Legend Biotech Corporation (LEGN) Earnings Call Transcript & Summary

September 9, 2025

US Health Care Biotechnology Company Conference Presentations 35 min

Earnings Call Speaker Segments

Terence Flynn

Analysts
#1

Great. Thanks for joining us, everybody. I'm Terence Flynn, Morgan Stanley's U.S. biopharma analyst. I'm very pleased to be hosting Legend today. From the company, we have Ying Huang, company's CEO. Thanks so much for joining us, Ying. Before we get started, I have to read my disclosures. Please see the Morgan Stanley research disclosure website at www.morganstanley.com/researchdisclosures. If you have any questions, please reach out to your Morgan Stanley sales representative. Again, thanks so much, Ying, for being here with us today.

Terence Flynn

Analysts
#2

I thought maybe just to start high level, you could give us a little bit of an overview of kind of your strategic priorities, particularly as you're approaching your goal of operational breakeven on CARVYKTI by the end of this year as well as profitability in 2026.

Ying Huang

Executives
#3

Sure. First of all, thank you, Terence, and also Morgan Stanley for inviting us. In terms of our top 2 strategic priorities, very clear, right. Number one, we want to maximize the market potential for CARVYKTI. On the heels of the recent data at ASCO, where we showed that up to 1/3 of the patients who are in CARTITUDE-1, very sick, heavily pretreated patient population who actually can achieve 5-year treatment-free cancer remission. And some doctors would actually take this as a so-called functional cure. And by the way, this has never been achieved in myeloma because historically, multiple myeloma has always been accepted as incurable cancer. Patients cycle through different lines of therapy and eventually they succumb to disease. So that is a very unprecedented life-saving data for patients who are in fifth line beyond. And then also recently, we achieved the label addition in Europe to include the survival data from CARTITUDE-4. And then we're looking forward to actually FDA label update in the near future for that label inclusion in the U.S. as well because last year, we hit the first preplanned survival analysis. And we saw a very clinically meaningful and also statistically significant reduction of death by about 45%. And that is against the standard of care, which is a 3-drug cocktail, including DPd, Darzalex, Pomalyst, dexamethasone or 10% patients in that standard of care arm also chose PVd, right? So in fact, at a recent ODAC held by the FDA to discuss [indiscernible] approval, Dr. Paul Richardson from Harvard Medical School [indiscernible], he mentioned in one slide that, in fact, in all second-line trials, CARVYKTI was the only drug and CARTITUDE-4 was the only second-line trial to show a drug is actually better in terms of improving survival over standard of care. So that is very significant, and we intend to fully leverage that, and we're actually going to the community and directly promoting second line. And hopefully, in the near future, we'll get the label update on survival, right? At the same time, we and our partner, Johnson & Johnson, also are conducting 2 global Phase III trials looking at frontline patients. So hopefully, in the next couple of years, we'll start to get the first readout and then we can leverage this in the front line. So in short, we're trying very hard to really bring this life-saving therapy to early line patients as early as possible. Right now, we can do that in second line in both U.S. and Europe. And eventually, hopefully, we'll get positive data in front line. So that is a big strategic priority, right? How do we actually deepen the penetration for CARVYKTI so that this immune therapy can be accessed by many in early line patients in myeloma. And then secondly, we also want to fund our internal proprietary pipeline, right? We're doing research in 3 large fields, right? The first one is solid tumor. Recently at ASCO, we actually, for the first time, presented data for our DL3 targeting CAR-T for small cell lung cancer. That is partnered with Novartis. We also published some data on the gastric cancer patients trial in the [indiscernible] trial. That's one focus of the research. The other one is allogeneic. We still have quite a few active Phase I programs running, including allo alpha-beta T, allo gamma-delta T, and also allo NK. I think the most recent entry for our research effort is the third area, which is in vivo CAR-T. And as you can probably see from disclosure on clinicaltrials.gov, we're now actively running 2 trials. Both are CD19, CD20 dual targeting in vivo CAR-T for lymphoma, non-Hodgkin's lymphoma. And in fact, we have dosed patients already by now. So we're very actively pursuing that because we see that as an emerging new field for research and cell therapies.

Terence Flynn

Analysts
#4

Okay. Great. Well, I think we're going to dig into both of those priorities here in the next 20, 30 minutes or so. CARVYKTI posted another strong quarter of growth here on a sequential basis. As we think about the forward outlook here on growth into '25, '26, can you talk about some of those drivers? I mean, you alluded to a couple of these in your opening remarks here, but how are you thinking about the sustainability of that momentum that we've seen so far coming out of the second quarter?

Ying Huang

Executives
#5

Yes. So recently, in August, we reported our financial results for the second quarter. And just to reiterate, CARVYKTI brought in global net trade sales of $439 million. We're also very proud that it's the second quarter where CARVYKTI now is actually the biggest selling CAR-T product in the world, right? So hopefully, this will be the case for the many more quarters and years to come that this will remain the #1 selling CAR-T. So that was really a big milestone for CARVYKTI. And also, I think it's also very important to say that CARVYKTI is the only CAR-T targeting BCM for myeloma that's got a second-line label and also with a survival benefit. So we really intend to capitalize on that. And I think if you look at the multiple myeloma market, right, in the U.S. alone, you're looking at about a total prevalence of 190,000, right? So 190,000 patients are the total patient number who, unfortunately, have been diagnosed with terrible disease. And then right now, in the second line and beyond market, we're looking at a total addressable market of roughly 100,000 patients flow every year. Just in the U.S. alone, you look at probably 35,000 to 40,000 patients who fit into that label. So I would say, even though we have a very strong second quarter, we're really just scratching the surface for these early line patients in multiple myeloma. We still have a long way to go, and we fully believe that with this onetime convenience and also the recent data from CARTITUDE-1 in terms of 5-year follow-up and cure as well as the second-line data survival improvement in CARTITUDE-4, I think a lot more patients will demand this therapy. And really, it's our responsibility to increase the supply so that many more patients can access this therapy.

Terence Flynn

Analysts
#6

Yes. And then maybe just can you walk us through kind of the ex-U.S. side? Again, we'll unpack a little bit more on the U.S., but just where we stand on the ex-U.S. side?

Ying Huang

Executives
#7

Yes. We're seeing a meaningful growth last quarter as well. Last quarter, I think we brought in about $81 million in total revenue. That's becoming now a more important growth driver for CARVYKTI. So right now, we have a site in Ghent, Belgium. It's called Obelisc, which is already commercially producing CARVYKTI under the approval from the European regulatory authorities. But we're looking forward to, in the very near future, an official commercial license from Europe for our Tech Lane facility in Europe to supply the European market. So Tech Lane facility is going to be about a 220,000 square foot facility, state-of-the-art modern facility for CAR-T production. Right now, we're approved only to use that site for clinical trial production. But in the very near future, we look forward to commercial license approval there. So that will take our revenue in Europe to another level. But just if you look at the second quarter, right, we're already seeing very healthy growth that is coming from our production from the site in Ghent called Obelisc. Also, we do have some limited slots we're deploying from the U.S. sites to supply European market. And so far, out of the 5 major EU markets, we have launched in Germany. And last quarter, we also officially launched CARVYKTI in Spain. And in fact, we're seeing a very good uptake. Right now, we're already seeing a lot of incoming orders in Spain. So we're launching 2 major markets. In total, we're now available -- our coverage is available in 11 ex-U.S. markets today. And we hope that by end of this year, we'll continue to launch in additional markets. And hopefully, next year, we'll launch at least 1 or maybe even 2 major European market as well.

Terence Flynn

Analysts
#8

What -- and then just can you frame for us, I know you told us the Tech Lane site is 220,000 square feet. How big is Ghent on a sizing basis, square foot?

Ying Huang

Executives
#9

So Obelisc is much smaller in terms of square footage. We don't discuss other detailed technical specs in terms of square footage. But in general, I can tell you that we're seeing a very significant upside in terms of the supply available from the Tech Lane side versus the Obelisc side.

Terence Flynn

Analysts
#10

Okay. So at least like tenfold.

Ying Huang

Executives
#11

I don't want to go into quantifying, but I would just say that it's going to be one of the largest cell therapy production facility in the world.

Terence Flynn

Analysts
#12

Okay. And that's -- you said that's near term, like any [indiscernible] months.

Ying Huang

Executives
#13

We have said that definitely in the second half of this year. We look forward to European approval for commercial license in Tech Lane.

Terence Flynn

Analysts
#14

Okay. Okay. Got it. Great. All right. Now maybe if we pivot back to the U.S. here. I know the other big effort is, obviously, you talked about moving to earlier line setting. So that's where the CARTITUDE-4 label comes into play. But also this expansion into the community setting that's pretty important. And I think there have been a number of fits and starts, more so on the CD19 front, where we've seen some of these companies kind of face some challenges as they try to move out into the community setting. So maybe you could talk about your and J&J's strategy here to address some of those challenges that other companies have faced. And as you think about any differences for myeloma versus lymphoma as we consider the ramp in the community setting, where I think it's, what, 80% of myeloma patients are treated.

Ying Huang

Executives
#15

Sure. So first of all, we do believe that CARVYKTI has a unique profile. In all the trials we conducted to date, right, CARVYKTI has a very consistent median onset of CRS at about 7 to 8 days. That gives us a wide window, right, which means really there's no critical need to hospitalize the patient in the first week or so, right? So that is actually very unique compared to all the other CAR-Ts because typically, a CAR-T would have immediate onset, like onset of CRS of 1 or 2 days. In that case, I think physicians are very shy about releasing the patients out of the hospital, right? Because what if CRS happens or ICANS happens, then that patient needs to really come back to the hospital setting. And that's really not beneficial to either the physician or the patient itself. Now in our clinical trial setting, because of the 7- or 8-day onset, we knew that commercially, this could be one advantage because we all know that right now, most of the CAR-T administration happens in the tertiary teaching hospital setting, right? In the U.S., you're looking at about maybe at a city of 180 to 200 tertiary centers because you don't have any more than that in terms of tertiary teaching hospitals around in this country. So you're limited by the number of sites, you're limited by the number of beds those hospitals may have. Now in the case of CARVYKTI, we actually instituted an outpatient program in the CAR-T program. So we actually experiment different ways to do this. And now if you look at the protocol, right, typically, when the patient is coming in for CAR-T infusion for CARVYKTI, it takes a few minutes for that drip infusion. And then the patient will stay in the same facility for 6 hours for monitoring. If nothing happens, then the patient can check out and then they'll come back maybe daily for monitoring for the first 10 to 14 days. But there's no need to hospitalize that patient. So now we're seeing in the commercial setting. In fact, we said on the third quarter financial earnings call that more than half of our use today in commercial setting actually happens in the outpatient setting. So that is actually very consistent with what we saw in the clinical trials. And we're glad that we're seeing the majority of patients are being able to be treated with CARVYKTI in the outpatient setting, which is very convenient, right, which means you don't have to be away from your family or caretakers. You can actually either go home if you live in the vicinity of the CAR-T centers or you can find a facility where you can stay overnight, but it's not in the hospital setting, right? So that's what we're seeing. And in fact, we predict that with the second-line launch into the community, we should see even higher uptake of outpatient use for CARVYKTI. And recently, by the way, some abstracts come out from the IMS meeting, which will be held next week. And there's one abstract where they looked at -- I think that's so far the largest commercial real-world study for CARVYKTI. So about 20 academic centers in that [indiscernible] registry, they published the abstract showing that out of 595 patients who received CARVYKTI commercially. The grade 3 or above CRS was only 4%, lower than what we saw in the trial setting, in fact. So that shows you that in the real-world setting, safety is actually better. Physicians know how to manage CRS. And really, there's no need to hospitalize a large number of patients, right? So this is why we're seeing this in the community. Now to your second question, how do we deepen our penetration in the community? I mean, as you correctly and rightfully pointed out, really other CAR-Ts have not seen much success in terms of going into the community, even though they may have the second-line label, right? And on the second quarter financial results call, we did say that right now, actually, we're basically seeing that the CARTITUDE-4 patients, the second to fourth line patients in our revenue mix account for about 50% of our revenue. And out of that, probably 70% are actually referrals from the community into the centers, right? So we're doing a lot of work educating both physicians and also patients about the benefit of CAR-T and also the fact that you can actually get CARVYKTI in the outpatient setting. You don't have to -- hey, you have to stay in the hospital for 2 weeks, for example, right? And that is a big benefit, I think, and also convenience for the patients receiving CARVYKTI. So I think that's a good advantage we have in terms of educating the second-line benefit for CARVYKTI patients here. We're seeing that also we're starting to see more and more referrals following the publication of the New York Times article talking about treating a lethal disease. Now hopefully, some of the patients can potentially be functional cure, right? That's another, I think, tailwind we have because we're seeing anecdotally, patients are coming in, they're calling their doctors, they're contacting their doctors, hey, I heard that CARVYKTI is approved in second line. Can I get that? So I think we're starting to see that benefit. And lastly, I want to mention that recently, we and our partner, Johnson & Johnson, we started this direct-to-patient campaign. So you can actually see this message on channels, including Peacock, AWC, YouTube, for example, right? It's a very targeted effort because we know that in the community setting, the awareness of CAR-T is low. In fact, based on our survey, 1/3 of the community-based hematologists, they're actually not aware of CAR-T or specific CARVYKTI, right? And even in that 2/3 of community-based physicians, they are aware. But so far, only half of those physicians have referred a patient to CAR-T treatment. So clearly, there's a lot of upside opportunity here. There's untapped opportunity where we can educate those physicians about the benefit so that they understand the CAR-T benefit. They also understand how to treat the patient with CARVYKTI.

Terence Flynn

Analysts
#16

Maybe a couple of follow-ups there. The community setting, you said it's about -- or sorry, the outpatient over about half of your use right now. Where can that ultimately go over time given some of these initiatives that you guys are instituting?

Ying Huang

Executives
#17

Yes. If you look at where the multiple myeloma patients are seeking care, right, typically in second line or second to fourth line in general, about 70% to 80% of the patients, they're being cared for in the community setting. They don't go to a tertiary teaching hospital such as Sloan Kettering in New York City, right? So eventually, I think we would expect that is also consistent with what we should see commercially. That is maybe 70% or 80% of patients should be treated in the community or in the vicinity of that community, right? And that's our goal. Obviously, we'll see -- we have a lot of education and hard work to do, right, because we also have to provide the logistics support when you help those centers use CARVYKTI in the outpatient setting.

Terence Flynn

Analysts
#18

And what -- is there anything on CRS monitoring that you guys can do in terms of this outpatient setting because you mentioned onset 7 to 8 days, but I'd imagine it's still stressful for patients, physicians, if you are one of those people who unfortunately has those side effects. And so is there something you can do from a remote monitoring basis to kind of [indiscernible] increase comfort?

Ying Huang

Executives
#19

In fact, we and Johnson & Johnson are experimenting a new approach where a patient can be sent home with a wearable device. So that wearable device is something like Apple Watch, for example, right? It does measure certain vitals, including body temperature, including the blood oxygen saturation level because, as you know, if a patient has a fever or the blood oxygen saturation level is low, that's -- these are the 2 telltale signs of CRS. So we can actually see that signal remotely, right? It can be the signal to the hospital or to the monitoring centers. Therefore, we know even sometimes before the patient knows, right, okay, there's a sign of CRS. And then we try to proactively manage CRS at a low level, right, grade 1 or grade 2, but not anything above, right? So if we can pull those patients back, sometimes it's as easy as give them some one shot of IL-6 or some Tylenol or some other anti-fever medication, for example.

Terence Flynn

Analysts
#20

Yes. And when will be a time line for like a broader rollout of that kind of thing?

Ying Huang

Executives
#21

Yes. It depends how we see this turn out in the field, right? But I would say, broadly speaking, unless you have a patient who lives in a rural area, which is really kind of far away from a center, otherwise, if they're living within the vicinity, for example, 1.5 hour driving distance, it may not be necessary to have such. But on the other hand, if patients overwhelmingly say, you know what, we want that, certainly, we can leverage that.

Terence Flynn

Analysts
#22

Okay. Great. And then just one more follow-up on the community side. You have this collaboration with Virginia Oncology that you guys recently talked about. Maybe just provide us with a little bit more detail about why that was the initial focus? Like what was it about Virginia Oncology that they decided to move in this direction with you guys? And then how are you thinking about leveraging the learnings from that other centers? And what are some of the metrics that we should focus on?

Ying Huang

Executives
#23

Yes. So even as recent as maybe 2 or 3 years ago, people would tell us, you know what, you guys can never use this drug outside the hospital. Forget about community, right? So we say, no, we believe based on what we see in the clinical trial [indiscernible] and also the fact that you have this unique 7- to 8-day median onset of CRS, we think we can. So we follow up with this, and we announced in our second quarter earnings call that we actually officially signed up Virginia Oncology Associates as the first truly community-based site or customer to use CARVYKTI, right? So Virginia Oncology Associates, they're not a hospital chain. They're actually a conglomerate that operates 9 clinics in the state of Virginia. So this is, like I said, truly community setting, right? Patients go in, they get the drug and then they go home, right? They don't stay overnight in Virginia Oncology associates. So first of all, we prove that we can actually do this. And secondly, anecdotally, I can tell you one interesting story. So one reason we go to communities because we think that multiple myeloma patients as a group, they're actually quite knowledgeable. I mean I don't know whether you try to read some of those online forums where they discuss treatments and outcome, right? They're actually very knowledgeable in terms of how they understand the science or which treatments are available in the commercial setting. So sure enough, the first patient who came from Virginia Oncology Associates, it's actually through a patient inquiry. A patient walks in, ask the doctor and say, hey, I heard about CARVYKTI. Can I get CARVYKTI? And sure enough, the patient got CARVYKTI, and I'm happy to report that we finished manufacturing, we shipped that drug and the patient was infused already. So it shows you that, yes, you can actually go to community with this new technology called CAR-T. And it doesn't add too much burden for the patient because the patient can get treatment in his or her own community where they live, right? This is the first, but definitely it's not the last. We and our partner, J&J, we were engaged in many different community-based clinics or group practices. So we'll continue to roll this out. And I believe in the future, right, we'll have a majority of the patients who can actually get treatment in their community. And they will be monitored and follow-up also in their community.

Terence Flynn

Analysts
#24

Yes. And what does that look like? I mean I think you mentioned what was 180, 200 hospitals. Those are systems like Virginia Oncology or that's like an individual footprint number just as we think about mapping this, like how big is that set of potential similar facilities or health care providers, I guess?

Ying Huang

Executives
#25

So I think right now, we have about 126 hospitals or centers like VOA that are certified to use CARVYKTI in our network. But going forward, we'll continue to increase the tertiary hospitals in our network. But as you just mentioned, right, we'll probably push to that city maybe next year, you'll reach a maximum of the tertiary centers, but we're not stopping there because we'll continue to spend a lot of effort in going into the community, signing up more accounts such as Virginia Oncology Associates. There are a lot of regional clinics or even national GPOs, right? So these are organizations that are in the community. They have a big number of sort of like a chain stores, right? They all follow the standard protocol. So once you educate the whole chain, they can use that. And that is going to be our future business model to go to the community, to go to the second line.

Terence Flynn

Analysts
#26

And does this -- is this now -- can this be a profit center for some of these community oncology centers? Or is this more breakeven when you think about the reimbursement economics?

Ying Huang

Executives
#27

I mean we do believe it can be financially viable for those centers because, as you know, if you look at the total treatment cost for CAR-T, right, a big part of that is actually ascribed to the hospital cost, right? So if you go to a CAR-T center, tertiary center, right? And then if it's a patient covered by Medicare because he or she is 65 years or older, then under Part A, you get one single check. And apparently, many hospitals actually unfortunately lose money on that because if you calculate the cost of our CAR-T drug and then the hospitalization, you probably know how much it costs, right, overnight stay in the hospital in the U.S. and all those preferred care. A lot of times, I mean, we have heard that maybe as much as much half of the case where hospital could lose money because of that. Now because you're omitting this hospitalization and then you take a big part of that cost out, you can actually make that financially viable because you're using existing square foot in terms of the facilities in the chain or in the clinic. So you don't need to add anything special. There's not any extra cost of that. It's most like a typical, what I call the Part B medication.

Terence Flynn

Analysts
#28

I just want to touch on a couple more CARVYKTI before you get to the pipeline. But just you mentioned the first-line studies that you guys are doing, CARTITUDE-5 and CARTITUDE-6. Obviously, there's the transplant population, transplant ineligible population. You're doing separate trials in both of these. Maybe just level set us what kind of enrollment and then remind us like data timing, what you guys have said. It sounds you said something alluded to over the next couple of years or so. So it sounds like we shouldn't expect anything in '26. I mean, it's more of a '27 type readout.

Ying Huang

Executives
#29

I wouldn't confirm that because as you probably know, CARTITUDE-5 and CARTITUDE-6 are what we call event-driven trial. So we have filed with the global regulators, including FDA and EMA. We need to hit a so-called certain pre-specified number of events before we can unblind the trial. So CARTITUDE-5 is done in patients who are either not eligible for transplant or they're eligible, but they have decided to defer transplant because of convenience or other factors, right? So we finished that enrollment a while ago, more than a year ago, and now we're just in a follow-up period. So the comparison arm is standard of care called RVD. So it's a 3-drug cocktail, including Revlimid, Velcade and dexamethasone. What we have disclosed in clinicaltrials.gov website is that the primary completion will be 2026. So we don't know exactly when, but broadly speaking, 2026, right? That's what we have said so far. Now CARTITUDE-6 is another trial where we're comparing CARVYKTI onetime treatment with a standard of care called DRVD for 6 cycles, followed by Revlimid maintenance. So in that trial, we're planning to enroll a total of 750 patients, 1:1 randomized between CARVYKTI and the standard of care transplant arm. And we're happy to report that actually, we already closed the global enrollment ahead of our planning. And right now, we're just enrolling a separate cohort in Japan only for the Japanese approval in that setting. So right now, again, we're in the dosing and follow-up period. I believe the data readout probably likely will be 2030 and beyond. But right now, it's probably too early to talk about that because -- as you know, in those patients who are eligible for transplant, the median PFS can easily be 5 years or even longer, right? That is why it's not anything in the very near future. But for CARTITUDE-5, right now, our disclosure on the ct.gov trial website is that early 2026.

Terence Flynn

Analysts
#30

Okay. And you feel pretty good about that based on how events are tracking in CARTITUDE-5.

Ying Huang

Executives
#31

We don't talk about all these events. I think we'll disclose when we have more clarity about the readout timing.

Terence Flynn

Analysts
#32

Yes. And what -- just remind us like RVD, what it did? I mean that was back when probably you and I were both covering Celgene when that data read out. What's the median PFS in NASH for that.

Ying Huang

Executives
#33

In the Celgene trial [indiscernible] trial that won RVD the FDA approval in this setting, the median PFS was about 34, 35 months, so about 3 years, right? But recently, if you look at the PERSEUS trial done by J&J, I think in that trial, the control arm RVD actually outperformed, it was at about 40 months PFS. So let's just call it in that range of 35 to 40 months range.

Terence Flynn

Analysts
#34

And I know you guys generated some data. I think it was a CARTITUDE-2 study that you did in the frontline setting. that's, I'm assuming what gives you confidence to pull the trigger on these studies. And so maybe just remind us like in that CARTITUDE-2 setting, what was kind of the key finding that gives you confidence that you can essentially beat this RVD benchmark that you just talked about?

Ying Huang

Executives
#35

So actually, when we started CARTITUDE-5 and CARTITUDE-6 trials, we did not have any data even internally for frontline at all. We did subsequently enrolled and treated 7 patients in CARTITUDE-2 trial. Those 2 cohorts are Cohort E and Cohort F. So far, we have not published the data yet. The reason is you do need a pretty long follow-up because these are frontline patients, right? 6 months or 12-month follow-up really is too short to show anything. That is why we have not published data yet. But we do have reasonable confidence that we should be able to have a positive trial because in CARTITUDE-1 trial, these are heavily pretreated sick patients, right, where the median prior lines was 6.5, right? So very sick patients. Still, we had a median PFS that was 35 months and median survival that was 5 years, right? We just published at ASCO this year. And then for CARTITUDE-4, at this moment, we have not even reached the median PFS yet for the CARVYKTI. But suffice to say that it should be longer than that 3-year mark we saw in CARTITUDE-1, right? So we feel pretty good about the chance of winning in CARTITUDE-5.

Terence Flynn

Analysts
#36

Yes. Okay. Understood. The last one I just want to ask on is just the latest on MRD negativity as an endpoint to accelerate time lines here. I know there's new leadership at the FDA, but what's your sense of where FDA is shaking out on this? And is that something that you guys are considering here for -- I'm guessing more CARTITUDE-5.

Ying Huang

Executives
#37

So for CARTITUDE-5, the primary endpoint is progression-free survival or PFS. In CARTITUDE-6, we did put MRD as a potential MCR as a potential co-primary endpoint. But still, our base case has always been that we intend to go to FDA using PFS as a clinical outcome here for approval. You're right. Last year, in March of 2024, FDA convened ODAC. They looked at MRD as a potential endpoint for multiple myeloma. And in fact, the external experts on ODAC voted yes to recommend FDA to use or endorse MRD as an endpoint. But I believe that FDA may take a more conservative stance on this. We continue to engage with the FDA on this. But I can tell you that today, our base case remains that we would use PFS as the endpoint to go to FDA to seek approval in frontline. And in fact, as you mentioned, right, under the new FDA, I think both commissioner and also the division chief have said that they really want to see survival, not just only PFS in any oncology trial. So I think that shows you the emphasis from the agency in terms of demonstrating a survival benefit.

Terence Flynn

Analysts
#38

Is there an opportunity with CARTITUDE-6 because MRD is a co-primary to have an interim look at that? Or is that not built into the design such that you have to kind of wait longer?

Ying Huang

Executives
#39

I think, first of all, we'll continue to engage with global regulators, including both FDA and EMA to discuss the possibility of using MRD as endpoint. I must say, like I said, we continue to think that FDA is pretty conservative on this. And in Europe, maybe EMA can be more open, but still, you got to remember, right, in Europe, reimbursement is very important. So an EMA approval does not guarantee reimbursement. And I can tell you, when you talk about reimbursement to all this health care authorities or country governments, right, they do want to see PFS of survival. It's going to be difficult, I think, to use MRD to secure reimbursement in Europe. That's our baseline.

Terence Flynn

Analysts
#40

Okay. Got it. Just in the last couple of minutes, you walked through very nicely your pipeline. Sorry, we're not going to take questions right now, sorry. So we're going to talk about your pipeline. I know you outlined pretty nicely here what you're focused on. I guess there's been a lot of excitement around in vivo CAR-T, also allogeneic for autoimmune. But as you think about these 2 programs, what's kind of the next milestone that we should focus on?

Ying Huang

Executives
#41

Sure. So we do spend a lot of research effort in those 2 areas, right? Allogeneic. We have active Phase I programs in allogeneic alpha-beta T cell program. We have allogeneic gamma-delta T program. We also have one allogeneic NK program that's active now. And then I think the most exciting new area for research in cell therapy is in vivo CAR-T. And we actually started that effort a while ago, more than 2.5 years ago. And as I just mentioned, right, it's public information on clinicaltrials.gov that we opened 2 clinical trials in Phase I. Both are CD19, CD20 dual targeting CAR-T for non-Hodgkin's lymphoma. So obviously, we think a lot about in vivo CAR-T. That's what I would say. But right now, we're not in a position to disclose any data yet.

Terence Flynn

Analysts
#42

Is that '26 event potentially, do you think?

Ying Huang

Executives
#43

Potentially, Yes.

Terence Flynn

Analysts
#44

Okay.

Ying Huang

Executives
#45

But we do believe that we're in a leading position now at this moment, given what we know in the field.

Terence Flynn

Analysts
#46

Okay. And what about on the allo side, Obviously, more of a focus, I think, here on the autoimmune indications relative to cancer. But how should we think about updates from your progress there?

Ying Huang

Executives
#47

We actually probably first want to know how our allo T cells or NK cells perform in cancer first because -- if you can actually see efficacy in cancer, then more likely than not, you will see efficacy in autoimmune indications because the durability requirement is much higher in cancer treatment, right? So I do think that we want to see a signal whether we can see good expansion. And then once you see good expansion for the allo cells, does that lead to a durable cancer response or not, right? Then we'll look into autoimmune indications. But I do think that autoimmune indications have different safety requirements, also maybe cost as well as the need for lymphodepletion. These are all different needs in autoimmune, right? So this is why I think it's a different model in terms of how you look at safety, efficacy, convenience, cost and everything.

Terence Flynn

Analysts
#48

Okay. Great. Well, thanks so much, Ying. I think we're up on time, but I really appreciate your time today.

Ying Huang

Executives
#49

Thank you, Terence.

Terence Flynn

Analysts
#50

Thank you.

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