many successes that propelled our growth throughout our 22-year history. One key factor in our future growth is the breadth and depth of our proprietary pipeline, which we anticipate will expand to nine programs in the clinic by the end of this year. Now let's move to slide five and look at some of the recent achievements in our pipeline and beyond. We moved a major step closer to our goal of bringing our own medicines to patients with the FDA's acceptance of the tisotumab vedotin BLA for priority review. Data from the clinical trial on which the BLA was based, the innovaTV 204 phase II study, was also recently published in The Lancet Oncology. As we shared with you last quarter, the predicted target date for our potential U.S. FDA approval is October of this year.

Along with our partner Seagen, we look forward to updating you on the progress of tisotumab vedotin in metastatic cervical cancer in due course. Data from two of our other pipeline products was also featured at recent medical conferences, including multiple presentations of updated dose escalation data for epcoritamab and a presentation of preclinical data for GEN1042, one of our DuoBody products in co-development with BioNTech. Excitingly, we are anticipating an additional DuoBody product in the clinic by the end of the year, following a recent CTA submission for DuoBody-CD3xB7H4 or GEN1047, which may have potential in solid tumors. We look forward to additional pipeline expansion in the future, including potentially from our oncology research and development collaboration with Bolt Biotherapeutics. In addition to progress in our own pipeline, the power of Genmab's innovation was reflected in important updates for products being developed by other companies.

inclacumab, formerly in development with Roche, is now in phase III development with Global Blood Therapeutics. The pivotal studies are assessing the safety and efficacy of inclacumab in reducing the frequency of vaso-occlusive crisis or VOC-related hospital readmissions in patients with sickle cell disease. There were also exciting updates for clinical stage products that incorporate our DuoBody technology. Novo Nordisk published preclinical data on the DuoBody-based Mim8 in the journal Blood, and multiple abstracts evaluating Janssen's bispecific program leveraging Genmab's DuoBody technology platform were presented at this year's ASCO. In June, Janssen also announced that the FDA granted breakthrough therapy designation for teclistamab in the treatment of relapsed or refractory multiple myeloma. Now let's move to slide six and look at the most significant milestones to date for Genmab's DuoBody technology.

In May this year, Janssen received FDA approval for RYBREVANT for patients with metastatic non-small cell lung cancer with epidermal growth factor receptor exon 20 insertion mutations. This is the first regulatory approval for a therapy created using our proprietary DuoBody technology, and we hope this is the first validation of many of the major potential of this innovative technology to create truly differentiated bispecific antibody therapeutics. With the approval of RYBREVANT, there are now four therapies on the market that incorporate Genmab's innovation. DARZALEX, which has now been part of the treatment regimen for over 200,000 patients, continues to evolve with additional approvals in both Europe and the U.S. The approved indications for multiple myeloma expanded in both territories based on the phase III APOLLO study, and subcutaneous daratumumab is now the only approved therapy for AL amyloidosis in both the U.S. and in Europe.

DARZALEX was also granted an approval in China based on the phase III LEPUS study, which examines daratumumab in combination with VELCADE and dexamethasone in patients with relapsed or refractory multiple myeloma. Sales in the first half of the year were also strong. We reported $2,798 million in net sales by J&J, an increase of 52% over the first half of 2020, resulting in DKK 2,360 million in royalties to Genmab. We are enthusiastic about the future of all four of these medicines as they exemplify our commitment to applying our world-class antibody expertise to create differentiated antibody therapeutics with the potential to fundamentally improve patients' lives. The collaborations for these medicines provide us with a recurring revenue from royalties, which we can then use to invest further in our business to deliver on our inspirational vision.

I'm now pleased to turn the call over to Anthony, who will discuss our revenue in more detail. Anthony?

Anthony Pagano
CFO, Genmab

Great. Thanks, Jan. Let's move to slide seven. As I've done in the past, I'd like to start with an overview of our financial framework and the related key drivers. First off, let's think about our revenue profile. On the left, you can see our current and future recurring revenue streams. There are now four approved products created using our innovation. That's DARZALEX, KESIMPTA, TEPEZZA, and most recently, RYBREVANT. Each of these have exceptional growth profiles. Taken together, we expect them to generate significant cash flows for us in the years to come. We have an additional potential revenue stream that could come online later this year, as we submitted the BLA for tisotumab vedotin in Q1. If Tiso is approved, that will bring the total number of approved products to five, which for me is really exciting. Onto our focused approach to investment, shown on the right.

We'll continue to invest in our business and capabilities to position us for sustained success. We'll accelerate and expand the potential winners in our pipeline. We'll also ensure we are ready to launch should Tiso and, in the future, epcoritamab be approved. As well as investing, we will of course, remain focused on the bottom line. With this context set, let's take a closer look at an important component of our recurring revenue growth, DARZALEX sales, on slide eight. We saw continued strong performance for DARZALEX in the first half of 2021. You can see that in the chart on the left. Overall, DARZALEX sales grew by 52%. That's net sales of approximately $2.8 billion, which translates to DKK 2.36 billion in royalty revenue. This exceptional growth was driven by continued strong market shares across all lines and by the strong uptake of the sub-Q formulation.

DARZALEX remains a key driver of our revenue, as you can see on slide nine. Looking at the graph on the left, you can see our recurring revenues grew by 49% in the first half of the year, primarily due to higher DARZALEX royalties. We've already spoken about DARZALEX and the very strong performance there. Moving to KESIMPTA, we're encouraged by the nice quarter-over-quarter growth seen in the first half of the year. For TEPEZZA, due to the supply chain disruption, we didn't record any royalties for the first quarter. However, Horizon started to supply the market again in April with strong sales reported in Q2. We're also enthusiastic about the recent approval of RYBREVANT and look forward to seeing how sales progress.

Our revenue profile continues to get stronger with increases both in recurring and non-recurring revenue after excluding, of course, the one-time upfront payment from AbbVie in 2020. We're taking our strong recurring revenues and investing in a highly focused way, as you can see on the next slide. Total operating expenses grew 26% in the first half of the year, and here you can see where we invested. We've continued to accelerate our investment in our product portfolio, especially the advancement of both epcoritamab and DuoBody-PD-L1x4-1BB. We've also continued to strategically spend on expanding our team, hiring key team members to support our growing product pipeline. We've continued to build our commercialization and broader organizational capabilities to support our expansion. Finally, we are leveraging the AbbVie collaboration by utilizing their expertise and significant financial contributions to further expand and accelerate our partnership programs.

Let's look at our financials as a whole on Slide 11. Here you can see our summary P&L. For H1, revenue came in at approximately DKK 3.6 billion. That's up 83% on last year if we exclude the one-off payment from AbbVie in 2020. Total expenses were about DKK 2.2 billion, with 79% being R&D and 21% G&A. Operating income was DKK 1.3 billion compared to DKK 4.6 billion last year. This was also impacted by the upfront payment from AbbVie. Our net financial items amounts to a gain of DKK 527 million, which was primarily driven by the strengthening of the US dollar against the Danish kroner on our US dollar-denominated cash and investments. We have tax expense of DKK 444 million, which equates to an effective tax rate of 24%. That brings us to our net income of around DKK 1.4 billion.

As you can see, extremely strong financial performance for the first half of 2021. Let's look at our guidance on slide 12. Following our strong first half numbers, we are improving certain aspects of our 2021 guidance. We now expect our revenue to be in the range of DKK 7.3 billion-DKK 7.9 billion, driven primarily by the continued strong growth of DARZALEX. Our OpEx guidance will stay in the range of DKK 5.5 billion-DKK 5.8 billion as we continue to step up our investments in the second half of the year, in line with our overall strategy and our 2021 key priorities. Putting this together, we're planning for substantial operating income in 2021 in a range of DKK 1.5 billion-DKK 2.4 billion. For my final slide, let me provide a few closing remarks. In summary, we've had a very solid first half.

We've created growing recurring revenue streams based on products with exceptional growth profiles. That gives us a strong backbone of significant underlying profitability. We're investing those revenues in a highly focused way to realize our vision and capitalize on the significant growth opportunities in front of us. On that note, I'll hand you back to Jan to discuss our key priorities.

Jan van de Winkel
President and CEO, Genmab

Thank you, Anthony. Let's move to slide 14. Our world-class team continues to work tirelessly to meet the many ambitious goals we set for ourselves for this year. We are especially excited to share updates on our clinical programs, including data from both our DuoBody and our HexaBody-based proprietary programs. As we continue to build our pipeline and evolve into a leading, fully integrated biotech innovation powerhouse, we are looking forward to a busy second half. Let's now move to our final slide. This is slide 15. That ends our presentation of Genmab's first half 2021 financial results. Operator, please open the call for questions.

Operator

Thank you. If you do wish to ask a question, please press zero one on your telephone keypad. If you wish to withdraw your question, you may do so by pressing zero two to cancel. Please keep to one question per person then register for a follow-up. Our first question comes from the line of Wimal Kapadia from Bernstein. Please go ahead.

Wimal Kapadia
Analyst, Bernstein

Oh, great. Thank you very much for taking my question. Could I just ask on epco, just curious how you think about the POLARIX data from earlier this week from Roche suggesting we have a new standard of care in first-line DLBCL. Just wanted to hear your thoughts on a potential trial for epco with POLIVY. How quickly you could begin a pivotal trial in this setting? I'm curious if you actually believe first-line DLBCL is the largest opportunity for epco, at least based on what we know about the molecule today? Thank you.

Jan van de Winkel
President and CEO, Genmab

Thanks, Wimal, for the question. I'm going to pass the question on the POLIVY trial to Judith Klimovsky, and then Anthony Mancini can potentially detail the first-line, diffuse large B-cell on lymphoma market opportunity. I can tell you, Wimal, we are going for that for sure. Judith can explain how the POLARIX data may potentially impact the route for the diffuse large B-cell lymphoma. Judith?

Judith Klimovsky
Chief Development Officer, Genmab

Yeah. Thank you, Jan. We are aware of the result the same as you. Thank you for the question. So far, we have a high-level announcement without details on the data. As soon as the granularity of the data becomes available, we will assess it thoroughly and determine what is the impact or what other steps we need to take to ensure our clinical development plan is aligned with the most current potentially standard of care. It's very premature to say because we don't know the results in detail.

Anthony Mancini
COO, Genmab

Wimal, just to follow on on that in terms of the market opportunity, we certainly see the frontline DLBCL opportunity as a significant one for epcoritamab, but we also see a broader lymphoma opportunity as well. I think, again, as Judith commented, it's too early to comment at this point. We'll certainly ensure you're informed as we evolve the strategy.

Jan van de Winkel
President and CEO, Genmab

Thank you both. Wimal, I think I give it back to you now.

Wimal Kapadia
Analyst, Bernstein

Okay, great. Thank you very much.

Jan van de Winkel
President and CEO, Genmab

Thank you.

Operator

The next question comes from the line of Matthew Weston from Credit Suisse. Please go ahead.

Elizabeth Walton
Analyst, Credit Suisse

Hello. Good afternoon. This is Elizabeth Walton on for Matthew Weston. I'm wondering if you can help us a little bit on costs. We've seen you raise your sales guidance but not your guidance for your operating expenses. You can help us think about the cadence of your commercial spending given that tisotumab Japanese submission is delayed. On the R&D spending, you've underspent versus consensus expectations for this quarter. Can you also help us there in thinking about your cadence of R&D spending going forward? Thank you.

Jan van de Winkel
President and CEO, Genmab

Thanks, Elizabeth, for both questions. I will hand them over to Anthony Pagano. Anthony?

Anthony Pagano
CFO, Genmab

Sure. Thanks, Elizabeth. You're right. I think overall, H1 costs were a bit on the low side relative to our full year guidance. Maybe starting in the R&D, expenses were impacted by phasing of costs related to the various pipeline programs, and particularly epco and DuoBody-PD-L1x4-1BB. Here from our perspective, it's a matter of timing, and we expect costs related to these programs and other programs and R&D activities more broadly to ramp up in the coming quarters. We also have some chunky CMC investments to come later in the year. As a reminder on epco, together with AbbVie, we are still in the planning some additional late stage trials, so more to come on that. Overall, from the R&D perspective, it's primarily timing and phasing, and we expect to make up a lot of it in the second half of the year.

On the SG&A side, our focus here really is on the near term potential launch of tisotumab vedotin. Team is really geared up to make sure we're ready if that ultimately the PDUFA date is hit in October. Team is working hard on that. Maybe in a minute, Anthony Mancini will provide a bit of color on that one. At the same time, we're also super excited about epco. In this regard, the team is preparing for epco and potential launch and overall making some important investments in building the overall commercialization infrastructure and a lot of exciting pre-launch activities. In summary, Elizabeth, we believe our 2021 guidance on OpEx to be at the right level for now. Anthony, anything you want to add as it relates to SG&A and some of the prep going on for Tiso?

Anthony Mancini
COO, Genmab

Anthony would add, just a couple of comments as it relates to tisotumab vedotin. One of the important things is that we are now, as Jan alluded to earlier, working towards launch readiness for the target PDUFA date of October 10th for tisotumab vedotin in collaboration with our partner Seagen. We actually are now launch-ready in the U.S. with fully trained field teams in place, in anticipation of that PDUFA date. We're really looking forward to a robust launch. We have robust launch plans in place, and we're confident that we can ensure broad awareness and adoption of TV upon approval. That's kind of where I'll leave it.

Jan van de Winkel
President and CEO, Genmab

Okay. Thanks, Anthony and Anthony. Thank you, Elizabeth, for the question.

Operator

The next question comes from the line of Emily Field from Barclays. Please go ahead.

Emily Field
Analyst, Barclays

Hi. Thank you for taking my question. I hope I'm not getting too sleuthy here. It looked like in your internal development chart that the color bar for GEN1042 advanced this quarter from last quarter. I was just wondering if you could give us an update on when we may see that dose escalation data in the back half of this year, and any guidance into what tumor type we may potentially see that in.

Jan van de Winkel
President and CEO, Genmab

Thanks, Emily. I think what I can say is that we have submitted multiple abstracts to different conferences and also an abstract for GEN1042 for one of the conferences in the coming months. We haven't yet received feedback on whether it's accepted, but what I can tell you is that we are super excited about the data with GEN1042, and I hope that you will share that sentiment with us once you see the data. It's a bit too early to comment on the exact tumors, but what I can tell you is that we have seen signals in multiple tumors. We have to further explore probably which ones to pursue. We are very, very excited about GEN1042.

Emily Field
Analyst, Barclays

Thank you.

Jan van de Winkel
President and CEO, Genmab

Thank you, Emily.

Operator

The next question comes from the line of James Gordon from JP Morgan. Please go ahead.

James Gordon
Analyst, JPMorgan

Hello, James Gordon, JP Morgan. Thanks for taking the question. A question on GEN1046, please. The question is that GEN1046 is an Fc-silenced 4-1BB PD-L1 bispecific in the clinic. Just beyond maybe plan to market, where are you seeing differentiation versus some other companies that are also following the same approach? Also just in terms of how we might think about what data we're going to see next. Is it logical to think that we're going to see the data all in one big lump, so potentially at something like SITC in mid-November? Or are we going to get the data at various different conferences over the year for the nine or 10 cohorts, please?

Jan van de Winkel
President and CEO, Genmab

This is a question related to 1046, I think, James. I didn't catch that in the beginning. Why don't we pass over that.

James Gordon
Analyst, JPMorgan

That's all, yeah.

Jan van de Winkel
President and CEO, Genmab

Yeah. Why don't I pass over to Tahi Ahmadi. Tahi can give you some further color on the type of data you can expect in the coming time, James. Tahi?

Tahi Ahmadi
Chief Medical Officer, Genmab

Yeah. If I understood Thank you. If I understood the question correctly, there were two components. One was on the construct in and of itself. I think we've spoken many times about the complicated biology of engaging 4-1BB in this conditional activation that we try to achieve with our model, and as it relates to the advantages come from the DuoBody platform to try to interrogate that complicated biology. We feel very comfortable and confident in our asset because we knew how difficult it was to get actually a construct that would elicit the biology that we were looking for. As it relates to the data, it's probably fair to say that there will be some data readouts as data becomes available. We're continuously enrolling and obviously generating data. We will probably provide some updated data at SITC.

Similar to the comment that was made for GEN1042. Obviously, we have submitted some data, but we have not yet confirmation that this will be presented. For the other tumor types, as we generate the data, we'll present them at an opportune time when the data is mature, any updating conferences, probably more in the first half of next year.

Jan van de Winkel
President and CEO, Genmab

Thanks, Tahi. Thanks, James, for the question. Operator, next one.

Operator

The next question comes from the line of Michael Novod from Nordea. Please go ahead.

Michael Novod
Analyst, Nordea

Yeah, thanks a lot. Just a question to epco in CLL. Maybe you can just provide whether some of the data you've submitted to conferences also include some of the initial data. I know it's early, data in CLL. Secondly, maybe you can just remind us about the inclacumab royalties and economics with now GBT. Lastly, in terms of your Dara sales guidance, I know it's of course also based on what sort of feedback you get from J&J, the midpoint indicates no growth between first half and second half, or the low point, no growth between first half and second half. Is that even realistic? If it is realistic, what should drive no growth in sales in the second half? Thanks.

Jan van de Winkel
President and CEO, Genmab

Thanks for the questions, Michael. I will handle the first two, and then pass the third question over to Anthony Pagano. Definitely, epco, multiple data sets submitted, Michael, and I'm willing to say here, also including the early data for CLL from the first patients. Let's hope that we can present them near the end of the year. Economics for inclacumab. This is another program which we started off with Roche in the early, I think it was around 2003-2004 timeframe. Economics are very similar, I can tell you, to the TEPEZZA economics, Michael. I don't know the exact milestones here, but they're very similar. The molecule was made in the same era as teprotumumab. I probably want to leave it with that and then hand the other question over to Anthony Pagano.

Anthony Pagano
CFO, Genmab

Yeah. Thanks, Michael. I guess after a strong start to the year, I can see why you'd ask the question. For me, at this stage, our guidance, it sort of feels at the right level. Let me spend a couple of moments and explain to you why. I mean, to start and start thinking about the growth rates that we saw in the first half of the year, I think it's useful to remember that the year-over-year growth rates that we saw were positively impacted by some of the favorable comps, right. Due to the softness we experienced in the early parts of 2020 due to COVID. Turning to our guidance, when we think about our revised guidance for Dara, we really focused on two main scenarios to kind of bookend it for you, Michael.

The 5% sequential growth rate we saw in Q2. This is really the most recent data point we have and reflects the continued very strong fundamentals for Dara, where we've seen very nice market shares across the board, particularly in frontline where we've seen some meaningful gains in the U.S. This, of course, is coupled with ongoing strong uptake of the sub-Q formulation. This level of continued growth gets us towards the top end of our guidance range of $5.9 billion. The second scenario, the second sort of point I'd like to make, Michael, is that unfortunately, as you know, we all still find ourselves in the midst of a global pandemic. As we've heard from a number of the other companies, COVID continues to represent a challenge in diagnosing new cancer patients, and in some cases, getting the needed treatment to existing cancer patients.

For sure, so far, this doesn't seem to have been a significant barrier for Dara, but it's something I think we do need to be mindful of and take into consideration when formulating our guidance. Here, to reflect what I just explained and the fact that we could see some unexpected choppiness in the second half of the year, we assume that H2 sales level that approximates at H1, and that gets us to the bottom end of our guidance range of $5.6 billion. When you take this all together, we believe that the $5.6 billion-$5.9 billion is the right level for us overall. Maybe just to step back for a second, though.

Overall, we continue to be super pleased with the very strong fundamentals of Dara, the continued investment that's being made in terms of continued development of Dara, as well as the overall growth profile for DARZALEX just sort of generally.

Michael Novod
Analyst, Nordea

Okay, great. Thanks a lot.

Jan van de Winkel
President and CEO, Genmab

Thanks, Anthony. Next question, operator.

Operator

The next question comes from the line of Michael Schmidt from Guggenheim Securities. Please go ahead.

Michael Schmidt
Analyst, Guggenheim Securities

Hey, guys. Thanks for taking my questions. I have another one on epcoritamab. I noticed that your broad phase I/II study, the 480-patient study, is still enrolling patients. Just curious if you could update us how you're tracking towards completion of enrollment of some of those cohorts and how you're thinking about potential timelines for accelerated regulatory submissions in some of those indications?

Jan van de Winkel
President and CEO, Genmab

Thanks for the question, Michael. I will hand it over to Tahi Ahmadi, who is on top of the recruitments. Tahi?

Tahi Ahmadi
Chief Medical Officer, Genmab

Yes, I'm on top of the recruitments. I'm not entirely sure if I will communicate them in detail. The study has multiple arms with different B-cell malignancies that are obviously occurring at different speeds because of the different incidence prevalence as it relates to the specific inclusion/exclusion criteria for relapsed refractory DLBCL , relapsed refractory follicular lymphoma, and relapsed refractory mantle cell lymphoma. It's a little too early to speculate on the timelines, but we are quite happy with where we are in the recruitments, particularly with the COVID challenges that certainly have had implications broadly across the entire landscape. We've been enrolling basically on our projections.

Jan van de Winkel
President and CEO, Genmab

Thanks, Tahi.

Michael Schmidt
Analyst, Guggenheim Securities

Just a quick follow-up.

Jan van de Winkel
President and CEO, Genmab

Michael, please go ahead.

Michael Schmidt
Analyst, Guggenheim Securities

I was just curious around about the data updates on epco later this year. Will this be another follow-up on the phase I data, or will this include some of those phase II cohorts as well?

Jan van de Winkel
President and CEO, Genmab

What I can say, Michael, is that we have submitted multiple abstracts and that will include data I already stated in my answer. The first answer on CLL. It will also be potentially some combination data, combination therapy data, which is new, which you haven't seen anything from. Potentially updates, of course, on the already the phase I/II data, which you have seen already before. It will be a combination of data, and I think we are very excited about, I think the potential of epco. We believe it will be an absolute transformative therapy in the lymphoma space, and we can't wait to hear back from the conferences, Michael, whether the abstracts are accepted and then we will have an open discussion on that.

Tahi Ahmadi
Chief Medical Officer, Genmab

Maybe to add to the question, I think, less general, like registration enabling or potential registration enabling data sets are usually first submitted to health authorities before they are presented in the public.

Jan van de Winkel
President and CEO, Genmab

Thanks, Tahi.

Operator

The next question comes from the line of Graig Suvannavejh from Goldman Sachs. Please go ahead.

Graig Suvannavejh
Analyst, Goldman Sachs

Yeah. Hey, thank you very much. Good afternoon, everyone. Thanks for the update as well. Just two questions. One, in your interim report, you quantified the potential impact of the outstanding DARZALEX litigation at DKK 146 million . I was just wondering if you could provide any color on the math on how you got to that, and then assuming continued growth in DARZALEX sub-Q, would you expect that for the second half it would be somewhere in that neighborhood or slightly greater? That's just my first question. Second, just on DARZALEX sub-Q, Halozyme reported earlier this week and they shared that they had data to suggest that the conversion from IV to sub-Q is about 66% in the U.S.

I was just wondering if that data matches what you're seeing in the U.S., and can you comment on what you think that conversion looks like outside the U.S.? Thanks so much.

Jan van de Winkel
President and CEO, Genmab

Thanks, Graig, for the questions. The first one can probably best be handled by Anthony Pagano. The second question on the conversion rate and then how it looks in the U.S. versus the rest of the world, can probably be addressed by Anthony Mancini. Maybe Anthony Pagano, you can start.

Anthony Pagano
CFO, Genmab

Yeah. Graig. We'll have some fun, do some math together here. Just remember when we provided our original guidance for 2021, I talked about the kind of, call it the headwind as it relates to what Janssen is doing in terms of withholding some royalty from us with [inaudible]. The appropriate thing involved in general is not recognize that revenue. That's exactly what we've done. I highlighted at the beginning of the year that we thought the impact would be DKK 150 million. Now with the improved guidance of the DKK 500 million on a full year basis. How do you get to that number? Effectively, it's a function of what the total sub-Q sales are relative to total sales. If you multiply that through, and you can get the number that you referenced here for H1, out DKK 140 million or so.

I think on a go-forward basis, as we've kind of already seen, expect the total level of sales of Q to be higher and continue to grow as we move up. We do expect that number to increase significantly in the second half of 2021 as total sales increase, but also as the total amount of sub-Q sales relative to IV sales also continues to grow up. Graig, hopefully that helps you get to the math. I can't give you royalty rates, et cetera, specific amounts of what Janssen's withholding. That's just some things. We're not party to that contract with them.

Jan van de Winkel
President and CEO, Genmab

Thanks, Anthony. Maybe Anthony Mancini, some color on the conversion from IV to sub-Q.

Anthony Mancini
COO, Genmab

Thanks, Jan, and thanks, Graig, for the question. On IV and sub-Q usage, it's really data sets, so what Halozyme reports depend on the data set, but it's largely in line with what we're seeing based on IQVIA and Symphony data. At the end of Q2, what we saw about 64% of U.S. gross sales expressed in terms of Faspro. Obviously, Craig, that number continuing to evolve in a positive way with a slow, steady positive trend in favor of the U.S. if you look at more recent in IQVIA and Symphony data.

If you look at outside of the U.S., now that the sub formulation is launched in the EU and actually achieved public reimbursement in a good majority of countries, in fact, four of the top five EU countries, we can say that it's about 54% already in sub-Q, and that's really highly variable depending on the system in each of the countries, which as you know, are very different. Hopefully that gives you a little bit of color on sub-Q inside the U.S. and out.

Graig Suvannavejh
Analyst, Goldman Sachs

Thanks so much. That's great. If I could just get a quick follow-up. What do you think that max conversion could look like? I think there's a good reason to think that some patients would prefer to stay on IV for a variety of different whether it's social factors. Can you help us think about where you think ultimately this conversion could go to?

Jan van de Winkel
President and CEO, Genmab

Anthony, do you want to comment on that?

Anthony Mancini
COO, Genmab

I can sort of give you my sense of this. Look, normally when you have a subcutaneous version and an IV version, practice economics play a factor in sort of determining where it could go. In the case of Faspro, that's really not a factor because they continue to both be in Part B. We really don't see any huge barriers to continued sub-Q adoption in the U.S. I think because of the In fact, it's quite the opposite. It's three to five-minute injection versus a multi-hour infusion. We actually see more advantages than any disadvantages. You mentioned kind of the social aspect of the infusion. It's hard to tell exactly where that would sit, there's no other real reasons to not use sub-Q. Just hopefully that gives you a little bit of color, Greg.

Graig Suvannavejh
Analyst, Goldman Sachs

Okay. Thank you very much.

Jan van de Winkel
President and CEO, Genmab

Thanks, Greg.

Operator

The next question comes from the line of Jonathan Chang from SVB Leerink. Please go ahead.

Jonathan Chang
Analyst, SVB Leerink

Thanks for taking my questions. On the Bolt collaboration, can you discuss the rationale behind partnering with Bolt to evaluate bispecific immune-stimulating antibody conjugate therapeutics? How does this platform compare to others you may have evaluated in the process? I'd also be curious to know how you think about target selection for this approach. Thank you.

Jan van de Winkel
President and CEO, Genmab

Thanks, Jonathan, for the questions. I will happily hand that over to Tahi. I can tell you that we have had intense discussions with multiple candidates for these type of conjugates, and we're super excited about the Bolt Biotherapeutics technology and platform. We are already working with them now on a very large number of target programs. Let me ask Tahi to first give a perspective on why we have selected the Bolt technology, and then maybe I can add to that at the end. Tahi?

Tahi Ahmadi
Chief Medical Officer, Genmab

Well, I mean, let's start first. Thank you for the question. As Jan was saying, we're very enthusiastic about the potential of engaging in the innate immune system and see it as very complementary to some of our mechanisms that we currently are having in clinical development or that are going to come in clinical development in the very near future. It's very a complementary strategy to the things that we have already been working on, either with Genmab alone or in our collaboration with BioNTech. We have looked, of course, at the number of companies that are working on this. We felt at the time that in all of these deals, that there was a good collaborative spirit and a joint scientific idea and belief with the colleagues at Bolt.

This was one important part. We also felt that they were very much leading or at least on top of the field as it is emerging. I think that's all there is to say at this point. As Jan alluded to, as these discussions went on, we had a lot of work that was already done in terms of proof of concept. We're quite happy with what we saw, which led to the deal, and I don't think we would, at this call, give any indications on targets except that this is a very important cornerstone of our future I-O strategy.

Jan van de Winkel
President and CEO, Genmab

Thanks, Tahi. What we should also say is that the approach is, of course, already clinically validated, Jonathan, in the HER2 space, which is very different from some other technology platforms. We are very excited. We have already, I think, more than several handfuls of potential targets we are pursuing, both with monospecifics and with bispecifics. I think there's definitely more to come here, Jonathan. We're very excited about this new partnership, and we will progress it maximally from here.

Jonathan Chang
Analyst, SVB Leerink

Got it. Thank you.

Jan van de Winkel
President and CEO, Genmab

Operator.

Operator

And just-

Jan van de Winkel
President and CEO, Genmab

Let's move to the next one.

Operator

Final reminder. If you do wish to ask a question, please press zero one on your telephone keypad now. We have one more question from the line of Asthika Goonewardene from Truist Securities. Please go ahead.

Asthika Goonewardene
Analyst, Truist Securities

Hi, guys. Thanks for taking my questions. I hate to dwell on this, but it's just important for us to understand, so appreciate any color you can give here. For SITC, for GEN1042, Jan, you mentioned that there was a single abstract submitted. I'm curious if you can tell me how many abstracts with clinical data were submitted for GEN1046. Then if I can tag on just another catalyst-related question here. Previously, you've alluded that you might have epcoritamab initial expansion data this year. I just want to know, have any abstracts for the NHL expansion been submitted? Thank you.

Jan van de Winkel
President and CEO, Genmab

Thanks, Asthika. I think I can answer you that for GEN1046, we have submitted one abstract. For epcoritamab, we are not commenting on that because we have multiple abstracts there from different studies. We are not going to comment on that until we have heard back from the conference, Asthika, on whether that is accepted or not.

Asthika Goonewardene
Analyst, Truist Securities

Got it. Thanks, guys.

Jan van de Winkel
President and CEO, Genmab

Thank you.

Operator

We have one final question from Kennen MacKay from RBC. Please go ahead.

Kennen MacKay
Analyst, RBC

Hi. Congrats on the quarter and guidance, and thanks for squeezing me in here. Jan, you've mentioned epco potentially being a blockbuster therapy. I think another one from your pipeline that could fit that bill is Cami, the ADC in development in collaboration with ADC Therapeutics. Just wanted to get your perspective on that asset and whether or not that GBS signal that's being seen there is something that could improve as that moves forward in standard of care, in Hodgkin or in solid tumors, or if there's really any understanding of sort of where that's coming from. Thanks, and congrats again.

Jan van de Winkel
President and CEO, Genmab

Thanks, Kennen, for the kind remarks and for the question. I'm going to hand over the ADC Therapeutics question on to Tahi, I think who's on top of that data, and Tahi can maybe give you a bit of perspective on how we look at that on the IL-2 receptor ADC concept. Tahi?

Tahi Ahmadi
Chief Medical Officer, Genmab

Sure. Yes. The challenge with this concept, of course, is the toxicity related to the payload, which is difficult to manage, and I think the team at ADCT is continuously working through optimizing the management of these toxicities. I think there is still some work to be done in order to fully assess the opportunity for Cami in both solid as far as in Hodgkin. As the data right now, there are some concerns around the tolerability, particularly if you want to go into combination in the future. That's probably all we can say from our end.

Kennen MacKay
Analyst, RBC

Fair enough. Thank you.

Jan van de Winkel
President and CEO, Genmab

Thanks, Tahi.

Operator

As there are no further questions, I'll hand it back for closing remarks.

Jan van de Winkel
President and CEO, Genmab

Thank you for calling in today to discuss Genmab's financial results for the first half of 2021. If you have any additional questions, please reach out to our investor relations team. We hope that you all stay safe and remain healthy, and very much look forward to speaking with you again soon.

Operator

This concludes our conference call. Thank you all for attending. You may now disconnect your lines.