Good afternoon, everyone. Thank you for joining us today and thank you for your continued interest in IMMANOVIA. My name is Patrik Dalen. I am the CEO of IMMANOVIA, and I will be presenting the quarter 1 2021 results for IMMANOVIA. Next page, Page 2.
Here you can read our disclaimers and forward looking statements, and I encourage you to read these at your leisure. If I could have the next page, please, Page 3. Today's agenda is as follows. I will start by discussing the importance of early detection of pancreatic cancer. 2nd, I will give you a summary of the Q1 highlights.
Here, I will review the blind validation study and the optimization study that were presented in Q1. Thirdly, I will touch upon the road to reimbursement and reiterate how we see that process going forward. Next, I will discuss the market opportunity for our blood based test IMRAPAN Candi in the U. S. With a particular focus on the market size for the familiar and hereditary risk group.
I will then touch upon our pipeline projects in discovery stage, after which I will touch upon the financials for Q1 2021. And following the financials, we will go into a Q and A session. Next page, please, Page 4. I wish to take this opportunity again today to remind everyone how important the mission we're on here at immunovia. With our blood test, In Gray Pancandi, we will provide an entirely new solution for early detection of pancreatic cancer.
Early detection of pancreatic cancer is critical for improving the survival of the pancreatic cancer patients. When pancreatic cancer is detected in Stage 1 and 2, the 5 year survival significantly improves. It goes to 50% survival rate after 5 years compared to less than 5% when pancreatic cancer is detected at Stage 3 or 4. Today, the median survival rate for a newly diagnosed pancreatic cancer patient in Europe It's as low as 4.6 months. And the reason for this is simply that 80% of all pancreatic Cancers detected today are diagnosed too late in Stage 3 and 4.
Pancreatic cancer tumors at Stage 3 and 4 are not resectable, which is the cause of the high mortality rate of pancreatic cancer. Surveillance programs for high risk individuals based on imaging techniques such as CT, MRI or EUS for high risk individuals are currently in use in many parts of the Western world. There are many drawbacks within the current programs, namely high cost, lack of available imaging capacity, time inefficiency, geographic challenges, etcetera. And this leads to the programs being limited in scope. A blood test like the IMBRY PANCMD We'll significantly change the paradigm for surveillance in our opinion.
And this opinion is supported by key opinion leaders in the field. Next page please, Page 5. Now I will move to discuss Q1 2021 highlights. Next page please, Page 6. Quarter 1 of 2021 was a very busy quarter for Immunovia.
We reported early in the quarter that we had collected the samples that were necessary for the blinded validation study. And late in quarter 1, we reported the results from the IMREI Pan can be blind validation study. I will go further into the results in my discussion today as it requires a deeper dive and then a one liner. Furthermore, we reported that we in PanFam have collected samples in a large cohort of more than 1300 individuals with familiar hereditary high risk profile. Altogether, We have collected more than 3,000 samples from these individuals collectively.
We also reported results from the optimization work that we have performed in our R and D department here in Lund, Sweden. We saw a significant improvement in results when we tested a small cohort of symptomatic risk patients. I will make a dive into those results later in this discussion as well. Next page, please, Page 7. After the close of the quarter, We had a few events worth mentioning.
We have submitted our CLIA application to the CLIA office in the state of Massachusetts. Furthermore, we released an update on the market size for IMbRAE PENKINDI in the U. S. And I will go into more details in today's discussion. And we have reiterated our view on the road to reimbursement, which I will also discuss in more detail today.
If I could have the next page, please, Page 8. We reported the results from the blinded validation study performed at Immunovia Inc. In our lab in Marlborough. This was a multicenter case controlled study covering 5 91 patients' serum samples. The serum samples were collected from 11 different sites in the U.
S. And in Europe. We had altogether 167 PDAC samples, of which 56 Stage 1 and 2 patient samples. We included 203 controls from the familial hereditary controls from the PanFam cohort. This was the first time we had used a control group with the relevant family history and or genetic traits.
We also included 221 healthy controls or blood donors, mostly collected from U. S. Sites. If I could have the next slide, please, Page 9. We obtained excellent results for early stage 1 and 2 PDAC patients versus the familiar hereditary Control Group.
We saw an accuracy of 92%, specificity of 98% and a sensitivity of 85%. Again, I want to emphasize that the specificity and sensitivity is given for Stage 1 and Stage 2 patients. This is absolutely outstanding results and shows that the test has a high sensitivity for early stages of PDAC, which gives us the confidence that the clinical performance of our test meets the market requirements. If I could have the next slide, please, Page 9. I have recently had the pleasure of meeting with a number of experts and key opinion leaders in the field, and I have listed some institutions or universities on this slide where the experts come from that I have discussed with.
We have discussed extensively the role of IMRAP and CAND as a test for surveillance of the familial hereditary risk group. And the feedback has been very positive. For instance, in one discussion, the initial reaction was These are the best data ever reported for detection of early Stage 1 and 2 PDACs versus controls in a familiar hereditary risk group. Obviously, many of the key opinion leaders want to see the Imray Bank and D test performance in their own surveillance groups and on their own at risk patients prior to making public statements. However, I have the pleasure of sharing some quotes from some named key opinion leaders with you today.
Doctor. Steven Pereira from UCL University College London commented, and I quote, A blood test for early detection of pancreatic cancer with the performance reported in the blinded validation study fulfills our criteria for a test to be used for monitoring of high risk familial individuals. Furthermore, we hear from individual physicians who see at risk individuals in the U. S. The interest is very high for our test.
For example, Doctor. Burns from Wellesley Hills, Massachusetts comments and I quote, as a personalized care physician, I look forward to offering my familiar pancreatic cancer risk patients The Imrepan can D test, a clear cut and informative blood test option to help allay their fears and has their own pancreatic high risk surveillance. The interest for our test among private U. S. Persons who have had pancreatic cancer in the family is also increasing, and they are contacting us at an increasing rate.
The recent seminar called Latest News in Oral Detection of Pancreatic Cancer organized by the patient advocacy group pancreatic cancer action network has certainly spurred interest as well. In this seminar, Doctor. Rosie Sears from the Brendan Colson Center For Pancreatic Care expressed her enthusiasm of our blood based test, and it has certainly led to increased awareness among individuals with a family history of pancreatic cancer. I can just summarize that the support and interest for our test in the U. S.
Is solid. We are excited to soon be able to help the pancreatic cancer community with the blood based test for early detection of pancreatic cancer. If I could have the next slide, please, Page 9 11, sorry. As we explained in our webinar on December 17, we have dedicated a R and D team here in Lund, Sweden to look for ways to further optimize the IMbrey PENKAN D for use in the symptomatic risk group. We reported in Q1 on a small study we conducted with the IMPROVE test.
The study included in all 4 33 patient samples collected from 7 different U. S. And European sites. Out of these, two zero two samples were from patients with pancreatic cancer, Stage 1 through 4, and 89 of the patients We're from Stage 12. We used 231 symptomatic controls in this study.
If I could have the next slide, please, Page 12. The results from the optimization study conducted in Lund in our R and D lab showed an accuracy of 89% and the specificity of 92% and the sensitivity of 80% in detection of Stage 1 and 2 PLEC patients against a cohort of symptomatics. Again, I emphasize that the performance I referred to is for early stage pancreatic cancer Stage 1 and 2. The performance we saw in this study is very close to the performance we saw in the CTMS study and it looks like we're back on track with regards to sensitivity and specificity also in the symptomatic cohort. If I could have the next slide please, Page 13.
We have discussed the results from the optimization study, and we have had positive response from our key opinion leaders. Doctor. Grutzmann from University of Erlang in Germany commented and I quote, to detect this very deadly cancer, Pancreatic cancer, as early as possible is very important. Therefore, it is very relevant to offer IMBRY PANCKND blood test at GP locations and at gastroenterology clinics. The test will be promoted to existing referring GPs and Astro Networks in connection with local regular trainings performed by the University Hospital and the results from this collaboration between GP and DASTRO clinicians, could be published in a main physician journal, Deutsche Adzeblett.
And Doctor. Perera from University College London commented and I quote, the results presented recently are very encouraging and open the opportunity to further validate the current clinical pathway for patients with early non specific, but concerning symptoms suggestive of pancreatic cancer. A minimally invasive test such as IMROI PANCAN D, which can be made available at primary care level, could help prioritize investigations, accelerate PDAC diagnosis and reduced anxiety linked with long waiting times. End of quote. So it seems the steps We have taken to improve the performance of the test in the symptomatic risk group has been effective, and we showed improved performance, which now again resemble that of the CTMS study results we saw earlier.
Next, We need to confirm this data also in our U. S. Lab in Marlboro prior to the launch in the U. S. Assuming we See the same results in our lab in Marlborough.
We should be ready to release also this test for commercial use in this symptomatic risk group as well in the very near future. Please turn to the next page, Page 14. Next, I will discuss the road to reimbursement. If I could have the next slide, please, page 15. Briefly stated, we will follow a route which is well established for lab developed tests in the U.
S, with a very clear path and milestones. As you all know, we will launch the test as a self paced PayTest, which is very common in the U. S. And the people who order the test will pay out of pocket. In order to get the broadest possible utility, one seeks reimbursement for the test.
In our case, This means we will seek a PLA, which is short for proprietary laboratory analysis code for the IMRAE pan can D test shortly following the data from the PanFEM study. We will then conduct further studies as needed illustrating analytical and clinical validity and utility. Furthermore, we will monitor and collect clinical data from our ongoing out of pocket commercial testing. We will obtain endorsement from key opinion leaders and leading institutions. We will then use all of this data and supporting evidence to build a dossier with which we can seek a local coverage determination from National Government Services, who is the Medicare Administrative Contractor for Medicare Services Providers in the New England region of the United States.
We have already conducted 1 payer study that gave us a lot of detailed information. However, we now start a new payer study with specific focus on Medicare. These studies are important so that we get the latest and best possible feedback from the Payers. I again need to emphasize that our test will be for surveillance of high risk groups such as the familiar hereditary risk group with tight inclusion criterias and therefore a well defined relatively small population in the U. S.
Thus, The test is not seen as a screening test. Diagnostics reimbursement expert, David Parker, the Senior Vice President of Precision for Medicine comments, and I quote, market research indicates and surveillance imaging of patients at high risk for pancreatic cancer is already routinely covered by payers. And it is not considered as a screening application of the imaging modalities. Immunovia will be seeking coverage for the same surveillance use in the same population. It seems highly unlikely that payers will view the IMRAPE and Candid test as a screening test when they cover the clinical alternatives as diagnostic.
The medical community and the associations that focus on pancreatic cancer in the U. S. Have issued several guidelines and recommendations. All of these guidelines and recommendations are against general screening and for surveillance of high risk groups. The payers obviously listen to the medical community.
On the other hand, in terms of the symptomatic risk group, there's obviously no obstacles either to obtain reimbursement for testing patients in the symptomatic high risk group. In terms of timing, we fully expect to have a majority of the coverage agreements with payers in place by end of 2022. Please turn to Page 16. Next, I will make a few comments on the updated market size. Please turn to Page 17.
Thank you. Organizations such as the U. S. Preventive Services Task Force, National Comprehensive Cancer Network, American Society of Clinical Oncology and the International Cancer of the Pancreas Screening Consortium make regular updates to their guidelines and recommendations. A number of recent updates have led us to reexamine the potential market size in the U.
S. The market opportunity for surveillance, A familiar hereditary high risk group is estimated to 315,000 to 350,000 individuals annually. This is based on the understanding of the number of new cases per year, disease association due to familiar and hereditary background, an understanding of what's called the average U. S. Family of 2 parents and 2 siblings and of course the range of the recommended surveillance H, etcetera.
This means that the potential market size for IMMANOVIA range from 630,000 to 700,000 tests annually, of course, assuming twice a year surveillance. Current programs run once a year surveillance with MRI and EUS. And we think twice a year surveillance could be the future. In order to catch Stage 1 and 2 as early as possible as disease progression is fairly rapid. If I could have the next slide, please, Page 18.
Lifting our horizon into the future, We can see now that several opinion leaders and medical organizations such as NCCN are recommending all individuals with a family history to be tested for mutations and included in surveillance programs. This includes persons with just one first degree relative. Recent publications do indicate that there is a significant ninefold increase of risk of pancreatic cancer among persons with just one 1st degree relative. There is an estimated 3,100,000 individuals in the U. S.
In the surveillance each bracket of 50 to 80 years with 1 first degree relative. It is also fair to state that a blood test Based surveillance would be the only way to deal with such numbers of individuals in a surveillance programs. Again, we are not suggesting this happens in the near future, but it is certainly something to consider when we speak about the long term potential for IMBREAK and Candi in the marketplace. Next page, please, Page 19. Briefly on the U.
S. High risk symptomatic group, we maintain our view on the market size here. It is roughly 500,000 individuals per year as we have previously stated. If I could have the next slide please, Slide 20. I will say a few words now about our discovery pipeline.
If I could have the next slide please, Slide 21. Whilst our main focus is on the launch of Imbrey PANCKND for early detection of pancreatic cancer, we continue to work with our discovery platform. We currently perform early stage discovery studies in the area of rheumatoid arthritis and lung cancer. We have established key opinion leader networks for these discovery studies, both to secure we have the right knowledge mass and of course to secure high quality samples from well defined disease cohorts. As you know, collection of samples is still affected by the COVID-nineteen pandemic.
As these are discovery studies, meaning they are in the early stage of our R and D model, It is not my intention to give firm time lines on these 2 discovery studies today. We will report data when we have new data and information. If I could have the next slide please, Slide 22. Next, I will just have a few words on the financials Q1 2021. Next slide, please.
Slide 23. Our income in Q1 2021 was SEK 123,000. Swedish kronze. This income is royalty income, and we've seen this type of levels of income in the past. Net operating earnings were minus SEK 23,000,000 in the quarter.
Cash flow in the quarter was negative SEK 43,000,000 Cash and cash equivalents at the end of the period was SEK 425,000,000. Based on past, that is 2020, and current burn rate, we have a run rate of over 2 years at current full year levels. We will update our view on cash contributions from sales in our Q3 report, thus giving some more color on our cash position in the years out. This was indeed the last slide that I wanted to share with you today. And I want to turn to the next page, Page 24, and we can open up the call for questions and answers.
Thank you.
Thank There will be a brief pause while questions are being registered. We have a question from the line of Lars Ihavrin from Danske. Please go ahead. Your line is open.
Yes. Thanks. Maybe I missed that In your remarks. But can you just elaborate a bit on The phasing of the rents here, I mean, the second quarter, the launch, the early target groups And what kind of in some way, if you could what you can say in terms of early Doctors, the number of hospitals that we would or physicians that we would address, some so we could have some color of what how From the next quarter onwards, I guess from the next quarter results and onwards, I guess this will be seen as a commercial stage company And how we should assess the level of success?
Yes. So Actual commercial testing, meaning that we can also invoice for the testing that we're doing, will commence as soon as we have a clear number. That should happen within weeks, within a very short period of time. So we are fully expecting that to happen within May month. The first Target Group is obviously familiar hereditary risk individuals.
Many of these are coming to us as private individuals either directly or through their primary care physicians. Obviously, also there is a great deal of interest amongst already established surveillance programs that are running across the U. S. There is roughly 60 well established Surveillance programs around the U. S.
And included in continuous monitoring in those programs is roughly 10,000 people. So that gives you sort of an idea of the sort of immediate target group, so to speak. As we have said, we estimate that the total number of People in the U. S. That have a familiar and hereditary risk profile is roughly 315,000 to 350,000 individuals and obviously we will work very diligently to identify these individuals and target our marketing and sales towards this.
With regards to the symptomatic risk group, Obviously now with the data we have from our R and D lab in Lund, we are going to confirm that data in the U. S. In our lab there. And once that is confirmed and they've run their study there, then we will be in a position to launch IMbrikant can be also for symptomatics. The customers there are primarily in the Gastro Centers.
And as you know, we have established a sales force for dealing particularly Gastro Centers. We have a group of 5 people in the sales force who will be focusing on the East Coast Gastroenter to begin with. It's a little bit early still I think to comment too much on how we see sales In Q2 and how we see sales in Q3, I think I'd like to see exactly sort of the take up and sort of the run rates going here. All I can say and comment on is that The influx of inquiries is steadily increasing day by day as we move close to being able to actually commercially launch.
Okay. That's very helpful. Thanks, Patrik. And just first to understand the I mean, the sequence of commercial The level of activities in the U. S, when you that was Last time, it was updated in the CMD back in June last year.
But can you just tell us you have 5 people today. When you can expand the scope and you can address the other main areas such as the West Coast, Florida, the Texas, Some regions around that, the sequence of events and the scale up of the organization.
I think we'll very safely take a quarter to see how well we progress on the East Coast with regards to the gastro centers there and be very sure with regards to that we have the pitch right and that we have the sort of positioning right and everything is correct. And then we'll evaluate that. So I don't think in the 3rd quarter, We'll be doing much in terms of building out the sales force, but probably start to look at that for the Q4.
All right. I got it. And a last question from myself. Which pantheon in Europe of size do you think is going to be the first When the price is going to be available?
So we will update the market with regards to the launch in Europe before the end of this quarter, quarter 2. As you are aware, the Reimbursement landscape in Europe looks very different from the U. S. It's 28 EU countries deciding for themselves. And therefore, it takes a very significant amount of work to figure out exactly which sequence one should use in order to approach that.
On the other hand, we are very close to certain key opinion leaders in certain European countries. So obviously, that will give you a little bit of indication where we will start. The second thing that's happening, of course, from a European perspective is the regulations, The CE regulations are changing and there is a new regulation coming, the new IVDR rules by May 2022. And obviously, that's another thing that we will need to take into consideration as we sort of look forward.
Yes. Okay. I got it. Thank you, Patrick.
Thank you, Lars.
Our next question comes from the line of Alex Rupert from Kempen. Please go ahead.
Hi, Patrick. Thanks for taking my questions. So I was just wondering on the Hi, this is symptomatic group. How do you plan to expand kind of the reimbursements? What would the next steps be from here?
Yes. So what's become very, very clear is that there's a little bit of misunderstanding of the road to reimbursement for this particular group. And as I think everyone is agreeing that So the general screening of the population for pancreatic cancer is not advisable and it's not advisable from the a view of the medical community and it's certainly not something that we would be advocating for either with our blood based test. So obviously, for us, in terms of obtaining reimbursement, the key is actually to focus on a high risk group, such a familiar hereditary group. Within that group, if one wants to further narrow it, there's obviously Certain syndromes like the Peutz Jager syndrome that has an extremely high highly elevated risk for pancreatic cancer.
So if one Really wanted to pinpoint a high risk group where it would be very, very easy and very fast to conduct studies to point to clinical utility, then there certainly are subgroups within the familial hereditary group that we can work with. We have, however, come to the conclusion based on the work that we've done For years now, that the combined familiar hereditary risk group is well accepted as a first starting point for surveillance. And therefore, it's also well accepted starting point in terms of working towards reimbursement. So that is actually very much our strategy to work towards reimbursement for this well defined from the hereditary risk group.
Yes. No, I think so I think maybe I didn't take my question correctly, but I'm referring to the symptomatic patients. So I know that you plan to redo a study in the U. S. And launch it for these patients.
So I was just wondering how do you see getting reimbursement in that broader category?
That group is, of course, equally straightforward, maybe even more straightforward than from the hereditary group, in that obviously there the starting point is symptoms. And that is of course, I don't think any contingents there with regards to reimbursement. So basically, it's the same process as for the familiar group, I. E, we We do the data in the United States. We conduct some local studies with principal investigators in the United States for the symptomatic group.
We collect a dossier that shows Clinical Utility and Validity. And with that at hand, we approach the payers. So it's very much the same process and roughly the same time lines. And would
an additional prospective study be required given it's a larger population?
We don't think so actually, given that again, you have a fairly high who high density of patients, very clearly defined current clinical practices and we would supplement those with the blood based tests. So don't see that we would necessarily need large broad based prospective studies, but indeed very focused studies for the sort of clinical utility and mobility as compared to current practices. So we don't foresee long and cumbersome prospective studies needed.
Got it. And just another question I have. I know that the competitor of yours received a breakthrough designation for their pancreatic cancer detection testing patients with new onset diabetes. So I was wondering if this would be a basket where you are planning to pursue and if not, why wouldn't you?
So when it comes to the NODs, which continues for us to be an extremely interesting application for IMOI-1Candi, I think Most recent discussions, whether it be academic or private companies, There's an ever increasing interest for the notes and we're very happy that that's happening because it's also our view that this is another risk group that definitely needs a surveillance approach in order to early catch pancreatic cancer in this group. For us, the next milestone for the NODs is actually running the PANDEA study and getting the first indications of what a Nod Group looks like in our hands. So for us, that is the sort of next milestone is to report out on the Pandya and showing what is the performance of IMred and can be in this particular at risk cohort. From there, we will then make further projections and milestones regards to what are the next steps. But obviously, it will look pretty much like what it's looked like in the past for from your hereditary group and the symptomatics.
So and seeking FDA Breakthrough determinations for us is not at this stage in the plans as we least for the foreseeable future, we'll continue to have an approach where we work with laboratory development tests.
Okay. Thank you.
Thank you.
Our next question comes from the line of Victor Sundberg from ABG Sundal Collier, please go ahead.
Hi. Thank you for taking my question. So first one for me is on the PanFam study. So what expectations should we have on the interim readouts going into that event in the second half of twenty twenty one? I guess my question is what the study is powered Fine in interim study in terms of perhaps number of PDAC cases that IMRAE would pick up that imaging would also confirm.
I mean, just in terms of trying to match expectations for that study, is a 2 confirmed cases of feedback a success? Or would you say that the number have to be 10 in order for you to use that data The pipe withholding and subsequent coverage and pricing. Thank you.
So I think with regards to the PanFEM study, like Just about any study of that pertains to familiar hereditary large scale studies, Whilst one is collecting samples for many years and conducting and enrolling large numbers of patients, there's no guarantee that you will hit fixed numbers of beta cases. We obviously don't know that yet. So we don't know how many there will be. And we don't know either with regards to how many might there be that have not been detected by imaging at this stage. So I think from that point of view, it's obviously too early for me to comment with regards to the power of the study per se.
That said, seen from my chair and with My experience in the field, I would say, what is important is obviously to show the clinical performance and the Test performance with regards to the test's ability to detect early stage PDACs in a cohort like Panfam. And that's obviously there are many ways to secure that and do that in a way but we're still prospective like we've done and where you just secure that you also get the sort of analytical and clinical sensitivities and specificities at a reliable level. So that's kind of how I think about it and how we will be proceeding.
Okay, great. So maybe one question on screening also and surveillance. I mean the communication earlier from IMMANOVIA That the Familiar Group was considered to be asymptomatic and would be considered for a screening. I think that was reiterated as late in June. What has changed in your communication with experts that have made you pivot away from this line of thinking?
Of course, you're the new CEO of the company. So just curious what you have learned that Perhaps previous management, please.
I don't want to point on previous management by any stretch of the imagination. I just go by common knowledge and what the medical community are saying and that is that screening in the area of pancreatic cancer is not recommended, Surveillance is and that there is a there are given risk groups where surveillance should be conducted and should be conducted based on certain inclusion criteria. And this obviously limits the number of persons to a very much smaller group than the general population of United States. And therefore, it changes dramatically the view on reimbursement and how to distinguish between screening and surveillance. The second thing to say is, we've also learned that The current surveillance programs and persons enrolled in those do get their screening process reimbursed by commercial payers.
And the commercial payers clearly see The processes that are used and the imaging techniques that are used as diagnostic modalities and not as screening modalities. And that is another learning, obviously, that is a key here.
Yeah. And also one question here on next steps after this hereditary familiar group after you have secured reimbursement in that Group. Do you think that the symptomatic group is the next in line? Or would that be the Nord group Just in your Yes,
the symptomatic group we will run-in parallel with the familiar hereditary group. So that will go more or less hand in hand. I mean, those two risk groups are not far from each other with regards to timelines and ability to obtain reimbursement for. So actually those two groups will run-in We'll run-in parallel. So that's how you should think about it.
Within 2022, we should We perfectly placed also for the symptomatic group. The group to consider a little bit sort of out of sync with the 2 first ones It's obviously the Nord Group. And as I said before, very, very optimistic about the Nord Group. It's commercially, obviously, a very interesting group. I think it's clinically for the sake of minimizing pancreatic cancer cases going forward.
It's obviously an extremely important group to be able to establish surveillance for. But I think for me, the key is to be able to report data from the PANDEIA because that is actually the establishment of the sort of baseline for us with regards to test performance in that particular clinical cohort. And I think it's quite important that we get that settled first before I start looking into sort of long term views on commercialization for that as well as reimbursement road to reimbursement.
Okay. Thank you very
much. Thank you, Victor.
There are no further questions registered. So I hand back Speaker for any closing remarks.
Great. Thank you so much, everybody. Thanks for the great questions. Thank you very much for your continued interest in IMMANOVIA. And I certainly look forward to reporting again on Q2 update as we progress.
Thank you very much. End of call.