Excuse me. Hey, everybody. If you could just start taking your seats, please, we're gonna get kicked off here in a second. So as you're getting seated, I will just start in with the introduction. First off, thank you all for coming tonight. We really appreciate it, both online and in person. It's great to see such a great turnout, and we're excited about the session we have in front of you. For the next 45 minutes or so, we'll be joined by a distinguished panel and our CEO, Bernard Zovighian, and looking forward to the discussion. Before we get into it and before I introduce Bernard, I want to just flash up the forward-looking statements. Just note that management may be speaking and making some forward-looking statements. They do not undertake any obligation to update them after today.
They're also available on our website, so please take a look there and familiarize yourself with them. I should also mention that we'll be hosting our Q3 earnings event tomorrow. We'll also have another investor event on Thursday afternoon. We hope you can attend both, but for the purpose of tonight, if you could limit your questions to the SAPIEN 3, excuse me, PARTNER 3, five-year data that we presented this morning, that would be great. And so with that, let me introduce our CEO, Bernard Zovighian.
Thank you, Mark. You know, everyone, you know, good evening. It's great to be at TCT. TCT is always, you know, a very important meeting for all of us at Edwards. You know, it is an opportunity for us, you know, to highlight our breakthrough innovation, and you know that as a company, you know, we care, we care so much about, you know, breakthrough innovation. It is also an opportunity for us, you know, to show our commitment to science and evidence. And obviously, you know, also, you know, to meet our strong, you know, physicians, you know, partnership, you know, around the world. So you know us well. We have a very unique innovation strategy with a vision to impact, you know, patient care. And this year at TCT is even more special.
You know, we have three pivotal studies presented between today and Thursday. So, you know, for today's event and tonight's event, you know, let's focus on PARTNER 3. You know, I am, and we are very proud of the PARTNER 3 trial and the data presented, you know, this morning. We are also very proud of the physician partners and our teams who made, you know, this possible. You know, we have two of those physicians with us tonight that need very little introduction. Dr. Marty Leon, Professor of Medicine at Columbia University, Director of Cardiology at NewYork-Presbyterian. Dr. Mike Mack, Medical Director of Cardiac Surgery at Baylor University Medical Center. Both, beyond being physicians, are visionaries in interventional cardiology and surgical structural heart.
Both have played a major role in advancing structural heart innovation and treating tens of thousands of patients over the years. So we are honored to have you, Dr. Leon, Dr. Mike, you know, with us tonight. You know, also on stage, tonight, you know, we have Larry Wood, our Group President of TAVR and Surgical. Larry has been with us, you know, for almost, you know, 40 years. He doesn't like, you know, me to talk about, you know, his 40 years, but it is, you know, it is amazing, you know, to have someone like Larry, who has been part of this, you know, TAVR journey since the beginning. So I am sure you are going to enjoy, you know, this panel tonight. Thank you so much. Larry, back to you.
Thanks, Bernard. It's very kind. You know, this is a great milestone in our TAVR journey. It's certainly not by any stretch the end of the journey, but it's a great milestone because, you know, we did PARTNER 1, we did PARTNER 2, and now we've done PARTNER 3. But this is the first trial where we actually have younger patients, 73-year-old patients, where we actually have an opportunity to collect long-term follow-up on a great much higher percentage of the patients, which I think gives us a really important data set to understand the role of this therapy. And I just can't say enough about how just absolutely blessed I've been to have Dr. Leon and Dr. Mack as partners through this entire journey.
They were people that designed the trials, that worked directly on the statistics, but, I don't think people appreciate, how engaged they are as principal investigators. When we analyze the data set, like the data set that was presented today, they literally go through every single patient narrative for every single event and make sure they understand it, they agree with the adjudications, and that we apply only the highest level of scientific rigor. And it's incredibly, rewarding that the fruit of that effort is, this represents our eighth New England Journal of Medicine publication, which I think is pretty unprecedented for a single technology to drive that many publications in the New England Journal. So that's really a credit to these gentlemen for all the work that they've done and for the dedication they've showed for that.
So, with that, I think we want to open up to questions, and we'll go from there and see where you take us. I think we have mics going your way. Mark, Mark, why don't you decide who gets the question first? Mm-hmm.
Hi, thanks. Matt Miksic from Barclays. So just one question for the investigators, I guess I should say. The Dr. Reardon was talking about a reduced risk level for the Evolut studies based on the exclusions were taken out. Is that an accurate way to think about the baseline of for PARTNER 3, or is the baseline data that we're familiar with, the 1.9 or so to 2.0 risk level is that consistent with sort of post-exclusion treated patients, et cetera?
You want to start, or you want me to start, Marty? I don't know what all that means.
I have absolutely no idea what he's talking about. The reality is that we were part of the patient risk assessment process. We invented the idea of having risk assessment calls to be able to identify patients that would be protocol candidates. This started with the earliest PARTNER experience. The exclusion criteria for the two trials are essentially superimposable. We excluded bicuspids, they excluded bicuspids. If there was excessive calcium in the LVOT, they were generally excluded. If they had severe coronary disease, they were excluded. The STS scores were 1.9. The ages were the same. You could match every one of the baseline characteristics. They are identical.
In fact, four years ago, when we presented this initially, everybody was talking about the fact, the strength of these two studies next to each other were that the populations were the same, therefore, you could aggregate the data. In fact, Eugene Braunwald got up and said that as a panelist in the first presentation. Now, all of a sudden, there's a higher than low risk and a lower than low risk that comes out of I don't know where.
Dr. Leon, maybe just to follow up on that, that we did see a divergence in the surgical outcomes between the two trials. Is there something else that could explain why the surgical arm in PARTNER 3 did so much better than the surgical arm in the Evolut Low Risk Trial?
Well, yeah, I'll tell you, it's the guy next to me, Mike Mack, and he'll tell you what we did in terms of our communication with the surgeons and some of the other factors that were not discussed that we're glad to share with you tonight.
Yeah. So, my initial charge to the surgeons in our trial was, "This is the ball game. We need to pitch a shutout." Everybody pays close attention to every aspect of surgery, but especially true here, in spades. I don't know how to explain the differences in the outcomes between the surgical arms of the trials. If you look at the 30-day mortality, they're virtually the same. That is an operator, operation factor. But what's happened over time is by 4 years, the mortality is double in the Evolut trial than it is in the PARTNER trial. Now, you could say, well, it could be different patient selection, it could be higher-risk patients. But again, as Marty just said, every parameter that we can measure, they appear to be id-
Hey, this is operator. Are you able to hear me?
... that less than 50% of younger patients were getting treated with a TAVR versus a SAVR. I remember this conference last year, a lot of the discussion was around lifetime management, as you just talked about. So what is left to prove now that you have five year data? Is it, do you need 10-year data? Do you need a different valve? Do you need SAPIEN X4? What, what is left to get that from less than 50% to well north of 50% of patients treated with TAVR?
Yeah, well, those are great questions. First, I mean, this study was intended to treat a segment of the low-risk population. So we didn't get into the lower age patients, and that also brings into play bicuspid disease. So if we really want to expand the TAVR market, it's going to be for the current indication of severe symptomatic AS in younger patients and with bicuspid disease. And that may require, not may, should require more evidence. In the younger patients, we need more durability data. Now, that durability data, you know, pick a number. I think, you know, certainly 10-year data is going to give us a great deal of confidence. I'm sure we'll look at the data before then.
No, I don't think we're going to report it every year because I don't think that makes any sense, but I do think that we'll choose strategic time points, pre-specify them, and if we have 7- and 10-year data, I think, you know, at that point, we'll feel reasonably confident about what we can say about durability, and that will affect treating younger patients, which I think is very important.
I think it's also important to talk about durability, and Mack, you feel free to weigh in on this. When I worked, you know, grew up in our surgical valve space, the way we measured durability was freedom from explant due to structural valve deterioration. So if a patient had a valve that was not functioning well, but they died before they had their valve replaced, that wasn't counted against the valve for being durable. The criteria that's being applied in our trial is the BARC-3 definitions for bioprosthetic valve failure and bioprosthetic valve dysfunction, which is a much more sensitive methodology than looking at just freedom from explant. I don't know. Do you want to comment on that, Mack, the differences?
Yeah. So, you know what I'd add to it is what we do know from the surgical experience is that the younger you are, the less durable your valve is due to the immune processes or calcification processes. But valves don't last as long in younger patients as they do in older patients. The second part of this is the other thing that we're going to learn on top of this is the management of patients at the time they need their second valve. Because the younger you are, you're going to need a second valve at some point in time. And Marty and I just hosted as part of the Heart Valve Collaboratory, a whole seminar on management of when the first valve fails. What do you do?
And the more valves we begin you know, see failing as patients get 8 , 10, 12 years out, be it surgery or whatever, we're going to be that's the learning that we're going to have about knowing how to manage these patients long term. Who gets surgery first? Who gets TAVR first? Is your second procedure a valve-in- valve? Is your second procedure TAVR, explant, surgery, et cetera? These are the challenges that we're going to begin to be seeing.
Hi, Josh Jennings from TD Cowen. I just wanted to follow up on your answer there, Dr. Mack, and maybe you could just review for us the TAVR-in- TAVR optionality and the benefits of SAPIEN 3 or SAPIEN 3 Ultra, potentially SAPIEN 4 as the first valve selection and limitations from some of the other competitive platforms in TAVR-in- TAVR optionality.
Yeah, I think it is a—it's a work in progress that we're just beginning to learn what platforms. You know, do you put a self-expanding in a balloon expandable? Do you put a balloon expandable in a self-expanding? Do you put a balloon expandable in a balloon expandable and vice versa? The permutations are almost infinite here. There's a surgeon named Vinayak Bapat that's just come up with an app that's going to help guide us through the field here. So I think it's still too young and still too early in experience to be able to make some definitive statements, but it's going to be a robust area of investigation in the next few years. Marty, do you want to add anything there?
I think the only thing I'd add is that if durability wasn't a factor, if the durability were equal among two different TAVR system, having a short-frame device with open cells, with easy coronary access that is intra-annular, I think will have advantages in younger patients that may need a second procedure. If you put a long-frame device that covers the coronaries, it's going to be difficult to access those coronaries. If you put a long-frame device that is supra-annular and has long leaflets, then you're going to have issues in terms of being able to do valve-in-valve and protect the coronaries. So if you're really talking about the low-risk, younger patients, then I think the genre of TAVR system should be shorter and designed to allow you to be able to do another procedure.
I think as we think about lifetime management strategically, the way that I think about it is no patient, every patient should have zero to one sternotomies, and that means your first valve, whether it's TAVR or SAVR, has to contemplate that next procedure. And, you know, we've seen bad examples where the first valve was a surgical choice, but it wasn't a good surgical choice for an eventual valve-in-valve procedure. And we need to be thinking not just of the first procedure that you're doing, we need to be thinking about what that second procedure looks like and make sure that first procedure facilitates that second procedure.
Hey, Mike Pollock from Wolfe Research. On the topic of lifetime management, it's early days, but lithotripsy is being explored for valvular disorders. Can you comment on kind of what level of promise you see in that technique and how you might anticipate way down the road it playing a role in clinical practice?
Well, maybe I'm being very short-sighted here, but I don't see much of a role for it at all in lifetime management. Do you feel differently?
No, I don't. I don't. I mean, we've tried this before. It's not new. We've got some new versions of new devices, but manipulating the native valve in order to improve flexibility to prolong its lifespan, I think is going to be very problematic. And, I, you know, I think that, it's an interesting concept, but I don't really, you know, believe that it's going to bear importantly in, you know, in the kind of management discussions that we're talking about.
So, Larry Biegelsen through Wells Fargo. So two questions. One, why not show the data annually? Medtronic is saying they're going to show it annually, you know, the PARTNER, PARTNER 3.
Can I answer that first?
Sure, please.
So we've had 10,000 patients in the PARTNER trials. We published eight manuscripts in the New England Journal of Medicine and three in The Lancet. We've done five randomized trials. We have never shown the data annually. We show it at the primary endpoint, which has been one or two years. We show it maybe one year after to see if there are any trends, then we pre-specify a long-term follow-up, which has been typically five years, and we published five-year data in every other trial. The random noise that occurs between one year and two years and three years is a cut above nonsense, especially when you get out later, when all kinds of other factors influence your endpoints. So all-cause mortality. It's going to be hard to look at all-cause mortality at 10 years.
Do you recall what the all-cause mortality was in the NOTION Trial at 10 years?
You said it today. I don't know, 30, 40-
60%. 60% that is now being recharacterized as a low-risk study, 30% mortality at five years. There's so much non-cardiovascular comorbidity confusion when you deal with all-cause mortality as you get further on, in a follow-up trial that, you know, we prefer to pre-specify, do it at strategic times, collect the best data, analyze it aggressively, get it published in the best journals to give us what we think are the proper answers. This every year reporting. Have you ever seen a coronary DES trial reported every year?
No, but morning late breakers for TCT, come on.
So, if we had published at three and four years, what do you think the chances are the New England Journal would have accepted the five-year paper today? They would have yawned.
Where was the four-year paper published?
It was a letter to the editor in JACC.
It was a letter in JACC, 800 words.
All right, fair enough. So for my real question-
Next question, Larry.
That was supposed to be an easy one. That was supposed to be the short answer.
Is that why we should reduce these academic efforts to?
So, so let's think ahead. We're going to be at ACC next year. We're going to see the SMART trial. Medtronic is saying better hemodynamics. We're going to see the benefit in these small annulus patients. Predict what we're going to see, you know, then.
All I can say is we did look at valve size, we did look at annulus size. We did not see any effect on the five-year outcomes in this study, either for the all-cause mortality endpoint or for the triple composite endpoint that was the primary endpoint. In fact, we saw a reverse trend. We saw in the smaller valves, the results were actually numerically a little bit better. So I don't know how to predict the SMART trial. I think we need to see what the results are, and then we'll respond to it.
Suraj Kalia, Oppenheimer. Dr. Mack, a question for you, two-part. Not to belabor this because the surgical arm threw a wrench, at least comparatively, between the two. I want to follow up on what Chris also said earlier. So what was the percent site overlap in the SAVR arm for P3 versus Evolut? Just kind of curious what experience level was the sites.
Site overlap?
Yeah, of what kind-- You know.
Sites participating in both studies?
There are no-
Yeah.
There are no sites.
Participating.
There are no sites participating-
Zero
in both studies.
Zero.
You had to do one or the other.
In terms of Evolut, I believe they said 23% of patients were less than 70 years of age. So theoretically, the survival should be better, but the surgical arm showed higher mortality. So I'm curious if you could help reconcile that, you know, and what you also saw in the P3 study at the five-year mark also.
Do you remember what percent in our study were under 70 years old? I think it was 9% or something.
9%. Yep.
Yeah. So they had more younger patients. You would expect, you know, the survival to be better. And we had 9% under 65, they had 23%. So it's counterintuitive, you know, kind of what happened here, and again, I can't explain it, and I don't feel I should have to explain it. I think the burden should be on them to explain it.
And remember, the four-- I'm sorry, Mike. The four-year outcomes on all-cause mortality were 20% lower in the SAPIEN 3 data than in the Evolut data, the absolute numbers. So when you talk to a patient, you talk absolute numbers. Frankly, I, I, you know, I like the way we framed the first conclusion. Really, what matters to patients is cardiovascular mortality, because you can, you can die for a lot of reasons, but it's cardiovascular mortality. We don't use that as a primary endpoint because it would cost these guys too much money, and we'd have to, you know, double the sample size of all of our trials.
Very inexpensive to do it this way.
The cardiovascular mortality was 5% at five years. That's a 1% per year cardiovascular mortality associated with this device in this trial and a 1% per year stroke rate. You know, and I don't know what to say. And the reintervention rate being 2% and the bioprosthetic valve failure rate being 3%? These are data that, frankly, when we started this process, we wouldn't have dreamed of. So to try to feel like we should be apologetic for those kinds of results. And by the way, surgery is really a good therapy for these patients. The most difficult project I ever had to undertake was to be able to say that we were going to treat and attempt to compare the best surgical, cardiac surgical procedure, which is replacing the aortic valve in low-risk patients against TAVR.
That was never in our minds in the beginning. The fact that we were able to accomplish that and demonstrate these kinds of results, I think, you know, we should be celebrating for the field and not nitpicking about market share.
I think that should be the headline, honestly, that 90% of the patients that are in this trial, regardless of which arm they went into, were alive at five years. 90%, all-cause mortality. And that is a pretty spectacular outcome, and you're talking about 73-year-old patients.
So two questions for the doctors. What do you do with this data when you go back to talking with your patients? What is your takeaway? And I think there are some investors with the view that most low-risk patients have already had their TAVR or maybe their SAVR. Can you try and quantify, maybe in your practices or what you're aware of, who's on the sidelines? And then for Larry, Medtronic is going to have a lot of fun marketing this. What are you telling your salespeople, and what are you going to do with this data? Thank you.
Well, what do we tell the patients? I think the message has got to be a simple one that they can understand, and Mike has already shared some of that. We tell our patients that, you know, if they're a lower-risk patient and they receive-- and, you know, and we decide together that that would be a better choice for them to get TAVR, the expectations based upon this trial is that they have greater than a 7 in 10 chance of having fewer no symptoms than being alive at five years. They've got more than an 85% chance of being alive with a durable valve and about a 1% per year chance for cardiovascular mortality.
That is as good as what we've ever seen from any surgical trial in a comparable population and should give them some confidence in believing that this less invasive therapy may be a meaningful alternative to surgery.
With- With the caveats that we don't have 10-year data and, you know, but that's the major limitation right now.
I think that, you know, you tell patients we have two great options here.
Mm.
And, and you let them make the decision, but you help them inform them how to make the decision. So the default is going to be patients, understandably, will always take—usually take the less invasive option. You know, they don't have to have a general anesthetic, don't have to be on the heart-lung machine, and go home the next day. However, there are some patients that are still better served by surgery, and our job is to educate those patients why TAVR may not be the best option for them. So some of those reasons are a heavily calcified valves with low-lying coronary arteries, in which-
... TAVR is the more risky procedure. So rather than looking at surgical risk, you look at TAVR risk. Heavy calcification in the left ventricular outflow tract, some type, some types of bicuspid aortic valves that have a calcified median raphe and possibly a dilated ascending aorta. Concomitant coronary disease that's but best treated with CABG, concomitant valvular disease like mitral or tricuspid regurgitation. So you, you, you factor in all these other factors that help steer you. Is there a reason, one way or the other, to go with surgery or TAVR? Larry, how are you going to market this?
Yeah, you know. So glad I invited you guys. The number one thing is that we're so proud of our data. We're so proud of the performance of our platform and how well that it's done. I think to be able to tell patients that if you're a low-risk patient, there's absolutely no difference right now between having surgery and having TAVR, anatomical considerations aside, as Mack points out appropriately, there's absolutely no difference in outcomes at five years. I think it's a very powerful thing to tell a patient when they're trying to make a decision of whether having surgery or TAVR in their low 70s. So I think that's the most important thing we need to communicate.
I think when I think more broadly about the field, though, I do point to the field continues to generate powerful evidence that says TAVR is a spectacular therapy for patients. And, you know, to get into a share battle and make that the focus of, of our marketing efforts, our energy, or our patient activation efforts, when we only treat 12 out of 100 patients with severe symptomatic aortic stenosis, I don't think is the right use of our time. So I think more than anything, we want to make sure that referrers and patients and their families and caregivers know that this is a proven, safe therapy, that we now have five-year data published in the New England Journal of Medicine that says it's equivalent to a much more invasive surgical procedure. And, and that's, that's our message that we lead with.
We've got about eight minutes left, so there's time for two more questions. Marie?
Yeah. Thank you. Marie Thibault, BTIG. Thanks for hosting this panel. After you said that, Larry, I really hate to drag it back to kind of a myopic view of market share, but I was very intrigued by the, you know, post-COVID. You know, 75% of deaths and strokes were on the TAVR arm and possibly some speculation about protective, you know, functions of anticoagulation in the SAVR arm. Any idea why we didn't see that in the Evolut trial? I understand it's not your trial, but I'd just like to hear your thoughts.
I wish I could answer that. I know we looked very, very hard, and the endpoints were defined by a consensus document that we coauthored, and it was a very exhaustive process. I really can't explain. When you look at the data from the CT substudies, they had the same frequency of subclinical leaflet thickening and thrombosis that was seen with the SAPIEN valve s o I can't explain why, honestly. But to follow up on Mike's point, I think that the default likely will be that patients who are good candidates for TAVR would choose that as the preferred therapy, irrespective of their risk status. But there are going to be some surgical, excuse me, anatomic reasons why surgery would be better.
It takes a really good discussion with the patient to understand and to be able to lead them in the right direction if TAVR is not an optimal choice. And by the way, we have a lot more data coming. I mean, there were six presentations today. These will all find their way into important manuscripts, we hope, over the next several months. We can look forward next year to data being generated on two important clinical trials. The first moderate AS trial, UNLOAD. It's a small study, but extremely important, and the EARLY TAVR Trial at some point next year. Enrolling very aggressively in the PROGRESS Trial. So we're still pushing the envelope in terms of how we can treat aortic stenosis preemptively with transcatheter techniques, and I think there'll be a lot more data to talk about.
Thanks. Chris Pasquale from Nephron again. Appreciate you taking another question. Dr. Leon, the ALIGN- AR data today seemed to strike a chord with you. Curious, that felt like the start of maybe a new therapeutic category with dedicated devices for regurgitation. Just some quick thoughts there, and then, Larry, how do you think about that as an opportunity going forward?
Yeah, that's a major shift in gears. I mean, AR is a different disease, obviously, and we do need and we needed a dedicated valve, and it looks like the JenaValve is going to serve that purpose. I think the results were, you know, very robust. Now, it was a registry, not a randomized trial. It'll simply create a crack in the door to be able to get into the space, and it's going to require a lot more data, a lot more iteration of the device platform to really get into the broad scheme of AR treatment. And by the way, surgery is pretty good for AR as well. So I think the next studies are going to have to be large, randomized trials to demonstrate that they can achieve results that are equivalent to either surgical repair or replacement for AR.
Yeah, I think it's interesting. If we go back in sort of the pre-TAVR world, there wasn't near as much surgery done for aortic regurgitation. And what's interesting is, as TAVR has taken off and a lot of the isolated AS patients have gone over to TAVR, I think surgeons have backfilled that void by being more aggressive in their treatment of AR. And I think we see that in the makeup of surgical cases today. So I think it is a growing field. There have been quite a number of cases done with SAPIEN, where people have done it in cases with pure AI or with mixed disease. But we haven't studied it in a systematic way to really understand how our platform could play a role or what patients we could optimally treat.
And it all starts with, you know, where does our platform work well and, and what patients can it help? Having a dedicated platform for, for AR is a different challenge than if our current platform would work for AR. But with the skirt that we have on the Ultra Valve now, I think, and some of the work we're doing on X4 with the variable sizing, I think it probably does open the door for us to consider looking at AR with our current platform. But we haven't really gone down that road yet. We haven't really spent a lot of time other than just hypothesizing at this point.
On AR. So Peter has promised me it's one question. It's very quick, he says. So two minutes.
Pito Chickering, Deutsche Bank. So following up actually on Joanne's question, looking at today's, you know, late breakers with a commercial outlook, you know, looking at the spread between, you know, Evolut and SAVR and mortality and SAPIEN and SAVR mortality, I understand there's a big difference between outcomes between the baseline and SAVR data, makes it hard to compare. But if Medtronic reps are showing this data to docs on why they should choose Evolut, what's the best counter on why a doctor should keep using SAPIEN?
I'll start, and I'll let the physicians finish. I think it's a little bit of a misnomer to say that the rep goes in and... I've never been in a case for all the years I've been doing this, and I've been standing there and they're getting ready to do a SAPIEN 3 case, and then somebody comes in, and they said, "Have you seen this latest brochure from a competitor?" And Marty says, "Oh, my God, I can't believe that. Let me switch." That's just not quite how the field works. And I think once a physician uses 100 of your devices and they use 100 of the competitor devices, I think their own experience becomes a very powerful determinant of what their choice is gonna be.
Clearly, data, you know, if there was a huge durability signal with one platform versus another, there was something like that, then that would obviously play a role because those would be things that, that aren't solved in the acute setting. But I think the fact that both valves platforms have shown to be incredibly durable at this time point, I think it is gonna come down to usability and other features and what systems people are comfortable with and what their own personal experience has been. And I think that's what, what drives usage, and, and, you know, that's, that's my opinion on it.
Yeah, no, I tend to agree. I think the beauty of TAVR, in particular, the balloon expandable platform, is the fact that it is teachable, it's trainable, it's generalizable, has a lot of versatility in terms of being able to treat a whole variety of different situations, anatomic and otherwise. And I think that that's a feature that physicians really respond to. So, I don't think that these two data sets, other than providing confidence that we can treat low-risk patients with a higher likelihood of predictability in terms of future outcomes, I don't think these two trials should indicate that there should be a preference for one versus the other.
And the only thing I'd add to that is, yeah, I agree that it adds more confidence to the field in general. I don't see this data affecting market share at all. I think, you know, both platforms are pretty mature. People are gonna use what they're gonna use. There are some nuances on the edges that one may be better than another, but I don't see this data shifting market share.
All right, everybody. On that note, thank you all once again for coming. We really appreciate it. A special thank you to Dr. Mack and Dr. Leon. Really appreciate your time. Thank you.