Greetings. Welcome to the Immunocore 2022 financial results and business update call. At this time, all participants are in a listen only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note this conference is being recorded. I will now turn the conference over to your host, Clayton Robertson, Head of Investor Relations. Thank you. You may begin.
Thank you, Daryl. Welcome to our Q4 and 2022 financial results call. Before we begin, I would like to remind you that this call will contain forward-looking statements within the meaning of the safe harbor provision under the Private Securities Litigation Reform Act of 1995. These include expectations and plans concerning future events, prospects and performance, including with respect to commercialization, clinical development and trials, regulatory approvals and financial results. Actual events may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those disclosed in our filings with the SEC. Such statements represent our views only as of the date of this webcast, and should not be relied upon as representing our views as of any subsequent date. We specifically disclaim any obligations to update such statements. I'm now pleased to introduce Immunocore's CEO, Dr. Bahija Jallal.
Thank you, Clay. Good morning and good afternoon, everyone. We're very happy to share an overview of our 2022 performance. With me today are Ralph Torbay, our Head of Commercial, Brian Di Donato, our Chief Financial Officer and Head of Strategy, and David Berman, our Head of Research and Development, who will be happy to take questions at the end. 2022 was a momentous year, one that established Immunocore as the leader in TCR therapeutics. It is not every day that a company can achieve a first, which makes it even more meaningful to have delivered 3 firsts with the launch of KIMMTRAK. We will not stop there. We will stay true to our mission to radically improve outcomes for patients with cancer, infectious disease and autoimmune conditions, and we're never satisfied with incremental benefit.
I'm extremely proud of how our teams have advanced this mission in 2022. Let's take a look at the highlights from 2022. KIMMTRAK is the first and only approved treatment for unresectable or metastatic uveal melanoma. It is now approved in more than 30 countries, and we have treated more than 500 patients since the end of phase III trial with KIMMTRAK. We have revenues of just over $140 million with 25% quarter-over-quarter growth. For a biotech of our size, what the team has achieved is amazing. Ralph will provide you with more details about our launch performance as well as our plans to launch in more countries and make KIMMTRAK available to even more patients.
Our research and development teams, having successfully passed the baton for KIMMTRAK to the commercial and medical teams, have delivered substantial progress with our pipeline. Starting with tebentafusp, we are screening patients with advanced melanoma in phase II/III trial. We presented initial data with our ImmTAC therapy targeting PRAME-A02 at ESMO, showing 3 things: RECIST responses, reduction in circulating tumor DNA across multiple solid tumors, and most importantly, durability of response. Our focus now is increasing the trial footprint for the PRAME-A02 phase I/II trial across multiple tumor types, as well as in combination with standards of care. In addition, we have announced 3 new candidates in our pipeline. The first to expand our PRAME franchise with ImmTAC therapies targeting PRAME-A24 and PRAME-A02 half-life extended. The third one is an exciting one. It's a first in class novel immunotherapy targeting PIWIL1.
PIWIL1 has a potential for patients with colorectal cancer and other GI tumors which are so far insensitive to checkpoint inhibitors. Confirming further the potential of our ImmTACs platform, we presented the first safety and pharmacodynamic activity with our ImmTACs in HIV just last week at CROI. With these HIV candidates and our HBV therapy we presented data last year, our aim is to evaluate their potential as a functional cure. As you can see, we had a very busy and productive 2022. We are well placed to deliver these ambitious goals with our projected financial runway taking us into 2026. I will now hand it over to Ralph.
Thank you, Bahija. I'm delighted to be here today to provide you with an update on what was a very successful launch here. With approvals in over 30 countries and the launches of KIMMTRAK, we have strongly delivered against the promise of radically improving outcomes for patients living with metastatic uveal melanoma. This has been recognized with KIMMTRAK's inclusion into the ASCO and NCCN guidelines.
Recommending it as a standard of care for patients with MUM, through the prestigious Innovative Therapy Award from The Galien Foundation in France and the Best New Drug Award from Scrip. Our teams have executed flawlessly, launching KIMMTRAK just days after approval, achieving reimbursement in the U.S., Germany, and France, transitioning all EAP patients to commercial supply within weeks, importantly, establishing KIMMTRAK as the most prescribed medicine for HLA-A*02:01 positive metastatic uveal melanoma patients across all countries that we've launched in. In 2022, we recognized $141 million in net sales of KIMMTRAK, primarily in three major countries. Our Q4 net sales of $51 million represents approximately a 25% quarter-over-quarter growth. This was driven by strong demand in the U.S., including a one-time increase in year-end stocking at our specialty distributors and single-digit demand growth in Germany and France.
Let's now look at our progress in the U.S. and what to expect moving forward. The outstanding execution by our U.S. team delivered KIMMTRAK to 240 new accounts in 2022. We believe these capture approximately 50% of the patient potential. We plan to continue increasing the number of new accounts, especially in the community. Our focus on enabling first-line patients, we close the year with 60% of KIMMTRAK share in first line. Being treated closer to home is important for patients and the future of our therapy. At the end of 2022, one out of two patients were being treated in the community. I'm pleased to see the efficacy and tolerability of KIMMTRAK reported in our phase III clinical trial playing out in the real-world setting.
While it remains early to confirm the average duration of therapy, our commercial persistence models indicate that KIMMTRAK's duration of therapy is tracking to a mean of around nine months, which is broadly in line with our expectations. From an access perspective, our teams have done a tremendous job in securing formal policy coverage for over 90% of all potential patients in the U.S. Last year, we saw 99% of prescriptions covered. We continue to work hard towards our goal of supporting access for every single patient who needs KIMMTRAK through our KIMMTRAK CONNECT program. Let's move on to Europe, where we've had a fantastic launch as well. With over 100 accounts treating patients with KIMMTRAK across Germany and France, we are capturing nearly all potential patients with MUM in these key markets.
The European team are dedicating their efforts to increasing patients treated with KIMMTRAK in first line by working to expand our treatment footprint into office-based physicians in Germany and with dermatologists in France. The clinical value of KIMMTRAK has been recognized in Germany by the G-BA with a considerable added benefit rating. This is particularly important as KIMMTRAK becomes one of only three orphan oncology products in the last 10 years to have received this strong rating, which will support our ongoing price negotiations. We expect to reach a negotiated price by the first half of the year. This negotiated price will apply retroactively, and we have started accruing for this potential discount in our German net sales as of November 2022. In France, we have received an ASMR rating of three and an SMR benefit of important.
With no restrictions and no relevant clinical comparators, this strong rating will enable us to begin pricing negotiations in the second half of 2023, with an agreement expected in the first half of 2024. 2022 was certainly a historic year for patients with MUM and for Immunocore. One year ago, we began delivering the amazing innovation that is KIMMTRAK to patients. Today, we have successfully launched in three countries, radically improved outcomes for more than 300 patients, and our early access program has benefited over 500 patients globally. Looking ahead, we expect to launch KIMMTRAK in one major European country around mid-year and in up to five additional countries by year-end. Across countries where reimbursement is not yet available, we continue to offer KIMMTRAK to nearly 200 patients through the EAP.
We remain focused on our ambition of making KIMMTRAK available to over 1,000 patients by 2025. With that, I wanna thank the team for an excellent 2022, thank you for your support, and I invite Brian to take you through our financial results.
Thank you, Ralph. Today, we will focus on the financial highlights in the fourth quarter and year-end 2022 and provide some insights into 2023. Please refer to the press release we issued this morning and our SEC filing on Form 20-F later today for our full financial results. Comparisons discussed are versus third quarter 2022 using U.S. dollar communion rates, convenience rates unless otherwise stated. On slide 14, you see a summary of our financial results. I'm excited to report that our teams continue to execute and to deliver KIMMTRAK to patients in the United States, Germany, and France with impressive site expansion and seamless reimbursement, while continuing to expand our global early access program in new countries, currently treating nearly 200 patients.
In Q4, we increased bio sales in both the U.S. and Europe. Total fourth quarter net revenue, as Ralph mentioned, was $51.1 million when converted to U.S. dollars, an increase of 25% over Q3. In the U.S., we saw a 50% increase in Q4 net sales, in part due to some one-time year-end stocking and a year-end adjustment of gross to net, which reduced 340B and Medicaid assumptions. In Europe, even with an increase in vial sales, net revenues decreased to $12.2 million due to new reimbursement accruals for Germany, which started on November first and will continue until final pricing agreement expected in Q2. On the expense side, SG&A increased to $52.1 million in Q4, partly due to a currency loss of $15 million on U.S. dollar reserves when it's translated back to great British pounds.
R&D expenses for the quarter increased to $32.8 million and are expected to marginally increase throughout 2023 as we expand and accelerate our clinical port development portfolio. The company is capitalized with over $400 million in cash and cash equivalents at year-end. This provides a runway into 2026 with the converted current development plans, including our new ImmTAC portfolio candidates. Ralph has shared with you some of the key drivers for KIMMTRAK looking ahead. It summarizes some of these insights as we head into 2023. A key dynamic will be formal reimbursement agreement in Germany and France, as well as the expected launch of commercial KIMMTRAK in one additional major European country by mid-year and an expected 5 additional new countries by year-end.
In the U.S., one opportunity for growth is new community oncology accounts, which tend to be lower density than academic centers, which may lead to lower U.S. growth rates as we move into 2023. Globally, it's still too early to know real-world duration of treatment. However, currently, we are approaching the 9 months as observed in the clinical trials. Another consideration in the U.S. is the 2021 Refund Act. The act requires drug manufacturers to rebate CMS for discarded drug amounts. Starting in Q4 2023, CMS may request a rebate of a portion of our CMS sales for KIMMTRAK. We plan to seek an exemption from CMS as we follow FDA and USP guidance regarding required fill to ensure patients safely and consistently receive 68 micrograms of KIMMTRAK.
Given the number of moving revenue targets in 2023, it is still too early to accurately provide sales guidance for the year. The team and I are extremely pleased with the commercial team's execution in bringing KIMMTRAK to patients globally. We look forward to continuing to help and support patients with metastatic uveal melanoma. I will now turn the call over to David, who will review our portfolio updates. David?
Thank you very much, Brian. We are very proud to have brought KIMMTRAK as the first approved medicine for metastatic uveal melanoma. gp100, which is the target of KIMMTRAK, is also expressed in other melanoma types, including cutaneous melanoma. All of the efficacy signals we observed in early trials for tebentafusp in MUM are also replicated in cutaneous melanoma. This gives us confidence to initiate a registrational program in previously treated cutaneous melanoma with a survival endpoint. The study is now screening patients, and we estimate the opportunity in this indication is 2 to 4 times the size of uveal melanoma. gp100 is a melanoma-specific target. With PRAME, we have the opportunity to go to other solid tumors. Based on the strength of the phase I data, we have invested in building a franchise around this target.
The lead program, F106C, targets a PRAME peptide presented by HLA-A*02. At ESMO last year, we showed that F106C induced durable PRs in uveal melanoma, cutaneous melanoma, and ovarian carcinoma. Our focus now is to expand the trial footprint globally and enroll 4 monotherapy expansions as well as combinations. We expect to have efficacy data by the first half of 2024. In January, we announced that we will be bringing two new PRAME ImmTACs to IND in the next 18 months. P119C targets a PRAME peptide presented by HLA-A24, this will expand the potential addressable population by 30%. In Japan alone, for example, 60% of patients are positive for HLA-A24. P115C targets the same HLA-A*02 peptide as the lead program but has an extended half-life.
We know that our current platform with a standard half-life is very active, with durable PRs in multiple solid tumors and for tebentafusp, a dramatic survival benefit. Nevertheless, given our enthusiasm for PRAME, we are also investing in an HLA version which could enhance patient convenience. Our discovery engine has a pipeline of unique targets where we will push the boundaries of using TCRs to unlock solid tumors. Here, I'm delighted to present a novel TCR target called PIWIL1. PIWIL1 has several features reminiscent of PRAME, one of which is that it's a negative prognostic marker, suggesting it has an important role in tumor progression. PIWIL1 has broad homogenous expression in about a quarter of colorectal cancer patients. NCRC historically has been insensitive to checkpoints reminiscent of uveal melanoma.
We believe the addressable population is 35,000 patients per year. An IND is planned for fourth quarter of this year. T cells scan for cancer, but they also scan for virally infected cells. Therefore, it was logical to apply our technology to attempt functional cure in HBV and HIV. Both have viral reservoirs where current therapy cannot remove or eliminate the residual virus. The goal of our TCR bispecifics are to eliminate these reservoirs. One one three B, our HIV ImmTAV, is potent at killing HIV-infected CD4 T cells and works by recruiting the cytotoxic CD8 T cell to punch holes in the infected T cell. We opened a single ascending dose portion of the HIV trial last year and have had very strong enthusiasm in enrollment of people living with HIV who are stable on antiretroviral therapy.
The primary objective was safety and to identify a dose for the multiple ascending dose portion. We identified 15 micrograms as a dose that was well-tolerated with no clinical cytokine release syndrome, but induced IL-6 in the blood. We have found in our oncology programs that IL-6 is a sensitive downstream biomarker of T cell engagement and redirection. This consistency from oncology to infectious disease is striking to us and provides reason to move to the MAD. We have now opened the MAD portion, where participants living with HIV will receive three months of IMC-M113V on top of antiretroviral therapy.
The primary endpoint is safety and to determine a phase II dose. We are very keen to also look at antiviral activity, including stopping the IMC-M113V and the antiretroviral treatment after three months to see if we can affect, slow, or decrease the kinetics and magnitude of HIV viral rebound. We believe this trial should provide early POC for a functional cure. I'll now hand back to Bahija.
Thank you, David, Brian, and thank you, Ralph. As you have heard, 2022 was an amazing and transformative year for the company. We have definitely written the next chapter in oncology treatment as we pioneered and now launched KIMMTRAK. This pipeline reflects the large potential that our ImmTAC platform can offer to patients across many cancer types, and as you just heard, also infectious diseases. Given the breadth and depth of our pipeline, we need to continually prioritize our portfolio candidates. You'll note that we have removed our ImmTAC candidate targeting MAGE-A4. We have opted out of our co-funding agreement with Genentech given our focus on PRAME. In the collaboration, we are eligible to receive development of commercial milestones if Genentech advances the MAGE-A4 therapies. This is a robust pipeline based on which we will continue building Immunocore as the growing leader in TCR therapeutics.
Officially, Immunocore is now a commercial stage biotech company. I'm very proud to report such revenues for Q4 and 2022 and a cash runway into 2026 that will allow us to continue delivering against our commitments as we have done to date. Our performance is even more significant in the context of what has been another challenging year for the biotech sector. As we wrap up our remarks, I'm excited for the year ahead. If 2022 was a transformative year, 2023 will be a year expanding on those successes. Our priorities are clear. We are focused on launching and growing KIMMTRAK and enrolling the cutaneous melanoma trial. For our PRAME program, we are investing in increasing the site footprint and enrolling patients in multiple tumor types as well as in combination with standards of care.
We are also expanding the PRAME franchise with an eye towards multiple INDs in the next 18 months. In oncology, we plan to file an IND for our first-in-class therapy targeting PIWIL1 later this year. In infectious disease, we have finished a single ascending dose portion of the HIV trial and started the multiple ascending dose part to identify safety and also antiviral activity that could lead to a functional cure. Along the way, we will continue to focus on cost and cash discipline the way we have been every step of the way. As we enter 2023, we do so with same drive, determination, and sense of urgency to radically improve outcomes for patients. For that, I wanna thank every single employee at Immunocore.
I wanna thank you as our investors and shareholders for your support, but most importantly, I wanna thank our patients and their families. Now, be happy with the team to take your questions, and we'll open the call for questions. Thank you.
Thank you. We will now be conducting the question and answer session. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment please while we poll for your question. Our first question comes from the line of Michael Yee with Jefferies. Please proceed with your question.
Hey, guys. Good morning, and thanks for the update, and congrats on a good year. Hey, on two questions. On the KIMMTRAK sales in U.S., there was a very strong number there, then you mentioned that there were some one-time positive ImmTACs like gross to net and also some inventory. Could you just help us understand what the underlying number of demand there was in the fourth quarter so that could help us get a good run rate going into 2023? Describe what you think the growth rate looks like throughout 2023 for the U.S. Then a question on PRAME maybe for David. I know you're enrolling the phase II or phase I-B expansion cohorts.
Can you talk to us a little bit about how you think about the bar for lung cancer and the expectations for lung cancer given what you've seen previously, and just help right size us for what is good lung cancer data? Thanks.
Great. Thank you, Michael. Great questions. Brian, you'll take the first one, and then David.
Yeah. Michael, some more specifics around those two increases in Q4. Together, they're about $5 million that we saw for increase in stocking and a reduction of gross to net, mostly 340B assumptions that we used. We're probably a little bit conservative. About $5 million. U.S., instead of being $38 million, was probably around $33 million in real end demand. That's probably a pretty good number as we move into Q1 for benchmarking. As we mentioned, as we have saturated or have now penetrated most of the academic centers and we're moving to community growth, you should expect growth to be slower in 2023, in the U.S. The other dynamic is we'll have another month of German discount for Q1 versus versus Q4.
That'll reduce it a little bit more as well from a benchmark perspective.
Yeah. Michael, I guess I would answer it in two ways. The first is that, you know, lung is a very complex tumor, so we need to study different populations. For example, the EGFR/ALK mutation is historically IO insensitive. Of course, we're studying patients now who've also failed on checkpoint. There's that lung complexity we need to take into account. In terms of expectations of what we're looking for, I think I would look at it two ways. One is we're looking to get confidence that F106C is active in lung. Is there any evidence of activity, i.e., ctDNA reductions? We're looking for confidence in RECIST endpoints. Is there the opportunity for response rate or PFS?
I think those are the two levels of activity that we're looking at.
Thank you. Our next question comes from the line of Jessica Fye with JPMorgan. Please proceed with your question.
Hi, this is Nick on for Jess. Thanks for taking our questions. I believe today you mentioned that you're about 650, 60% of patients on therapy in the first line setting. Does that hold true across the U.S. or Europe, or is one region more heavily weighted towards first line or second line versus the other?
Ralph, perhaps you can take that one.
Nick, thank you for the question. Look, in the U.S., we are seeing 60% of the KIMMTRAK patients in first line. Right? The remainder of them are in second line plus. In Europe, specifically in Germany and France, we're seeing around 45%. That's where we're focused in increasing because our focus is first line. That's where we see OS, that's where we see the duration of therapy. We're focused on increasing that to as high as we can get it.
Thank you. Our next question has come from the line of Tyler Van Buren with Cowen. Please proceed with your question.
Hi. Good morning. This is Tara, on for Tyler. When you say that the PRAME dose expansion data are expected by the first half of 2024, is there a chance that it could come later in 2023, maybe at, you know, ESMO or one of those conferences? Are there any other data updates this year that we can look forward to? Thanks.
Yeah, it's really, you know, the our strategy was to invest early into expanding the footprint for the clinical footprint. I think that, you know, in any drug development, that's what takes the longest, and that's exactly what we wanna focus the team on. That, you know, it's a pretty comprehensive program with multiple arms for the monotherapy plus the combination. That's really the focus, and that's why we are, we are going globally, and we said we'll bring the data by the first half of 2024.
Thank you. Our next question comes from the line of Patrick Trucchio with H.C. Wainwright. Please proceed with your question.
Thanks. Good morning. I actually have a follow-up question on the capital allocation focus, specifically with KIMMTRAK revenues ramping while multiple programs continue through development and these new programs emerge. I'm wondering if you can discuss the focus for capital allocation in the next year and beyond, particularly as it relates to balancing the focus on R&D and pipeline development with the potential eventual pivot to profitability. How do you balance these priorities, and when might the company achieve profitability?
Yeah, thank you. Thank you for the question. I'll start and then Brian. You know, really our focus is expanding the pipeline. As you have seen, the pipeline is expanding, and that's exactly what we will be, you know, the dollars will go there. I think it's very important we have some great assets. Brian, you wanna comment on that as well?
Yeah, great question, Patrick. If you look at our research expenses over the last 3 years, we've been pretty consistent in our research expenses, and we've been able to deliver these new ImmTAC molecules like PIWIL1, PRAME-A24, PRAME half-life extension with those research expenses. We don't expect that to change dramatically. What will change and will scale, as you would expect, would be the development costs as we move and advance PRAME. It'll really be driven in the large part by how many large pivotal trials we need to run for PRAME. That's, that's where we're focused. We have those in the budget now. You'll notice that we did opt out of the co-development, co-funding of MAGE, as we focus on the PRAME expansion.
However, we still appreciate the collaboration with Genentech, and we'll still be in a collaboration with them and be able to receive milestones and royalties from MAGE-A4, if they move that forward.
Thank you. Our next question comes from the line of Justin Kim with Oppenheimer. Please proceed with your question.
Hi. Good morning. Thanks for taking the question. You know, with regards to the median treat integration, does the team have any insights on how physicians are managing patients through situations of potential pseudo progression? Are there any tools to observationally compare how the experience might be additive to the clinical trial experience, perhaps benchmarking against HLA-A2 negative patients?
Great, Justin. I think, if you can talk about the DOT and where we are compared to the clinical trials. Go ahead.
Justin, look, it's really great when we launch a new medicine and we see the experience in the clinical trial being replicated in the real world, because that means that the safety and efficacy that we've seen in the clinical trial is true, and physicians are able to really use the medicine the way that is intended. The patients are seeing the benefit and physicians are seeing that the patients benefit. From a medium perspective, we're at six months, and from a mean, we're tracking to nine months. If you recall, that's what we saw exactly in the clinical trial. As that relates to pseudo progression, we keep educating on that aspect or treatment beyond progression. We keep educating on that aspect.
Of course, today we see treatment patterns to very similar to what we're seeing in academic accounts, which is why we're also seeing this mean duration of treatment at nine, tracking to nine months.
Thank you. Our next question comes from the line of Justin Zelin with BTIG. Please proceed with your question.
Hi. Thanks for taking the question, congrats on the results here. Maybe just to follow up on the prior question just on duration of therapy. You know, do you expect that this duration of therapy will kind of stick in the results seen thus far mirroring the clinical trials in the real world? Or do you think that it's possible that you could see extension with more follow-up here?
Go ahead.
Justin, that's what we expect. We expect to see so far what we've seen in the clinical trial. If you look at our clinical trial, two out of two clinical trial, you see the median staying somewhat the same and then the mean growing not significantly, and that's driven mostly by the tail. We do expect that the longer we're on the market if physicians keep treating the way they're treating, we do expect the mean to be growing. Now, not significantly, and I think you can use the clinical trial as a benchmark to see where this is going.
Thank you. Our next question comes from the line of Peter Lawson with Barclays. Please proceed with your question.
Great. Thank you. I guess more a follow-up here just around where you think that duration of treatment could eventually settle for KIMMTRAK. The half-life extension, is that for patient convenience, or do you think that could help with durability as well?
Yeah. Great. I think, Ralph, you can take the duration and maybe David on the half-life extension.
I think the best answer I can give you is that we're going to be providing an update of our three year overall survival, which will include duration of therapy and PFS at upcoming conference. I'd invite you to take a look at that so you can see where we expect the mean duration of treatment to go. David?
Yeah. Peter, you know what's remarkable with KIMMTRAK with a plasma half-life of eight hours, we saw survival benefit with a hazard ratio of 0.51. We know that our current platform is, of course, very highly active. I think it's an open question about whether a half-life extension will have any improvement in efficacy or durability. We'll have to just be data-driven on that.
Thank you. Our next question comes from the line of Jeff Hung with Morgan Stanley. Please proceed with your question.
Thanks for taking my questions. For advanced melanoma, can you talk about why you're using ctDNA in phase II, and how predictive do you think that is for survival endpoint in phase III? For PRAME, how do you think about treating multiple HLAs and what needs to be done to get there? Thank you.
Great, great question.
For the advanced melanoma, the dual endpoints for the phase II are both ctDNA and overall survival. The reason we're doing ctDNA is because that gives us the earliest, fastest read so that we can make the decisions for the phase III, i.e., drop one of the arms, repower it. We also designed it, though, because ctDNA is not yet completely validated in cutaneous melanoma, we realized that it's gonna give us a directional look. We designed it also to have a survival look. We realized survival won't be mature at that point, but we will have enough power to get an estimate about whether survival is trending. That's really the reason for the ctDNA. With regard to the second question, I think you're asking about different alleles for PRAME. Is that correct?
Yeah.
After HLA-A2, the most attractive HLA allele for PRAME is HLA-A24. That's why we announced that we are pursuing this HLA-A24. We'll take the learnings from the HLA-A2 allele and apply it to HLA-A24 to make it develop faster. We estimate this will increase the opportunity, 30% from a patient population opportunity.
Thank you. Our next question comes from the line of Nick Gallo with Goldman Sachs. Please proceed with your question. Looks like we lost Nick. I'm gonna bring it through the next questioner. Our next question has come from the line of Ahu Demir with Ladenburg Thalmann. Please proceed with your question.
Thank you very much for taking my question, and congrats on a good quarter and a year. My first question is on KIMMTRAK. Could you maybe provide more color on discontinuation rates and treatment beyond progression in the real world?
Great. Thank you. Ralph, you wanna?
Great question. We are seeing the treatment discontinuations to be in line with what we expected in the clinical trial experience. In fact, we look at closely the reasons for discontinuation and they're really tracking very well. We're not seeing any surprises, which is always great to see when you go into the real world. With regard to treatment beyond progression, what we do is we ask physicians whether they are comfortable treating beyond progression, and obviously that's part of our conversations that we have from a medical affairs perspective with physicians. So far we are seeing that level of comfort. Of course, as we go into the community, more education needs to be had, and that's what we're focused on.
Yeah, I think it's a really good point because in the academic centers, the investigators are the ones who actually saw that there is benefit beyond progression. I think there is more work to be done when we go into the community. That's where the MSLs and the education and the science will come in.
Thank you. There are no further questions at this time. I would now like to hand the call back over to Bahija Jallal for any closing remarks.
Yeah. Thank you so much for your questions, and thank you for your support. We gonna now close the call. Thank you.
Thank you. This does conclude today's teleconference. We appreciate your participation. You may disconnect your lines at this time. Enjoy the rest of your day.