4DMedical Limited ($4DX)

Thank you for standing by, and welcome to the 4DMedical Investor Webinar. I would now like to hand the conference over to John Hester, Senior Analyst at Bell Potter. Please go ahead.

Thank you. Thank you very much, and welcome to everyone who is joining the call today. It's my pleasure to welcome you all here to today's webinar. My name is John Hester, and I'm the moderator for today's discussion. We are joined this morning by 4DMedical CEO and Founder, Dr. Andreas Fouras. Also here today is our special guest, we've got Dr. Joseph Mammarappallil, Associate Professor of Radiology, Duke University of Medicine in North Carolina. Welcome to you both. Our discussion will center on the latest data set from 4DMedical CT:VQ exam targeted to patient selection for lung volume reduction surgery or LVRS as I will be referring to it. For those of you not familiar, LVRS is a surgical procedure performed by a thoracic surgeon to remove the most diseased overinflated lung tissue in patients with severe emphysema, allowing the remaining healthier lung to work better. The key point is that LVRS is not suitable for all patients, and careful patient selection is very important because the procedure carries a meaningful surgical risk. With this in mind, the findings of the recent clinical trial investigating CT:VQ to aid in patient selection were presented at the recent American Thoracic Society Conference in Florida last weekend. So here to tell us more about the study and its findings, it's my pleasure to bring in Andreas Fouras, who will introduce Dr. Mammarappallil. So Andreas, over to you.

Yes. Thanks so much, John. And it's a pleasure to be here, and I really thank everyone for their interest in joining the call today. And yes, as John said, we had a really exciting ATS meeting, and it was really a great pleasure to have Dr. Mammarappallil there with us. He brings really significant expertise and as a radiologist who has deep expertise in this space, we found that the pulmonologists there were really keen to hear from him and hear his input and his thoughts about how he can benefit their patience and their practices and his thoughts on that. So Joe, we do have this paper there, and I'll be very keen to discuss it. But perhaps if you could just introduce yourself first, and then I think you also had some cases that you also wanted to share. But anyway, if you could just introduce yourself to everybody.

Yes, for sure. Thanks, Andreas, and thanks to everybody for having me today. Yes, my name is Joseph Mammarappallil. I'm a cardiothoracic radiologist at the Duke Medical Center. So essentially, what that means is I read a whole lot of chest imaging on patients with chronic lung disease. And so we are coming back from the American Thoracic Society this week, and we were really energized and jazzed about what this technology can do. And with my interactions with pulmonary colleagues, we really quite nicely see the benefit of this technology. So we're going to be talking about non-contrast CT:VQ imaging. Again, I want to emphasize the non-contrast aspect. It does not require contrast. And we'll go to the next slide. I want to show you some cases. Okay. So this is a standard chest CT. And I'm just going to tell you that this patient has chronic lung disease, what do they have? They have dilated airways. We call bronchiectasis. I did a lot of training. So it's hard for all of us to appreciate those findings. But there's thick wall dilated airways on this non-contrast chest CT. This is what I read every day. This is purely anatomic imaging. I cannot give any functional imaging or functional assessment of these lungs to our pulmonary colleagues. Now when we add this technique of CT:VQ, next slide. The first image you get is a purely ventilatory scan, and green is good. And so what we're seeing here is adequate ventilation of both lungs, the left and the right lung, really nicely displayed here. The next image shows you the actual added perfusion to the scan. On the next slide. And if you look at this, this is markedly abnormal. And so essentially, in the periphery, the outer areas of both lungs, what we see is a whole lot of purple, and that represents a lot of perfusion defects. It's a significant amount. When I go back and look at the anatomic image, it is difficult for me to parse out anything of what I'm seeing on that far right image. I am giving our pulmonary colleagues functional imaging here that is telling them that there is a whole lot of perfusion abnormality going out in the outer aspects of the lung. This comes into play big time with patients who may go on to treatment. These treatments become very, very, very expensive, and we want to be able to monitor these patients and we can't monitor them with just a standard anatomic image. We'll go to the next slide. So I can show you this next case. So this is a COPD case. So a standard smoker, you can see this is a coronal image where the patient is basically standing up. And you can see the lungs are really, really, really big. So anatomically, I can see big lungs. And that suggests obstructive lung disease or COPD, a patient who may be a smoker. If you look at the upper lungs here, you can see a lot of black. That's what we call emphysema, and that's destroyed lung tissue. And so now we're going to take a look at adding CT:VQ to this in the next slide. And so if you look at here, looking at the ventilation image here, relatively normal. There are some areas of red at the lung basis, but certainly, this patient is ventilating quite well. But now if you look at the next image, what we see here in the upper aspects of the lungs are a significant amount of perfusional abnormality. In the apices, [ atlas ] of the lung, lots of defects, there are lots of decreased perfusion, but even in the mid portions of the lungs as well. And as we kind of briefly talk about, this study guides our surgeons into saying what lobe should we maybe take out because it's not functioning, it's not perfusing, and so lots of things to be talking about there. One was lung volume reduction from our surgical colleagues and also with endobronchial valve reduction from our interventional pulmonary colleagues. And then we'll finish up with this last case here on the next slide. And so this is a CTEPH case. CTEPH is basically a patient who may get pulmonary embolism, so a whole lot of blood clots, and they get chronic pulmonary embolism with a lot of clots in the lungs. Ultimately, they basically develop a chronic lung disease. If you look at the anatomic image, so this is the image that the chest radiologist is going to read, what do we see? Not too much. They looks relatively normal. There are some areas of emphysema, but really relatively normal. It comes into play when my right heart cardiologists are saying, Joe, we're going to put these patients on these new treatments to reduce their right heart pressure and improve their CTEPH findings. How can we actually monitor that? It's very difficult with anatomic image. Here with a non-contrast CT:VQ, if you look at the middle image there, that's a ventilation image. Again, the issue here is not ventilation. Everything is relatively normal, relatively green. However, when you go to the perfusion image, what do we see pretty much upper lungs, right, greater than left areas of perfusional abnormality. Certainly nothing I'm going to be able to pick up on that anatomic scan. And when you treat this patient, I now have a baseline where I can say, this is where they're at. Are they getting better with these new meds that are very, very, very expensive. So these are 3 cases that I have that have really helped highlight how valuable this technology is, again, emphasizing that it's used with our regular CT scans and also that it's non-contrast.

Okay. Andreas, let's talk about -- so actually, Joe, I'll come back to you. For years now, we've had nuclear medicine to help you in the diagnosis of these patients. Just explain to us how you would potentially use nuclear medicine in these cases and why CT:VQ is transforming your management of these patients?

Well, I mean, nuclear medicine has been the, let's call it the gold standard for VQ for as long as it's been around. The reason why I like this technique over that is this is done with a regular CT scan with an inspiratory and expiratory image and it's also non-contrast. When you add the nuclear medicine portion of it, honestly, it gets very cumbersome because those scans take longer, and they're in a different part of the department. And it's a very, very low resolution examination where I'm trying to not see -- really the major perfusional abnormalities that I can see with the CT:VQ technique, it's very difficult with the VQ scan.

Okay. Andreas, let's come back and have a chat about then the paper that was released recently and the key findings from that.

Yes. Look, thanks so much, John. And it was really great to be able to -- with the pre-release of the paper to share some of these results at the conference. And I think the -- for me, what I find exciting about it is that we've really been pitching out there to doctors saying, look, look at this technology, it's a much more convenient workflow. And look at the results, the images that it gives are already natively on the CT and the quality looks really clean and sharp. And it makes sense that all of those things should be able to benefit your practice and your patients. But here we have our first kind of outcomes-based study that really directly goes to some specific benefits. And in the paper, the paper reviewed 50 patients where who underwent LVRS and had 23 of those 50. So 46% of those patients had a successful LVRS. And that was where basically they had improved lung function after the surgery versus before. And the study found that if we had been able to use CT:VQ to streamline to select the appropriate patients, then we would have been able to select a patient group that would have had 76% success. So a potential there to have a really dramatic increase in success for that operation, allowing both folks who have low chance of success to be spared, sparing the healthcare system, a bunch of money, but also potentially allowing a better review or better funnel to potentially find even more patients that can benefit from this procedure or also, as Joe mentioned just before, there are other procedures and other therapies that the patients have. It's not just only 1 option.

And Joe, how do you interpret that data? And how does that aid in your practice and your hospital?

Well, like you kind of mentioned, John, the -- putting endobronchial valve can be a very morbid procedure, I believe the data is somewhere a little bit above 20%, we'll have some complication. And when they get complications, it can be really, really bad. If we can streamline those patients and be able to capture the group that's actually going to benefit, you could pivot them from potentially a surgery to an endobronchial valve or from an endobronchial valve to a surgery, and I think it's definitely way better patient care.

Okay. So in the examples you got there that patient with severe or very poor perfusion, what would be the outcomes for that patient? And how would this data change the way you manage that patient?

It's interesting because a lot of chronic lung disease is 15 years ago, you had a disease that didn't matter because there weren't treatments out there. And so now I do a lot of work with pulmonary fibrosis. And those meds didn't exist in 2014. Now they've been around for 10 years. Those meds are really, really, really expensive. And essentially, we have a very poor way to monitor those with PFTs, which is global metrics. Here, we're giving you regional information and functional information of the lung, and you can see that change on follow-ups.

Okay. And what were the outcomes for that patient with very poor perfusion? He had good ventilation -- he or she had good ventilation, but very poor perfusion.

Yes. That first case was a cystic fibrosis case, and that patient actually went under lung transplant.

Okay. So in your discussions at ATS in last couple of days, what was the feedback you received from your peers about your presentation and the way you're using this technology?

Well, I mean, it was really interesting because when I first presented at an innovation hub or a bunch of physicians came, several physicians came up to me and said, wait, this is non-contrast, like this can be done on a regular CT scan and I can get functional information by adding 1 more scan about my patient, 1 brought up CTEPH in particular. And actually get me some numbers about the -- I mean, I was blown away by this because I've been talking about this for a year now but to actually see the pulmonary people say, non-contrast immediately on the CT scan, getting functional information that was very impactful for me.

Non-nuclear medicine results same day...

Exactly.

I mean one thing I always say is... Well please go, Joe.

No, I was just going to say I can barely read a VQ scan. So I can imagine our pulmonary colleagues. So...

Look, there was -- in the theater where Joe presented that, we literally had standing room only and folks kind of crowded out to all around the outside of that. There was so much interest in there. And just more broadly not wanting to pollute the message of today being largely a clinical and expert message. But you did ask, John, about the level -- how folks engage with us at ATS. And I'm pleased to say we had -- we've been at ATS 4DMedical for -- to 9 years now. And we had more leads generated, more sales leads generated, more doctors coming and visiting the booth and asking how they could use it than we did in the previous 8 combined. So really, now that we have this non-contrast solution, I think this is the kind of the moment, the step-change moment adds that convenience around that question because we hear the same question, too, is it really true? How do you do it? How is it possible that you can do this without contrast. And it really is changing the level of engagement we get from our clinical colleagues.

Yes. But to Joe's point, I think the key thing there was the functional data that you're getting. The anatomical thing is 1 thing, but it's a functional data that it is really aiding the decision-making process for these very ill patients. Joe, changing tack slightly, how many of these long volume reduction surgeries does the hospitals do perform each year? And give us an idea on the commercial aspects of the business of this medicine?

Yes. So lung volume reduction has to be a -- you've got to have a very specialized surgeon who's very good at this to be able to do these kind of techniques. We're probably doing -- if I had to guess because I see that -- I read the radiographs, we're probably doing about 15 a month. So that's 150-ish, almost 200 a year, and we're a high-volume academic center. I don't know what the numbers are nationally, but that's -- that would give you a Duke impact.

That's nearly $1 million worth of revenue a month just from the surgical -- working on a $50,000 sort of U.S. number. That's a decent sort of business. Now, how do you think this will change going forward, if you've got better data, able to make better decisions?

Well, I can tell you, I just pitched it to the -- a couple of thoracic surgeons, and they were beyond excited to not ever have to order a VQ scan. And so I would tell you it can streamline patients with COPD and really identify, like you may be able to capture more of them. You may be able to say, hey, there's more of these patients out there based on this type of imaging and better streamline patients. Well, actually, that may be an endobronchial valve as opposed to a surgery.

Okay. And Andreas?

Yes. I think that's really the win-win where the patients are better selected which is a great outcome for patients. But if you're speaking to, say, the CFO of the hospital, then they get to see that also this widens the net to capture more patients. So obviously, that's good from a patient perspective, too, where there's more treatments that are available, edge cases can be found and better refined to find the appropriate treatment. But speaking frankly for the business of medicine, being able to widen that funnel and treat more patients, get them the right treatments is good from that aspect of it as well.

And Joe, what are the...

Sorry, just -- sorry, John. And also I think -- it's also worth noting that in terms of adopting this or having the spread across the U.S., the folks that -- but the folks that do adopt it, will get those benefits, benefits to patients, better patient outcomes, more revenues. And that -- I think that naturally creates the tension, the competitive edge. These U.S. hospitals do compete to be the best in their region or the best in the nation. And they want to have the best technology. Best Doctors is great, but combining the best doctors with the best technology is the way to get them to the top of their league tables and the best biggest programs. Sorry, John.

Yes. No, that's fine. Thank you Andreas for that input. And Joe, to Andreas' point, how do you see that competition for podium space at your hospital? Is that something that your colleagues and yourself aspire to?

As far as being the best center whatever -- Yes. I mean we are like -- we're always like, how many lung transplants do we do? Well, how does that compare to Vanderbilt that compared to Pittsburgh. How many cardiac surgery we do? Now it's a big deal. And I'm a big lung biopsy and an [ interventional ] person. I want to know those numbers.

And just on a pragmatic matter, what difference does this surgery make in patient lives if you get it right?

It's interesting. I always thought, okay, you chop out a nonfunctional part of the lung, does it really help. And then I put in the chest tube on 1 of these patients, and he told me, when I came out of that lung volume reduction surgery, I felt immediately better. And I was putting in a chest tube in because he had a second surgery. And he was like, I couldn't wait to get the second surgery. I am functionally -- immediately better as soon as he was discharged and it's a game changer.

Okay. And you discussed also the various therapies, the medicines that are available for the treatment of these patients. Does CT:VQ exam allow you to monitor the performance of those drugs better?

100%, because you're getting functional imaging. And with that functional imaging, you're also being able to get regional information. There may be only a certain -- maybe it's right upper lobe, that's the only low that's doing anything. And you're going to miss on PFTs, but with this, you're going to see the change in the right upper lobe. And I think that in a $200,000 a year drug, that's a game changer.

If I can just -- I mean Joe always speaks so well, but if I can just try to explain this the way I've had to sometimes if -- let's say, you have 5 lobes in your lung, when you're doing PFTs, if you're only interested in the data out of 1 of those, the PFT is giving you data from 5 of them, and that's all combined into the 1 space. The doctor has to try to work out, do their best to try to understand how much of that signal they're seeing and the changes relative to the lobe they care about versus the other 4 that are sort of noise on that signal. Whereas when you can look at it and see and collect that data directly from each of the lobes on that regional basis, that really changes the sort of that signal-to-noise ratio. We get that feedback all the time that being able to just zoom in and only look at the data from the part of the lung that the doctor cares about is super helpful.

Andreas, a couple of weeks ago, you announced a deal, I think it was with MSK or 1 of the big pharma companies. Yes...

Yes, with Glaxo.

Yes. And they're interested in using this drug in their clinical trial process. So let's talk about that for a second because it's on the same sort of vein is what we're discussing here.

Yes. I think there's a number of ways that we can assist pharmaceutical companies in their work. One of them is that we can identify and help exactly as we just discussed here with the identifying, streamlining who are the right people to get lung volume reduction surgery. Drug trials can often fail in terms of who are selected to participate in the study. Can you find enough people who fit the criteria as neatly as possible who are likely to benefit? And in addition, we can also identify the changes who's benefiting from that drug throughout that trial. And then finally, I think the end goal for us and really the top of the mountain there is when we can be a key part of that development, a key part of identifying, who is appropriate for the drug in the trial, we'd love to be that in the clinical world as well, so that folks say, okay, let me get a 4D Medical VQ scan. And if they meet these criteria, then I'll put them on the drug because that's what the paper that I read said was the best way. And if we can have support from the manufacturers and adding GlaxoSmithKline for their COPD study, we already have AstraZeneca working with us with asthma, cancer and COPD. So just working out those indications, has the real potential for us to make a big difference to health care. Lots of people end up on these drugs. It is a long-term opportunity for really significant revenues. But in the meantime, there's really meaningful value in that folks at hospitals around the U.S. know that AstraZeneca and GlaxoSmithKline really do their DD and they can see that it gives us really significant validation in the marketplace in the short term as well.

Yes, that's increasingly encouraging. And Joe, you're clearly in the early stages of adopting CT:VQ. Do you anticipate further adoption for this process of monitoring the performance of these medicines?

Yes, absolutely. I think we need more studies like the one we just talked about the endobronchial valve. But as soon as those -- more of those happen, this is going to be an easy adoption just because of how simple it is to get the exam done.

Yes. And have you learned anything about the performance of these drugs since you've been using the CT:VQ exam? Anything you didn't know previously...

So Andreas, do you want to comment on that? On any...

Yes. Look, I think 1 of the -- I think, John, we're really -- I think we're too early to be definitive on that in that -- we've only really been -- I mean, Joe has had access to the technology, I guess, advanced access for a little bit of time. But in terms of clinical use, we really haven't, I don't think, had the technology there long enough to follow patients longitudinally down a drug -- down that pipeline. But we know with our experience with where we've been working with AstraZeneca for some time, we've been able to show in work with them that we've been able to dramatically shorten the period of time they need to follow patients because of the sensitivity of the technology we can reduce time points that previously might have been 6-month time points, down to 3- or 4-month time points because of that increased sensitivity.

Okay. That's good. Joe, just back with you. I just want to -- just round out this discussion now. In terms of getting more universal adoption at your hospital and also in other KOL sites and academic medical center sites, what are the keys from this point to more broad adoption do you feel?

I mean I think the key -- number 1 is just publications. This publication that just came out in the Blue Journal, I think, is going to be a game changer because now you're going to have some -- the pulmonologist who put in valves are always like, I need to identify a patient. They have no way to be able to really identify what patients would benefit. So as these studies come out, then people will get more confidence in it and it'll be using it at a ton. And I'll tell you the people who are doing procedures see the functional imaging and they want to do it.

Okay. And what's the level of excitement at your hospital, I mean, you're clearly converted, but you've probably got a number of skeptics there as well.

Yes. I mean we're definitely -- Duke is a skeptical society. That's for sure. We were very, very evidence-based. I'll tell you the images that I've shown -- and I've been targeting my surgeons and pulmonology colleagues, they are in love with them. And those are the people I want to impact. And so our CT surgeons and our pulmonologist like functional imaging with non-contrast, tell me more.

Okay. So what's your expectation for your use of this product over the next 12 months or so?

Myself?

Yes. And also your hospital. I mean Duke has got -- I imagine has got a number of hospitals in the group.

Yes. So we're a major respiratory center. We see every chronic lung disease. And so essentially the way I look at this is I really want to look at it with interstitial lung disease. I know my ILD colleagues who have shown it to with pulmonary fibrosis and stage lung disease, they really want to look at it because that's where the drugs are. But I've also been talking to my cardiology colleagues as well in those patients with CTEPH and right heart dysfunction, all of those patients have perfusion abnormalities. And I think there's excitement in the group to scan more of these people to see outcomes with those people.

So you're sort of painting a fairly optimistic picture there. So that's all sounding pretty good. Matthew, I'll just bring you in. Matthew Tucker, who's the Chief Operating Officer and Commercial Officer at 4DX. Matthew, good morning to you. You are in Sydney.

I am in Los Angeles [ for ] ATS. So I haven't [ made it back yet ].

I can't keep up with you guys. Matthew, perhaps a couple of comments from you.

Yes. Well, I think we talked about this prestigious publication in the Blue Journal, which is the ATS, the conference we have just been up there, their major scientific journal publication. But as Andreas indicated, we've had record number of sales leads generated, but the clinical team also presented a record number of posters for us there. We had 9 posters on display. We had at least 3 innovation hub discussions. Joe and I did 1. Andreas and Michael Lester out of Vanderbilt, and Mehul out of Pittsburgh, did another 1 and then Trishul Siddharthan, I think you've spoken to as well, John, out of Miami, gave a talk and all extremely well attended, great level of interaction and conversations of that. So my team in the U.S. has never been stronger and their sales funnel has never been stronger and really happy with the progress.

Okay. You were at ATS. What are some of the other things that you saw there that some of the other products you've got that were interesting to clinicians?

Yes. For that marketplace, John, as pulmonologists, we do need to remember the U.S. system is for profit. It's very different to the Australian system where we really don't want more people coming in the hospital door. They're trying to attract and find the right patient to treat at the right time and deliver the right care to. So our population health screening tools where we do the screening of the packs and find the appropriate patient and try to take them down into a suitable patient for the bronchoscopic therapies or the lung volume reduction surgeries, or even just a smoking cessation consultation with the pulmonologist. They're really something that was interesting to the group. Incredible conversations around long COVID. This is still a massive population problem, long COVID, that brain fog they get and the shortness of breath that is just ongoing. So great conversations around how CTV can actually help identify those patients from a physiological standpoint, and not be bound by just pure imaging.

Yes, it'd be nice to get...

If I can just jump in a cheeky point on the end of that too, there, I think I certainly observed directly a number of senior clinical teams from the VA visiting the booth over the course of the conference as well. So that was exciting to see that happening at ATS as well.

Yes. And obviously, your distribution partner in the United States is Philips. They would have had a, obviously, a very significant presence there as well what are they doing with this, Matthew?

Yes, they were really well engaged. They're on our booth. So they're part of the team, really just part of the family. They're driving a lot of activity at the moment. Obviously, working out some VA opportunities for us, which we will hopefully share with you shortly, but there's a considerable number of academic medical centers where we're hand-in-hand working through sales processes in the final stages at the moment.

Okay. All right. Now operator, I'm going to pause there, please. And I would like to invite any one or 2 questions from the audience if there are any. So if we could open the lines up, please.

All right. I'm just waiting for questions.

Yes, we will -- Okay. It looks like we'll just keep going for just a minute or 2 operator, if there are no questions coming through. Actually, I've just been informed that we weren't planning to ask questions from the audience. So perhaps I'll just take a moment just to wrap things up. And perhaps just a final question to Joe. Joe, can you give us perhaps your expectation then for over the next 12 months or so, what you'd like to see in terms of further product development? Or is the product there, do you think that you need?

Everything I've seen with the product is it's ready to go. But look, I was blown away by being able to get this kind of information from a non-contrast scan. And with the validation studies that have been performed, it's just very exciting. So I'm ready to use this clinically and just have it take off and see it in every chronic lung disease. And see what it looks like.

That's pretty good. Good. Andreas, some concluding remarks from you.

Yes. Look, I think it's very encouraging to hear that from Joe, I actually haven't asked him that question myself. So John, so that's great and encouraging to hear that. On that -- firstly, on that topic, we are very excited to be next working to be able to not only now -- as we can now replace nuclear VQ but soon to be able to replace CTPA for acute PE. I think that's an exciting next step. And as I said, with just the incredible level of interest, we have the pipeline really bursting at the seams, a sales team that's really firing on all cylinders. I think both commercially and clinically, the next 12 months is going to be just completely unlike anything we've had at 4DMedical before.

Andreas, you've got an ongoing clinical program as well. Is it appropriate to talk about any of those upcoming studies at this time?

Look, we're getting very close to being able to talk publicly about we're going to be doing a large multicenter study to be able to evaluate our technology to be able to go up against CTPA. We're getting -- we're just not quite in a position to add much more than that. But what I can say is that's really been very organically driven. Every time we speak to a site, after they finished learning about how they can replace nuclear VQ, always someone says, can we also replace CTPA? We'd love to do that. We have -- and there's a whole range of systemic issues around delivering contrast, whether it's the allergic reactions, the kidney issues or the very high level of scans that deliver non-diagnostic results. So we get that very organic drive from hospitals asking for that, and we're responding promptly and we'll be -- I think we'll be putting out something, I think, hopefully, in the next month or so to really talk through exactly how we're going to do that in detail.

And Joe, I imagine you read a heck of a lot of large CTPA exams as well.

Every day. We have about 15 we walk into. Every day from the evening. Yes.

And that will all be done with a single CT scan. So there's going to be a huge increase in productivity there as well. Matthew, perhaps a couple of just concluding remarks from you as well over -- of your expectations for the next few months.

It's incredibly busy, is the short answer. I think you'll see a lot coming from us is all I would say, whether that be VA, whether it be academic medical centers, other clinics. And obviously, we're -- we've got an eye on Europe, which Andreas has teased about as well.

Yes. Well, we haven't talked about Europe, but you've got some really good open doors into some of the major clinical hospitals in London as well. So that will be exciting next leg of growth. Look, we'll wrap it up there. Thank you all for your time today. Thank you, Joe. It's late where you are. Thank you, Andreas and Matthew, for your time this morning. I hope, as the audience, you've got some value out of today, we've certainly covered a lot of ground. And thank you for your time again. We'll wrap it up there. Thank you, operator.

That does conclude our conference for today. Thank you for participating. You may now disconnect.