Perspective Therapeutics, Inc. (CATX) Earnings Call Transcript & Summary

Thank you everyone for joining us today. My name is Kelly McCarthy. I'm an Executive Director within the Morgan Stanley Healthcare Banking Group, and I'm thrilled to be joined in person by Perspective, CEO, Thijs Spoor and for those -- actually, I'm going to read a disclaimer very quickly before we get into it. But for important 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. So welcome Thijs.

Good morning. Thank you for having me here.

Yes. Thanks for being here. And maybe just to begin, for those in the audience who aren't as familiar with the Perspective story, maybe you can just level set -- tell us a little bit of the history, how you came to where you are today and what you're focused on going forward.

Sure. So we've had a really exciting origin story. The name Perspective was -- came out of our name change when previously Isoray and Viewpoint merged together. And Isoray was a leader in Cesium-131 for brachytherapy. Viewpoint was focusing on targeted molecular therapies. And post that merger, because we specked imaging, so we thought kind of [ specktives ] and then that led to the whole Perspective name. Since that merger, we divested the brachytherapy business. And so for all intents and purposes, functionally, we're really focusing just on the radiopharmaceutical space. And in the radiopharmaceutical space, the origin there was a really fascinating group of investigators in Iowa. I spent a lot of time looking at the whole so gray chart of elements and seeing which radioactive elements are the best and how things can work. And they kind of zoomed in on being Pb being a really interesting way to go. And no one was touching led at that time. And the interesting thing about Pb is that you actually have two different versions, Pb-203 and Pb-212. And that prompted them that team to think what else could they do especially with the acute need that they saw. And based in University of Iowa, there's a pediatric neuroendocrine Center of Excellence there, where the whole goal is, can they make a safer drug for kids. So you can always find effective drugs for kids, but the big challenge is how do you develop the safest possible drug for kids. And so a lot of the early research focused on really tweaking the bio-distribution, tweaking the biochemistry, really focusing on what happens with the drug part. And so ignoring the Isotope payload what can the drug part do, to give your highest possible therapeutic index for a kid and it turns out that actually ends up being a safe thing for an adult as well. So that vision, they formed the company Viewpoint in 2015. And the view then was to then move forward and say, right, if they're going to start to commercialize Pb, what do you need? And what was really required was a good chelator for Pb and a good generator system. And neither of those was commercially available. So like all good scientists, they invented them. And so we have a proprietary chelator. We have filed IP on the Chelator. It's the backbone of all the contracts we do right now. And on the generator system, it's a way to actually obtain the isotope. That always gets tricky out of the gate if no one is supplying it. So the Department of Energy has a Pb generator that's available like the third Tuesday of every month, but that made it really tricky to actually kind of time your [ mouse ] experiments and do the work. So without meaning to become really good at it, we invented the generator as well. And so one of the interesting things about our company that people don't realize is they kind of -- we're not just, right? And we're not just a drug developer. We're good at that, but we're also an isotope distributor. And we're not just that as well, but we also are really good at on the discovery side and doing clinical work. So -- there's a lot of different things that we've had to do out of necessity and by becoming really good at these things, we're leaning in and doing them more. So going forward, there's a Series A that was done in 2020. Our science is so strong that during the founding years, we attracted $20 million in grants. And so as I say, other people's money is always better than your own, especially for some founders and that move things through. So a lot of validation from the NCI. And then since then, we've got great sort of recognition from the [ street ] and the ability to go and sort of fund our programs.

So you've got the Isotope strategy nailed down. You've wrapped around these kind of enabling technologies around it. I think when it comes to Pb, there have been speculation around Pb is it's a commercially viable Isotope because of the short half-life. How are you thinking about that? How are you addressing that? Is that valid?

So all questions are valid. But as we think about it, one of the things that a lot of people on the street are not as used to because they haven't had ways to invest in it, is really what -- how short is a short-lived Isotope and so just my own background and where I've come from. Before running Perspective, I took a few companies public. I've been in the field for a while as a Research Analyst. But 30 years ago before it was really cool, I started as a nuclear pharmacist. So I'll put out there the nuclear pharmacy is really cool right now. But we started as a nuclear pharmacist, and we were dealing with products with 15-second half life. And so the ability to actually produce the things that are 15-second half life, ultra-ultra-short things. you go towards what can be used only in a hospital setting if the patient is effectively almost attached to the Isotope source, into the one adjacency out from there is those with sort of hour-long half-life and that's about 18 million procedures a year across the U.S. You've got things with a two-hour half-life. So anyone has gone for a PET scan, gets FDG or they get a Flourine-18 labeled compound like the [indiscernible]. And that's got a 2-hour half-life but gets distributed across the U.S. every day, multiple batches, a lot of patients. The workhorse of nuclear medicine technetium 6-hour half-life. So I brought in a logistics team from General Electric from their short-lived Isotope group. And they said, what's the half-life we're dealing with here. I said, "Well, we've got 10 hours", like, okay, that's not -- that's easier, right, than 2 and 6 and so it's all a relative basis. But I think some of the questions that come out about half life are kind of the own question because it really should be -- it's not half-life, it's shelf life. And the shelf life of the drug you make is going to be about a day, though some of the other radiotherapies may have a shelf life of 2 or 3 days versus our 1 day, but still the same logistical challenge. You have to do just in time. And then paradoxically, you have to really tweak your manufacturing because you can't do things like 2-week sterility testing on something that's only got a 2-day shelf life. And so there's a lot of logistical complications that kick in where thankfully the street is getting a lot more informed now as they appreciate that there are some really interesting ways to do this. And it's not really new problems we're solving, right? If you're a patient anywhere in the U.S. who need a PET scan, it's never going to happen within an hour. It's always sort of 2 or 3 days advanced scheduling and the whole ecosystem, nuclear medicine, the radiopharmacies, the manufacturing sites, the nuclear medicine departments. They're all geared to have patients come in and receive a just-in-time product.

Can you go one level deeper on the comparison of Pb versus some of the Isotopes that are in the more advanced programs or even commercial programs, Actinium [indiscernible], and that debate that's ongoing. How do you see the advantages of Pb versus some of those isotopes.

So I mean it's -- Pb's got so many advantages. And so I have to look at the clock and make sure okay, we only have 27 minutes. So I want to be sort of mindful about this. There's upstream sort of before it gets to the patient, there's actually when it gets into the patient, and then there's downstream when it leaves the patient. And all the things are really important. The nice thing about Pb-212 is that it's precursor Thorium-228 is one of the only isotopes in nature ever that you can truly stockpile. So things with a 2-year half-life like Thorium-228, you can truly stockpile that and have it available on demand. Things with 2,000 your half-lives are radiotoxins are never used. Things with sort of 20-day half-lives, you can't stockpile. So you have the ability to stockpile Thorium-223 precursor, and that's a huge advantage of supply chains because it's taking a lot of complexity out of that system. When it gets in the patient, the idea of having a short half-life Isotope means you can hit a tumor hard and fast, and then disappears. You have an extraordinary [indiscernible] behind that. So when you're thinking about complex cancer biology, if you hit a tumor hard and fast with an alpha particle, which you don't get with a beta or an external beam, you get a crazy neo-antigenic storm, and that then allows this big response. And then what happens in a patient is you've got the innate immune system kicking in 3 days and the adaptive immune system kind of 5 to 7 days. So if you have the luxury of a short-lived one like Pb, you can hit the tumor hard and fast and then have a very calm tumor microenvironment to help the body kind of respond and have the immune system kick in to really give the therapy throughout the whole body. If you're doing something like actinium or lutetium, with both of those agents, you have a longer half-life, which means you're going to actually fight the innate immune system because those macrophages will be damaged as they come in and have the challenge of actually disrupting in the tumor microenvironment. If you go to lutetium versus Actinium. Lutetium as a beta doesn't have a neo-antigenic formation that alphas do. It has trade-offs. It gives a broader field of damage, whereas alphas going to be a very tight zone of destruction. If you're treating tumors in the pelvis, for example, you don't want a broad zone of damage. You really wanted all the damage purely isolated to the tumor type and not to adjacent organs. Lots of trade-offs to kick through. The nice thing about Lutetium and Actinium is the chemistry gets pretty easy. There's off-the-shelf key letters you can use. The nice thing about what we do with Pb is that we actually have a better chelator that actually holds everything really tight and guarantees everything surf on to target. But then once it goes into the patient and you think about how are you hitting the dose rate, there's very few cases in ecology where a long slow burn is considered a better approach for the tumor. If you need that, though, the great thing about Pb is if you could just do lots of little doses along the way. You could dose every week and actually get the equivalent of a long slow burn where that's all you can get with some of the longer-lived Isotopes. So we have the flexibility to hit hard and fast in the short time frame. We can do a long slow burn if needed and really tune what's going to best respond with that in that patient. But then the last bit is after the -- when the Isotope shows up, logistically for the hospital, if they're trying to receive a product with a long half-life. They have to dispose of all the waste. And if you search the web, you'll find almost horror stories of stacks and stacks of boxes vials with lutetium in them that were given to a patient, a residual amount cannot be thrown out the waste. And so what you have to do with that is you have to store it for 10 half-lives. So in Actinium's case, that's 10x, 10 days. So you've got 100 days where you have to store that vial with this residual amount before we can throw it out. That's -- okay, fine, that's space up the problem. But you also have to do that with the patient's biowaste. So they're tubing transfer set, okay? That's something you start to manage. And in Europe, you also have to do that with the patient's biowaste in terms of urine and stool and bedding and all these things. So there's a lot of things that are out there. The best way to deal with radioactive waste is to leave it and let it decay and do nothing, but it's 10 half-lives. And so with Pb with a 10-hour profile, it's a couple of days and you're good to go. With Actinium Lutetium, it's and being in the month's range, and that ends up being more of a challenge. So across the board, it's a good question to say, practically, what do you do with an Isotope? How do you get it? What happens when it goes in the patient? And how do you deal with it when it's leaving the patient. But really the question I hope people are asking is really, well, what about the drug itself? And can you do the best possible drug. The isotope works in conjunction with the peptide or the antibody. We saw some really unfortunate data earlier this year at ASCO with someone taking an antibody Lutetium and getting a lot of lung issues and lung deaths because you basically had a drug that didn't accumulate the tumor fast enough. It took about 5 to 7 days. And those first 5 to 7 days it's circulating the patient's bloodstream, you're effectively getting a whole body radiation with Actinium. And that really caused a major safety challenge sort of for those patients. So it's not just the Isotope. You have to be able to get it. You have to be able to dispose of it, but it's also what is the drug itself do. And that's really where we truly try and differentiate where most people, I think, aren't really focusing enough is what does that ultimate bio-distribution. It's a bio-distribution of drugs that matter.

Let's go there. Let's go from the theory to the application and get into some of your actual programs. So maybe starting with your SSTR program in neuroendocrine tumors. What have you seen so far the data there that's encouraged you and what's the next update?

Yes. So as we look at the biodistribution of these drugs, we have great animal data. But as everyone in this room knows, animals, they're not necessary -- mice are not the same as humans. They're not grateful. They don't pay. They don't always translate through. And you really -- it's a great indicator, but you have to be able to prove it out. What we like about Pb is that we can actually do imaging surrogates with Pb-203. So we can get a perfect bio-distribution in an animal or a human before we treat them. And so the animal data shown we can get extraordinary results if we can get that bio-distribution at the right level. If we can get them in neuroendocrine tumors, for example, that right ratio. So what we've been doing right now with our neuroendocrine program is dosing patients in the dose escalation study. We did two patients at a very low dose of 2.5 millicuries. The Safety Monitoring Committee said very quickly go up at a higher dose. And so we've been doing the 5 millicurie dose right now. We had previously negotiated or agreed with the FDA. It's always funny when someone says they agree or to negotiate. The FDA is pretty clear. They tell you to do it. You're going to do it. So we agreed to negotiate with the FDA that we would see them after the first results at that 5 millicurie cohort. And so as part of our fast-track designation, we had this obligation commitments agreement, whatever you want to call it, to speak to them, and we're happy to. They've been a great partner along the way to show -- to discuss our data, safety and efficacy and really looking through what's there. Our Safety Monitoring Committee along the way very quickly said escalate from 2.5 to 5, which is the second dose cohort. They also recommended adding more patients into 5, meaning the drug was safe enough to really add in a lot more patients in that cohort if we need to or want to. And they also recommended that we go after the 7.5 millicurie level. However, the data we're taking to the FDA will then inform our discussion with them to make sure that they're in agreement with where that goes. So I think people are really looking to see what happens in humans in this, we're calling a first-line setting. So the radiopharmaceutical therapy naive setting. So patients neuroendocrine, they'll get somatostatin. They'll get a treatment for their secretory tumors that's symptomatic in release, but not curative. And I think if you look at the ORRs for somatostatin in something like 3%. It's not really seen as a curative treatment. It's really managing symptoms. And so your first possible therapy with an impact can be LUTATHERA, and that's got a fairly low overall response rate in the package instead of 13%. And all the data that's coming up in the [ compassionate ] use space that's coming up and investigating initial trials are showing a much higher potential overall response rate.

So you started mentioning potential application in the first line to compete with LUTATHERA, how are you thinking about later lines of therapy?

So we've been doing some work in the, let's call it, second line, so the post-LUTATHERA [indiscernible]. And so the data there has been quite encouraging. Given the chance between that sort of first line instead of versus after, I'd much rather go into the instead of LUTATHERA bucket, a lot more patients there. Those patients have a clear unmet medical need. There's a clear need for better therapy something better than 13%. Those patients in that post-LUTATHERA environment, there's really no other choices for them. And so there is some activity there with some other agents in the radiopharma space, but those are patients where there is no other choice. And it's a kind of thing where the concerns about safety are real for some of these other agents. And so I appreciate that patients need any kind of choice, some choice if they've been a prior LUTATHERA responder, we'd rather than we just knock out the disease much earlier. So we're open to -- we have a pretty broader remit. We initially actually asked for a Fast Track designation in that second-line setting. And after submitting our data, the agency came back to us and said, no, you guys are in first line. So we were thrilled by that. We were not expecting it. We didn't ask for it. But the data is strong enough that we felt we actually could get into that lutetium naive setting and really start to explore how the drug can work.

Can you talk just a little bit about how that trial is enrolling and any updates on progress?

So yes, so we've had a great response from the physicians on that trial. We actually have two Phase I studies neck and neck, our melanoma program and neuroendocrine. And they both started within a month of each other. And both trials in the -- after that first cohort moved very quickly to the second cohort for enrollment. And so there's strong support and patient wait lists that come in the trial. The patients in the neuroendocrine space are incredibly well informed patients. They really understand what's out there. They believe that the alphas are better than betas. And so independent data, they've seen anecdotal things. They're firmly convinced that this way to go. Thankfully, the physicians are as well. And so patients and physicians are both really keen to get into this space and be enrolled in these trials. So we enrolled quite quickly for both our melanoma and our neuroendocrine trials. And then we hit that limit of where we wanted to be with that first sort of data cut. And those patients are still being treated. So -- the data is still maturing. One of the most common questions we get asked from investors is when will it be presented and what does it look like. And what we said is that by the end of this year, we will have that data come out at a medical conference that's reasonable. And so share with the community as we are sharing with the FDA what's happening with those programs in both safety and efficacy.

Okay. So on the melanoma program, specifically, you're going to have an update later this year on cohorts 1 and 2.

Right. So we'll be updating on cohorts 1 and 2 by the end of this year on the melanoma program. And the melanoma program is a different approach. So neuroendocrine tumors are really homogeneous tumor. Melanoma is incredibly heterogeneous tumor. Hence you get really, really -- it's completely different ways of thinking about how you manage these patients. The animal data shown, we do get some monotherapy efficacy, and we have to show monotherapy safety in order to move forward. But the value in the heterogenous tumors is really on the combination approach. And we previously announced a deal with Bristol-Myers Squibb to use nivolumab in a combination setting in conjunction with our drug in the melanoma patient group. And the advantage of using combination therapy in melanoma patients with such a heterogeneous tumor is that the way to think about it is you're taking a cold tumor making it hot again. And that's not just the holy grail in melanoma. That's one of these major hot points across all of oncology. And so the proof of concept there is quite extraordinary. The animal data was great. We showed that patients with both an alpha emitter are Pb in this case, and some sort of I/O therapy, end up getting about a 45% complete response rate. And even to the point that those animals, if rechallenged could never regrow tumor. I mean that's absolutely extraordinary think about in oncology, where you can actually literally have a complete response with the inability to ever regrow that tumor again. And the ability to sort of change in the immune system, train the immune system to really work is truly transformational. We've got another grant for $3 million from the National Cancer Institute to support that because it really changes things around quite drastically. So we're doing a major protocol amendment right now to allow that second -- that first dose cohort where the Safety Monitoring Committee said, alphas are very, very safe. So then allowed them to also receive a combination of our drug plus nivolumab.

Okay. Terrific. Good to cover off the combination strategy there. In terms of building your pipeline beyond those 2 programs that we've already touched on, what's the latest development plan for your preclinical programs? What's the outlook there? .

So we have a -- I have to -- my job is to brag about the company. So I don't want to sound like a brag, but I'm so proud of our team. We have a team of sort of 15 MD PhDs in Iowa to do fabulous discovery work. We have in-house facilities that allow us to really rapid sort of product modifications and change around the structures. I'll sight as an example, our FAP program. And for those in the audience, you can see all the images from that FAP program on our website in the corporate deck. But we spend a lot more time, we think we spend more time than most do to really get that bio-distribution right. And the bio-distribution is critical in the radiopharma space because anywhere that drug goes, it's going to cause damage. And so an ADC lingering in the kidneys doesn't necessarily cause a safety issue. Any radiopharma lingering in the kidneys will cause the safety issue. And so you have to be super clear about what's going to tumor and what's going off target. And that development is so important. There's a great image that we can show where you've got 3 different animals with sarcoma. And in that situation with 3 different drugs, one of them goes only to the tumor, and the other one goes to the tumor and kidneys. And so if you had to choose which one would you put into a human, it's going to be the one that's only going to the tumor. You don't want it lingering on the kidneys. So we have a pretty unrelenting approach that we don't bring anything into human until we've done this work on the bio-distribution, change the molecule, change the chelator, change the linker, change the peptide, do a lot of changes on that formulation and only then pull things in the clinic. We had another competitor that had a really unfortunate issue where they brought up a FAP program into the clinic. And we felt that they didn't have enough of that sort of tumor kidney ratio figured out. And so it feels like that program has been abandoned because -- you just don't -- if you don't get the right safety profile, you can't really develop as a therapy. So we have many programs ongoing at various stages of development. Some of them we solve very quickly. Some of them take a bit longer, but we're continually iterating through evaluating the products real time. We have the luxury to by using Pb-203. So the imaging version of that Isotope where we can do regular studies rapidly in the same animal over and over as its own control to perfectly predict the dosimetry in that animal. And so we have the ability to actually run these simulations real-time in vivo and really identify which compound should be best. And then we have to pray that the mouse to human transition work that reasonably. But we can also image a human and see really clearly if the drug is working. And so we showed some terrific images of our FAP program of a patient with [indiscernible] sarcoma of a lung cancer patient and the neuroendocrine patient, each of which had very different FAP patterns that really showed incredible potential for a therapeutic there. So a long way of answering your question, which is we've got a whole bunch of programs coming out. We're trying to get one out into human image every 18 months or so, which we think really de-risk things.

Been focused mostly on the therapeutics pipeline, but how do you think about -- when you started talking about the imaging of these patients. How do you think about the diagnostics piece of your business? Do you think of yourself as a Theranostics company? Or is that kind of more enabling to your therapeutics pipeline?

So it's -- we are a Theranostic's company because of the embedded imaging portion is so important for drug development, but the commercial world gets a little bit different, and as we think things through. So part of my origin story, I spent time at Amersham GE. I spent 11 years there, really working on the whole imaging side of the radioactive business. It's a great business. That's not the business that we're in. And there's some really strong players in that business right now that are really doing amazing things for diagnosing PSMA-positive patients, SSTR2 positive patients on the Alzheimer's side, on the cardiology side. That's not our focus. We're trying to really treat patients with cancer. In the case of our SSTR2 program for neuroendocrine tumor, there is an approved diagnostic imaging agent. And so I don't think it's good use of our shareholder funds to go through all the process to register a new diagnostic imaging drug when there is something out there that we're incorporating in the clinical trials that actually looks like it does a really good job. With the melanoma program, that's where the challenge kicks in because there is no approved good diagnostic for MC1R expression, right? You can diagnose a melanoma patient, but you can't pick up that expression except if you use our drug as its own biomarker. And so that strategy is evolving for what to do from a Theranostic's approach. We don't want to just to diagnose disease. There's a lot of ways to do that, that are really good, established and work quite well and patients can have access to. We want to find patients that will respond to our therapy. And so using the same chemical entity as its own biomarker is a fabulous way to actually go and actually figure out which patients can benefit.

Okay. The other critical piece of the business model is obviously the manufacturing. And you've made some key investments there over the years. So maybe you can talk about your manufacturing capabilities and how your focus on Pb is informing your strategy around that.

It's a great question because no matter what Isotope you're going with. And if it's Pb, if it's Flourine-18, if it's Actinium, lutetium, Iodine. The best way to actually roll out a manufacturing footprint is a distributed network. And I challenge people to find any modern management supply chain theory that says a single node of operations that could become a single point of failure is the most reliable way to develop any network. And we've previously received a lot of pushback on that. But I think what's coming on in the news, especially lately, Novartis has said they're building out several facilities now across the U.S. and around the world. No matter what Isotope business you're in, you need a distributed network of sites. And we've always maintained that the most efficient way for us to run a Pb business. We have a site right now in Iowa that we use to supply product for clinical trials. We have a site in Somerset, New Jersey that will be coming online. We're hoping this year to start producing doses. If you look at our last Q, we bought a facility in Houston. We bought a facility in Chicago. We're probably going to build some more. And hidden in plain sight in every corporate deck we've had for the past two years is a map of where high probability locations are to actually kind of put these facilities, gives you a distributed network that allows for ground distribution of product and usually supplemented by air, and that's for our own sites. But there's also an extraordinary CDMO network that's out there. And we'll often get challenged for the concepts, while CDMOs actually work in this space. And the great thing I'd point to is Lantheus has a pre-phenomenal drug PYLARIFY for imaging that accesses north of 50 GMP CDMO sites across the U.S. And so the whole thing like, well, yes, you have to look at their quality systems and how do you audit them, you do. And it's just the reality of the business. So you can put multiple sites on your drug master file, you can put multiple sites to manufacture your program. They don't have to be your own and there are for 4 competing commercial networks in the CDMO space that are also very keen to support and efforts of companies like ours, and they're all building Part 211 compliant facilities. They're rolling out pre-distributed footprints. The one thing this industry knows how to do is to really kind of build out last mile distribution logistics. And so some of it we solve ourselves, some of that we solve with partners.

So how does that -- how do you transition from the clinical to the commercial in terms of that footprint, the investment actually required or even the CDMO network, where are they from an infrastructure perspective to be able to meet that opportunity over time?

The whole industry is really building and growing right now. And so that CDMO footprint is being established. There's some existing players Cardinal Health, Pharmalogic that have a lot of experience in the spec and pet world, and they're expanding then into the SteroTherapeutics space. You've got some academic spinouts that are just focusing on the therapeutic portion -- they're trying to build out distributed nodes. There's capacity coming into the system. It's so hard with any one CDMO or innovator to really figure out what can you commit to. And so without knowing if our drug works, we're not necessarily going to commit to a full-on commitment and guaranteeing x number of products that we're going to buy from someone. So we know our drug works. And at the same time, the CDMOs aren't going to commit to building out extraordinary dedicated infrastructure, unless they know that's coming in. So it's a natural dynamic that evolves of trying to really secure supply chain manufacturing slots space, all those kinds of things.

I'll ask you to keep the finance hat on for another minute. You -- in your most recent quarter reported $293 million in cash and equivalents and guided to cash runway into mid-2026. How are you thinking about capital allocation strategy in the near term, both internal R&D, external opportunities, business development? How are you thinking about deploying that?

So we think across our 3 verticals in terms of discovery, manufacturing and clinical trials. And so the discovery team keeps developing novel composition of matter IP. And so we want to keep feeding that. They are so prolific. We keep inventing. We keep patenting and so we want to make sure that group gets -- is fully funded than they are to keep innovating and doing what they do, which is discovering new drugs that are transformative. . We do need to invest in our infrastructure following the math through that $292 million, and you can look at our monthly burn right now of being in that kind of $5 million to $6 million range. That should put us way past through two years, but obviously, we're going to be building out infrastructure on the supply chain side. And we also have the resources now to complete all the dose escalation work we're trying to do too. So we have dose escalation and dose expansion. The dose expansion work is covered on the major programs we've listed. So we're going to be sort of pretty mindful. Our spend is expected to increase if things go well. If things go horribly the spend will really decrease and will have a much longer runway. So we have tried to really model and guide to the fact that our products look like they are working, and we need to sort of add in our capacity on the supply chain side as well as on the discovery side.

We're definitely rooting for things to go really well for you.

Thank you. And there's a great phrase that Bio and [ J ] have and I encourage every innovator to be a member of Bio and [ J ] and their [ phrase ] because patients can't wait. And we've told our manufacturing sites that -- and our production teams and said, we told everyone across the company, patients can't wait. So anything we can do to really innovate and drive things forward is absolutely critical and we're doing whatever we can to get product as fast as we can.

So last question for you. There's been a lot of strategic activity in the radiopharma space, a lot of investor focus in this arena. How do you as Perspective, think about being a leader in that space, what excites you the most going forward about being in that evolving arena?

So the nice thing about the evolving arena is that the debate two years ago was really alpha versus beta and I think that's been resolved. Alpha really has a really strong place. Last year, there was a debate that's probably heavily contested. Is there a space for Pb at all vis-a-vis Actinium. And that's being resolved now. I think the sentiment is really shifting into. There is clearly a role not just on the Isotope basis, but let's find the best drugs that win. And that's always been our focus. Find drugs that are winners, find drugs that have the best possible therapeutic window, find drugs that are safer for kids, find drugs that are safer for unmet medical needs and really develop those further. What's rewarding to me as a nuclear pharmacist is that now there's a lot of investor interest in something that's always ignored, right? And it's always -- the nuclear medicine was never really a hot area. It was -- we had sort of Zevalin, the Bexxar in the early 2000s that struggled commercially. But now you're getting really interesting products that have much clearer ways to get used, much clear ways to diagnose the disease, ways to really kind of grow things forward. And the nice thing about this field is that there's a lot of interest and investment in the unmet medical need space. We're going to lean in on things where we have differentiated assets with really strong IP. We've learned that we can be really good at multiple things, and we're really trying to drive things forward.

All right. Well, thank you for joining me today. Thank you for attending our conference, and thanks to everyone in the audience for joining us here in person today.

Great. Thanks for hosting us. Really appreciate it. .