Hello, ladies and gentlemen. Thanks for standing by, and welcome to Zai Lab's First Quarter of 2021 Financial Results Conference Call. At this time, all participants are in listen only mode. Later, we'll conduct a question and answer session, and instructions will follow at that time. As a reminder, today's call is being recorded. It is now my pleasure to turn the floor over to Billy Cho, Chief Financial Officer of Zai Lab, who will make introductory comments.
Good morning, welcome to Zai Lab's First Quarter 2021 Financial Results and Corporate Updates Conference Call. Earlier this morning, Zai Lab issued a press release providing the details of the company's financial results for the three months ended March 31st, 2021, as well as product highlights and corporate updates. The press release is available in the investor relations section of the company's corporate website at ir.zailaboratory.com. Today's call will be led by Dr. Samantha Du, Zai Lab's Founder, Chairperson, and Chief Executive Officer. She'll be joined by Tao Fu, Chief Strategy Officer, who will provide more details on our recent commercial and pipeline progress. Jonathan Wang, Head of Business Development, Dr. Alan Sandler, President, Head of Global Development, Oncology, and Dr. Harald Reinhart, Chief Medical Officer for Autoimmune and Infectious Diseases, will also be available to answer questions during the Q&A portion of the call.
As a reminder, during today's call, Zai Lab will be making certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including our business plans and objectives and timing and success of our clinical trials, regulatory applications, and commercial launches. Such forward-looking statements are not guarantees of future performance, and therefore, you should not put undue reliance upon them. These statements are subject to numerous risks and uncertainties that could cause actual results to differ materially from what we expect. I refer you to our SEC filings for a discussion of risk factors that could cause our actual results to differ materially from those discussed today. At this time, it is my pleasure to turn the call over to Zai Lab's Founder, Chairperson, and Chief Executive Officer, Dr. Samantha Du.
Thank you, Billy. Hello, everyone, and thank you all for joining us. On this call, I'll discuss some of the highlights from the first quarter and provide remarks as to why we believe Zai Lab's future has never been brighter. We are off to a great start this year and believe 2021 will be another strong year of execution. The quality and speed that Zai Lab has been known to deliver. We are poised to become a leading global pharmaceutical company by executing our growth strategies. Since Zai Lab was founded in 2014, we have quickly expanded to create a portfolio of 21 innovative products across more than 40 indications. We have now commercialized the first two of these products in China with four indications. In March 2021, we gained approval for QINLOCK as a third oncology product approved within the last 15 months in China.
In addition, we recently received encouraging news on several of our key assets from our partners. The BLA filing of efgartigimod and gMG was accepted by the FDA with a PDUFA date of December 17th, 2021. The phase III pivotal LUNAR trial of Tumor Treating Fields in non-small cell lung cancer is recommended to continue with a reduced sample size based on an accelerated interim analysis. Bemarituzumab was granted breakthrough therapy designation by the FDA as first-line treatment for gastric cancer patients who overexpress anti-FGFR2b . We now have a total of 17 products in clinical development, of which 11 are in late-stage development, and five have already been approved in the U.S. In short, we have a broad, innovative portfolio with a visible pathway to achieve significant scale within just a few years.
I also want to highlight that along with our growing pipeline of utilized products, we have seven early-stage programs with worldwide rights, including three in global clinical trials. In the first quarter, Zai Lab continued to execute well with no aspect of our business. We entered into several strategic collaborations to further strengthen our gastric and lung cancer disease strongholds. Significantly boosted our I&I franchise with an exclusive agreement with argenx for efgartigimod a true pipeline-in-a-product opportunities. Advanced numerous clinical programs towards key data readouts. Gained regulatory approval for QINLOCK, our first commercial product in what we expect to become a leading gastric cancer franchise.
We generated strong revenue growth with ZEJULA, which added to NRDL in December of last year, with enrollment patients started in March 2021. Although we are just getting started, we expect to see continued strong volume growth of ZEJULA and remain confident in our ability to be the market share leader in China and make important [audio distortion] path in ovarian cancer. With the closing of our recent global public offering with gross proceeds of nearly $860 million, we significantly strengthened our capital position. With new capital, we allow us to expand our pipeline through additional strategic partnerships, accelerate the clinical development of our product portfolio, scale our R&D and commercial organizations to drive strong revenue growth and enhance our global pipeline. We remain on target to advance all aspects of our pipeline throughout 2021.
We continue to expect NMPA approval of NUZYRA for community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections. We plan to file margetuximab for HER2-positive breast cancer, TTFields for mesothelioma, and ZEJULA for late- line ovarian cancer in China. We're actively engaging with NMPA on a regulatory filing strategy for efgartigimod in gMG, and we anticipate numerous data readouts, including for Tumor Treating Fields for liver cancer and ovarian cancer, for KEYTRUDA with second-line GIST, for margetuximab in gastric cancer, for CLN-081 in non-small cell lung cancer, and for TPX-0022 in non-small cell lung cancer and gastric cancer. In our mission to address serious unmet medical needs for patients in China and around the world, we continue to execute on our aggressive growth strategy to create substantial value.
As demonstrated by our progress in the first quarter, we remain focused as ever on achieving our mission, and our future has never been brighter. With that, I'll now ask Tao to discuss our performance and prospects in more detail. Tao?
Thank you, Samantha. I will comment on the performance of our ongoing launches and discuss recent product highlights. First, I'd like to touch on ZEJULA. As a reminder, ZEJULA is approved in China for first and second line ovarian cancer and is the only PARP inhibitor approved for all comers in first line. In comparison, LYNPARZA has a label restricting its use to patients with gBRCA mutation, which comprise only about 15% of overall patients in this setting. No other PARP inhibitors have been approved for either first or second line. The results of the PRIMA study conducted by GSK globally and of the NORA study sponsored by Zai in China demonstrated that an individualized starting dose regimen of ZEJULA preserved efficacy while improving the product's side effect profile. This further differentiates ZEJULA from other PARP inhibitors. This quarter, we achieved an important milestone.
Our team was successful in gaining inclusion on a national reimbursement drug list for second-line ovarian cancer within the same year of our launch. This further underscores ZEJULA's significant clinical value for a broad range of ovarian cancer patients. The rapid NRDL inclusion provides patients much greater access, and we're already starting to see strong volume growth. In addition, our team has also been successful gaining coverage for commercial health insurance, with coverage currently being provided by 67 commercial health insurance plans and 52 supplemental insurance plans. We're very pleased with our launch performance so far, and over time, we believe ZEJULA will become the leading PARP inhibitor in China. Moving to OPTUNE. As you recall, we launched OPTUNE in China in the second half of 2020. The product is the first novel treatment in GBM approved by the NMPA in the last 15 years.
It was highly anticipated by the medical community, and it was already recommended by the China National Glioma Guideline prior to launch. With our team's effort, Optune became the first innovative medical device supported by commercial health insurance in China and is also covered in 13 supplemental insurance plans. We deployed innovative strategies to support patient access and rapid uptake, including establishing 28 direct-to-patient centers in China. Importantly, we're working with our partner, Novocure, to potentially expand the indications of Tumor Treating Fields in areas of large unmet medical needs. Additional late-stage studies are underway in tumor types, potentially affecting over 1.5 million new patients a year in China, including in non-small cell lung cancer, where that has been an important development. Last month, our partner, Novocure, announced an update regarding the global phase III pivotal LUNAR trial.
After the review by an independent data monitoring committee or DMC, Novocure was informed by the committee that the pre-specified interim analysis for the LUNAR trial had been accelerated given the length of accrual and the number of events observed. The DMC further concluded that it is likely unnecessary and possibly unethical for patients randomized to the control arm to continue accrual to 534 patients with 18-month follow-up. The DMC recommended a reduced sample size of approximately 276 patients with a 12-month follow-up, which could potentially accelerate the overall timeline of the trial by more than a year. Novocure has filed an IDE supplement with the FDA and is awaiting the agency's response.
We're encouraged by this important update in lung cancer, an area of huge unmet medical need in China, and look forward to additional clinical data readouts from Novocure in pancreatic, liver, and ovarian cancers, in brain metastases, and in glioblastoma with high-intensity arrays. We also have a China-only phase II pilot trial in gastric cancer that is expected to complete enrollment this year, and we continue to be on target to file Tumor Treating Fields in mesothelioma later this year. Now I'd like to discuss the recent regulatory approval for QINLOCK. We filed QINLOCK for approval in China last July, and it was accepted under priority review, and the NDA was approved in March, one full quarter ahead of the original schedule. We expect to launch the product in fourth-line GIST in the second quarter.
QINLOCK is the first approved tyrosine kinase inhibitor designed specifically for GIST patients, regardless of mutational status. The INVICTUS trial demonstrated a significant benefit versus placebo in progression-free survival and overall survival and served as the basis of the QINLOCK approval in both U.S. and China. Topline data for the phase III global pivotal INTRIGUE trial in second-line GIST are expected in the second half of 2021 and could potentially support label expansion in this important indication. We have many other products we'd like to discuss with you, in the interest of time, I will highlight one, bemarituzumab. This compound is a first-in-class antibody that is being developed in gastric and gastroesophageal junction cancer as a targeted therapy for tumors that overexpress FGFR2b.
In data presented at ASCO GI in January, bema in combination with modified FOLFOX demonstrated statistically significant improvement versus placebo versus modified FOLFOX in all three efficacy endpoints of the FIGHT trial, including progression-free survival and overall survival. Bema could address a significant unmet need in China. There are 680,000 new cases of gastric cancer every year, approximately 87%-88% of which are HER2- negative, and about 30% of these are potential patients for bema. The compound was a key driver in Amgen's $1.9 billion acquisition of Five Prime in April, when bema also received breakthrough designation from the FDA. Amgen is actively planning for pivotal phase III studies and is considering studying the compound in additional indications, such as squamous cell, non-small cell lung cancer. We will work closely with our new partners to maximize the full potential for this exciting product.
I would like to say a few words about our business development execution last quarter and beyond. We entered into three highlight strategic collaborations recently with argenx, Turning Point, and Cullinan Oncology in Greater China. Efgartigimod became the anchor asset for our autoimmune franchise with true pipeline-in-the-product potential. Since we entered into the partnership, efgartigimod's BLA for gMG was accepted with a PDUFA date of December 17, 2021. phase II trials are ongoing in CIDP, pemphigus , and ITP, and Zai Lab plans to enroll Chinese patients to these trials. Argenx also plans to identify and begin clinical testing in two additional indications this year, with more being planned for future years. CLN-081 and TPX-0022 significantly bolstered our lung cancer and gastric cancer franchises, two areas where we have built world-class portfolios.
These deals are great examples of how we use business development as a key strategy to quickly expand our business vertically and horizontally and create a sustainable platform for Zai Lab. Going forward, with our strong track record of execution and the new capital we raised through recent equity offerings, we will continue to leverage our partner of choice status to strengthen our pipeline through BD efforts. Our BD pipeline remains very strong. Looking ahead into the remainder of 2021, Zai Lab, alongside our development and commercial partners, is once again positioned to achieve key milestones, which are summarized in our press release.
We plan to expand indications in commercial products, achieve approvals for new products, submit for new regulatory approvals, provide key clinical data readouts from both late and early-stage programs, initiate numerous pivotal studies across our pipeline, advance internally developed assets with global rights, and aggressively pursue new business development opportunities. It goes without saying, we're committed to continuing Zai's track record of efficient and effective execution. I would like to turn the floor over to my colleague, Billy Cho, Chief Financial Officer, to discuss our recent financing and our first quarter 2021 financial results.
Thank you, Tao. I will give a brief summary of our recent financing and review of our financial results for the first quarter of 2021. Last month, we closed on a global offering of both American depository shares and ordinary shares with gross proceeds to Zai Lab of approximately $857.5 million. This offering was the first-ever dual tranche offering in both NASDAQ and the Hong Kong Stock Exchange. As mentioned before, this new strategic capital will allow us to expand our pipeline through additional collaboration agreements, accelerate the clinical development of our product portfolio, and scale the R&D and commercial organizations to drive strong revenue growth and enhance our global pipeline for years to come. Moving to our financial results for the three months ended March 31st, 2021, net product revenues were $20.1 million compared to $8.2 million for the same period in 2020.
Revenues for the period were comprised of $12.6 million for ZEJULA, compared to $6.3 million for the same period in 2020, and $7.1 million for OPTUNE, compared to $1.9 million for the same period in 2020. Research and development expenses were $203.9 million for the three months ended March 31st, 2021, compared to $33.7 million for the same period in 2020. The increase in R&D expenses was primarily attributable to the $62.3 million upfront payment in Zai Lab equity, which was determined at the fair value of the shares on the closing date, given certain restrictions, and the $75 million development cost share and payment to argenx, as well as the $25 million upfront to Turning Point. There were also additional expenses related to ongoing and newly initiated late-stage clinical trials and payroll and payroll-related expenses from increased R&D headcounts.
Selling, general, and administrative expenses were $35.8 million for the three months ended March 31st, 2021, compared to $18.7 million for the same period in 2020. The increase was primarily due to payroll and payroll-related expenses from increased commercial headcounts and related costs as Zai Lab continued to expand its commercial operations in China. For the three months ended March 31st, 2021, Zai Lab reported a net loss of $232.9 million, or a loss per share attributable to common stockholders of $2.64, compared to a net loss of $48 million or a loss per share attributable to common stockholders of $0.56 for the same period in 2020. As previously highlighted, the increase in net loss was primarily attributable to the new collaboration agreements with argenx and Turning Point recorded in R&D expenses.
As of March 31st, 2021, cash and cash equivalents, short-term investments, and restricted cash totaled $1.014 billion, compared to $1.188 billion as of December 31st, 2020. In addition, in April 2021, Zai Lab announced the closing of a global follow-on offering. The expected total proceeds to Zai Lab, including both the American Depository Shares offering and the ordinary shares offering, net of underwriting fees and other offering expenses, are approximately $818.1 million. We would now like to turn the call back over to the operator to open up the line for questions. Operator?
Thank you. We'd like to open the line for questions. If you have questions, please press star one at this time and to give opportunity to others, please limit your questions to one at a time. Once again, please press star one for your questions. Once again, please press star one to ask a question. Our first question comes from the line of Yigal Nochomovitz from Citigroup. Your line is open. Please go ahead.
Hi, good morning. Hi, Samantha, Billy, and Tao. Thank you very much for taking the question. Tao, you mentioned that the BD pipeline remains very strong. What should we expect in terms of the pace of new business development initiatives over the near term? Is the plan to continue to expand in disease areas where you already have exposure, such as oncology, Autoimmune and Infectious Diseases, or would you consider branching out perhaps into new areas such as rare disease and into additional treatment modalities, for example, cell therapy, where you currently don't have exposure?
Thank you, Yigal. Jonathan, do you want to address that question?
Sure. Thanks for the question, Yigal. I think over the last few years, we have really established a very sustainable platform as a company, and I think really to our development and commercialization regulatory teams' combined efforts. We've built up scale, we've built up leadership in China, and demonstrated through track record. As a result of that, these days, as Tao mentioned, we're getting a lot of inbound interest from potential partners as well as from existing partners across very diverse areas and products. For us, always, we aspire to bring in global quality, best-in-class, first-in-class assets. Quality is always the most important. I think if you look at our track record over the last couple of years, I think our track record speaks for itself. I think as we continue to build, our BD strategy is always to support the company's growth.
Our ambition is ultimately to be a global biopharmaceutical company. Your question also asked about therapeutic areas. I think if you look at, especially, for example, the last 12 months, we've done a number of deals which actually expanded our therapeutic areas. For example, the Regeneron deal, as well as the argenx deal. We got into two areas in hematology as well as for the autoimmune diseases, which we did not have strong presence in beforehand. Very quickly, through these anchor assets, we're able to build a pretty nice pipeline in those new areas. Going forward, I think we definitely continue to strengthen existing disease strongholds, in oncology, for example, in lung, in gastric, in areas like these, it's very important for us.
Also potentially to get into new therapeutic areas like what we've done with odronextamab, with Regeneron, and potentially also to enter into collaborations that would further accelerate our global ambitions. Hopefully that answers your question, Yigal.
Yeah. Thank you very much.
Thank you. Once again, to ask questions, please press star one on your telephone keypad. Our next question is from the line of Seamus Fernandez of Guggenheim. Your line's open. Please go ahead.
Targeted therapy. Just hoping you could help us understand, amongst the U.S. companies, there are some concerns raised about the pace of targeted therapy and patient identification in the market today. I was hoping to just understand better, given your broad targeted therapy portfolio, how this might differ in China, or if you just think that the market is misinterpreting the pace of uptake relative to the U.S. market and some other developed markets of these targeted therapies that you have partnered relative to COVID.
I'm just trying to maybe ask if you guys can tease out a little bit more of the strategy and optionality with the broad targeted portfolio, and if you see that having significant advantages in China, or if you just think that the concerns that are being raised today by investors around the pace of targeted therapy uptake and patient identification, if that's really more of a COVID-related issue in your view. Thanks so much.
Thank you, Seamus. We actually, as you said, we have targeted therapies. We have immunotherapy. We also have Tumor Treating Fields. All three offers exceptional approaches for combo opportunities. Specifically to targeted therapies, we have, for example, even in lung cancers and gastric cancers, there are several targeted therapies addressing different patient populations. I don't think COVID has much impact to our business from last year and this year, pretty much based on that you can see from our revenue and from our clinical development successes. I think China is right now more and more close to the developed countries' treatment standards and the companion diagnostics companies are also growing very well. Together with these global diagnostic companies, we don't see much issue with patient segmentation or finding the right patient population.
Having said so, if you look at our pipeline, the current three approved products, they are all all-comer status. For example, with ZEJULA, it's the only first-line, all-comer monotherapy for ovarian cancer patients in first line and second line. For QINLOCK, also it's the only all-comer status for later line patient population. For OPTUNE, there's no diagnostic requirement. For us right now, we're in a very good position to able to have a broader coverage to the patient populations, which each one of them have a much greater patient population than in the other countries. Seamus, did I answer your question?
Yeah. That makes sense. I guess as you move forward, it was more a question of are there opportunities to utilize your broader portfolio to optimize patient identification for the targeted therapies. I know that that's something that's unique to Zai Lab relative to others. I think you answered my question. Thanks Zai Lab. Thanks, Samantha.
Thank you. Yes. Let me just say you brought a very good point because in each one of disease, we have multiple targeted therapies. When we go to a doctor, we can offer many different test panels with different options for treatment based on the mutation type. Thank you.
Thank you. Our next question is from the line of Ziyi Chen of Goldman Sachs. Your line is open. Please go ahead.
Thank you, and congratulations on the strong quarter, and thanks for taking my questions. With the recent public offering, I think Zai Lab now have a very strong cash position, about $1.8 billion. It will be great that management could share with us more colors on how you're going to spend that money. What would that be? Are you going to accelerate the pace for the BD deals, or you're going to spend more efforts on in-house discovery team build-up or any color on building out the significant bigger commercial team? Trying to understand how you're going to allocate the resources and beef up the in-house pipeline and also the commercial strengths. Thank you.
Yeah, that's a very good question, Ziy i. Good evening. I'll ask Billy to address your question.
Sure. Ziyi, thanks for the question. You're right. Right now, if you add in the capital raise during April, we do have a little over $1.8 billion in cash if you combine that with the March close balance. Specifically through the capital raising from last month, it is based on our fundamental strategic needs. To your question, the answer is yes, in terms of research capital being applied to accelerate the timeline to scale up Zai Lab further. Breaking down further into specific areas within the functional departments, a good part of it will go to fund new business opportunities in terms of BD corporate development licensing opportunities that we were talking about in the call as well as the earnings release itself. Also we've identified opportunities to complete additional clinical trials, advance future candidates, and just overall scale up our R&D platform.
The same goes to our commercial efforts. We have a very significant schedule of not only ramping up the three innovative products we have right now, but we have many more queued for potential approval and launch over the next few years. As you know, it's over 10 with just the current pipeline in the medium term. Making sure that we can absorb that type of growth is going to be important. We want to allocate some funding to expand our commercialization efforts. Last but not least, also to enhance our global pipeline. These are the four broad areas where we see that we can deploy this capital and create additional shareholder value.
Got it. Thank you, Billy.
Thank you. Next question is from the line of Anupam Rama of JPMorgan. Please go ahead, your line is open.
Hey, guys. Thanks so much for taking the question and congrats on all the progress. Maybe I can ask a quick one on QINLOCK here. I know it's early days and the GIST launch is expected later this month, just wondering how we should be thinking about that launch curve here, say, relative to ZEJULA. Thanks so much.
Good morning, Anupam. Thank you for your question. Billy, you want to address that?
Yeah, sure. Anupam, thanks for the question. You're right. It's pretty exciting times right now. We're going to have our first launch in gastric cancer franchise with QINLOCK in advanced GIST. We expect to launch this month in May, and we think that we have an opportunity here to establish a new standard of care for treating patients with advanced GIST in China. Of course, later this year, we also have tech line data coming out. We're anticipating that outcome as well. We'll see. As you know, Anupam, there's approximately 30,000 GIST patients newly diagnosed in China every year. It's quite significant number. It's quite as many as U.S. and Europe combined. We have a pretty significant opportunity, and we have already built a commercial team in our gastric cancer franchise to launch QINLOCK well, and we're ready to go. We're not giving guidance just yet, but it's pretty exciting.
Thanks for taking our questions.
Thank you. Next question is from the line of Jonathan Chang of SVB Leerink. Please go ahead. Your line is open.
Hi, guys. Congrats on the progress and thanks for taking my question. With the recent approvals of anti-PD-1 drugs in front line gastric cancer, can you talk about how this impacts your gastric cancer strategy with multiple partner programs in the space?
Yeah. Good morning, Jonathan. Thank you for the question. Alan, do you want to address the question?
Sure. Thank you very much, thanks for the question. Of course, as you know, gastric cancer is the second largest cancer in China, both in terms of incidence and mortality, there are significant unmet needs. Fortunately, more and more treatment options are available, which Tao had mentioned earlier. The FGFR2b expression appears to be orthogonal in that it appears to occur in those patients not necessarily expressing HER2, for example. There continues to be a definite unmet need and opportunity there as well. With respect to HER2 and the recent accelerated approval for [pemetrexed], we still believe, as does our partners, MacroGenics, that there's definite opportunity there, continue to evaluate margetuximab with PD-1 checkpoint blockade, believe that this may create synergistic anti-tumor activity to enhance tumor-specific T-cell immunity. We still believe there are considerable opportunities in this important area. Did I address your question?
Yeah. Partially. Maybe I can just sneak in a follow-up then. On bemarituzumab specifically, how should we be thinking about next regulatory and development steps? What could a potential phase III study look like in the context of an evolving gastric cancer landscape?
Jonathan.
Sure.
Definitely can .
Oh, sorry.
Go ahead. Go ahead, Alan.
I think it's safe to say we're working with our partners, Amgen, in evaluating the recent changes that have occurred in this particular area, and we'll be working towards the optimal design of that phase III study moving forward.
Got it. Thank you.
Thank you.
Thank you. Next question is from the line of Michael Yee of Jefferies. Please go ahead. Your line is open.
Hi. Thank you. Congrats on a great quarter of progress. Going back to the follow-up about the recent significant capital raise, I was wondering about your consistent stated goal to become a global pharmaceutical company. I'm wondering if that specifically means that you would be interested in expanding more so into other geographies, Asia, East or West, and thinking about what that means to become a global pharmaceutical company beyond China, and how the capital raise may play a role in that, if at all. Thank you so much.
Good morning, Michael. Thank you. It is early morning for you, right? West Coast. Thank you for the question. I think as we mentioned earlier, we definitely aspire to be a global biopharma company. In the next three to four years, we plan to have additional 10 more products launched without taking into account any new partnerships, indication expansions, or combo studies. What I also like to highlight is China is now the second largest global market, and it's going forward, it's going to continually with double-digit growth. Doing well in China means doing well globally. We also, as I mentioned earlier, we have a very strong pipeline. On top of what we talked about, we have three products already approved, with one more to be approved this year and 10 more to be approved over the next three to four years.
We believe our commercial position is very strong in Greater China and Asia. We also have a very strong pipeline, not only at later stage, but early stage, which we talk about seven internal discovered pipeline with global rights, including three in global phase I trials. We do believe by the next three to four years, we will have some of them entering into pivotal stage. Of course, innovation. We have a very strong BD team, our BD team continue to seek strategic collaborations to bring more promising assets that address unmet medical needs to our portfolio. Some can be of global rights, some can be of China rights based on the stage and also based on the patient population. This is also along our strategy to supplement our own internal pipelines accordingly.
We have over the last few years expanded our other footprints and our R&D team globally. We have now teams not only in China, in Shanghai, in Beijing, in R&D, but also we have teams in Boston and San Francisco focusing R&D as well. We believe with all of these approaches, we are well-positioned to realize our ambition in the near future. Thank you.
Thank you.
Thank you. We have Yang Huang of Credit Suisse for the next question. Your line is open.
Thank you for management to take my question. My question is on Tumor Treating Fields commercialization progress in China. We understand it's already almost a year since we commercially launched the product in China. Can you give us more color on commercial progress? For example, if compared to developed countries, do China patients stay on the device longer or shorter? We have various collaboration with supplemental insurance in China. How does those insurance plan increase our new patients who are using our devices? Yeah, any color on commercialization would be helpful. Thank you.
Sure. Good evening. I'll let Billy to address your question.
Hey, Yang. Thanks for the question. The sales of OPTUNE in China has been robust. You saw from our earnings release that first quarter 2021 came in $7.1 million, compared to $1.9 million in the same period last year. The momentum is quite strong as we continue on in second quarter and beyond. We're not yet giving full year guidance, but I'll just also let you know that given the momentum, we did double the number of sales teams, from about 50 at launch to about 100 now. To your point also, you specifically mentioned the other payer types that we've been able to leverage and to set up some of their adoption. You're exactly right. There are 13 supplement insurance plans that we were added to, and there's additional commercial plans as well.
It's mostly still driven by private pay, but we think that over the longer term, these additional payer pools, if you will, is going to be quite favorable long-term, and the contribution should increase. Those are all trending the right direction. Hopefully you also asked about sort of the experience we've had specifically with Chinese patients and how they compare to ex-China patients. We're not giving specifics on that, partly because the launch is relatively new as well. It's really in the back half of second half last year, where we were actually in the initial stages of the current launch curves. We see strong uptake, as I previously mentioned before, new patients, and we're collecting good data right now on a monthly basis. It's definitely trending on the right path, and we think that we're going to set a new benchmark in terms of first 12 months scripts.
Okay. Thanks a lot.
Thank you. We have David Ng from Macquarie for the next question. Please go ahead. Your line is open.
Hi, it's David from Macquarie. Thank you for taking my question. If I may, I can just focus on the ZEJULA and OPTUNE again. For first quarter, very strong year-over-year sales. Can you tell a little bit about the quarter-over-quarter trend for ZEJULA? I guess specifically after March, when the new price and NRDL coverage kicks in, can you share with us what you notice on the ground, especially in terms of volume expansion? Is the speed satisfactory and entering into April and May has the ramp-up continue? That's ZEJULA. Again, maybe also comparing against the two new competitors. Of course, their indications are not the same as you guys. I noticed that their price is also quite comparable with, I guess, BeiGene also just recently launched there.
Any thoughts along that line in terms of further pricing strategy for the rest of this year? Even post-NRDL inclusion, any thinking of offering some more kind of PAP program on top of NRDL to be competitive on ZEJULA? Sorry, a couple of questions on ZEJULA. On OPTUNE, basically, I guess, a strategic question, in the next three to four years, with much fewer competitive threat in China, does it make sense not to go after NRDL, like, on a national level?
If that's the case, does it mean that it can afford your team more time to ramp it up more gradually and then achieve maybe potentially even higher peak sales, rather than compared to some of the other innovative drugs in China where they have to really go intensive in the first two years after NRDL inclusion? That's my question on the two products. Thank you.
Yeah. Good evening, David. I think you asked a lot of questions. For the interest of time, I would like Billy to take some essence from your question to address. Billy?
Yeah. Sure. Thanks, Samantha. Thanks, David, for the question. Let me go through it one by one. I'll go backwards and then address the earlier one. In terms of OPTUNE and your questions about sort of optimizing the private pay channel with a comprehensive strategy, the short answer is yes. We've always said that for OPTUNE, for GBM, that's going to be the base strategy and that there are other indications, larger indications that are progressing quite well, especially with weakened immune. We'll revise our strategy once those get finalized, and ultimately approved and launched. Fingers crossed, and that's going to be a great position to be. What can we do above and beyond sort of the current comprehensive private pay strategy with not only out-of-pocket, but installment plans, commercial payers, government insurance, et cetera.
Because David, to your point, certainly that approach, if you do it well, achieves rational pricing as well as increased adoption. To layer on something above that, we think would be a positive, but to be continued. To your first group of questions on ZEJULA, I believe you were talking about sort of the competitive landscape and then our first quarter ramp. In terms of the competitive landscape, you're right. I think the way we'll characterize it is the PARP asset class is becoming quite important to address not only ovarian cancer patients, but even beyond that in China. That's great to see the awareness building up in this asset class because we believe that we have already positioned ZEJULA as a best-in-class PARP inhibitor, and we see that. Although we're not giving guidance and specific kind of KPI, but we already see that.
In third quarter, when the NRDL was implemented, we saw a clear kind of volume ramp up. Of course, it's going to continue in terms of kind of adopting and sort of absorbing and transitioning to an NRDL drug, right? Because you have to now go out and get on all the hospital listings. Of course, the number of hospital listings has kind of noted upwards, trending up nicely into the second quarter and beyond. Of course, that's the reason why we've also doubled the number of sales team from 150 at launch to 300 as of right now. We'll continue to invest because we see good momentum. Yes, so hopefully I did an adequate job in answering your questions.
Thank you.
Yeah, I think, David, regarding to competitive landscape for ZEJULA, we right now are the only company who has mono all-comer-status approved, any all-comer status approved for ovarian cancer. we also, on the second line, got linked to NRDL end of last year. the two competitors you mentioned, we don't view them as our competitors because they are in BRCA and a later line, and they just launched this year. Thank you. we don't feel we need to address. We don't, at least for now, for near term, we see any justification for us to modify our strategy because of those latercomers for later line patients.
Thank you. Thank you, Samantha. Thank you, Billy.
Thank you. I'm showing no further questions at this time. I will now turn the call back over to Zai Lab CEO, Samantha Du, for closing remarks.
Thank you, operator. I want to thank everyone for taking the time to join us on the call today. We appreciate your support and look forward to updating you periodically on our progress throughout the year. Operator, you may now disconnect this call. Thank you all.
Thank you. This concludes today's conference call, and thank you for participating. You may now disconnect.