The following is excerpted from the question-and-answer section of the transcript.
(Questions from industry analysts are provided in full, but answers are omitted - download the transcript to see the full question-and-answer session)
Question: Richard Vosser - JPMorgan Chase & Co - Analyst
: Thanks, Bruno. A couple of questions. First of all, on Ocrevus, Perhaps, Teresa, could give us a little bit more color in terms of the logistical challenges,
what they are, how easy they are to resolve and when we think subcutaneous will start enhancing the growth of the brand? It looks as though we
may be plateauing a little bit in the US in Ocrevus, just what's going on there, please?
Second question, just on the HER2 TKI. We've seen quite a few of these in the past, and I think they always had tolerability, challenges maybe
diarrhea in the past. So just what's the tolerability profile and what you're thinking about there? And then I could go further, but I think I'll stop
there because -- we'll stop there. Thanks very much.
Teresa Graham - Roche Holding AG - Member of the Corporate Executive Committee, Chief Executive Officer of Roche Pharmaceuticals
Great, thank you. So I think when you think about the logistical challenges for Zunovo, they're not that dissimilar than from what we saw with
Phesgo when we were moving Phesgo into the oncology setting. It's about making sure that the workflow in the infusion suite is set up to just
handle a different kind of -- a different technology. And so we are well versed in what we need to do because we have done it before, and we are
steadily working with our community clinics and our academic centers to actually get them in to the flow of how to work with Zunovo.
It is interesting that when you hit that tipping point, and we saw this with Phesgo as well, when you hit that tipping point, clinics go big because
they get immediate good feedback from the pharmacist. They get immediately good feedback from the infusion nurses and they get great feedback
from the patient, but it does take them a minute sometimes to think about how it is actually going to work in their particular clinic.
Over the course of the last couple of months, we've had now the opportunity to talk to a couple of physicians, who started slow and are now up
to 100-plus patients on Zunovo. So I do think we are going to start to see this ball rolling and really picking up steam. I think we are already seeing
now.
We are already seeing that we are expanding our prescriber base pretty significantly. We're starting to see some competitive indications that would
indicate that subcut is starting to get some traction, particularly in accounts that are in the more rural areas, where maybe Briumvi or Kesimpta
would have been initially a choice. Now they're really migrating towards beginning to migrate towards Zunovo. So I think this is an area that we
have a lot of confidence that we're going to start again to see this ball really picking up steam.
In terms of the HER2 TKI, thus far, it has been very well tolerated without any dose-limiting toxicities at doses of up to 100 mg monotherapy. And
it has a promising GI safety profile compared with other HER2 TKIs, which I think is one of the reasons why this was so attractive to us in addition
to the fact that it potentially has best-in-class brain penetrant profile. So this is a molecule that we're actually super interested in getting into clinic
and seeing how it does.
Question: Richard Vosser - JPMorgan Chase & Co - Analyst
: No, perfect.
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