Great. Good morning, everyone. My name's Jess Fye. I'm a biotech analyst at JPMorgan, and we're continuing our 44th annual healthcare conference today with Novocure. First, you're going to hear a presentation from the company, and then we're going to have a Q&A session. So for those of you in the room, raise your hand if you have a question so someone can bring you a microphone for the webcast. And if you're listening online, you can submit questions to the portal so I can read them off up here. But with that out of the way, let me turn it over to the company's CEO, Frank Leonard.
Thank you, Jess. It's my privilege to be here today to present Novocure's preliminary 2025 results, as well as look ahead to a catalyst-rich year in 2026. For those of you who don't know me, I have taken over as CEO just a few months ago. However, I've been with the company now for 15-plus years, and prior to that as a venture capital investor and part of the team that helped to bring the first institutional investments into Novocure, and through that time, I've covered multiple areas for the company, including our product development, corporate strategy, reimbursement groups, and then more recently, leading us through a reorganization of our commercial organization to drive us back to growth, and I'm excited because as much as we are proud of our past accomplishments, 2026 is a year of multiple catalysts, and we'll detail those as I move forward.
But first, let's set the stage on Novocure, the company itself. What are we today? First, Novocure has developed, pioneered, and commercialized an effective wearable cancer therapy that is currently a standard of care for glioblastoma patients. We built ourselves from there to have successful clinical trials across multiple indications that we'll discuss today. This is a unique way of treating cancer, and in a moment, I'll go back to our core mechanism of action and how it is unique from other therapies pioneered to date. We're proud that we've built a market-leading position not only in the United States, but across key markets around the world to help patients with glioblastoma, which, as a reminder, is the most deadly form of brain cancer.
We are also excited as a company that as we look ahead to 2026 and beyond, we have the ability to continue expanding both within glioblastoma, growing our existing markets, as well as entering new markets, and from there, launching in additional indications in pancreatic cancer and brain metastases from non-small cell lung cancer. We'd also like to be sure that we're communicating these growth opportunities in light of a clear commitment to a path to profitability, starting first with our commitment to reaching Adjusted EBITDA break-even. So let's go to Tumor Treating Fields, our core therapy, and what it is. Tumor Treating Fields are alternating electric fields that target the electrical properties of cancer cells. For those of you coming to the story from a biotech or a biology background, I'd encourage you to think about cancer cells and the accumulation of calcium ion. Cancer cells are unique.
Through many different ways, their electrical properties transform. The introduction of a substantial influx of calcium ion inherently changes the capacitance of a cancer cell, making it unique relative to healthy cells. For those of you coming to the story from a medtech background, I'd ask you to think about the therapy in terms of how electric fields are typically applied in medicine. We've historically built devices at low frequencies and direct current that are stimulatory and have the ability to do things like TENS units and pain relief or bone growth stimulators. On the other side, with high-frequency devices, we can induce heating and ultimately ablation. We are applying intermediate electric fields that until our founders' research were thought to be inert. Our unique insight is knowing that those fields have a selective and unique effect on cancer cells due to the differentiated electric properties of those cells.
What have we done with this therapy over the 25 years of our company's existence? We have demonstrated success now across a wide range of solid tumors where patients are desperately in need of additional options. Our business started first with success in glioblastoma, where we were able to show a five-month improvement in median overall survival for patients with glioblastoma. Most importantly, as you look at the Kaplan-Meier curve, our device, for the first time, moved to the five-year survival for glioblastoma patients above 13% for the intent-to-treat population. But I'll highlight that we have additional evidence showing that for patients who used our device at the maximum available usage per day and consistently, they were actually able to outpace that result and show strong, durable, long-term survival. From there, we moved on to our successful LUNAR study in non-small cell lung cancer.
Our LUNAR trial was in the second-line setting for stage four metastatic non-small cell lung cancer. Patients were able to use Tumor Treating Fields with a backbone systemic therapy or the systemic therapy alone, and the systemic therapy included a physician's choice of either docetaxel or an immune checkpoint inhibitor. In the intent-to-treat population in this trial, we demonstrated a significant improvement in overall survival, and specific to the patients who were treated with immune checkpoint inhibitors plus Tumor Treating Fields, we showed that the concurrent use of those two therapies produced a profound effect on clinical outcomes, specifically survival.
As I'll talk about in a moment, we believe this outcome from this trial shows that when you exert physical stress on a cancer cell, you achieve not only our primary direct cytotoxic effect, which is an antimitotic effect by inhibiting the mitotic spindle formation, but also a cascade of downstream stress signaling from the physical effect of Tumor Treating Fields on multiple proteins within the cell and through that stress signaling and upregulation of the immune response to tumors. More recently, in 2025, we announced final results from two additional significant pivotal studies. First, we announced and published our data from the PANOVA-3 study in locally advanced pancreatic cancer as a first-line setting. We demonstrated again a statistically significant improvement in median overall survival with a two-month OS benefit in pancreatic cancer.
We're also very excited that this trial showed a six-month extension in pain-free survival for patients with pancreatic cancer, and we note that pain-free survival is one of the most meaningful clinical endpoints for patients treating this disease. I'd also highlight that if you look between glioblastoma and pancreatic cancer, these two tumors have something unique in common. Both have a low bioavailability for drugs. They are difficult tumors to treat with systemic therapies. In glioblastoma, over the last 25 years, despite hundreds of trials, there has been one systemic therapy approved. In pancreatic cancer to date, with an even greater number of clinical trials, over the last 25 years, there have been five drugs approved. These are two tumors that I'll highlight through the presentation that are in specific need of a biophysical approach to augment the incredible systemic therapies that are being developed today.
Lastly, I'll note that in the September timeframe, we also announced and published the final results from our METIS study for patients with non-small cell lung cancer that had metastasized to the brain. In this study, patients were given SRS, stereotactic radiosurgery, to treat their brain tumors and either left for watchful waiting or added or given Tumor Treating Fields as an additive therapy. In this trial, we showed a doubling of the time to intracranial progression when Tumor Treating Fields was layered on top of the SRS treatment. Now, looking back to 2025 to summarize our results, first, I want to highlight that we are exiting 2025 in a strong financial position due to the growth that we were able to drive in our core GBM business. We saw growth in all of our active markets in glioblastoma, and I'll drill down on that in just a moment.
That growth led to us posting $655 million of revenue in our preliminary results that we announced this week, which represents an 8% revenue growth year- over- year. As I highlighted on the previous slide, our success in pancreatic cancer and in brain mets is enabling us to move forward with new clinical indications, and we have completed filings for both our PANOVA-3 data with FDA and our METIS data with FDA. Lastly, as a medical device that's worn by patients 24 hours a day often, we have a unique relationship not just with the physician who is prescribing to treat the patient, but also with the patient who is using our device to extend their survival.
As such, we aim to strengthen our relationship with that patient through the introduction of better technology to improve their ability to physically use our device, as well as through digital technologies that enable them to interact with us more in real time, to understand their treatment, to ask for troubleshooting, and to gain clarity over what needs to come next in their treatment with the device specifically. That we believe will enable the patients to use the device more consistently through the day, and based on our past results, we believe that that increased usage can drive a longer duration of therapy, so let's drill down and look at our GBM business last year in 2025. Across the globe, we drove a 9% increase in active patient volume. That growth comes from all of our key markets.
I'll highlight that in Japan, we grew our active patients by 29%, by 19% in France, and 10% in Germany, as well as showing growth in all of our smaller markets around the world. I'm also particularly excited to note that our U.S. GBM business has grown by 4% year- over- year based on a strong Q4 close. We are currently active in eight markets around the world, and we believe that our results in 2025 represent the strong work of our teams over the last three years to reevaluate, reprioritize, and then execute upon opportunities that were there for us to take and by extension for patients to gain access to this important therapy. Looking ahead commercially, we do intend to continue growing in both of our approved indications.
In glioblastoma around the world today, after our 2025 results, we believe in our key markets our penetration rate is somewhere in the range of 35%-40% of eligible patients depending on the country. We know that based on our strong pivotal trial results, we can drive that adoption higher. This is a disease where without our device, the five-year survival rate drops below 5%, and with it, it moves above 10%. We want to continue emphasizing the benefit of the therapy as well as introducing new data sets to further confirm the benefit of Tumor Treating Fields, and we'll elaborate on those in a moment. We also plan to capitalize on selective opportunities to increase our geographic footprint, and I'll note that in 2025, we announced we have achieved national reimbursement in Spain for Tumor Treating Fields for the treatment of glioblastoma.
Additionally, we're going to selectively look for new countries where the opportunities may be smaller, but they are substantial, and take those opportunities where we think they make sense financially. Now, turning to our existing business in non-small cell lung cancer, which is treating patients in the second line of stage four non-small cell lung cancer, we have launched in the U.S. and Germany, and we have acknowledged that our launch is behind plan and has been challenged. We currently have 122 patients on therapy in these two markets. What we are stating today is that we recognize this challenge, and we have accordingly addressed the sales and marketing spend within our existing lung business in the existing markets appropriately to recognize the challenges that we're facing.
Looking ahead, though, we do see markets where the treatment paradigm today for the second-line patient in stage four non-small cell lung cancer does justify continued investment. And we have consistently highlighted that in Japan, patients are more often continued on an immune checkpoint inhibitor from the first line to the second line. And we note that our discussions with KOLs in Japan have been favorable in terms of the benefit of adding Tumor Treating Fields into the second-line setting for patients in Japan.
So while we have seen challenges in this market and we are making the necessary financial decisions to recognize those challenges, we will continue to invest selectively where we see the potential to build a sustainable business. Looking ahead, as I've already highlighted, we have two exciting launches on the horizon. Again, our launch in pancreatic cancer will be in locally advanced patients in a first-line setting.
We believe the total addressable market includes around 15,000 patients in the United States, and we are anticipating a launch in Q2 following a regulatory approval in the same quarter. To put this in perspective, this market is slightly larger at 15,000 patients than the addressable market that we have in our GBM patients today. And as I've noted, we believe that in pancreatic cancer, where there have been so many failures, after so many attempts and billions of dollars spent to address this tumor with a systemic therapy, the physicians understand the unique benefit that biophysical approaches will bring to patients in need. Moving towards the end of the year, we anticipate a Q4 regulatory approval and launch for our indication treating patients with brain metastases from non-small cell lung cancer on the basis of our METIS study.
This market, again, at 16,000 potential on-label patients in the United States, is slightly larger than our existing market for glioblastoma, and so taken together, we believe these two markets put us on a path for a multi-year growth trajectory that will enable us to build a bigger and sustainably profitable business treating patients in these three indications. Now, I've spoken before, but I want to tie together some of the themes that we hope to address in the coming years as we think about both our commercial business and our R&D portfolio. Tumor Treating Fields in the petri dish and in animal models have shown a broad ability to kill cancer cells across multiple cancer cell lines and in tumor models in multiple different animal models. We really haven't seen a reason for Tumor Treating Fields not to work scientifically when you apply it against a cancer cell.
What we have seen is that this is a device that must be worn 24 hours a day and used by a physician who more often than not is comfortable using drugs over devices. And we need to, as a company, lean into and understand that our device has a specific set of unique benefits that, on the flip side, while maybe I would say advantages that allow us in some respects to target tumors that we cannot otherwise access, we do also at the same time have to recognize that wearing a device will also be something that we have to introduce into the paradigm. And accordingly, we want to invest very judiciously where we think the device can be recognized by both the physician and the patient as the most unique opportunity to address the clinical need.
Specifically, as I've mentioned before, two areas that we want to highlight today are tumors with low bioavailability for systemic therapies and tumors where our ability to upregulate the immune response through enhanced stress signaling of the cell will produce a better effect for immune checkpoint inhibitors against that target. With that, I'd like to turn to review our existing R&D portfolio in light of these two unique aspects of tumor-treating fields. First, we are excited that we have completed and will announce top-line results for our PANOVA-4 study in Q1 of 2026. PANOVA-4 is in the metastatic pancreatic setting, first-line setting for metastatic pancreatic cancer, where the patients will receive tumor-treating fields plus atezolizumab plus gemcitabine-nab-paclitaxel doublet, which is building on our PANOVA-3 study where the patients receive gemcitabine-nab-paclitaxel doublet.
We believe this is an important trial first in that it gives us evidence in the metastatic setting beyond the locally advanced setting studied in our P3 study, and additionally, this allows us to gain insights into whether or not Tumor Treating Fields can provide a stronger benefit for atezolizumab in this setting. We will also announce in Q2 2026 results from the TRIDENT study. TRIDENT is a Phase 3 study in newly diagnosed Glioblastoma, adding Tumor Treating Fields as a therapy on both arms of the study.
I think I want to emphasize this point again. Tumor Treating Fields in TRIDENT is a backbone therapy and is not. This study is one moment where the physician community around the world who treated Glioblastoma recognized Tumor Treating Fields is a standard of care, and the trial is designed not to answer the question of does Tumor Treating Fields work, but how does it work best.
On the active arm of this study, we have moved tumor-treating fields earlier in the treatment paradigm than our existing approval, such that tumor-treating fields will be used concurrent with radiation and chemotherapy, and in the control arm, patients will then wait to begin tumor-treating fields until the completion of their radiation and chemotherapy regimen, so this is a question for the trial. The trial is asking the question of how best to use tumor-treating fields within the glioblastoma setting, recognizing that tumor-treating fields should be the backbone therapy for all patients. Moving ahead, we are also conducting two large phase three studies. First, we have our KEYNOTE-D58 study continuing our research in newly diagnosed glioblastoma and leaning into our two unique benefits. In this study, again, tumor-treating fields is viewed as a backbone therapy and is being used as the standard of care on both arms.
In this study, pembrolizumab is being added as the active therapy on the interventional arm, giving us the chance again to study the effect of Tumor Treating Fields on taking a tumor such as glioblastoma where pembrolizumab has failed, as well as other immune checkpoint inhibitors have failed in multiple studies, and asking whether we can produce a better response for patients. We are announcing here that we're pulling forward the expected LPI date for this trial to Q4 of 2026. Lastly, within our R&D portfolio, I'll highlight that we are conducting our LUNAR-2 study, LUNAR-2 trial, phase 3 trial for the first-line treatment of metastatic non-small cell lung cancer. This trial builds on our prior result in the second line and brings the therapy forward to a first line again using concurrent pembrolizumab therapy in the first line.
We are looking at the study as I've highlighted and brought forward. As we move forward at Novocure, we will take a look at all R&D investments, including this R&D investment, to understand how does it best fit within our understanding of the unique benefits of Tumor Treating Fields relative to what the other systemic therapies can bring to bear for the tumor. So taking all of this together, let's look at the list of catalysts for 2026. First, in Q1, we have the release of top-line data from the PANOVA-4 phase 2 study in metastatic pancreatic cancer. Coming in Q2, we then release top-line data from the phase 3 TRIDENT trial in glioblastoma. And in Q2, we also anticipate the launch of Optune Packs for the treatment of locally advanced pancreatic cancer in the United States.
In Q4, we have two important milestones, one being the complete enrollment in LPI for phase three of KEYNOTE-D58, starting the follow-up clock for that trial, and additionally, our commercial launch following an anticipated regulatory approval for Optune Maya for the treatment of brain metastases from non-small cell lung cancer in the U.S. We are also excited through the year to continue building on our existing business in glioblastoma, expanding our penetration in our existing key markets while also selectively finding those new markets where we can build a sustainable business that is both helping patients and contributing to our bottom line. As we look at this together, our strategic roadmap is quite simple.
We intend to drive adoption in our existing businesses in a financially responsible way, which will enable us to invest in and scale our portfolio through strong launches in both pancreatic cancer and in brain metastases. By extension, we've made the choices necessary to ensure that further investments into the commercial activities in our lung business will be appropriate given the demand curves that we've anticipated through our launch years. We're also committing to ensuring that our investors hear us articulate a clear path to profitability as we move forward. Given that we have so many exciting growth opportunities ahead, it would be easy to simply state we're investing everywhere all the time to drive growth. That's simply not feasible as a device company trying to pioneer a new therapy.
And so we are announcing here today that at our February earnings call, where we announce our full-year result, we will provide guidance on both top-line revenue and bottom-line guidance on Adjusted EBITDA, which we view as the first important milestone in our return to profitability. We want our investors to understand both our vision for growth as well as how we intend to accomplish that through financially prudent investments. To take that one step further and just to share my new role as CEO, how I think about the prioritization, we have to start first and foremost with the fact that our business helping GBM patients is what makes everything else possible. And we have to continue investing there both on the commercial side as well as in our clinical portfolio, where we're going to bring important new evidence to bear through the Trident and D58 studies.
From there, we have to get our launches right in pancreatic cancer as well as in brain metastases. Putting those two priorities against this commitment to the path to profitability and our drive towards Adjusted EBITDA breakeven, we will review our R&D portfolio to ensure that our R&D allocations fit first and foremost with our top priorities, and we'll make additional announcements and details available as we move forward in the coming quarters on those decisions that we will take. Taking all of this and taking just one step back, I'll close by highlighting that Tumor Treating Fields is now in its 25th year of development. The technology, the insight, was developed by our founder, Professor Yoram Palti. And unfortunately, Professor Palti passed away this week. He passed away knowing that tens of thousands of patients have benefited from his technology, having met several of them.
I think that's what's always been unique for those of us who have joined Novocure is the fact that all of us are here today at J.P. Morgan because we want to advance the future of medicine. For those of you in the room who are focused on oncology, we really want to advance survival. Specific to Novocure, what I'm proud of is that because our therapy brings these differentiated effects that are not based on a systemic medical effect, we've been able to go after those tumors where we've seen failure after failure after failure.
While I will acknowledge, as a device in the oncology world, we do sometimes swim upstream of physicians who want to use drugs first. We think that we have these unique attributes of a therapy that can't be replicated that give us, number one, a clear path to commercialization in our key markets. Number two, as you've seen in our GBM business, strong, durable businesses that grow continuously. GBM, we've been in market in the United States for 10 years, and we're still posting growth. We've defended our profit margin and our pricing in the United States over 10 years.
I think as you think about Novocure, while there are challenges of being the device in the oncology world, it also produces the durable moats around the business that we intend to lead into in the coming years and do that as we try to continue the mission that we started on that Professor Palti set us on 25 years ago. With that, Jess, I'll turn it over to you for questions, and I'll invite my colleagues, Bill Doyle, our Executive Chairman, and Christoph Brackmann, our CFO, to come and join me.
Great. Thanks for that. As a reminder, for questions in the audience, if you do have a question, just raise your hand so someone can bring you a mic and they can hear it on the webcast. I'll start. Frank, as you've taken the helm as CEO, can you talk about what your goals are for Novocure and kind of what's likely to change and what's going to remain the same under your leadership?
Thank you. Yeah, I think I'll start with what's going to remain the same. I think that we are a company that thrives on tackling these aggressive tumors and taking shots where we think we can really move the needle in cancer. So you don't see us trying to pick up the easy indications. I think we will continue to operate where we think there's very high unmet need. But to reiterate, as I stepped in, I think the challenge we've had in the past is that because our therapy has worked in every cell line and every animal model, it's really easy to convince yourself that you can tackle every tumor type. And my mantra to the team today and over the last two months is really lean into the fact that we have differentiated benefits that we bring.
That should carry through both to the marketing materials of really explaining the therapy through this biophysical lens, through the failure of past drug trials to address tumor types. As we undertake our efforts to review our existing R&D portfolio to think through what does that mean going forward about how we invest the next R&D dollar.
Okay, so you highlighted the growth in GBM, and at the moment, it's sort of the core revenue driver. What gives you confidence in kind of sustaining this growth in 2026?
I would say I always think of it as two things coming together. I think on the one side, right now, through hard work over the last two years, we've done the operational effort to bring us to this moment. What do I mean by that? We have reinvested in our sales and marketing teams in GBM to ensure that they're in the best position to find the physician and the patient at the moment that the treatment decision is being made. That's just on the pure operational side. We've also put ourselves in a really successful position to have the TRIDENT study, which is largely run by radiation oncologists, has just closed out this last year, still has patients either on or now off, but in follow-up.
And that trial over two years gave us direct engagement on the clinical side to all of the rad oncs with CNS experience. We then coupled that trial as it was closing, opened the D58 study studying pembrolizumab for GBM patients, which then put us into the academic sites. And so if you look at 2025, we were engaging in academic sites that we haven't previously worked with. We were re-strengthening our relationships with rad oncs who have previously driven our business. And we were doing that all on the back of really operational excellence in how we approach the position. And those trends we expect to continue. So that's kind of one side of the story.
The second side of the story of why I see our ability to drive growth is that, quite frankly, with every year that goes by, the evidence accumulates that Tumor Treating Fields is producing a stable, durable, long-term effect for GBM. I would highlight that the Mayo Clinic across all of its health systems last year published a systematic review of patients over the prior, I think it was prior decade, showing that Tumor Treating Fields had a statistically significant improvement on OS within their health system and including noting that it was producing durable, sustainable, long-term survival, so then we layer on top of that, we have TRIDENT reading out, D58 coming up. I think we've put ourselves in a place to build additional evidence over the coming years to keep this growth going.
Question in the audience?
Thank you very much. Can you hear me? Great presentation. Two questions, if I may. One regarding pipeline beyond GBM and pancreatic tumor. I remember there were mesothelioma in the pipeline before. How are you thinking about what are the priorities besides challenges of the disease and bioavailability of the drug, how you're prioritizing? And the second question, our understanding is the main limitation of adoption has been some side effects regarding skin issues and battery packs, et cetera. Any R&D effort on that to solve those problems too?
Yep. I'll address the first part about R&D, but Bill, I'll actually ask you to talk about the product development side of this. So on the R&D, to just continue on, when we think about so we do have an approval for mesothelioma in the United States. It's a limited approval under the Humanitarian Device Exemption. We have the CE mark and have launched in Germany for mesothelioma. It's a relatively small indication to begin with, and for us, it's a relatively small patient population. So we generally group it as we think strategically with our overall non-small cell lung cancer portfolio, recognizing they are actually different diseases. What I would say is that we've seen over the last year, we know physicians who are interested in using Tumor Treating Fields for those diseases. We'll continue to support them. We're continuing to look incrementally for growth.
We're not intending to open up any new investments either in MPM, or as we move forward, we have our big investment in LUNAR-2 for non-small cell lung cancer. We're not at any time in the next couple of months anticipating bringing forward a new concept in those areas because, as I mentioned, in terms of a prioritization, to be clear, funding is growth in GBM, successfully launching the two new indications, and then within the R&D portfolio, figure out how we bridge to a path to profitability.
Thank you for your question about the product. We have the benefit that the therapy that Frank described so well comes with no systemic toxicity. So that's a plus. On the minus side, there is a patient burden. That's true. The patient burden is associated, as you described, with one, as we attach these patches to the skin, some patients have a skin sensitivity and exhibit contact dermatitis. I said to everyone in the audience, if I put a Band-Aid on your forehead for two years, chances are a number of you would get skin redness. The other aspect of the patient burden is that they do have to carry this box.
Today, the box weighs about a kilo, which doesn't sound like much, but if it's with you every day, all the time, it's something that has to be dealt with, and the patient has to overcome that. The good news for us is that we have a lot of opportunities to work on both of those patient burdens. The first change that we'll make is an introduction of a next array that changes the skin contact material. All of our testing to date shows that it's much less irritating on the skin. I think we have an opportunity in the midterm here to really address that issue. We're also very focused on the box now too. We benefit from improvements in battery technology. Quite frankly, we also need to look at product design.
Historically, our box has been designed by electrical engineers, and it kind of looks like it was designed by electrical engineers rather than designed by CPG experts. And our next generation will be smaller, will have a different form factor. And where we're also moving is to a combination device that is much more like a garment. So rather than patches that are either stuck to the head or the abdomen or the torso, it's going to be more like a garment that you take off and put on, allowing patients to shower whenever they want and make it much easier. So we see a path to short-term real improvements in the arrays, medium-term improvements in the way the box is configured, and at the same time, moving toward a garment-like device that just changes the use paradigm completely.
You touched on the TRIDENT study and that data coming up and how Optune is in both arms. So if that trial is successful, kind of encouraging the earlier use of Optune, how should we think about the incremental commercial opportunity that could be associated with that?
That's a fantastic question. I'll contextualize the data, and I'll ask Christoph, as our CFO, to talk a little bit about the downstream revenue opportunities. The TRIDENT study, to reiterate, is looking at moving Tumor Treating Fields earlier in the treatment of glioblastoma. These would be patients who are newly diagnosed, and in the trial, they're randomized shortly after their diagnosis or shortly after finishing surgery before beginning radiation or chemotherapy. This is a different population than studied in the EF-14 trial, which is our prior clinical study. It specifically includes the group of GBM patients who typically progress quickly through radiation therapy, which has historically been about 25% of the patient population.
I bring that up to help contextualize the data because I want to emphasize again, it's a different patient population than EF-14, and cross-trial comparisons should not be made in that setting because one trial, TRIDENT, includes patients expected to progress quickly, whereas EF-14 were patients who started at a stable position and used Tumor Treating Fields. So I say all that to say that, first and foremost, the TRIDENT study introduces Tumor Treating Fields to that additional 25% of patients we simply don't see today. So if physicians begin Tumor Treating Fields during radiation therapy, they have, on average, 25% more patient population to select from. Now, for that population, we do think duration may be slightly muted because, obviously, they will progress.
However, for those patients, for the other 75% of patients who will be stable, we do expect that we'll produce better duration of therapy overall than in our prior study. So it's a bit of a mix of puts and takes. But when you look at all of them, they're all on the positive side.
Okay.
Yeah, and maybe to quantify a little bit more, so as Frank said, we charge for our therapy on a monthly basis, right? So longer duration directly translates into higher revenue for us. So on the one hand, we would expect, because patients would start with a treatment journey about two months earlier, that's about 20% additional duration just from starting earlier. Then the other question that we don't know is what would be the additional benefit on being maybe longer on therapy because of additional efficacy. And the other area of where there could be a benefit is by starting more patients earlier, albeit with maybe a smaller duration for the total population.
Okay.
Yeah, and if maybe I can add one more point around TRIDENT. Today, the GBM patient journey starts with usually a seizure, then an MRI, then they go to a surgeon, then they get this two months of chemoradiation from a radiation oncologist, and then they get their maintenance chemo from a medical oncologist. As Frank's described, our best prescribers are radiation oncologists. They understand physical modalities. If the point of prescription is the point where they're directing therapy, that's also a potential advantage for us in addition to the advantages that Christoph described.
Yeah. Makes sense. And then heading into the PANOVA-4 data in metastatic pancreatic cancer, what would be the next steps there in assuming or encouraging data, and what are the benchmarks we should look at when we interpret that dataset?
Yeah. So okay. So to start with the benchmarks, we've pointed investors to this study by Dr. Dan Von Hoff and his colleagues that established approximately a 50% disease control rate for that patient population, and disease control rate is our primary endpoint. So we think we're coming in while the trial is a single-arm Phase 2 study; it is one that will be well understood within the historical context of results, and I think what comes next is that we do have to see the data to look at pathways forward. The landscape for the treatment of metastatic pancreatic cancer is obviously evolving minute by minute. I haven't followed what happened in the last 10 minutes here. We're very aware of that, and we're aware of the evolution of the RAS inhibitors. We'll need to see the benefit from an immune therapy.
We have multiple pathways forward to design our next study in pancreatic cancer, noting that objective response rates with the RAS inhibitors are still at best hitting around 50%, which means there's a strong need to augment the therapy. Noting that we're talking about taking patient survival in the six- to eight-month range and trying to move the needle, that's a long way to go to getting patients to having five-year survival.
Yeah. Maybe in the last 20 seconds, I'll add to that. We're really excited to see these data with checkpoint inhibitors. But we've always described Tumor Treating Fields as a modality that can be combined with whatever the best pharmacology is. So we've already started work of Tumor Treating Fields plus RAS inhibitors as well. And at least preclinically, it's very promising.
Okay. Great, so we'll leave it there. Thank you.
Thank you.
Thank you.