Adaptive Biotechnologies Corporation (ADPT)
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Morgan Stanley 22nd Annual Global Healthcare Conference

Sep 6, 2024

Tejas Savant
Research Analyst, Morgan Stanley

At morganstanley.com/researchdisclosures. If you have any questions, please reach out to your Morgan Stanley sales rep. It is my pleasure this morning to host Adaptive Biotech, and speaking on behalf of the company, we have Chad Robins, CEO. Thank you so much for joining us, Chad. Appreciate it. Maybe just to kick things off, you know, it's been an eventful year for you guys. You have the strategic review, you have the FDA ODAC meeting, which we'll get to as well. What would you say are your key learnings this year? Do you feel better about Adaptive's prospects today than you did twelve months ago?

Chad Robins
CEO, Adaptive Biotech

Thank you, first of all, Tejas, for having us again at Morgan Stanley Healthcare Conference. Really appreciate it, and good to see you. Yeah, I feel, I feel really good about Adaptive's business and where we are. We've made, you know, a significant amount of changes and have done some heavy lifts. You know, in particular, segment reporting, we have two businesses, one in MRD and the other in immune medicine.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

In terms of allocation of capital, dedicated resources, a very crisp understanding of the catalysts and milestones in each of those businesses, the financial discipline that we've put into place, you know, and also the traction that we've made, you know, over the last twelve months. Yeah, I think there's a lot of momentum in the business right now. You know, culturally, people are feeling, you know, very, very inspired, and feel like, you know, even though we've been through some challenging times and have had to make some tough decisions in terms of kind of reductions in workforce, in terms of reductions and really focus on programming, those decisions, you know, have been well received and are starting to play out in a very positive manner.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. I want to start with, you know, the MRD side, you know, and the clinical piece. Just to set the stage, can you talk about your current volume mix and penetration across multiple myeloma, ALL, DLBCL, and CLL?

Chad Robins
CEO, Adaptive Biotech

Yeah, sure. Happy to do so. And that is exactly how we look at it. We look at penetration by indication. The area that we're most penetrated from is in ALL, because this was a conversion strategy. Clinicians have been doing MRD testing in ALL for a long time.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

...initially using flow cytometry, and now they've been converting over to NGS-based ClonoSEQ testing, and we're about 20% penetrated. The fastest growing area of our business is in multiple myeloma, and that business is 10% penetrated. And then you have kind of the CLL business, which is about 4%-5% penetration, and then you have DLBCL, which is the largest category of kind of non-Hodgkin lymphoma, represents about 35% of our overall test mix, but we're penetrated in about 3%. We can talk each of these indication and what the drivers of that penetration are as well.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... but that is your overall big picture on penetration.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. So one of the questions we still get, Chad, is, is why is ClonoSEQ penetration, where it is, increased relatively slower versus, you know, liquid biopsy tests for therapy selection? What's your perspective on that, or is MRD penetration for solid tumors the more appropriate benchmark in your mind?

Chad Robins
CEO, Adaptive Biotech

Yeah, I would say MRD penetration for solid tumors is probably the more appropriate benchmark. Remember, we've really developed the market in heme MRD, right? And it took a long time to generate the clinical evidence, meaning, how does a clinician use this information to make a treatment decision on each one of my patients and in each of the indications?

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

Broad, broad picture, it started with the effectiveness of new therapies.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

A great... I mean, let's pick multiple myeloma. Like, starting in 2015, you had this, a litany of new therapies that came onto the market, and these therapies were more effective, and they extended the life of a patient.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... usually, in the past, where multiple myeloma would be a death sentence for a patient, now patients are living longer with the disease. What that means is you need to track effectiveness of therapy.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... and then over the course of the patient care continuum, you need to look at the tumor burden.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... and then how to essentially use this arsenal of new therapies to, to be able to treat the patients. With that, the MRD market has grown in conjunction with the new therapeutic options. Like, new indication, for example, DLBCL.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... you have new therapies that are in trials and coming to market now.

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

The MRD market will develop in conjunction with those new therapeutic options.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. What is the share of flow-based approaches versus ClonoSEQ? And more recently, has that been an opportunity for you to gain share from Foresight Diagnostics, you know, following some of their legal challenges?

Chad Robins
CEO, Adaptive Biotech

The couple—let—I want to tease that out a little bit here.

Tejas Savant
Research Analyst, Morgan Stanley

All right.

Chad Robins
CEO, Adaptive Biotech

First of all, flow cytometry as a replacement strategy was used in ALL.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah.

Chad Robins
CEO, Adaptive Biotech

That conversion strategy of switching over to NGS-based testing, now we're starting to really kind of capture that. Flow is still probably about 35%-40% of the market. Second question, kind of related to, there are certain indications where flow, where MRD testing was, hadn't been done or wasn't done in the past, and it's truly a developing ClonoSEQ-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... as a method to test MRD.

Tejas Savant
Research Analyst, Morgan Stanley

I see.

Chad Robins
CEO, Adaptive Biotech

And so that would be, for example, in CLL and in markets like DLBCL. Now, DLBCL is a... It- whereas the other indications I've talked about have been a cellular test-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

DLBCL is a CT, a circulating tumor DNA test. This is an area where the area where we do see a competitor, you mentioned Foresight Diagnostics. I want to be very clear about Foresight: they do not have any presence in the clinic right now. They are competing with us in new pharma trials, and so that's an area where, you know, essentially, you know, and those new pharma therapies that are coming to market in CAR T and ultimately in bispecific, et cetera, that's an area where

Tejas Savant
Research Analyst, Morgan Stanley

I see.

Chad Robins
CEO, Adaptive Biotech

They do-- they're, they're not in the clinic.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Got it. Coming back to, you know, the earlier comment you made, Chad, about, you know, multiple myeloma being, you know, the largest driver for ClonoSEQ volume. Can you just dig a little bit deeper into, you know, the drivers of that growth, and how should we be thinking about growth in, in, in the other categories, the ALL, DLBCL, et cetera?

Chad Robins
CEO, Adaptive Biotech

Yeah. Yeah, so why... Again, I mentioned the therapy, but the other is blood-based testing.

Tejas Savant
Research Analyst, Morgan Stanley

Yep.

Chad Robins
CEO, Adaptive Biotech

Clinical utility of in, in evidence generation. There are two, two trials that I'll point to. One is the MASTER trial.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

What the MASTER trial says is if you have two successive MRD negative time points, that you can take a patient off of maintenance therapy, and then over the course of two years later, that patient, 85% of those patients are still disease-free.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

And why that's so important is if you have multiple myeloma and you're getting maintenance therapy, there's a ton of side effects, and it's really challenging living with some of these side effects. These patients are really thrilled to be able to have a negative MRD test and have the confidence, and the doctors have the confidence to take these patients off of therapy. There's another test called the MRD2STOP test, which is a trial out of the University of Chicago. It is a multimodal test, but ClonoSEQ can tend to the negative six, is one of the important components of the test, also to take a patient off of maintenance therapy. These are really, really important to continue to generate the clinical evidence.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. You know, that point you just made on blood-based testing, I think it's about 40% of your volume-

Chad Robins
CEO, Adaptive Biotech

Yeah

Tejas Savant
Research Analyst, Morgan Stanley

... and it's been a steady increase, you know, for a while now. What time frame do you see this essentially replacing all sort of bone marrow biopsies within your clinical volume? Or are there any sort of advantages to marrow versus blood in certain settings?

Chad Robins
CEO, Adaptive Biotech

Yes, particularly in... The advantage in the community, if you look at about 60-65% of patients are treated in the community.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Community, for the most part, don't do bone marrow-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... pulls, they do blood draws.

Tejas Savant
Research Analyst, Morgan Stanley

I see.

Chad Robins
CEO, Adaptive Biotech

Being able to have that blood-based testing in the community is a huge component of that. The blood-based testing in the community really go hand in hand, and we're looking at really three initiatives on increasing penetration in the community. You know, the first is around integration.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

We have Epic integration, which is mostly centered on academic medical centers, but we're also starting in the fourth quarter, OncoEMR, which is a Flatiron integration, which will hit by second half of next year. We'll do some piloting, but it'll hit about 200 community hospital centers, so really excited about that. The second is we're increasing... If you look at our, kind of marketing promotional spend-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... a lot of that increase is going into the community, where we're having kind of that, the KOL peer-to-peer, going out and really focused on the community hospital settings.

Tejas Savant
Research Analyst, Morgan Stanley

Okay.

Chad Robins
CEO, Adaptive Biotech

The third is really more of a structural element, where we've reorganized the sales force, where most of the community practices are centered in these large community practice accounts.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... where we wanna focus our time. In the past, we've had that done kind of by geography, but what we've recognized is, how you sell into these large community accounts. Now we have a national strategic account group that kind of services the country, and we have this really dedicated playbook to say, "Here's how you go in and put kind of what we call KPI, KPIs, and how clinicians should implement, throughout the different time points in a patient's continuum, how they can implement MRD testing.

Tejas Savant
Research Analyst, Morgan Stanley

I see.

Chad Robins
CEO, Adaptive Biotech

It's a combination of workflow, peer-to-peer education, and how it is that we're targeting and selling.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. And just cutting the data, slightly different way. I- in terms of advantages of blood versus marrow, are they universal across all heme malignancies, or are there certain categories where marrow-

Chad Robins
CEO, Adaptive Biotech

No, that's a great—that's a good question. There are certain—so there are certain indications where we only do it in blood, and it's blood-based testing. For example, CLL—

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... DLBCL-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... is only going to be a blood test. There are certain indications, like ALL, where you have 100% concordance data, meaning, like, we're sensitive and specific in the bone marrows.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... when we are in the blood. The outlier there is in multiple myeloma, which is a disease of the bone marrow.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

But our test is so much more sensitive than flow-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... like, we're sometimes able to pick up in the blood what flow can't even pick up in the marrow.

Tejas Savant
Research Analyst, Morgan Stanley

Interesting.

Chad Robins
CEO, Adaptive Biotech

However, you have a set of clinicians who are used to... They're always, especially in academic medical centers, they're always gonna take a bone marrow draw.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

What we're saying is, if you're in the community-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... and you start with the blood, start with the blood. If you can get the ID sample, if you can find it in the blood, we can track it in the blood.

Tejas Savant
Research Analyst, Morgan Stanley

Mm.

Chad Robins
CEO, Adaptive Biotech

If you can't find it in the blood, then you can reflex to the marrow.

Tejas Savant
Research Analyst, Morgan Stanley

I see.

Chad Robins
CEO, Adaptive Biotech

So there's a whole kind of pathway as to how you treat patient, and it is a good question because there is a nuance that there-- you're not gonna a hundred percent... replace marrow-based testing.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

-in multiple myeloma, but we can get a long way there, and we can have a pathway to get there.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. You know, on that point, you talked about, on the EMR front with the Flatiron Health rollout here, are there any learnings from the Epic integration that you can leverage? Are there any notable differences in terms of the integration processes between Epic and OncoEMR?

Chad Robins
CEO, Adaptive Biotech

Yeah. I'm gonna take this question in two parts. First, I'm gonna talk about Epic to Epic-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

-and the learnings that we've had-

Tejas Savant
Research Analyst, Morgan Stanley

Okay

Chad Robins
CEO, Adaptive Biotech

-there, and then we'll talk about the differences between Epic and OncoEMR. Epic to Epic, y- so we've done now, well, six is the last earning call. We did another one and have two to three scheduled by the end of this month.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

We've got another 12 on the docket.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

'Cause we said, "Hey, we're hoping to get 20 by this year.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Which means that we've got a long ways to go, and there's been a ton of learnings. I mean... And by the way, my friend from Exact, who was on our board for a while, Kevin told me this to begin with, is that it's kind of like this double-edged sword. It's really hard to get these, all these institutions to implement Epic, but once you do, it's a nice competitive advantage. It's another moat around your business because once you're in the accounts, the switching cost is high because-

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

you get used to using it, and you get et cetera. So getting IT resources, getting the clinical champion, and getting everyone centered with kind of more of a productized, "Here's the Epic offering that we're doing, and here's how to do it.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

That took... There was some upfront work, and then that takes kind of a while to kind of get that packaging down. The last Epic integration, the last Epic integration we did went faster than any of the other ones that we've done to date.

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

We're getting faster at it. I should also say that we started with kind of some of the smaller accounts because we didn't, frankly, want to screw it up, and so we piloted some of these accounts. We saw really nice kind of 40%-40%+ really early growth, growth in terms of volumes from those accounts. Now, we are moving to doing our two largest accounts, and that one will be done by the end of this year, and one may be done in the first quarter.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

When those are done, 25% of our total overall volume will be kind of represented by those Epic integrations. Okay, so that's Epic. Learning a lot. I think they'll go faster moving forward. Big competitive moats.

Tejas Savant
Research Analyst, Morgan Stanley

Mm.

Chad Robins
CEO, Adaptive Biotech

Gosh, it is challenging and tough, I'll be honest with you. What's easier, we think, or what we've been told, is Onco... And, one more thing, Epic has this—you have to have this plugin called Aura.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

to be able to integrate with Epic.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

OncoEMR has a, a plugin, it's somewhat similar, but you can, like, you can have this diffuse turn on-

Tejas Savant
Research Analyst, Morgan Stanley

I see

Chad Robins
CEO, Adaptive Biotech

-of all these events, and it's called MPI. We will do some piloting in some smaller accounts, make sure it gets up and running. That contract work starts in the fourth quarter. We do all the build.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Second half of 2025 is when we're looking to turn on, and we'll have access to 200 accounts.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

Like, you know, one of the questions, you know, we ask is, "Hey, can you continue to grow at, I mean, these, these 30% volumes year- over- year?" What we're looking at, there's new things every year, and one of the big growth volumes is these... As these integrations take hold, that's an important component of it.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. How should we think about mapping accounts to volumes?

Chad Robins
CEO, Adaptive Biotech

I'm not sure I totally understand yet.

Tejas Savant
Research Analyst, Morgan Stanley

Just in terms of like, you know, when we think of the, the, the fraction of your... because not all accounts are equal, right? Some are gonna be, like, higher volume, some are gonna be lower volume.

Chad Robins
CEO, Adaptive Biotech

Mm-hmm.

Tejas Savant
Research Analyst, Morgan Stanley

Depending on the mix of the accounts that transition over to these new, you know, get integrated on these EMRs, just trying to get a sense of how material this could be for you.

Chad Robins
CEO, Adaptive Biotech

Yeah. Yeah.

Tejas Savant
Research Analyst, Morgan Stanley

Six months out versus-

Chad Robins
CEO, Adaptive Biotech

Yeah

Tejas Savant
Research Analyst, Morgan Stanley

you know, a couple of years out.

Chad Robins
CEO, Adaptive Biotech

Yeah. So, you know, obviously, I'll just state for, you know, those kind of listening in, the advantages of integrating to Epic is workflow implementation. It's just, as a doctor has a terminal sitting in front of him, instead of going off of it and having to go to a portal and log into a special system, it's just in, you have all the prepopulated data, et cetera. So that doctors who's already using ClonoSEQ is going to order more tests.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Secondly, more of the clinicians in that practice-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

will sign on because the ease of ordering, not having to get set up and do a, kind of, separate workflow.

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

-is a big deal. Now, what—the, the number I just referenced, the... What we've seen so far is a 40% volume increase-

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

From some of the... I want to be clear, these are smaller accounts, and you're growing off of a smaller base. I think it's too early to tell.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

What the volume increase will be because of Epic, but we have heard, and we have seen some big numbers from our peers. Again, we're not at this point changing—I mean, this is part of all of the projections that we've put in place in terms of our long-range planning. Epic has already... And Flatiron has been kind of part of that, but what we do say is that it's a de-risking event to be able to support—

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

-that double-digit growth profile that we have next year and into the future.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Quickly on mantle cell recent launch for you, can you talk to us about, you know, the opportunity, and what is the magnitude of the tailwind that you expect over the balance of the year?

Chad Robins
CEO, Adaptive Biotech

Yeah. So, when you say recent launch, we actually aren't promoting it yet. We haven't gotten Medicare coverage. We are expecting to... You never can know with the government and Medicare, but we're hopeful that we get coverage in the second half of this year, and then we'll technically be able to promote the test.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

-and go kind of full board. We are offering it as a test, as a non-covered indication right now. The magnitude of the potential. We look at it really like it's-- there's a lot of comparabilities to the ALL market. You know, it's five percent of the NHL market right now.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

And kind of obviously, we're not promoting it or penetrating now, but it's-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... it's something that I think will be active use among the clinical community, and there's great, great-- some nice new therapeutic options to be able to treat it. We do look at it that we should be able to kind of, over time, be able to achieve kind of a 20% penetration of that, um-

Tejas Savant
Research Analyst, Morgan Stanley

Got it

Chad Robins
CEO, Adaptive Biotech

-of that market.

Tejas Savant
Research Analyst, Morgan Stanley

You guys got IVDR certification recently-

Chad Robins
CEO, Adaptive Biotech

Yeah

Tejas Savant
Research Analyst, Morgan Stanley

-for ClonoSEQ. Can you speak a little bit to, you know, what that means for you in terms of your OUS footprint?

Chad Robins
CEO, Adaptive Biotech

Yeah, I would say it opens up the opportunity.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

-for the OUS footprint.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah, yeah.

Chad Robins
CEO, Adaptive Biotech

Our focus, and it's great, and by the way, it's a, as you know, a requirement, one of which we checked off the box.

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

... early. It really opens up the, when we dedicate additional resources, it makes the ex-US opportunity available. I think there's, as we just talked about from a penetrate, there's a lot of work to be done in the United States right now. The other area that I think is really impactful is with pharma.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Being able to, you know, run pharma trials on a global basis and knowing that you have that certification in place is, is... I don't know if tailwind's the right way, but it's a, it's a nice check the box, you know, for pharma companies as well. I wouldn't-- it's, it's great, great that we have it, great that we're kind of one of the early ones to get it.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

As we continue to grow our business and see opportunities, I do wanna be clear, we do have some international business in terms of technology transfer agreements, where we send kind of a lot of reagents and then have five centers that then take those reagents and create a test out of it, and then we are paid for that bulk of reagents that we sell kind of upfront.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

That is part of, it is a very, it's a small part of our revenue profile.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. I want to switch to pharma. On the, you know, the ODAC approval of MRD as a primary endpoint, I think you were—you talked about being in advanced discussions on three new studies. Have those now converted into bookings? And more importantly, what does the order funnel look like, both in terms of the studies, the new ones, as well as those, you know, upgrading to MRD as a primary endpoint?

Chad Robins
CEO, Adaptive Biotech

Yeah. We've had two existing studies convert from secondary to primary. We're in discussions on an additional three converting from secondary to primary. The ODAC decision has catalyzed—

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... many, many discussions, both in the indication of multiple myeloma, where the decision was made, but also in other indications where pharma companies are having to be thought forward to say, "Eventually, this is gonna come down. We better start thinking about, you know, our indication and being able to add in as a primary endpoint to that." Those are all good. Now, from a financial profile, what it means is, on average, for us, if the milestones that we get as a secondary endpoint are $1 million-$4 million, and as a primary, are $5 million-$9 million.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

It's really a... Just on, on- if you take a mean average, it's a doubling of-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... a doubling of the milestone potential. And then, secondarily, what it means is, if the whole idea of using MRD as a primary endpoint is that therapies can be approved based on the MRD data, which means that you're not having to wait for progression-free or overall survival, which takes a lot longer.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Which means ultimately, that therapies would be approved quicker, and that we'll be able to access those milestones a lot sooner.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

So again, we're not in a position, obviously, yet to talk about next year's guidance and everything else.

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

If you look at milestones, they're becoming, you know, more of a real component. I mean, they have always been a real component, but more of a tangible component of, you know, the pharma business.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Will you include those in your top-line outlook when you do provide it, presumably in January, you know, given the usual uncertainty around, you know—

Chad Robins
CEO, Adaptive Biotech

Yeah

Tejas Savant
Research Analyst, Morgan Stanley

...timelines? And then second, as we think about the revenue ramp, you know, broadly across, you know, from the ODAC sort of uplift, if you will, you know, multiple myeloma trials can take, you know, a long time to enroll and read out. How do you think about this coming through to your top line over the next, say, three years or so?

Chad Robins
CEO, Adaptive Biotech

Yeah. The answer is yes and no. Yes, they will be included as some component of our revenue, but how we do it, we will continue to take a conservative approach to milestones. The reason is, is 'cause we cannot predict timing of when the FDA is gonna approve therapies. What we can do is provide a risk-adjusted number to say... We literally go in and look trial by trial, and we talk to our pharma partners, and we try to understand and predict potential timing, and then we can kind of put some level of probability and risk adjustment on that.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Then kind of add up all those numbers and use that number as, you know, a revenue milestone, revenue associated with milestone payments in 2025. The, you know, there may be some upside to—

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... to the numbers we provided based on, based on that information.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... should things materialize, you know, either quicker or if they all happen, right?

Tejas Savant
Research Analyst, Morgan Stanley

Yeah.

Chad Robins
CEO, Adaptive Biotech

Those are the two kind of factors. It's probability and the associated timing.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Got it.

Chad Robins
CEO, Adaptive Biotech

What was the... Sorry, what was the second question?

Tejas Savant
Research Analyst, Morgan Stanley

No, I think you covered it.

Chad Robins
CEO, Adaptive Biotech

Okay.

Tejas Savant
Research Analyst, Morgan Stanley

On the consortia that you talked about, you know, working with the FDA for use of MRD as a primary endpoint in CLL and DLBCL.

Chad Robins
CEO, Adaptive Biotech

Mm-hmm.

Tejas Savant
Research Analyst, Morgan Stanley

Where do things stand on that effort? Do you expect this to be a tailwind that could materialize over the next year or two, or is it more of a long-term thing?

Chad Robins
CEO, Adaptive Biotech

It's more of a long-term thing.

Tejas Savant
Research Analyst, Morgan Stanley

Okay.

Chad Robins
CEO, Adaptive Biotech

What I will say is I don't think it'll take ten years. I mean, I was mentioning this to some of our investor meetings earlier. I mean, I think the first paper that was written and the group that got together, the International Myeloma Working Group, and this whole consortia around multiple myeloma was 2015 or 2016, so this would take a, take a lo- And there was a... We thought it would be, like, really, really soon. The data made sense.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah.

Chad Robins
CEO, Adaptive Biotech

And it took ten years. I don't think the next DLBCL and CLL... I think there's much more of an acceptance, much more of an understanding of MRD and its use for in pharma trials right now, broadly.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

That time frame would be accelerated, but I, I... It would be foolish of me to come and say that I could predict that the FDA would approve the next one in a year or two.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

I can tell you there's a lot of momentum behind it and a lot of our clinical, you know, partners, and our KOLs are pushing hard and starting to have those conversations. We will know. Let's just continue to keep abreast of the situation. It will not be in our numbers for the next year or two.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. And what about the halo effect from the ODAC vote on the clinical business, Chad? How broad is the evidence of the uplift so far in your physician conversations?

Chad Robins
CEO, Adaptive Biotech

It's... How, how broad is the awareness of it, you mean?

Tejas Savant
Research Analyst, Morgan Stanley

Yeah, or potential... I mean, is it starting to fluctuate?

Chad Robins
CEO, Adaptive Biotech

Yeah, yeah, so I was- Yeah. No, I think what's been great is it's everybo- the awareness is really, really high. Everyone-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... knows about it, and then what it's allowed us to do is, certain, certain clinicians who've been reluctant or haven't really adopted MRD into their practice.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... which really catalyzed a new set of, kind of discussions.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... and opened up a ton of doors for us. You know, also in the community setting, where they're not as up on the newest set of tools, you know, being here, being able to, like, you know, hear on the ODAC decision, has really kind of broadened that awareness. Certainly, certainly getting a nice, a nice tailwind and-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... from that decision. That'll play out over the next several years, you know, as well.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. And then just on the portfolio reprioritizations we're hearing from pharma, what's your take on the latest there? Any impacts to be thinking about versus what's contemplated in your guide on the MRD pharma business?

Chad Robins
CEO, Adaptive Biotech

Yeah, I mean, it's a little bit of a balance. I mean, I think all pharma buzzers are being constrained and they're being asked to do more with less and kind of reduced budgets, et cetera. That's on the negative side. Then on the positive side, you have ODAC and the importance of MRD-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... and the acceleration of, you know, the potential approvals. There's certainly a balance, but look, you look, I mean, it's always, always about balance going in and, you know, fighting for budget dollars, you know. Fortunately, I think, you know, we have a test that is extremely, well-received and, and considered, you know, in a critical, of critical importance to their programs.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Where it may have, it may be some trade-offs in the number of patients or the number of time points that you do per patient, things of that nature.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... because they may have a fixed budget for MRD. They are certainly not seeing them cutting MRD from the program.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Switching to immune medicine.

Chad Robins
CEO, Adaptive Biotech

Yeah.

Tejas Savant
Research Analyst, Morgan Stanley

Maybe, just a bigger picture question first. You know, since the restructuring of the business as a separate reporting segment, have you noticed any sort of improvement in the operating efficiency? How are you thinking about the allocation of resources between, you know, immune medicine and MRD?

Chad Robins
CEO, Adaptive Biotech

Yeah. So the answer is absolutely. I mean, it's just the strategic review and then really the segment reporting. The segment reporting is really a by-product of how we're organizing the company.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... which is we have an immune medicine segment and an MRD segment, and from there, we have resources that are dedicated to each of those businesses.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm. Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

A very, very crisp focus on what programming we're doing in each one of those businesses. For example, like even software, certain laboratory operations, all the way down the line, you've got to dedicate. Then you've got a shared resource layer in G&A, that it... And the allocation to your question is really 70%, 70% to MRD-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... 25% to immune medicine, then 5%, we've got a bucket of corporate unallocated.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

It's really provided, if you think about not only allocation of capital-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... but it's the focus on programming and people being energized about what it is, the goals and catalysts that they're trying to achieve in each one of those businesses.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... which is of critical importance. Last, and I mentioned it, but I'll come back, the financial discipline around it and having kind of understanding how much is being not only allocated, but kind of what the budgets are for each one of those businesses. 'Cause if you look at it, you know, for example, we'll get into immune medicine-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

... but really understanding that even though we're not, even though we're not guiding and we don't think that revenue is a driver of value in that business.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... it is an important, for example, burn offset.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah.

Chad Robins
CEO, Adaptive Biotech

There is revenue being generated that can say, "Hey, this is a truly," if you look at the IM business overall, like, we're not spending that much money for what we think is a potential of very large upside.

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

So that's just from a big picture.

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

-how we think about it and how we characterize it.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Any updates on just when we can expect the next sort of catalyst to occur on the Genentech front in your work on TCR-based cell therapy products there?

Chad Robins
CEO, Adaptive Biotech

Yeah, so I just wanna characterize the Genentech relationship. We're, this year, we've been really focused on the personalized cell therapy.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

It started last year, where we, for 165 patients, we did kind of a full end-to-end characterization of those patients, understanding the T cell receptors that were specifically responders to that patient's, tumor antigen.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

To tumor mutations in that specific patient. And we've characterized into those, those T cell receptors, and then this year it's been really focused on turnaround time.

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

Like, moving from trying to get to a seven- to ten-day turnaround time on, on our part.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

They've done a bunch of work to get... to reduce the turnaround time on their part, too. That's important for two reasons: one is the product profile-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

-to reduce the cost of goods sold. The second is, and I think probably most importantly, you wanna get that infused product, that personalized treatment, back to the patient-

Tejas Savant
Research Analyst, Morgan Stanley

Right

Chad Robins
CEO, Adaptive Biotech

As soon as possible. In terms of timing, we, and I know this is a frustration, but we do not control the timing.

Tejas Savant
Research Analyst, Morgan Stanley

Right.

Chad Robins
CEO, Adaptive Biotech

You know, or the ability to communicate, you know, externally. It is a Genentech, under their control.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

When they announce that, we'll—

Tejas Savant
Research Analyst, Morgan Stanley

Got it.

Chad Robins
CEO, Adaptive Biotech

We'll know. I can tell you that, you know, both companies are extremely excited about, you know, the programs that we're developing.

Tejas Savant
Research Analyst, Morgan Stanley

What about on the autoimmune side? I mean, that's still sort of in your control as far as, you know, the target discovery process for Type 1 diabetes. And same sort of question on MS. What's the latest there?

Chad Robins
CEO, Adaptive Biotech

Yeah. Let me, I'll back up, and then we can talk about-

Tejas Savant
Research Analyst, Morgan Stanley

Yeah

Chad Robins
CEO, Adaptive Biotech

Those, those two and others, 'cause we're... What we're-- Basically, what happens, we are focused in autoimmune for our own programs.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

For autoimmune, what you have is T cells that are attacking self. What we've been good at identifying is that antigenic, antigenic target that those T cells are attacking.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... and the particular T cell receptors that are implicated in that disease. We've kind of a multimodal strategy, where we're going after—we're developing an antibody campaign against both the target and the T cells.

Tejas Savant
Research Analyst, Morgan Stanley

Yeah.

Chad Robins
CEO, Adaptive Biotech

The goal in the two indications you mentioned, multiple sclerosis, T1D, and another, we're looking at three different indications right now in the autoimmune space. We're gonna pick a lead candidate to go to preclinical work next year. We have those immunization campaigns to develop antibodies against those in three different autoimmune disorders right now.

Tejas Savant
Research Analyst, Morgan Stanley

Got it. Just to wrap up, Chad, almost out of time. I want to pick your brains on, what were your key learnings from the strategic review process? I mean, conversations with, with prospective buyers of, of, you know, immune medicine or, or to the extent that you engage in the other side of the business. Following a few more quarters of stabilization, where's your head at in terms of revisiting that process?

Chad Robins
CEO, Adaptive Biotech

Key learnings from the strategic review, the thesis that we had was that, you know, ultimately, having diagnostics and therapeutics companies under one roof is, is challenging.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

We also recognize that it's early in the process, and both businesses have opportunities to—

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... to grow, to grow and to inflect on their value.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

That really having the financial discipline and to be able to focus on that programming is going to be absolutely key.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

-to our success moving forward. And to be able to generate those proof points and to be very, very clear, for each one of those businesses, not only how much you're spending-

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm

Chad Robins
CEO, Adaptive Biotech

... but kind of what the catalysts and milestones are. In terms of revisiting, you know, as a management team, as a board, you know, it's our, it's, you know, it's our job and our fiduciary to continue to look at different opportunities to maximize value of the business.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

Right now, I would say, you know, we're not under a review right now.

Tejas Savant
Research Analyst, Morgan Stanley

Mm-hmm.

Chad Robins
CEO, Adaptive Biotech

We're heads down, operating and executing, as hopefully you can tell by the financial results of the last two quarters, and we've got to focus on continuing to do so.

Tejas Savant
Research Analyst, Morgan Stanley

Perfect. That's great. Thank you so much for spending the time with me, Chad. I appreciate it.

Chad Robins
CEO, Adaptive Biotech

Great to see you, Tejas. Thank you.

Tejas Savant
Research Analyst, Morgan Stanley

Thank you.

Chad Robins
CEO, Adaptive Biotech

Bye-bye.

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