Gilead Sciences, Inc. (GILD) Goldman Sachs 44th Annual Global Healthcare Conference (Transcript)

Gilead Sciences, Inc. (NASDAQ:GILD) Goldman Sachs 44th Annual Global Healthcare Conference June 12, 2023 1:40 PM ET

Company Participants

Daniel O’Day - Chairman & CEO

Merdad Parsey - Chief Medical Officer

Conference Call Participants

Salveen Richter - Goldman Sachs

Salveen Richter

Great. Good morning, everyone. Thanks for joining us. I’m Salveen Richter, Biotechnology Analyst at Goldman Sachs, and we're really pleased to have Gilead with us. So we have Dan O’Day, Chairman and CEO as well as Merdad Parsey, CMO.

Question-and-Answer Session

Q - Salveen Richter

To start here, maybe we'll start with some big picture questions can you just give us a 30,000 foot view of where the company stands today and where the challenges have been, the accomplishments? And then how you think of kind of look forward from here?

Daniel O’Day

Sure. So first of all, it's having great to be here and with Merdad and we're delighted to share some updates on Gilead. So at the 30,000 foot level, I think, Merdad and I would say that we're really pleased with what's happened over the past four years. I mean, to remind you what our objectives were, what some of the challenges we had four years ago. We had a world leading virology business and we needed very much to strengthen that and to continue on that, but also add significant other pillars to our growth.

And I would say, from a transformation perspective, let Merdad speak for himself, but I think we've really exceeded what we thought we could do in those four years. A couple of things to that I think I'm most impressed the team has done is, they haven't taken their eye off the ball on virology. And so as we think about our world leading position in virology and returning now to growth last year, excluding Veklury, we had an 8% growth last year.

In the first quarter of this year, excluding Veklury, we had a 15% growth and that's driven the first quarter of this year, two-thirds by virology and a third by oncology, which roughly equates to what our goal and aspiration is of having a third of our business in 2030 coming from oncology and that's off of now a sizable base. So last year, we had more than $2 billion in sales in our oncology business, just the beginning, I think, of our growth rate there, both coming from cell therapy and also from Trodelvy.

So we're just at the beginning of unfolding, what I think is a really powerful portfolio in oncology. We put a lot of capital to work over the past four years, novel assets and today, I think we're really in the conversation space, if you like, in oncology, coming off of ASCO. We've got a leading TIGIT program, which I know we'll get into. We've got a leading next-generation ADC in Trop-2 that's on the market today in breast cancer and in bladder cancer. And we have other novel mechanisms now that will unpack including a world-leading cell therapy business as well that is growing very nicely.

At ASCO, we had two overall survival presentations, oral presentations, one with our ZUMA-7 trial and second-line large B-cell lymphoma, really astounding data on overall survival and bodes well for changing the paradigm from transplant in the second-line setting. And then we also had the other overall survival update on our hormone receptor positive HER2-negative Trodelvy data, which continues to show really great promise, and we're seeing that as well in our market data as well.

So just -- I know we'll get into the details, but I just couldn't be more impressed by what the team has done by keeping their eye on the ball on virology, building this world-leading oncology program and also an early inflammation program. And now it's really about execution. It's about quarter-on-quarter execution which we're focusing on last year and continuing into this year. And I think we're just at the beginning really of a growth phase for Gilead.

Salveen Richter

Great. Merdad, if you want to add anything?

Merdad Parsey

What I would add is I think, one, I didn't think we'd be talking about competing with Roche and AZ and Merck in oncology four years ago. I think we're -- that's where we are. And I'm really looking forward. I think all this investment now, now we're going to start to see the data. And I think that's what I'm excited about. I'm the data junky, but I think, in particular, we have so many readouts coming up over the next couple of years. I'm really excited to be able to share that turn over some cards.

Salveen Richter

So with regards to the HIV business, you've highlighted expectations for positive growth for the business driven by Biktarvy and long-acting assets. How should we think about the magnitude of the growth here and where do you see the greatest risk?

Daniel O’Day

Well, we're now seven quarters back into what we used to see before the pandemic in terms of growth rate of the HIV market overall. And it's roughly 2% to 3%. Biktarvy continues to grow extraordinarily well and still room ahead of us in terms of market share. What I'm most excited about for patients living with HIV or people that could benefit from PrEP is our long-acting program as we go into the second half of this decade.

So Sunlenca and lenacapavir once every six-month subcutaneous injection was launched in highly treatment experienced patients at the end of last year in both the United States and in Europe. And we truly believe that this is potentially the best tool yet we've had in almost three decades that could end the epidemic for everyone everywhere. And the reason for that is one pill once a day standards with both Biktarvy and Descovy for PrEP are doing well, but we know that patients living with HIV want options.

And on the treatment side, we have more than nine programs now as a partner for lenacapavir, and we think that's really going to back to the growth question, provide us with both stability. By the way, I should say that we have really no patent expiries in our HIV business or throughout our business until the early 2030s because of some patent wins that we also had at the end of last year. And we think providing patients with options on long acting with a variety of programs that are now in the clinic that Merdad is managing on the treatment side will really help us not only maintain our leadership on the treatment side, but grow that over the course of the second half of the decade.

But what I'm potentially most excited about for the epidemic, and it relates to our growth, is the potential for lenacapavir for PrEP. I mean, today, in the developed world, only about one out of four people are actually on PrEP that could benefit from it. And we think a lot of that has to do with the burden of taking a daily pill. But if you -- and we believe we have two large trials now running in PrEP with lenacapavir as a single agent.

If you can change the paradigm through once every six-month subcutaneous injection where people at risk or people who can benefit from PrEP, literally go see their caretake (ph) once every six months, make sure they're HIV-negative, get their next round of six-month protection we believe that, that market is going to more than double by the end of the decade on the PrEP side and will be really important in both the developed world and developing world for ending the epidemic.

Salveen Richter

And for the long acting treatment regimens here. The programs are all fairly early, but where is your key focus now? And then for PrEP the Phase III is on track for mid-'24. What are you focused on here when we finally see this data set?

Merdad Parsey

Yeah. It's a great way to divide it up. I think really focusing on PrEP for a minute. It's the PURPOSE 1 and PURPOSE 2 trials, several thousand patients in each and those studies are going well. We're still in the enrollment phase for both trials. So I think the timing will be clearer as we get to completing enrollment, but we do anticipate that, as you said, '24-'25 we'll be able to both share data and get our regulatory work done. So I think that's going really well.

And as Dan mentioned, I think that's where we see the power of lenacapavir really in the near term, providing some options. In parallel, we're working on the treatment side with lenacapavir as sort of the backbone to get us two long-acting therapies. And, excuse me, as we showed at CROI, we're kicking that off with the bNAb combination, which really lets us get to every six-month treatment. So you have lenacapavir plus bNAbs lasting about six months. So we've moved that into Phase II and that's moving ahead nicely.

But we think the real inflection will come with the small molecules coming forward. So we have a number of assets in that -- in the treatment paradigm coming up. They're fairly early, as you said. The important thing in HIV is that from a mechanistic standpoint, we're not taking a lot of risk. We know these molecules will work if you can get to a certain level, in -- by PK basically. So between PK and tolerability. I think we'll understand much better what our candidates are.

In the long acting space, there's oral and parenteral. Oral, we're looking at weekly if not monthly dosing orally. And then parenterally, we're really looking at Q3 months, potentially up to every six months. And so we have a number of candidates in both of those -- in all of those areas that we're working through. And we'll know reasonably early on whether they have the PK and importantly, where they have the tolerability to move forward. So we're really excited about those program.

Daniel O’Day

And while we're early, of course, things move very fast and HIV drug development, which is -- it's light speed compared to any other therapeutic areas.

Merdad Parsey

Yes.

Salveen Richter

So oncology in that vein. Daiichi is expected to share data from their Phase III TROPION study, LUNG01 study. And versus docetaxel, right and second-line positive lung, what do you see as the read-through from here to non-small lung cancer?

Merdad Parsey

Yeah. We have three studies ongoing, two Phase III. Our frontline Phase II study, I'm going [Multiple Speakers]. Yeah. Our frontline Phase II study, we announced that we'll share some data later this year from that. So that will be our ability to show the performance of Trodelvy in second-line lung, the comparable population.

Daniel O’Day

First line.

Merdad Parsey

In first line. So -- and then our second-line study, which is EVOKE-01 is slated to read out next year. So that will be similar comparison to docetaxel in second-line. And then our front-line Phase III study is EVOKE-03, and that's the one that Merck is operationalizing and that's going really well. They're enrolling that really, really well. So we'll know that more about timing once that's fully enrolled, but that's going really, really well. So we're really confident with what we have, right? Probably most important in all of that is that we think we have best-in-class Trop-2 ADCs.

First of all, we're already in the market, right? We have approvals in triple-negative, HR-positive, HER2-negative, the accelerator approval in bladder. And the molecule from a medication standpoint, seems to be holding up very nicely. We have great efficacy and our tolerability profile is really showing familiarity with our practitioners, and they know how to deal with neutropenia and diarrhea, and that's working out well. We think in lung, it's very important. We have not seen ILD, which I think is going to be a very positive differentiator for us in lung cancer.

And we're not seeing stomatitis, which the Merck drug that's much earlier than ours showed about 50% stomatitis and we don't see that either. So we really think we have a best-in-class molecule. Not only are we way ahead where we think we have a best-in-class molecule. Very excited about where we're going.

Salveen Richter

When you look at a Trodelvy just more broadly, right, where do you think -- maybe you could just help us understand where you say best-in-class and you look at these competitors out there, where exactly do you think you are kind of best-in-class and how does that result in a certain sales outlook here?

Merdad Parsey

Yeah. I think look, again, we're approved NCCN category 1 recommendation for Trodelvy. So I think that in breast, in particular, I think, gives us a real advantage. In lung, we're -- we think we're going to get to comparable efficacy but without the ILD. I think that's going to be very important for us in the long run as we move forward. So I think we're really excited about that opportunity. And then in bladder, assuming we get confirmatory data, I think we've shown nice efficacy, and I think that will be a good complement to the other therapies that are available. We saw data at ASCO, the combination of Padcev's and Trodelvy in bladder cancer that looked really interesting and exciting. And then we showed endometrial data as well.

So starting to -- our strategy has always been to go broad. We've really been ahead with breast and lung and bladder, but now you're starting to see these other tumor types where we think we're going to have efficacy endometrial being the first of hopefully many where we're going to continue to show Trodelvy’s potential over the long run.

Daniel O’Day

And the thing that I would add to Merdad's statement in addition to going beyond breast and bladder and lung into other disease states, the opportunity because of the profile of what Merdad mentioned for the medicine to think about it in three drug combinations. So obviously, we're studying the combination with PD-1 right now, our TIGIT program, which I know we'll get to, but there's a probability and possibility of bringing Trodelvy into a three-drug combination like a PD-1 TIGIT Trodelvy.

And importantly, because of the profile, bringing it up into earlier lines of therapy, which is obviously what we're looking at. So Trodelvy is really -- I mean, just at the beginning, I think the source of your question of its growth potential and its ability. And it's been largely derisked because of the very large late-stage Phase III programs that we've had and a profile such to bringing up to earlier lines of therapy, which provides even more benefit for patients and more growth opportunity for us where we could really see that coming, both alone and in multiple different combinations within our portfolio and outside of our portfolio.

Salveen Richter

On the cell therapy business, as you mentioned earlier, I mean, it's been really nice to see how the autologous assets have performed and the move to earlier lines. How do you think about further investment here not just on the autologous side, but also on the next generation, whether it's allogeneic or other approaches or move into solid tumors, like how are you thinking of that the investment and then just the outlook here for cell therapy.

Daniel O’Day

Why don't I start and Merdad can add. So look, we are now today, clearly the world-leading company in cell therapy. And I think it's -- we've been able to get to that position because of three main things. One is the profile of the process and the cell therapy CAR Ts that we have.

Secondly, the investment, to your point, in manufacturing and the continued investment in manufacturing because at the end of the day, for cell therapy where the process is the product, I mean, the ability to have available capacity, but also for that capacity to be a quick turnaround time makes all the difference for some patients in terms of life and death.

And the third component is really setting up the infrastructure needed commercially to get this done, validating the ATC centers, I mean, part of our big objective now is to make sure that we get community referrals because at the end of the day, even with this extraordinary data that's potentially curative out to now five years and beyond in the third line setting and this great OS data in the second-line setting, there's a fraction of patients that are being referred today. And so really working that referral network is very important.

So we have a lot to do with what we have in our hands right now to continue to drive growth in cell therapy. And to your point, I think several years ago, some people thought that autologous had a very short lifespan. Well, it turns out that particularly with being able to reduce the cycle time down to we're really world-leading now at 16 days turnaround time, paying to vein. That's seven days manufacturing, seven days on quality release in two days of transporting either end.

We want to bring that down even further. And as that comes down and we have this long survival data and cured of potential, the difference between autologous and allogeneic becomes much more narrow. Having said that, of course, there's still 50% of patients that we're not getting effecting. And then of course we want to be on the cutting edge of the next generation technologies. So we have a variety of programs in our development program bicistronic applications that we think might be able to get to those other 50% of patients, CD19, CD20 that aren't responding today. We have collaborations with several companies, including our own house and the allogeneic approach should it hit and by the way, also some collaborations on in vivo approaches.

So we want to make sure that we're not only word leaders today, but on the next cutting edge of where the technology is going to go and where the indications go for development. So -- and we're exploring it in areas -- obviously, outside of hematologic malignancies, and we'll see -- we still think the scientific bar is quite high there. But if we think we are going to be able to attack other diseases and things beyond hematologic malignancies, it will be done with a broader kind of context in what our Gilead profile brings it.

So thinking about mechanisms we might have within Gilead around the tumor microenvironment and others. That's more of a longer-term play, I think, as we think about CAR-T and other areas. But big investment in the here and now, big investment in kind of next-generation CAR-T and then thinking beyond just CAR-T and to other mechanisms that could enable the immune system to respond more to cell therapies, if you want to....

Merdad Parsey

No, I would just add, I think, examples of the Kite team staying focused on what's coming are the Arcellx partnership we did in myeloma and the community partnership good part armored CAR-T. I think those are all examples of where the strategy has been to really stay close to everything and leverage our manufacturing and our know-how there with the evolving landscape. So I think you should look test to continue to be at the leading edge there.

Salveen Richter

And you discussed the importance of investment in manufacturing, as you mentioned, but we've seen these bottlenecks that have been playing out for supply. And so -- how do you continue to invest there on your own side but also maybe through partnerships with excess capacity out there. We just saw J&J do a partnership with Novartis. So how are you thinking about supply on the board?

Daniel O’Day

Well, we're in a very different position. I mean, today, and we haven't -- we have no capacity constraints right now and that's in a fast-growing market, but that's because of the decisions we made three years ago. So we teed up -- and it was at risk money at the time. We didn't know if second line would be successful. But we knew if second line was going to be successful, it would be too late to invest at that stage. So obviously, with a bit of prudence in some stage gates. We now have manufacturing facilities at different stages of automation on the West Coast of the United States, East Coast and in Europe. And we're also supplying Asia out of our West Coast facilities. So I think we're in a good position today.

The other thing that we've done in advance of supply constraints is thought about bringing certain critical steps of the process in-house such as viral vector manufacturing. We're almost at a stage now on our Oceanside facility where we're in addition to what we source externally, we'll be doing that internally. So I actually think that, yes, we work with partners. But at the end of the day, we're managing that capacity and very importantly, as the cycle times come down, so as we were able to automate more steps, that has a direct impact upon releasing capacity within our systems. If you can turn a sell around in less than seven days, five days that automatically gives you a 20% or whatever the number is increasing capacity.

And it's one of the reasons why, to Merdad's point, why the Arcellx deal collaboration is really interesting to us because it allows us to take an area in multiple myeloma that today has massive shortages in terms of the number of patients that could be treated in the available capacity and put that essentially into our platform and our system with hopefully what will be as good or potentially better efficacy platform. We'll see how that plays out in Phase III on an established manufacturing network to allow more patients to benefit from the BCMA therapy moving forward. So we'll continue to invest. I don't think there is a lot of CDMO kind of capacity out there for cell therapy. We know we have to build it ourselves. And I think we're really in a very good position on the manufacturing side.

Salveen Richter

TIGIT at ASCO, post the Phase II ARC-7 data, we saw about a three month drop in median PFS versus -- compared to the last interim update. And I think you've reiterated your confidence in this program. Help us understand in that context when you look about the competitiveness versus anti-PD-1 and just overall, I think what we've been seeing in the competitive landscape for TIGIT, your continued confidence in this program, help us understand why you're reiterating that.

Merdad Parsey

Yeah. Sure. I think probably just starting on ARC-7, it's really important that, that -- the data set shared in December, we've said and continue to say was early and immature. And you're seeing the data mature remembering that each arm is only about 50 people, right? So this is a small trial that's designed to show that donanemab adds activity. And so the PFS estimate are pretty unstable. If you think about it, right? One patient out of 50 can really move your median a fair bit.

So no concern from our standpoint that, that median shifts around a little bit. It will continue to shift around until we get to the final analysis. So no concerns there. Because, again, the primary objective of the study to show that we could add efficacy on top of the PD-1. And I think we've shown that clearly at this point, which gives us the confidence on our Phase III programs in terms of moving forward. I think we acknowledge that a lot of people are waiting for the Roche data to read out, the skyscraper data to read out. I don't know how that's going to read out either.

We believe in the biology, whether that study is designed, and we'll show the results that we think it will show, whether it was powered, we'd have to wait and see what the data look like. But we're confident we've moved into our Phase III trials, and we're moving together aggressively. A lot of discussion about Zimberelimab for me, for us, PD-1s have shown over and over again that they behave very similarly across the board. There's really no reason to believe that a new PD-1 would behave differently.

And indeed, when we look across either real-world data in the non-small cell standpoint or even in cervical data, for example, where we show an [indiscernible] that's better than KEYTRUDA. We are very confident in the activity of zimbrrelumab and the ability for us to move quickly with zimbrelumab to stay out ahead and to really not lose any time is critical. And we recognize that one of the advantages we hope to provide is that the practitioners don't have to choose zimbrelumab monotherapy is not something we're going to be advancing per se as a revenue generator.

Our goal is to really prioritize and be really aggressive with our TIGIT antibody. And our hope is that we can provide people the choice of whether it's DERVA (ph) from PAC-08 (ph), or the ZIM pembro arms (ph) in ARC-10, we want to make sure we are informing folks about what ZIM can do, but really have -- given the the choice of a PD-1 inhibitor that they can use in combination with TIGIT. So we're excited. And I think the thing that Dan mentioned, again, the differentiating thing for us is that it's an FC novel variant, unlike the competition.

And from a safety standpoint, we're already seeing that play out. And our hope is that potentially we could see a benefit on the efficacy standpoint. If we -- if the hypothesis plays out, the clearing TIGIT containing cells, effector T-cells that an FC intact antibody would do that by sparing those, we think with Don, we might even see a benefit in efficacy that we're going to -- that's going to take a while to be able to play out. But certainly, from a safety standpoint, we're really confident that we are showing better safety. So for all those reasons, we're really -- continue to be very bullish on TIGIT and moving forward very aggressively.

Last thing I'll say is the AE profile, it’s really giving us confidence that this is something that could be combined more broadly. We really aren't bringing a lot of adverse events to the table with Domvanalimab (ph). So whether that's combining with Trodelvy or other agents from an I/O standpoint, we think there's an ability to increase response rates for patients in a way that doesn't bring a lot of tolerability issues.

Salveen Richter

With regard to the Roche TIGIT trial, how are you thinking about the impact to your programs, if Roche is successful versus if they're not successful?

Merdad Parsey

Well, I think if they're successful, of course, I think it supports what we've seen, what our own data show and what their data had shown in cityscape. So I think that's -- they're clearly a competitor. We think, and I think it will support the field around the importance of TIGIT. If they don't succeed, it really depends on why, were they underpowered was the study design, flawed. I don't know, right, until we see the data. We'll certainly look at that very closely. We have the ability to adapt. If there's something in their data that suggest that we should increase our sample size or something like that, we'll, of course, look at those data and decide. But so it really depends on why they fail.

Salveen Richter

Great.

Merdad Parsey

If they fail, which I don't think they.

Salveen Richter

Perfect. So capital allocation. You've noted you can be selective about M&A given the deals that you've done over the past several years. When you look at your portfolio and where it stands today, how are you thinking about business development and M&A in particular? And could you just sketch out if you are interested, what a potential deal would look like? Is there a size or a therapeutic area you're most focused on?

Daniel O’Day

Yeah. Sure. So again, I'm really impressed by what the team has done. When I think of M&A, I think of acquisitions, but equally, I think of partnerships and license arrangements we've had. And I think as we thought about -- I mean, first of all, we put more than $35 billion of capital to work over the past four years in different types of structures and constructs.

We're now at a stage where we more than doubled our -- close to doubled our portfolio, but more importantly than the number, we've got really a richness of assets and targets and combinations that give us a risk reward for our portfolio that's drastically different than it was four years ago and it's very it's very late stage rich right now. We’ve got ‘22 Phase III trials. We're going to start another one later this year '23 Phase III trials, which for our company our size is with the top in the industry.

So we'll now get into a bit more of a Phase IIIs rolling off a new Phase III study as we go into the next couple of years. What I love is that the portfolio that Merdad leads at the company has a lot of pressure on it within the company. What that means is there's lots of NPV-positive projects that are coming to his committee that don't quite cut it. So we're clearly putting a lot of focus into long-acting HIV and Trodelvy line sector programs and then TIGIT and others.

So it's a very robust competitive atmosphere now in our portfolio, which I think is important, which means that our capital allocation needs to continue to feed that portfolio. Where we have a gap in our organization is probably more late research, early development now because of all the work we've done in the late stage. And again, the therapeutic areas, we'll stay true to our strategy, which is virology, oncology and inflammation.

So those will be the three therapeutic areas. And you'll see us doing a lot of partnerships and acquisitions supporting that late research early development. Of course, we'll look at late-stage assets, but we feel we have what we need in-house on a risk-adjusted basis to drive that top-tier growth, but we always want to supplement and we want to make sure we're into a normal rhythm in routine and cadence of adding things also from the outside. So I think you're going to see bolt-on acquisitions, research, early development focused and an occasional look at late stage that we think can complement our assets in our portfolio, either alone or in combination, in oncology, virology or inflammation.

In virology, it's less likely that we come across things. So most of it will probably be in oncology or early-stage inflammation. Just to note on inflammation. We really want to be novel in inflammation. So we're looking at new targets, new areas, potential combinability products, both within our own research, which has come up with some interesting approaches, but also externally. And I think inflammation is something that's kind of the next leg of the stool that plays out as we go into the 2030s, whereas urology and oncology leads us between here and the next -- the end of the decade commercially, I would say.

Salveen Richter

Okay. Any questions from the audience?

Unidentified Participant

You talked about offering flexibility with your TIGIT asset, in terms of which PD-1 they use. I mean, is that a straightforward thing. I mean you're not going to have to add an arm of like KEYTRUDA to or ARC 10 or anything like that, you just show benefit and then you think doctors and regulators be comfortable with?

Merdad Parsey

Yeah. I think it's going to be part of a hole, right? There won't be any single thing. We're putting it together in -- to build a broad story, right? So again, the PAC-08 study with [indiscernible] gives us some data with DERVA (ph). We'll have data with zimberelimab, and we have that pembro arm, pembro and ZIM arm in ARC-10 that people can look at pembro and ZIM essentially in the same population in a randomized trial as opposed to trying to do these cross-trial comparisons. I think those things around building the confidence around the comparability of ZIM are going to be our focus to make sure everybody is comfortable.

Salveen Richter

One.

Unidentified Participant

Obviously, the data that was presented at ASCO from the ZUMA trial was really intriguing. And just when you're thinking about bringing these CAR-T therapies into earlier lines, there's been a lot of progress there. What do you think remains in terms of educating physicians to begin to utilize it for their patients.

Merdad Parsey

Great question. I think the ZUMA-7 data that really opened up second-line. What we're seeing is that what happened is a lot of third-line patients started getting treated based on that. And now moving into second-line, a lot of this is around changing practice and people becoming more comfortable and confident in terms of referring patients to get treated and potentially with these long-term outcomes that look so great.

So capacity not being an issue. I believe the longer run is going to be around really getting people more and more comfortable. There's a lot of work to be done in second line still. There's just a huge need there and a real opportunity to continue to refer patients into the second-line. And as that builds up, people will continue to move forward. It's important to I think in the front line, our [indiscernible] is really effective. And I think it's going to be really difficult to compete there. But for second line and beyond, I think it's wide open.

Daniel O’Day

There's a subset of patients in the first-line and they can't have R-CHOP, so I think that's where that was the trials but I really think -- I mean, I was in the room, I think the fact that the 27% reduction in risk of death with a 57% crossover because tactically, you had to cross over will be a really strong, compelling way.

And to Merdad's point, I mean, really now working with community oncology to give them the confidence that they can refer patients and get them back for the longer term. I think that's a practice shift we have to change, and we're working with community oncology organizations that have connections in with these ATCs in a way that we've never been able to have these conversations before because of the strength data.

Salveen Richter

Maybe one last question. Your inflammation portfolio, if there's an asset or more that you want to highlight, where should we focus?

Merdad Parsey

Alpha 4 beta 7, our oral program, I think, is moving forward nicely. We're excited about that. And then I think beyond that, the rest of the portfolio is earlier -- but we're really focusing on novel mechanisms, as Dan said. And part of our hope, especially like with the MiraBio acquisition is that we can leverage what we've learned on stimulating the immune system in oncology looking at PD-1 agonist, for example, on the inflammation side, really changing the course of the disease. So I think as those start to mature, we'll learn a lot more and we're excited about that.

Salveen Richter

Great. Well, thank you very much. Appreciate it Dan and Merdad.

Daniel O’Day

Thanks for having us, Salveen. Appreciate it.