Cytokinetics, Incorporated (CYTK) Earnings Call Transcript & Summary

Welcome, ladies and gentlemen. I'm John Henderson. I'm Chairman of the Board of Cytokinetics' Board of Directors. Welcome to our 2024 Annual Meeting of the Stockholders, and I now call this meeting to order. John Faurescu, Associate General Counsel and Corporate Secretary, will record the minutes. Before proceeding to the formal business, let me introduce Robert Blum, the company's President and Chief Executive Officer. Robert will provide a review of our 2023 accomplishments and plans for 2024 after our formal proceedings. Before proceeding further, I would -- pleased to introduce the other members of the Cytokinetics Board of Directors who are here with us today: Muna Bhanji, Sandy Costa, Ed Kaye, Lynne Parshall, Sandy Smith and Wendell Wierenge. I would like personally to thank Sandy Smith for his long-standing service to our Board as he steps down and will not be standing for reelection today. Sandy has contributed greatly to Cytokinetics over many years, and we're grateful to him for his dedicated service and his insights and oversight that guided us. Sandy's wife, [ Ellen ], is also here with us today, and we welcome her. We have another special guest today, our former Chairman, Pat Gage, and his wife [ Arina ] are also in attendance. Welcome to you both. It's great to see you. I also would like to introduce the other members of the company's management who are joining us in person today: Steve Cook, Senior Vice President, Supply Chain and Tech Ops; Erin Donnelly, Vice President, Portfolio Management; Sung Lee, Executive Vice President, Chief Financial Officer; Diane Weiser, Senior Vice President, Corporate Affairs; Robert Wong, Vice President and Chief Accounting Officer; and Scott Jordan, sorry, I've got [indiscernible] alphabetical order here, Senior VP, Global Marketing and Commercial Strategy. Finally, I would like also to introduce Dan Coleman of Ernst & Young LLP, the company's independent registered public accounting firm. He is available to respond to appropriate questions. Now I would like to turn the meeting over to John Faurescu to conduct the formal business of today's meeting as set forth in your notice of annual meeting and proxy statement. After the formal part of our meeting, Robert Blum will review the company's recent business activities. Robert? Sorry, John?

Thank you, John. I have at this meeting a complete list of the stockholders of record of the company's capital stock on March 26, 2024, the record date for this meeting. I have proof by affidavit that the company's proxy statement, proxy card and annual report on Form 10-K were deposited in the United States mail commencing on April 8, 2024, to all stockholders of record at the close of business on March 26, 2024. The affidavit, together with copies of the proxy statement, proxy card and annual report, will be filed with the minutes of the meeting. In addition, Robert Wong, Vice President, Chief Accounting Officer, will serve as the Inspector of Election to carry out the duties set forth under the General Corporation Law of the State of Delaware. Mr. Wong has signed an oath of office as Inspector of Elections. The oath of Inspector of Election will be filed with the minutes of the meeting. We have present, in person and by proxy, holders of a sufficient number of shares to constitute a quorum, so the meeting is duly constituted. We will vote by proxy and written ballot today. If you are a stockholder attending the meeting today in person and have turned in a proxy card and do not intend to change your vote, then it is not necessary that you vote because we will count your votes as expressed in your proxy. Those attending stockholders present in the room today, who did not turn in a proxy card or who wish to change your vote and have your proxy card with you, please raise your hand. Are there any additional proxies to be submitted at this time? Is there anyone present, whether or not you already submitted a proxy, who now wants to vote in person? The first item of business is the election of directors. The following 2 directors are nominated by the Board of Directors as Class II directors of the company to serve until our 2027 Annual Meeting: Robert Blum and Robert Harrington. The Board of Directors recommends that the stockholders vote for these 2 Class director nominees. The second item of business is the approval of the amendment and restatement of the company's amended and restated 2015 employee stock purchase plan to increase the number of authorized shares reserved for issuance thereunder by 300,000 shares of common stock. The Board of Directors recommends that the stockholders vote for the approval of this proposal. The third item of business is the ratification of the selection by the Audit Committee of our independent auditors. The Audit Committee of the Board of Directors has selected Ernst & Young LLP to serve as our independent registered accounting firm for the fiscal year ending December 31, 2024. The Board of Directors recommends that the stockholders vote for the ratification of this selection. The fourth item of business is the advisory vote on the executive compensation of the company's named executive officers as described in our proxy statement for this annual meeting. The stockholders have been asked to vote on an advisory basis on the following resolution: resolved, that the company's stockholders approve, on an advisory basis, the compensation of the named executive officers as disclosed in the company's proxy statement for the 2024 Annual Meeting of Stockholders pursuant to the compensation disclosure rules of the SEC, including the compensation discussion and analysis, the related compensation tables and the narrative disclosure to those tables in this -- in the proxy statement. The Board of Directors recommends that the stockholders vote for the advisory proposal. We will now review if there are any questions about the aforementioned proposals before we close the polls. If you have voted in today's meeting, would you please give your ballots to the Inspector of Election? It is now 10:08 a.m. Pacific Time, and the polls for each matter to be voted at this meeting are now closed. No additional ballots or votes and no changes or revocations to ballots or proxies will be accepted. At this time, I would like to report on the results of the voting. Regarding Proposal 1, the proposal to elect each of Robert Blum and Robert Harrington. Robert Blum received 87,317,169 votes for his election, 2,214,926 votes were withheld and there were 6,649,555 broker nonvotes. Robert Harrington received 78,347,186 votes for his election, 11,184,909 votes were withheld and there were 6,649,555 broker nonvotes. Therefore, the proposal to elect each of Robert Blum and Robert Harrington is approved. Regarding Proposal 2, the approval of the amendment and restatement of the company's amended and restated 2015 employee stock purchase plan to increase the number of authorized shares reserved for issuance thereunder by 300,000 shares of common stock. Votes in favor of the proposal were 88,586,473. Votes against the proposal were 481,098, 464,524 votes were abstained and there were 6,649,555 broker non-votes. Therefore, the proposal is approved. Regarding Proposal 3, the ratification of the appointment of Ernst & Young LLP by the Audit Committee of our Board of Directors as the company's independent registered accounting firm for the fiscal year ending December 31, 2024. Votes in favor of the proposal were 95,957,265. Votes against the proposal were 97,750, 126,635 votes were abstained and there were 0 broker non-votes. Therefore, the proposal has been ratified. Regarding Proposal 4, the resolution concerning the advisory vote on the compensation of the named executive officers as disclosed in the company's proxy statement for the 2024 Annual Meeting of Stockholders. Votes in favor of the proposal were 85,814,395. Votes against the proposal were 2,927,007, 790,693 votes were abstained and there were 6,649,555 broker nonvotes. Therefore, the proposal is approved. This concludes the formal business of the meeting, and we would now like to begin our report to stockholders. The meeting is now concluded. The following discussion and presentation contain forward-looking statements under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Our actual results might differ materially from those projected in these statements. Factors that could cause our actual results to differ materially are contained in our SEC filings, including our most recent annual report on Form 10-K, quarterly report on Form 10-Q and current reports on Forms 8-K. Copies of these documents may be obtained from the SEC or by visiting the Investor Relations section of our website. These forward-looking statements speak only as of today. You should not rely on them as representing our views in the future, and we undertake no obligation to update these statements. I will now turn the meeting over to Robert Blum, our President and Chief Executive Officer.

Thank you, John. In my role as President and CEO, I'm pleased to be addressing you at Cytokinetics' 20th Annual Stockholder Meeting. Thank you to everyone who has joined us in person and to those listening by phone and online. As reflected in our shareholder letter, 2023 was a year in which Cytokinetics reached new heights related to the advancement of our cohesive muscle biology programs, anchored by cardiac myosin inhibition. Most notable among our achievements was our sharing positive results from SEQUOIA-HCM, the pivotal Phase III clinical trial of aficamten, our cardiac myosin inhibitor in patients with symptomatic obstructive hypertrophic cardiomyopathy, or HCM. The results surpassed already high expectations and represented a transformational inflection point for our company. We just returned from the European Society of Cardiology, Heart Failure 2024 Congress in Lisbon yesterday, where these results were presented more fully and published in the New England Journal of Medicine to great enthusiasm from the scientific and medical communities. In 2024, we are now proceeding with conviction toward regulatory submissions in both the U.S. and Europe and have activated our next phase of commercial readiness ahead of the potential approval and commercial launch of aficamten in 2025. At the same time, as patients from SEQUOIA-HCM enroll in FOREST-HCM, the open-label extension clinical study of aficamten, we continue to collect evidence of the efficacy and safety of longer-term treatment. In fact, earlier this year, we shared data from FOREST-HCM showing that treatment with aficamten resulted in favorable cardiac structural remodeling, suggesting that our potential medicine may be able to alter the architecture of the heart in patients with obstructive HCM. Building on SEQUOIA-HCM, last year, we expanded the development program for aficamten with 2 additional Phase III clinical trials: MAPLE-HCM, evaluating aficamten as monotherapy compared to metoprolol as monotherapy in patients with obstructive HCM; and ACACIA-HCM, a pivotal trial evaluating aficamten in patients with non-obstructive HCM. Each of these clinical trials holds opportunity for aficamten as a next-in-class cardiac myosin inhibitor to potentially support additional patient populations with HCM as may be potentially underserved by currently available treatment options. And more recently, we announced the start of a third clinical trial called CEDAR-HCM, evaluating aficamten in the pediatric population with symptomatic oHCM. Alongside progress made with aficamten in 2023, we also advanced our earlier-stage pipeline. During the year, we started a Phase I study of CK-586, our cardiac myosin inhibitor with a mechanism of action distinct from aficamten that we intend to develop for the potential treatment of a subgroup of patients with heart failure with preserved ejection fraction or HFpEF. Despite available therapies, patients with HFpEF remain at high risk of cardiovascular events and are in need of new therapies. We recently announced positive results from this study, which informed the advancement of CK-586 into a Phase II trial expected to begin later this year. In 2023, admittedly, we also experienced setbacks, including our receipt of a complete response letter from the U.S. FDA regarding our New Drug Application for omecamtiv mecarbil for the potential treatment of heart failure with reduced ejection fraction. And also, we announced the termination of development of reldesemtiv after COURAGE-ALS, the Phase III clinical trial in patients with ALS showed it had no effect, unfortunately, on either the primary or secondary endpoints. While these setbacks were indeed disappointing, we remain committed to learning from all experiences in furtherance of our mission. Now in 2024, we're well positioned to execute that mission. We begin the year on strong financial footing with approximately 2 years of forward cash runway. And as more programs mature from our laboratories and into the clinic, we look forward to further expansions of our pipeline beyond the mechanics of muscle contractility to also extend to other areas of muscle biology, including metabolism and energetics of muscle, and as may further unlock shareholder value and move Cytokinetics to the next tier of biopharmaceutical companies. In the abbreviated corporate presentation that will follow, I plan to share highlights and elaborate on this progress we achieved in 2023 as well as provide you an update on some more recent activities related to these development programs. For those of you joining us by webcast, you can find a PDF of the presentation slides under the Downloads tab in the webcast window. And I'll now move to the podium and begin a further update on the company. Again, I'll be making forward-looking statements. And as John already elaborated, we don't provide updates on these statements. You shouldn't rely on them, but rather instead return to our SEC filings for caveats with regard to these forward-looking statements. Here, again, we outlined our Vision 2025, which we believe we're executing well on. And as recent progress demonstrates, we continue to make progress towards enabling of regulatory approvals, we hope, from our pipeline by 2025 and the building of commercial capabilities to enable support of expansion of our business to ensure access of potential medicines to patients who may benefit. And at the same time, we hope to be setting the table for generating sustainable and growing revenues from product sales while also expanding our development programs and expanding the discovery platform, all the while remaining that science-driven company people want to join and partner with. I'm very excited that this year, under the supervision of Scott Jordan, we're going to be conducting a strategic planning process for which we're going to outline for the company and, ultimately, for shareholders what should be those tenets of our Vision 2030. Today, our research and development pipeline is anchored in this structure, the sarcomere. You've seen us talking about this time and time again. We believe we're the first company to really mine this structure, this biological unit of muscle contractility, for potential medicines. And as you'll hear, and I'll update today, primarily with regard to aficamten, omecamtiv and CK-586, these modulators of cardiac myosin are important to how we achieve our mission as well as our purpose. And as these drug candidates are all either activators or inhibitors of cardiac myosin, we believe that's the cornerstone for how we can ultimately reward shareholder value. Here is a snapshot of our pipeline today, and you can see it's anchored in cardiac myosin. Aficamten represents the leading edge of this pipeline. It's our first inhibitor of cardiac myosin advancing to patients, but CK-586 represents a second one, around which we're lifting the veil in recent weeks. Omecamtiv mecarbil, a cardiac myosin activator, remains important to our strategic value. And as you can see here, we have other pipeline programs that are advancing, albeit at earlier stages. Today, again, I'm going to focus more primarily to aficamten. But all these together form a mosaic of our interest for what could ultimately be the business anchored in a specialty cardiology franchise directed to those patients with severe cardiac dysfunction and muscle weakness and for which there's a concentrated customer segment addressing those potential market opportunities. And here, you see the prevalent patient populations for those more severely ill cardiac patients that form the basis of our ambitions in cardiac specialty franchise areas and for which we believe a concentrated sales and marketing infrastructure can produce a higher return on shareholder equity, a higher return on shareholder and sales and marketing investment. Starting with aficamten. This is the market opportunity that we're focused on. It's an opportunity defined by hypertrophic cardiomyopathy. Here you see both those patients currently symptomatic and diagnosed as well as what we believe to be a prevalence of those that might still have this disease and perhaps not yet properly diagnosed. We believe this is a large and growing opportunity, albeit concentrated, as I mentioned, to a fewer number of treatment centers, roughly weighted 2/3 those with obstructive disease and 1/3 those with the nonobstructive form of this disease. Like other market opportunities where new cardiac innovations have unlocked the door for higher diagnosis rates and more prevalence, we believe that's also going to be the case in the area of HCM as is already occurring with the introduction of a first new medicine indicated for this population, BMS' Camzyos or mavacamten, now commercially available. Aficamten represents a potential next-in-class opportunity, next-in-class cardiac myosin inhibitor. And here, you see outlined our aspirational target profile. We believe aficamten has been designed and engineered and is already demonstrating, in clinical research, properties that could be enabling of a next-in-class profile and potentially become ultimately the physician choice in this category. Properties, as you see here, like: a rapid onset and rapid reversibility due to up-titration with a short half-life; speed to optimal dose that can be contributing to faster time to symptom burden relief; and again, a predictable dose response; absence of [ tetrageneity ] (sic) [ teratogenicity ]; and also, we believe, no clinically meaningful drug-drug interactions. These are the properties that we're designing into our clinical trials to elaborate on with hopes that aficamten can become next-in-class and physician's choice. We're also pursuing an aggressive, ambitious and broad development plan for aficamten, led by SEQUOIA, which we just announced to the medical community on Monday, but followed behind with other Phase III clinical trials, MAPLE, ACACIA and CEDAR, as well as a continuing open-label extension FOREST. We believe this represents an unusual and uncommon broad development program as we'll inform physicians and, ultimately, payors as well as for the potential benefit of patients. SEQUOIA is outlined here. This is the first of what we hope will be several pivotal Phase III clinical trials. This study, 24 weeks in duration, looked at aficamten added to standard of care with a primary endpoint of change from baseline in peak VO2 measured at 24 weeks and secondary end points, as you can see here. We ultimately enrolled 282 patients with baseline characteristics described here. Bottom line is this table defines what is a well-treated population adherent to standard of care in a very compliant way and, as we believe, represents a real-world population of primarily New York Heart Association Class II and Class III patients, who could stand to benefit from a potential add-on treatment, given what appears here to be already still remaining high disease burden. And as we look at the primary endpoint, we're very pleased to see here a clinically meaningful and large change from baseline in peak VO2, a measure of exercise capacity and stamina. This was mentioned when presented earlier this week as an uncommonly high treatment effect. Perhaps no other treatment study has demonstrated such a meaningful effect on peak VO2. This measure of exercise capacity is a proxy for other hard clinical outcomes and has already been accepted as an endpoint for potential FDA registration. So we were very, very pleased with large magnitude effect observed here on top of standard of care. And you can see with a p-value followed by many 0s that this is deemed highly statistically significant. So this is a moment of celebration for our science and also our company and for the benefit of patients and shareholders. When these data were presented on Monday in Lisbon, the crowd cheered and clapped their hands in a way that's quite unusual in a medical meeting. Here are the prespecified subgroups. And what you can see here is the effects were consistent and robust, large magnitude and consistent across all prespecified subgroups. This, too, is unusual, no anomalies, no outliers. This is reassuring of the primary effect, most especially, as you can see here and as we believe, reinforces a potential next-in-class profile. The effect was observed on peak VO2, whether patients were on beta blockers or not. There was no attenuation of effect in the presence or absence of beta blockers. And we think that is going to be another point of advantage, potentially, for aficamten. Also, very importantly, and this is quite important, we saw highly statistically significant large magnitude of effects across every single one of our prespecified secondary endpoints. And as you can see, as highly statistically significant, this is not something one sees every day and provides, perhaps, some evidence to the adjective I've used in describing this data set as pristine. And some of these decimal points go out to many, many, many, many, many, many 0s and -- so many that we didn't reflect them on this slide. I think this'll be further reassuring that these are, in fact, high fidelity results. Getting a little bit deeper into these data, you can see in terms of secondary and exploratory endpoints, large magnitude reductions in left ventricular outflow tract gradients measured resting and Valsalva. These effects are observed promptly after initiating of dose, and they're maintained. And as you would want to see, the effects subside with a washout of the drug after 24 weeks. We're also seeing large improvements relative to standard of care in measures of New York Heart Association Class, KCCQ. These are measures of physician respondent -- or patient respondent, safety and quality of life as well as a reduction in guideline eligibility for SRT. SRT is the surgical alternative to the use of a potential myosin inhibitor. The fact that patients promptly are no longer eligible for SRT means the drug is doing what it's supposed to do. We're also seeing very large decreases in BNP. This is a measure of cardiac wall stress, which is perhaps the best prognostic biomarker of disease burden. Here, you can see the safety. And we're pleased to see that even as added to standard of care, the addition of aficamten provides a balanced safety profile, the AE incidents balanced across treatment groups. No serious adverse cardiovascular events with aficamten attributed to treatment in SEQUOIA-HCM. We believe this will provide, again, further confidence to not only convenient dosing, but also the safe and well-tolerated profile. Now we did measure what would be EF excursions in this study. By protocol, those that were determined by the site led to down titrations in a few, relative less than 5% of patients. And that was further validated by an echo core lab at the Brigham & Women's Hospital. And whether you look at site-read echos EF below 50 or core lab echo excursions below 50, in no instances where there treatment interruptions or terminations, no heart failure experienced by any aficamten-treated patient. And this -- the strategy of down-titration when EF falls below 50 was deemed by the investigators to be sufficient to maintain patient safety. Where it did occur, there was a rapid reversibility of that EF excursion with a down titration. And that, overall, contributes to, we believe, again, a next-in-class profile. Here, you see the conclusions as determined by the investigators when these data were presented on Monday. I won't read them all. You can read them yourself. But I think it goes a long way to meaning that we achieved our objectives across all of the endpoints for safety and efficacy as well as potential convenience from this pivotal study. And we look forward to now moving forward with regulatory submissions with the U.S. in terms of an NDA to be submitted to FDA. We expect that'll occur in this Q3. And similarly with EMA and MAA to be submitted in Q4. And alongside of our partner, Ji Xing, moving forward with potential regulatory submissions in China. We believe we're doing right by this science to now aggressively move forward across the globe and seek regulatory approval and marketing authorization for aficamten based on the results of SEQUOIA-HCM. We hope those approvals will come in 2025. In the meantime, we're continuing to conduct other clinical studies, as you heard me mention before: MAPLE as could be enabling of aficamten to demonstrate superiority to first-line beta blockers, ACACIA as could be extending of this mechanism to the adjacent population of nonobstructive HCM, CEDAR to a pediatric population of oHCM. And all of these patients are rolling into the open-label extension for us as is continuing to demonstrate, we believe and longer-term follow-up, the continued safe and effective use of aficamten. As we think about going to market, here, you can see our believed diagnosis of HCM, those that are still under the hood, so to speak, in terms of undiagnosed and where we see this potential market going. This is a market that we will enter that's already demonstrating to be receptive to the use of a myosin inhibitor, that being BMS' Camzyos, and we look forward to potentially joining BMS in that marketplace to ensure more and more patients may ultimately benefit from a myosin inhibitor. As we go forward, we're now conducting our commercial readiness activities. And even before we had SEQUOIA, we had a target product profile. We tested that target product profile in market research. Here, you can see the results. There seem to be a majority of physician responders who looked to the target product profile as preferential for aficamten as could lead to ultimately a dominant market share. But again, now that we have these actual data, we should repeat this market research, and we intend to do that as of this week. We've kicked off new market research with the actual data, and we'll go back to market research to inform what could be, ultimately, positioning and forecasting and commercial strategy. Our business strategy is rooted in the expectation that we can do something uncommon amongst biopharma companies in the cardiology sector. Most biopharma companies in cardiovascular medicine pursue a different business strategy than that which is outlined here. They perhaps go after a broader cardiology arena. You can see the properties of that kind of strategy. We believe that with a specialty cardiology franchise, as does have some examples in our industry, we can focus to a concentrated subset of cardiologists where there's a higher return on investment, we believe, and where we think we can attract more experienced representatives and where there may be more leverage in the marketplace. And we can build on what will be already the work -- the good work that BMS is doing as could benefit more and more patients who may receive aficamten. And as we go forward with that strategy, we're focused to a fewer number of concentrated customer segments, those HCM centers, hospitals and physicians that treat a majority of these patients. Right now, roughly 400 prescribers account for about 80% of Camzyos prescriptions. We believe with the sales organization in the range of 125 to 150 representatives, complemented by medical scientists, payor liaisons and nurse navigators, we can focus to a fewer number of centers. And in context of our more limited access to capital, we can compete effectively for the mindshare of physician prescribers. But it's important that we do that in a fiscally prudent way. And we will continue our practice of looking at key derisking milestones, like regulatory approvals, like reimbursement approvals, to ungate spending, investment in commercial infrastructure. We don't intend to hire, for example, those sales reps until well into next year when we hopefully will have a read on potential approval and labeling positioning, and that will be coincident with commercial launch. Until then, we have in place already, we believe, most of those people that need to plan for that strategy to be implemented and deployed. So that's aficamten. But that same science, that same biology reads on how we're thinking about CK-586, another cardiac myosin inhibitor in another adjacent population. And here, you can see a slide that depicts the differential mechanism of action for CK-586 alongside of that, which is described for aficamten. It binds in a different place and has a different mechanism of action, and we think it may lend itself to different physiochemical properties that may render it an attractive drug candidate for this adjacent population of patients with heart failure and preserved ejection fraction. This is a much larger market opportunity, but again, with a concentrated customer segment that we think we can afford to go after. There are, trending towards 2030, upwards of 8 million patients of heart failure, about half of whom have heart failure with preserved ejection fraction. But it's about 1/3 of those patients who have the anatomy and the physiology that we think may benefit from a myosin inhibitor. These are not the heart failure with preserved ejection fraction patients who may likely benefit from GLP-1s, for instance. These are patients who are not your cardiometabolic syndrome patients, not your obese heart failure with preserved ejection fraction patients, but patients with higher ejection fractions and other characteristics that may render them benefiting from a myosin inhibitor. And our Phase I data, albeit in healthy volunteers, speaks to the safety, tolerability and pharmacokinetics that we believe provides the basis by which we should now proceed to Phase II later this year in patients with heart failure and preserved ejection fraction. The design of that study is still forthcoming, but built on the preclinical evidence. We do believe there's a good therapeutic rationale for a proof-of-concept study to start later this year in this adjacent population. You've heard over the years of how we think about omecamtiv, a cardiac myosin activator for the potential treatment of heart failure with reduced ejection fraction. To remind you, it was a program of long-standing commitment at Cytokinetics. We conducted -- or our partner Amgen conducted 32 clinical trials over many years, including a positive Phase III study called GALACTIC, which read out a few years ago. On the basis of GALACTIC, we submitted regulatory applications in both the United States and Europe. And with recent updates, we've provided, including our recent 10-Q -- we've elaborated that we received a CRL from FDA, and we withdrew our marketing application with EMA in both cases because regulatory feedback spoke to the following: that while the data were deemed encouraging, regulatory authorities would like to see a confirmatory study with regard to omecamtiv mecarbil,as could be reassuring that the effects observed in GALACTIC are, in fact, reproducible in a second study as would meet the standard potentially, if achieved, for a potential regulatory approval. So as it relates to that feedback, we're regrouping and reconsidering what should be our next steps with regard to omecamtiv mecarbil, and no specific decisions are yet forthcoming as we hope to perhaps elaborate on a go-forward basis. In the meantime, I'll now summarize with the corporate profile. Here, you can see how we're doing, again, relative to Vision 2030. We do -- 2025, rather. We do hope to be launching our first commercial medicine in 2025 while advancing the currently -- advancing clinical stage programs. You see here, ours is a company deeply rooted in a broad development program for aficamten, but with other interest in mind as our pipeline continues to mature, advance and broaden alongside of ongoing R&D. And we take great pride at Cytokinetics that, as we forward integrate, potentially to become a commercial enterprise, we haven't given up on our long-standing commitment to advancing new innovations in research and development, again, always disciplined and rooted and anchored in muscle biology. Ours is a company now of over 400 employees, both here in South San Francisco and in Radnor , Pennsylvania, and more recently, a nucleus, a small group of employees based out of Zug in Switzerland. We believe we have a strong balance sheet for what we aspire to do. We recently reported over $600 million on our balance sheet at the end of Q1, which represented, relative to our guidance for this year, approximately 2 years of cash consumption forward runway. And we expect to be able to add to that balance at the same time later this year as we've guided to our goal to conduct certain transactions that would be enabling of additional infusions of capital. Here's how we hope to reward shareholders and build more shareholder value over the next couple of years. In fact, these are nearer-term milestones that read on, we think, further advancement and further unlocking of intrinsic shareholder value as we hope will be rewarding of the commitments to this science and for the benefit of patients as well as all stakeholders. Here's the balance sheet as we reported at the end of Q1. I won't go into this in detail other than to say that if you have any other questions, I refer you to our earnings release or our recently filed 10-Q. Here you also see our net cash consumption financial guidance. And lastly, here are those milestones. I think I've touched on all of these in terms of what you should expect from Cytokinetics over these next few months, this year, and we look forward to keeping shareholders appraised of that continued progress as we appreciate your support and your interest. With that, I'll thank you. And I'll conclude these initial comments, open up the meeting for any questions as there may be any here in the room. There being no questions here in the room, I'd like to thank all of you who've gathered today, both in person and also online or listening in by telephone. I'd like to thank you for your continued support of the company. To be clear, we remain committed to our goal of transforming patient lives. We look forward to continuing to update you on our progress. Thank you again. With that, I'll turn it back over to John Henderson, please.

Okay. Thank you very much, indeed, Robert, for that update and the progress that Cytokinetics is making across our pipeline of muscle-directed therapies. As you will understand, 2024 is going to be a very important year for Cytokinetics as we advance aficamten toward regulatory submissions in the U.S. and Europe while continuing to execute on the broad development program for that compound and to expand the utility of that next-in-class cardiac myosin inhibitor across multiple patient populations in need. With a focus on building our specialty cardiovascular myosin business, including the advancement of our early-stage development of CK-586, another cardiac myosin inhibitor for the potential treatment of patients with heart failure with preserved ejection fraction, our future remains bright. And our values continue to guide us towards our mission to bring innovative medicines to patients and caregivers and to deliver continued progress against our goal of improving the lives of people living with diseases of impaired muscle function. I want to add my thanks to Robert, to all of you who have participated today in this stockholder meeting, and the meeting is now adjourned. Thank you very much, indeed, everyone.