Exelixis, Inc. (EXEL) Earnings Call Transcript & Summary

Fantastic. Hi, everyone. Thank you so much for being here today. For those of you that don't know me, my name is Courtney Breen, I cover large-cap biopharma here at Bernstein. I have spent a little while covering a lot of different companies, but my experience before being here was at Merck and spending a lot of time thinking about oncology. So I'm looking forward to this conversation today and getting to chat about kind of the work that's happening at Exelixis. I am privileged to share the stage today with Michael Morrissey, the CEO of Exelixis, and I will ask you to spend a couple of minutes perhaps giving a little bit of your background, kind of any high notes on the story that you would like to contextualize and then we'll dive into Q&A. A reminder for everyone in the room, please feel free to send through questions on the pigeon hole app, and I can integrate those into the conversation as well.

All right.

Over to you, Mike.

Well, Fantastic. Well, nice to meet you. We certainly aspire to be in your coverage universe. So good overlap there. But again, yes, I'm Mike Morrissey. I'm Chief Executive at Exelixis. Before I begin, I'll just remind you that I'll be making forward-looking statements today. So please see our SEC filings for a description of the risks that we face in our business. So Exelixis, commercial stage biotech company focused on oncology. I would say we're probably mid-adolescence in terms of our growth and development. Very fortunate to have a lot of really strong data and kind of time evolving the organization to the point where today, we're at a stage of having a strong franchise in RCC, kidney cancer, led by our flagship molecule called cabozantinib. Cabo is a molecule that we have discovered and developed in-house. It's in some ways, an interesting story about the journey biotechs can take over the years in terms of having early data, which may not pan out, early collaborations, which may not always reach fruition in terms of their success, having a company that has great people, great data opportunity to help a lot of patients and then commercialize their discoveries in a way that can bring value to shareholders, too. So that's really the cabo's story. First couple of indications didn't work well. It didn't fail in pivotal trials. We kind of shrunk the company kept hung in there with the belief and the data that it would be a big drug elsewhere in between 2015 and 2025. We have now a label with 7 different indications. The leading tyrosine kinase inhibitor in kidney cancer, new indication in neuroendocrine tumors that we think can really help revolutionize that tumor type and having the ability to monetize that, grow the top line, certainly been profitable for the last 7 or 8 years, investing a lot in R&D. Now with the pipeline of molecules across modalities, across combination partners, across indications that we think we really move forward pretty aggressively. So our goal quite simply is to take the learnings from cabo where we built a franchise from scratch and apply that to a pipeline that allows us to build really a pipeline of franchises. That's how you build real value for patients, for the system, the health care system and certainly for shareholders and that's our goal. So look forward to talking about all those different aspects today.

Fantastic. And I think kind of the way that you set that up kind of leads perfectly to where I wanted to take my first question, which is big picture on the company because you kind of highlighted some of the elements of the portfolio. You've got kind of cabo in market. It's got patent expiry in 2031. You've got zanza in Phase III kind of advancing and perhaps being that next innovation kind of coming pretty closely behind cabo. And then a series of Phase I assets. And these span of different modalities, different mechanisms of action, some in-house, some that you've acquired. What does the shape of the portfolio look like at the end of the decade? And how will you manage through that 2031 patent cliff? And I obviously spend a lot of time thinking about patent cliff in the companies that I cover.

Yes, as do we, right? So -- and I think that's the intermediate focus in terms of our aspirational goal to be -- to have this pipeline of franchise molecules, right? So yes, I think the whole cabo, zanza opportunity that transition is really designed and has been designed and we've been executing on to convert a patent cliff into, if anything, minor [pothole] in terms of how we think we can build revenues outside of cabo indications within cabo indications. Our main focus, and if you distill everything we do down to one phrase, down to one sentence, our goal is to improve standard of care for patients with cancer. Because as you know from your past life and what you do now, the only way you're going to get traction with prescribers. And then with payers and ultimately in the marketplace from a commercial point of view is to raise the bar for what patients can expect. Me-toos also ran, you may win with a P-value, but that doesn't necessarily mean you're going to win hearts and minds and ultimately, people writing scripts for you. So it's really around that. So how we navigate cabo to zanza is super important. And I think we've been able to kind of stage that and frame that really well in terms of we don't want to build zanza, cannibalize cabo in the process. So how do we maneuver things temporarily around the 2030 area. Certainly, overlapping indications, we want to see them hit kind of their terminal commercial velocity, if you will, post the LOE, but then building in things like CRC, other tumors where we think we can have a definite impact in 2025, 2026, et cetera. So a lot of moving pieces. Our pipeline is similar to what you would see with I think most big pharmas. We have diversity of targets, diversity of modalities, diversity of combination approaches. It all comes down to execution and really investing and looking at investments in terms of the ROI that we're looking forward on relative to, again, changing standard of care and then being able to monetize those assets. So we don't need to over invest early. We need to let the winners present themselves to us and basically say, with this data, moving into full development. With this data, it makes sense from an ROI point of view, from a science point of view, from an upside point of view commercially to be able to invest there. So we have a different approach. Most biotechs certainly today, they're looking for their next financing. We don't play that game. We've been out of that game for years, right? It's really around how do we -- in a very disciplined fashion prioritize how we invest because our commitment to keeping R&D at about $1 billion a year is real, and we've been really sticking to that. So we can have other -- we have lots of free cash then to utilize in other important ways. But it's that mix and match of how we do our investments and how we focus in terms of execution that we're always building value.

Absolutely. And I think you touched on a couple of things that I'd like to dive into. One is kind of the zanza as your second kind of asset here kind of going after the same opportunity space as cabo compared to going after kind of new indications that you are not currently playing in and sequencing that at the right time. How are you thinking about those priorities when it comes to price that you can garner for different indications, kind of when revenue will be generated, when perhaps the standard of care becomes cheaper and so therefore, your comparator is kind of coming off a lower base? Like how are you trading off all of those access as well as scientific challenges?

Yes. So for us, it's always about improving options for patients. Everything else is a second. And I think that has certainly been proven time and time again. You can exact the premium from a pricing point of view if you change the equation for patients. You can actually offer them something that will take a relatively acute opportunity therapeutically and make it into a chronic disease. And that's what we and others in collaboration with the competition have done in that space. You've taken a $3 billion, $4 billion market in the teens to what will be probably a $10-plus billion market moving into the 30s because you've -- the epi really hasn't changed, but you've actually pie bigger because patients are living longer, patients are on drug longer. You've changed the needle. You've changed the trajectory of their disease. And that's what we aim to do across the board, certainly in renal cancer, kidney cancer, in colon cancer. I mean everything we work on. And it's a pretty narrow focus is to do that. And that's what we bring to patients. And I think the system is set up to really support that as old drugs, which we beat go off patent and are then less -- a, they're certainly cheaper, but they're less likely to be used because there's other agents that are better. So that's the game. It's a simple game. It's just really hard, right? But it's mixing the science and the clinical work in the business. But look, we're in the p-value business. We have to -- we have pivotal trials have to work, and they won't always work and they won't always work as well as they do. But obviously, when they work well as they have for us, we can do a good job with them monetizing in terms of the commercial setting.

Fantastic. You also mentioned about kind of the cap on R&D spend and kind of the way that you think about financing your business, financing your innovation and continuing to advance the portfolio. Can you talk a little bit about how both your balance sheet and your margin profile today set you up to kind of navigate this cost and kind of give you the opportunity to make the bets that you need to? Do you have to look outside in terms partnerships, collaboration, anything along those lines?

So we look at capital allocation, and we're in a fortunate spot to be able to even be talking about capital allocation at this stage of our existence as a very important part of the business. We're investing and we have certainly made investments over the years in terms of both internal innovation as well as external innovation. We're not as GungHo about doing high-risk modest reward M&A. And I think we -- our work and our team has done a very, very deep dive into that. The fastest way to incinerate a lot of cash is to do bad M&A, right? And that's been proven time and time again. We're really focused on doing the right level of BD that allows us to back-end load investments and pay for success. And certainly, our -- say, our ADC platform, our bispecific platform has really been built on the back of external technologies that we like, that we've used very, very effectively in collaboration with a variety of biotech in a way to move the needle on the pipeline as well as then on the clinical side. If you look at the cabo development, we had clinical collaborations with every major player in the oncology space, and we're doing that with zanza now as well in a way to combine and conquer, right? And I mean, 9ER, the CheckMate 9ER trial was cabo/nivo versus sunitinib in the front line setting. I mean that's got to be in the ROI hall of fame, right? We paid $0.25 on the dollar for that trial. And it basically -- the success there and the ensuing commercial kind of focus and investment raised revenues by 2, 2.5 fold. So it's a really, really important way to understand how you can maneuver in a way that kind of keeps the P&L and the balance sheet and focus that allows us to maneuver. So everybody has a spending cap. Everybody, whether you're the biggest pharma in the world or your smallest biotech, you have what you can spend and you have to use that wisely, and that takes a degree of discipline and prioritization, which I think we do well.

Absolutely. And one of the other things that you touched on in your conversation upfront was around kind of going after patients that really need kind of improved cancer outcomes and demonstrating that clear improvement as being such a critical part. And cabo has just kind of launched into the neuroendocrine tumors, which is kind of a challenging space for many, many patients when you get NET tumors showing up, really high area of unmet need. It sounds like kind of the launch is kind of moving towards your expectations, but perhaps there's been a bit of confusion on the sell side as to what this launch might look like. Can you talk us through some of the parameters here, kind of perhaps how much of this market is new patients coming in versus ongoing treatment and how you might see this NET market overall...

Yes. So let's talk about NET and the opportunity there. Again, it's a relatively I would say under -- not underserved, but underfocused indication. Cabo was the first new drug approved in that space in 2015, 2016. It has a lot of standard of care is a lot of older drugs, sunitinib, everolimus, CAPTEM, all the parenteral SSAs and then Lutathera, which came online actually years ago, it continues to work well. So there's a variety of offerings. These patients, again, they have relatively indolent tumors and they can live for a long time. They have a lot of choices in terms of how they operate because they're not under as much pressure as you would normally see in more, I'd say, more advanced debilitating tumor types, which is -- it's a different mindset that you have to be able to play into from a marketing point of view. So we've looked at the oral therapy focus market, if you will, because that's certainly where cabo plays. The CABINET data was, I think, just outstanding in terms of being able to look at a wide variety of patients in their journey who needed an oral therapy, largely because it took long to enroll because it was a U.S.-only center study done by the Alliance Cooperative Group. So it took -- probably took 6-7 years to enroll. So standard of care was evolving there. We covered all the bases. So the data we have is very, I think, very interesting, very encouraging in terms of its efficacy as well as the opportunities to build upon that going forward commercially, right? So yes, so we got approved at the end of Q1. I think the -- as you would often expect, we have covering analysts. A few of them maybe got over their skis a little bit in terms of what was expected in the first quarter of launch, where you would normally see new patient starts only because you have much time for refill. So I would say, in general, there was, I think, good consensus on expectations. There were a few that got ahead of themselves, but that's fine. But yes, launch is going great, very strong feedback. I think the rate-limiting step here is simply patients coming off their existing therapy, looking for new opportunities of which cabo would be one, if not one of the more preferred ones. So we're excited about where we're going and tracking it very closely and looking forward to continuing to see the ramp there. Now if you look at the situation with renal, where we've grown market share literally every quarter over -- since 9ER read out and was approved in early 2021, we would expect the same kind of ramp here, right, because of just a population is indolent by nature and slowly evolving. But we have big aspirations there, both with cabo and then with zanza, where we're going head-to-head against everolimus in a broad setting. And we have some other assets that we're excited about. So there's lots to do there. But that's an area of focus where we want to build a franchise and that we want to be able to really focus there going forward.

Yes. And I think kind of you also touched on as we were talking about cabo before, you -- in the early development phase, you kind of partnered with many companies. You've also competed with many companies in terms of delivering those market share gains that you just kind of alluded to. Kind of -- can you talk about the shape of your kind of sales and marketing organization, kind of how have you been able to compete with kind of -- whoever you partnered with Bristol in some of the indications? You're competing with Merck, you're competing with Pfizer, you're competing with some of these other players in the RCC space?

Well, it's an interesting, again, case study. I think the whole opportunity is, can you expect a small little company like us, especially in 2016, where we spent the last 3 or 4 years before them kind of looking over the edge of this -- of just implosion. So the -- as we've talked about previously, great data, great team, great energy can really make very, very rapid kind of inroads into competing in areas that arguably, if not, we're owned by big pharma, certainly dominated by big pharma. But I think we've been able to do that really effectively, by having the right data and the right cadence of data and supported by the team that is built to compete. I mean every single day, we compete with -- in that setting. And again, you can't go in there with kind of half big ideas and half resource teams, cutting corners from a marketing point of view, cutting corners from a sales point of view. You've got to go all in all the time every day. And it's the -- it's the small, nimble, highly intense team that can make a difference and make the extra call, have the extra data, have those kinds of things. So we're -- I think that's just who we are. We're a bigger company now than we were 10 years ago, but we still have the small company mentality. We think we're a big small company. And that nimbleness that intensity covers every gamut of the business, whether it's in R&D, whether it's in the FP&A team, whether it's in sales, all those things have to come together for us to be effective. And we do that very, very aggressively, right? We use analytics and we understand the marketplace literally on a day-by-day basis to be able to kind of refocus the team to be able to maximize the chance of success. So we have to operate that way. We can't be complacent. We can't be content with success -- today's success because we can build on that for tomorrow.

Absolutely. And you just noted that you kind of leaned on analytics a lot on kind of continuing to pivot, continuing to evolve how you target, how you approach your kind of delivery of those market share gains. Have you seen much change kind of off the back of COVID in terms of your ability to engage with physicians, your ability to kind of support that kind of conversation, that ongoing conversation?

Well, certainly, right after COVID, that was challenging. No question, challenging for everybody. I think we're more or less back to normal now, right? So I think from the standpoint of our ability to -- we don't really sell, we educate. We don't -- there's no tricks to this. It's really here's the data, here's what we have to offer. So it's that enlightenment that I think HCPs and prescribers can -- and then we support. We've always had a very real focus on a white-glove service approach, make it easy for patients to help them navigate their disease, right? And we can -- whatever we can do to help that process will help them, will help the practices and will ultimately benefit us. So it's a real kind of organic approach to being able to build the business and build momentum.

Absolutely. And I'm sure you have a lot less bureaucracy in your organization than...

We certainly do.

I did want to spend a little bit of time on zanza, your next asset. We've just seen a late-breaking abstracts get announced for STELLAR-303, colorectal cancer. That will be at ESMO next month. Tell us what we should expect here, kind of why colorectal cancer? Why is this an exciting opportunity? And what's different about the way that you're approaching the development with zanza now with some of the learnings...

Well, everything we've done with zanza is based on the foundation from cabo, right? So the -- for a variety of reasons with cabo, we explored a very, I would say, kind of focused area of the white space where we could actually have taken cabo. Zanza is built to be a kind of gentler molecule, maybe more easily used by HCPs. Same target inhibition profile, same pharmacodynamics. Again, cabo being a multi-targeted TKI, you never really know exactly what part of its inhibition profile is driving what. But we hit all the important cell types in the tumor microenvironment, some on purpose, some by accidents, and that's great. And to be able to phenocopy that with zanza with a shorter half-life, which did make it easy use and dose adjust, which every patient will dose adjust in terms of how TKIs operate. So yes, so we're excited about that and having that foundation of understanding and expertise and pivotal trial success with cabo then going off and trying to say, improve standard of care in overlapping indications like renal, like liver, maybe thyroid, but then finding new indications too. And CRC was really prime there, right? It's the large addressable population. Standard of care has evolved slowly. Options are minimal. Checkpoint utilization there is low because it's just not a very hot tumor outside of the MSI-high population, which is very, very sensitive to checkpoints. So -- and to be quite frank, there have been 4 failed pivotal trials there with checkpoints just underscores the challenge of actually operating there. So zanza, atezo-303 against an active control, a big win. Again, we're in the p-value business. So to get that to work in the ITT population was fantastic. The non-liver met population, which has a better prognosis, we just barely missed. So hopefully, that was an interim look, and then I'll get over the goal line in the meeting months as we accrue more events because we weren't fully powered there yet. So yes, so it's the first step in the ball game, right? Non-clear cell RCC is up next. That's fully enrolled, discounting events looking for that to read out. And then we have a whole swath of pivotal trials ongoing after that, too. So -- and we're constantly evaluating where we invest, what makes sense. We had a head and neck trial going in terms of the Phase II/III process that we've stopped to be able to move into, say, earlier line, CRC based upon the success of 303 as well as something like miningenoma, which is completely underserved in terms of therapeutic kind of approvals. And we think is a very, very important area for us to be in based upon some early cabo data. So we're constantly reevaluating our investment asking the right questions as you would have done in your old job in terms of how that strategy goes forward and tactically what makes the most sense from an ROI point of view and patient benefit, for sure.

Absolutely. And you spoke about kind of the science in many ways, leading the day in terms of which indications you go after next. I also wanted to ask kind of policy pressures, things like the Inflation Reduction Act and kind of a small molecule 9ER time horizon, causing you to run more studies in parallel and think about kind of the sequencing of zanza in a different way than you perhaps would have done otherwise?

Yes. So yes to know. I mean, think about the cabo development. I mean, we've -- I think the number of pivotal trials that we were part of either we ran ourselves, our partners ran or were run by cooperative groups in the '15, '16, '17 range. So we embrace the idea that key values make or break value. And you've got to run large global randomized pivotal trials to move the needle for patients, for the system and certainly for our shareholders. So I don't think we have changed our approach with zanza per se. The IRA constraints, maybe they're here today, maybe they'll be gone tomorrow. I mean who knows, right? So I think the whole idea that people would stop working on small molecules when this came out a couple of years ago, it just hasn't. And you see that across the semester, you see it across the spectrum. So look, we're investing in the science. We're investing in what we has the best probability of success and the higher -- highest ROI category, so we can capitalize that, because it's a high attrition business. You're not going to win every one of these examples, and you've got to be able to have enough high-quality inputs to be able to manage the upside on the -- when you've got those open the envelope and see the p-values and then move forward. But look, the oversight issues, MFN, [tariffs], FDA, the whole list of them are real. And there's certainly a level of uncertainty there. But what is certain is that if you don't invest and you don't have the opportunity to open the envelope and have a positive p-value, then you're not going to move forward. And so it's balancing that risk and balancing that uncertainty with the idea of making the right scientific kind of decisions that give you the best chance for success.

Yes. Fantastic. And I think everyone in the sector is grappling with all of those issues. So kind of on an ongoing basis, and we'll see how they play out.

For sure. Yes, yes, no doubt, no doubt.

Every day is a new day. In addition, just on zanza, it sounds like you have entered into a partnership with Merck regarding belzutifan and kind of the potential for combining those assets as well kind of in the past, we saw kind of the Bristol combination being kind of a critical anchor and CheckMate 9ER being kind of a very critical trial. How important is this partnership, this collaboration on the science side? What do you hope to achieve over the long term? Are there learnings from partnerships? You spoke about partnerships that worked and that failed in your first time around. What it could look like for you?

Yes. So this is an example of a clinical collaboration as was 9ER. We had the COSMIC collaboration framework with Roche. Those are clinical trial collaborations, where you -- if you will combine and conquer or try to conquer on the clinical side without sharing any commercial rights. So we like those kinds of collaborations. I would call it more of a collaboration than a partnership. We have a partnership with Ipsen and Takeda with cabo ex U.S. Takeda has Japan. Ipsen has the rest of ex U.S. And that's obviously a -- those are partnerships that enable the broad commercialization, and we're doing very well there financially, right? So like getting a check from those guys every quarter, that's great. So it's really mixing and matching how we do that. But yes, we're thrilled to be working with Merck, obviously, the leader in large cap oncology and their record of success there speaks for itself. It's a very strong way to go. They'll be running those trials themselves. We'll be paying for half of one, which is great. And certainly, the goal is to look forward. And I think the discussion leading up to that collaboration was can we align and what standard of care could look like in the 30s and then design the right trials and the right combinations to be able to go forward. So you're always looking for -- you're not really trying to beat what's happening today. You're looking forward 4, 5, 6 years and trying to kind of estimate where you think things will be and how you can fill gaps that might exist there that can drive value for patients and shareholders. So we're doing that with them and having a lot of other discussions across the portfolio with others, especially with zanza around how we can do that. And it's -- again, it's a great way to be P&L friendly with what you're doing in R&D and, at the same time, maximize your chance of success by just having more shots on goal -- good shots on goal that could really move the needle.

The spend associated with some of those clinical trials and oncology can be astronomical.

Oh gosh, yes, no doubt, yes.

I did want to dive into some of your earlier assets. We spent a bunch of time talking about cabo and zanza, which are TKIs that kind of sisters or cousins or siblings of one another. As we think about kind of the earlier stage assets that you have in your portfolio, we see bispecifics, we see ADCs, we see new modalities coming through, some of which you've acquired kind of into your organization. Why were these the right assets for you to own? Why does it feel like this is the right thing for us to have inside our portfolio than perhaps something for us to combine with or kind of consider collaborating with in the future?

Yes. Well, a lot of those were internally derived. I think it's only one partnered assets. We have a lot of activities going on in, say, USP1 that made sense to -- we like that asset. We certainly had a lot of data on that. So at least preclinically. So it's -- yes, it's a constant, I would say, balancing act of where you invest from a discovery and early development point of view and how you mix and match those investments and to maximize the success, right? So if you do that in a very disciplined sort of way, you can spread the risk across the modalities and across indications and combination just maximize your chance of finding the winner. And it's -- we use the needle in a haystack analogy a lot for BD and even for kind of our internal portfolio efforts, right? We're looking to burn haystacks and then find the needle as opposed to searching for needles as we go forward, right? And it's a very -- if you can discard the losers quickly and then focus on the winners, I think that's the best way to a, use your P&L and use your balance sheet in a way that can really be enabling. But also, it's very focusing and that positive momentum can then really drive and accelerate everything you're doing inside the organization. So yes, so it's -- we're excited about our ADC program. We think we've got really good ideas and really good kind of next-gen molecules. Obviously, the data will speak for itself, right? Our small molecule programs are really best-in-class. We've invested a lot in our internal technology platform around structure-based design, cryo-EM. We're getting just amazing insights, both in terms of more combinatorial approaches, higher throughput approaches, but also then looking kind of at the atomic level of what's happening. So I feel good about that. And end of the day, it's how fast can we move preclinically into clinically into then that next -- I mean the most important decision then is actually, okay, is this molecule worthwhile developing in terms of full development, pivotal trials, combination, et cetera. So that's the -- I mean it takes a while to get there. But once we're there, say with zanza, we know how to operate there. And we're not shy about making the big bets because that's the only way you're going to be able to monetize that.

Absolutely. And I think with some of these modalities as well, we're seeing a lot of crowding around targets. We're seeing a lot of kind of perhaps group sync in some of that...

which has been happening for decades...

Exactly. And especially when you get to a modality where there's some scientific risk on that modality, you want to reduce the modality risk by having a target that's well validated and so we'll go after the same target. So how are you thinking about...

Yes. We've played that game both ways and tried to stay on the edge, stay on the line between the 2. And that's where I think our scientific rigor and discipline comes into play because we don't have the luxury or the balance sheet to be able to spend a couple of billion dollars on a flyer. I mean that's not a pocket change for us. That's real money, right? So we have to be extra maybe skeptical about some of the new stuff and ask the hard questions. And we've seen this with the bispecifics recently. PFS and lung is interesting. You don't have survival. It's kind of a [nonstarter]. We kind of saw that coming. And it could still play out differently, who knows. But it's how you navigate that early, middle and late and that makes a difference. So the choices you make, it all come down to your risk profile and where you're going to put your bets, right? So I think we have a very -- a different lens, right? And cabo is a great example, right? We got it back twice. First pivotal trials failed. We had enough data to be able to believe that there was activity in indications. We just had to learn how to use the drug better, and we did that. So I really like that dynamic, and it's always -- you never have all the data you need to mandate, things are going to work in perfection, but you've got to be able to navigate them. I think we have a good nose for how to do that going forward. And then we execute really well, too. So that...

Yes, absolutely. Absolutely. I do want to spend the last couple of minutes thinking about kind of the long term and kind of the big decisions you have to make. And so as we think about where you're sitting today, over the next 3 years, what do you think are the most important decisions that you have to make at Exelixis and how do you get comfort in making the right ones and we think about the uncertainty of science, the uncertainty of the policy environment and as well as kind of with that competition kind of reaching fever pitch in many places, kind of what gives you that you're going to be sitting in the right place at the right time?

Yes. So I mean it's a good question, right? I mean what gives me comfort is that the team we have has been successful, proven success in the face of as many roadblocks clinically, legally commercially as most companies see -- could see over a long span of time, right? So I've been thrilled with that you're mixing a little bit of COVID on top of that. It's been a time when everybody has been tested, right? And we have, I think, come out with a great deal of momentum and focus. And we haven't lost an intensity of what it means to be successful and how you earn success going forward. So look, we all make decisions day, everybody faces the same generic decisions, where do you invest? What do you kill? What do you accelerate? What's happening on the global stage or the domestic stage that can mess things up. So you have to keep your widths as you go as well. I think we've done that pretty well over the years. So it's the momentum that we've got. And I really think it's the mindset of what -- we've charted a course for success over the last 10 years that we think we can replicate and then on a much broader scale than with just one single molecule. That's the challenge. It's all about the pipeline. It's all about building a franchise, a portfolio of franchises because when you track companies that have scaled from $5 billion market cap to a $100 billion market cap, it all comes down to revenue multiples, right? And the math is simple, right? And how you do that is by having the ability to put up numbers in terms of values and revenue that can give people the confidence that you can be bigger and better in the out years too. And we have that, right? So we've got a lot going in our favor. And the decisions, if you have the right data and you have the right people, the decisions are usually obvious. Those that aren't, then we just navigate carefully we have to course correct. We can do that, right? We have that. Again, big small company mentality. Our governance is -- we do things in hours that most companies take -- big companies take months to do, right? Because we can do that, and we can course correct and move as we go forward. So that nimbleness is a really important part of our store of our culture too.

And to the point of kind of the journey that Exelixis might be on? What does -- what's the goal? What does success look like over the long term for Exelixis in your mind?

Well, we can quantify that in terms of market caps and patients treated and all those kinds of things. Obviously, bigger is better. But we have to do that in a way that, I think, reinforces our culture of big and small, right? Because I think it's the individual accountabilities and urgency, that intensity at an organization level is what drives success of any organization. It's kind of the 80-20 rule, if you can shift that to 50-50 or 60-40, you can do amazing things. Small companies can compete with large companies head-to-head any time because of all those additional attributes that are just hard to find elsewhere, right? So for me, success is all about moving the needle for patients. If we can improve standard of care, then we're confident based upon our past success with cabo. We can move the needle for patients. We can move the needle for prescribers. We can move the needle for the health care system. Obviously, then that will have an impact on our shareholders, too. So that's the goal.

Fantastic. Thank you very much, Michael. I enjoyed the conversation today.

Yes. Great one. Thank you so much.

Wonderful. Thank you all so much.