4/30/2026

speaker
Operator
Conference Operator

good day and thank you for standing by welcome to the nova q1 2026 earnings call at this time all participants are in a listen only mode after the speaker's presentation there will be a question and answer session to ask a question during the session you will need to press star 1 1 on your telephone you will then hear an automated message advising that your hand is raised to withdraw your question please press star 1 1 again please be advised that today's conference is being recorded i would now like to hand the conference over to your first speaker today Adam Dainey, please go ahead.

speaker
Adam Dainey
Head of Investor Relations

Good morning, and thank you for joining us to review NovoCure's first quarter of 2026 financial performance. I'm joined on the phone today with our Executive Chairman, Bill Doyle, CEO, Frank Leonard, Chief Innovation and Medical Officer, Ori Weinberg, and CFO, Christoph Brockman. Other members of our Executive Leadership Team will be available for Q&A. For your reference, slides accompanying this earnings release can be found on our website, NovoCure.com. on the investor relations page under quarterly reports. Before we start, I would like to remind you that our discussions during this conference call will include forward-looking statements, and the actual results could differ materially from those projected in these statements. These statements involve a number of risks and uncertainties, some of which are beyond our control and are described from time to time in our SEC filings. We do not intend to update publicly any forward-looking statement except as required by law. Where appropriate, we will refer to non-GAAP financial measures to evaluate our business, specifically adjusted EBITDA, a measure of earnings before interest, taxes, depreciation, amortization, and share-based compensation. We believe adjusted EBITDA is an important metric as it removes the impact of earnings attributable to our capital structure, tax rate, and material non-cash items, and best reflects the financial value generated by our business. We do not provide forward-looking guidance for adjusted EBITDA on a GAAP basis, due to the inability to predict share-based compensation expenses contained in the reconciled GAAP measure net income without reasonable efforts. Reconciliations of non-GAAP to GAAP financial measures are included in the press release, earnings slides, and our Form 10-Q filed with the SEC today. These materials can all be accessed from the Investor Relations page on our website. Following our prepared remarks, we will open the line for your questions. I will now turn the call over to our Executive Chairman, Bill Doyle.

speaker
Bill Doyle
Executive Chairman

Thank you, Adam. This morning, we reported results for the first quarter of 2026, and I am pleased to say we've had a strong start to the year. Both active patients and net revenues grew with double-digit rates year over year. Our launch in pancreatic cancer is off to a promising start, and we are making progress on our journey to profitability. With a number of additional catalysts expected this year, we look forward to building on this strong first quarter. On today's call, we will begin with a review of our pancreatic cancer program. Frank will then provide an update on our GBM and lung cancer programs. Christoph will conclude with a review of our first quarter financial performance before we open the line for questions. The leading news in the quarter was the FDA approval and subsequent U.S. launch of Optune Pax for patients with locally advanced pancreatic cancer. Physician feedback has been positive since the Panova 3 data were presented and published at ASCO last year. There is broad recognition of the importance of the outcomes observed, including extensions in overall survival and time to pain progression. We believe Optune Pax can play a significant role in the treatment of pancreatic cancer, and we are pleased to be bringing Optune Pax to pancreatic cancer patients. The early days of our Optune Pax commercial launch have been encouraging. We received FDA approval on February 11th. In the seven weeks between the approval and quarter end, we certified 868 healthcare providers, 27 of whom are prescribers in academic centers, an exciting development as historically we've seen slower adoption of TT Fields therapy in academic centers. Through March 31, We've received 169 prescriptions and completed 90 patient starts. We ended the quarter with 83 patients on therapy and a backlog of starts in the funnel. We are also pleased to report our first major payer coverage policy for OptumPax with Elevance Health, covering over 30 million lives. It will take a few quarters to fully understand the OptumPax adoption curve and reimbursement dynamics, But again, the early signals are very encouraging. During the quarter, we also announced top line data from the Phase 2 Penova 4 trial, evaluating TT fields therapy together with atezolizumab and gemabraxane in metastatic pancreatic cancer. Penova 4 met its primary endpoint with a disease control rate of 74% compared to 48% in the historical control. Median duration of therapy was 25.6 weeks, a strong indication that TT Fields therapy is feasible for use in the metastatic population. As the pancreatic cancer treatment landscape evolves, we will evolve with it. After years of limited clinical success in pancreatic cancer, the medical community has seen positive outcomes in the Panova 3 and Panova 4 trials, and positive data from a trial testing the pan RAS inhibitor, Durexone RASID, in second-line metastatic pancreatic cancer. RAS inhibitors are likely to be an important backbone therapy in pancreatic cancer in the future, and we are working to understand the benefits of their concomitant use with tumor-treating fields. Earlier this month, at the American Association of Cancer Research, or AACR, annual congress, Two posters were presented which evaluated in vitro and in vivo use of TT fields with daraxone racin in pancreatic cancer models. The data presented show that KRAS inhibition, which blocks upstream oncogenic signaling, and the downregulation of the CMIC protein caused by TT fields produce greater antitumor activity when used together compared to either therapy used alone. These data are promising, warrant clinical investigation, and will be important inputs as we consider the next steps in our pancreatic cancer program. Finally, a quick update on our product development initiatives. Over the last year, we've launched a number of product enhancements aimed at making TPfields therapy easier for patients and prescribers. This includes an HCP portal, which simplifies the prescription process, lighter, more flexible, more comfortable HFE arrays for Optune GIA, a mobile app to help patients and caregivers navigate their TT fields experience. We are starting to see the fruits of these enhancements in our 90-day persistent rate, which hovered below 70% as recently as 2024. In 2025, we have seen quarterly persistent rates tick up to 73%. Our next major product improvement will be a new array for the torso. We are now finalizing the design, which will be compatible with Optune Pax and Optune Lua. The new arrays are designed to make major improvements in comfort and usability. We also expect these arrays to be more cost-effective to manufacture. We have completed usability testing in healthy volunteers and are evaluating performance in non-small cell lung cancer patients. Our next game is to have the newer arrays available for use in future pancreatic and lung cancer clinical trials by year end. I'll now pass the call over to Frank for an update on our GBM and lung cancer programs.

speaker
Frank Leonard
Chief Executive Officer

Thank you, Bill. Our Optune Geo business remains the core driver of our commercial portfolio. We are off to a strong start to the year, with 9% year-over-year growth in active patients globally. We saw our strongest growth in Japan, Germany, and France, which contributed 20%, 12%, and 9% year-over-year active patient growth, respectively. Our global market segment also had an outstanding quarter with 17% active patient growth, driven by a promising launch in Spain. We believe we can maintain low- to mid-single-digit active patient growth in our mature markets and even higher growth in new markets like Spain and Czechia. The next major catalyst in our GBM program will be top-line data from the Phase III Trident trial, expected in the second quarter. The Trident results will provide us with a better understanding of how TT fields can work with radiation therapy. Trident moves the start of OptuneGeo earlier in the GBM treatment journey, beginning with chemoradiation rather than following chemoradiation. In Trident, the patient population eligible for inclusion is broader than our EF14 trial. In the EF14 trial, patients who progressed in the short time between chemoradiation and screening were not eligible for randomization. In the Trident trial, where randomization occurs prior to the start of chemoradiation, we are able to assess the use of TT fields in this previously ineligible cohort. We expect Trident to give further insight into whether earlier use of TT fields therapy can drive additional survival benefit to a broader population of eligible patients. Turning now to Optune Lua. In March, we received national reimbursement in Japan and began treating commercial patients. Japan provides a promising market for Optune Lua, as our lunar clinical trial data more closely reflect the standard of care in Japan. On March 15th, we hosted a symposium with approximately 250 Japanese lung cancer physicians in attendance, including a number of leading key opinion leaders. We are in the early stages of our launch, but we're encouraged by the physician interest and engagement thus far. On the clinical trial front, as I have said from the beginning of my tenure as CEO, we need to update our strategy for the Lunar 2 trial. We are exploring options now to modify the trial with the goals of compressing the timeline to completion and significantly reducing the cost. We look forward to engaging with regulators to discuss the potential changes and providing a full update later this year. Overall, This was a very strong quarter, and we are pleased with our progress. Our commercial focus is on expanding adoption in GBM, maintaining the momentum of our Optune Pax launch, and capturing value in the markets where Optune Lua potential is greatest. We've reached a number of exciting commercial and clinical milestones in the first quarter and look forward to sharing more information on additional catalysts throughout the year. Christoph will now walk through our financial results from Q1.

speaker
Christoph Brockman
Chief Financial Officer

Thank you, Frank, and thank you all for joining us this morning. We had a strong start to the year, continuing our momentum from 2025. Net revenue in the first quarter was $174 million, an increase of 12% year-over-year. The increase was driven primarily by continued growth in our markets outside the U.S., including increases of $6 million and $5 million from Germany and France, respectively. Germany benefited from increased approval rates, which provided a one-time benefit of $2.5 million, and France benefited from contract performance improvement, which provided a one-time benefit of $1 million. We also had a $5.6 million tailwind from changes in foreign exchange rates compared to Q1 2025. Net revenue from OptinLure in the first quarter was $3 million compared to $1.5 million in Q1 2025. Based on the strength of our first quarter results in GBM, we are updating our full-year revenue guidance to a range of $690 million to $710 million, representing 5% to 8% growth. We are maintaining the range for combined revenue from option Lua and option Pax at $15 million to $25 million for the year. Gross margin in the quarter was 78% compared to 75% in Q1 of 2025. This was primarily driven by lower costs for arrays, resulting from improved array utilization and lower supplier prices. We continue to expect annual gross margin in the mid-70s for the full year 2026 as we bring more opportune tax patients on therapy prior to establishing broad reimbursement. Research and development costs in the quarter were $58 million, an increase of 8% compared to the same period in 2025. This was primarily driven by increased costs associated with the keynote D58 trial. As a reminder, this is a 700-plus patient trial, which we expect to fully enroll by the end of this year. Sales and marketing expenses in Q1 were $58 million, up 5% from Q1 2025. This was driven by launch costs for OptumPax in the US and OptumLure in Japan. G&A costs in the quarter were $86 million, up 92% from the same period last year. As we mentioned last quarter, we incurred a $43 million share-based compensation charge triggered by the approval of OptumPax. I do want to note this expense is included for GAAP accounting purposes and the grant associated with this charge did not vest and shares were not distributed. Our net loss for the quarter was $71 million compared to $34 million in Q1 2025. Excluding the one-time share-based compensation expense, net loss was $28 million. Loss per share in the quarter was negative 62 cents. Adjusted EBITDA in the quarter was negative $0.3 million compared to negative $5 million in the first quarter of 2025. We are updating our full-year adjusted EBITDA guidance this morning to range from negative $15 million to break-even. This reflects our strong start to the year, as well as accelerated expenses from our Obtune Pax launch. Our cash and investment balance as of March 31, 2026, was $400 and $32 million. Thank you all for joining us this morning. We will now open the line for Q&A.

speaker
Operator
Conference Operator

Certainly. As a reminder, to ask a question, please press star 1-1 on your telephone and wait for your name to be announced. To withdraw your question, please press star 1-1 again. Please stand by while we compile our Q&A roster. And our first question will be coming from Jonathan Chang of LeRinc Partners. Your line is open, Jonathan.

speaker
Jonathan Chang
Analyst, LeRinc Partners

Hi, guys. Good morning, and thanks for taking my questions. Can you provide any more color on the early Optune Pax launch, like the number of prescribers, the types of centers where you're seeing utilization, the early clinician-patient feedback, and help us contextualize how does this compare to the early lung cancer launch experience? Thank you.

speaker
Frank Leonard
Chief Executive Officer

Thanks, Jonathan. I appreciate the question. We are seeing... We're really proud of the OptumPax launch, both our preparation and also the response from the market. As Bill mentioned in his opening remarks, we had over 800 certified prescribers in just the opening month, essentially, of approval. And as Bill mentioned, 27% of the certified prescribers are from academic centers. And while we haven't given specific statistics on the number of prescribers who actually wrote in the first quarter. I will say that we were pleased it was a breadth across both community and academic centers as well as prescribers who even in the first five weeks wrote multiple prescriptions. So I think as we get into the second quarter, we will be able to get a little bit more color on that quantitative color on the prescribing trends and who's prescribing and where. But in terms of just the aggregate demand experienced in the first month of launch, we're very pleased. And to your question about how this compares to our lung launch, we would say this is across whatever metric we want to look at it as multiples of demand and really just a significantly different reception from the prescribing community.

speaker
Jonathan Chang
Analyst, LeRinc Partners

Understood. Thanks for taking my questions.

speaker
Operator
Conference Operator

And our next question will be coming from the line of Jason Bednar of Piper Sandler. Your line is open, Jason.

speaker
Jason Bednar
Analyst, Piper Sandler

Thanks. Good morning, everyone. Congrats on a really nice quarter here. And I'll start with OptumPax. So I'll start there. The launch here is significantly better than what we were thinking. It's really nice to see. Wondering if you could expand a bit more on those results, where you're at with physician onboarding versus the prescribing process. And I guess what I mean there is is your early metrics are so strong, it has me wondering about the steps of converting certified prescribers into active prescribers. Are those prescribers predominantly those that were part of your trial, and that's why they were able to move so quickly with prescriptions? Just any color you can add here as we think about the launch curve after physicians are certified and then moving into that prescribing of Pax.

speaker
Frank Leonard
Chief Executive Officer

Jason, thank you. I appreciate the question. What I would say is the... To your question sort of around who are those initial prescribers, I would actually start by just referencing back to the fact that this is the first significant approval for this indication. It's really, if we look just to the stage of locally advanced pancreatic cancer, this is the first successful trial in that space, and so while we've seen very strong engagement from the PIs who participated in the trial, the interest is much broader, and it was you know, essentially a buildup of demand that we were able to meet at centers we've never worked with before, academic centers where we've previously had, you know, very difficult times gaining access, wanted to have us in there in the first week so that they could immediately add to the standard of care. So, you know, I think we'll really go into some more numbers as we move forward into the next quarter, but it's, again, I would say this is very broad-based, There's not one single cohort that was able to go first. And more on that process, to remind everyone, as a device, we do have to train and certify our physicians as a first step. Once that training and certification takes place, they're able to prescribe right away. Those who have worked with us before might be a little bit more sophisticated about how to transfer prescriptions to us. But what I'm also really pleased to say is we've made significant investments over the last year into our HCP portal, the ways in which we work with physicians to transfer the prescription and the related data that's required, such that I think we've lowered the bar in terms of the burden on the physician. And as a result, we've seen that speed to prescribe.

speaker
Bill Doyle
Executive Chairman

Yeah, and the only thing I'd add is the enthusiasm really started to build at ASCO last year when the data were first presented. You know, just a great reception from the podium. And so, you know, to your specific question, the interest has certainly had an opportunity to build and was far broader than the investigators.

speaker
Jason Bednar
Analyst, Piper Sandler

Okay, excellent. Maybe one quick follow-up and then a separate one on guidance. But the quick follow-up, just as we think about that launch curve, you've been in market here for now three months or almost three months. What does that look like in February to March to April? If you can share any real-time feedback on that launch trajectory. And then separately on the guidance question, for revenue, you bump the midpoint by $10 million. You beat consensus by $6 million. That's a pretty strong statement out of the gate here. Maybe talk about, if you could, what you're seeing real-time or over the balance of the year that left you comfortable raising the revenue guide by more than the beat.

speaker
Frank Leonard
Chief Executive Officer

Jason, thank you. I'll comment on the trajectory and then pass to Christoph. We can't comment on the trajectory in the current quarter, only on the prior quarter. I would just say that when you look at the FDA approval, then there's a bit of time where we have to refile our labeling with the FDA. And you look at the last quarter really in the context of essentially four weeks in market. I'd go back to what I said before, that we were very pleased by the results. We see real strength in that initial interaction with our customers, and we are very excited for the rest of the year in terms of continuing the momentum.

speaker
Christoph

Yeah, and Jason, Christoph here.

speaker
Christoph Brockman
Chief Financial Officer

So, to your guidance question, I would say came off the back of a very strong 2025 and also Q4. And we have seen in Q1 that we were able to carry that momentum into 2026, which gave us the confidence combined with the strong revenue also in Q1 to increase the guidance to what we've seen, $690 million to $710 million.

speaker
Christoph

Okay. Thanks again. Congrats.

speaker
Operator
Conference Operator

And our next question will be coming from Kevin DeJeter of Leidenberg Bauman. Your line is open, Kevin.

speaker
Kevin DeJeter
Analyst, Leidenberg Bauman

Congratulations on the great quarter. Specifically, can you comment on kind of what you're seeing in terms of your funnel for contracting and coverage with some of the commercial payers and provide any updated thoughts on the engagement and potential for CMS coverage, and this is for OptumPax.

speaker
Frank Leonard
Chief Executive Officer

Sorry, Kevin. I think we were getting a little bit of a breakup as you were speaking, but I believe the question was directed towards our pathway to coverage and reimbursement for OptumPax in the United States. I'll start by highlighting we're very pleased to have our first major payer in the United States covering Oxfam tax with the coverage policies. And we will continue to work through the reimbursement process with the other major payers, private payers in the U.S. What we've typically said is that we expect around a year to two years to work through a coverage process in the U.S. for private payers and more on that full two-year window to have a revision to the LCD for the Medicare coverage. In terms of contracting, we have existing contracts in place with most payers in the United States, so we actually do not have a contracting step on PACS. So once a coverage policy is issued, the reimbursement is in place on the private side. Lastly, I'll just close by noting we do view NCCN guideline inclusion as an important step, and we are continuing to, you know, we have filed with the NCCN to request that guideline inclusion, and we are monitoring the situation closely.

speaker
Operator
Conference Operator

And our next question. We'll be coming from the line of Vijay Kumar of Evercore ISI. Your line is open.

speaker
Vijay Kumar
Analyst, Evercore ISI

Hi, team. Congrats on a nice frontier, and thank you for taking my question. I guess, Bill or Frank, my first one was on this pancreatic neurotic RAS inhibitors. I'm curious, and just to be clear, I think Revolution Medicine had some good data. Just to be very clear, their approval is not a headwind to PAX, correct? Because, correct me if I'm wrong, the indications for your trial are very different versus Revolution Medicine. Could you just clarify that, please?

speaker
Frank Leonard
Chief Executive Officer

Thank you. Vijay, thank you very much, and thank you for the question. You know, we are, when we think about Optune, Pax, and TT fields for pancreatic cancer, I always want to highlight back to the fact that pancreatic tumors have a low bioavailability for drugs, which is a big reason for why so many drugs have failed in this indication in clinical trials. It's also a reason why we see that excitement from the treating community because using a physical modality against the tumor is intuitive when the tumor has low bioavailability. And so, we see this strength of interest in Optune Pax that you see in the commercial launch numbers, but we also do see that in clinical interest in the number of IST proposals we receive and the interest in helping us to design our next wave of trials in pancreatic cancer. And so we think our device has a unique biophysical rationale for being used in this tumor type that is definitely recognized by the treating community. In addition, as you know, we are approved for locally advanced pancreatic cancer, which is a unique indication from where the current RAS inhibitor phase 3 data is. And we think, you know, we feel very confident that we have we have and we have a path forward to continue the excitement that we've seen in the first quarter. And I'll ask my colleague, Dr. Uri Weinberg, to comment also on the exciting work that we've been doing to study TT fields with RAS inhibitors.

speaker
Ori Weinberg
Chief Innovation and Medical Officer

Thank you. Hi, Vijay. Nice to hear you. So, first, we certainly continue to monitor developments in all of our areas of interest, and we are encouraged to see the new advancements in the field of KRS-CoV-2 inhibition, first and foremost for the patients, but also with direct relation to TT fields. TT fields were found to inhibit CIMIC, which is a master regulator of cancer cell proliferation and growth. And therefore, TT fields mediation of downregulation of CIMIC may actually complement the upstream KRAS inhibition. And that would support a potentially more effective therapeutic strategy when the two treatments are used together. And in particular, SEMI can also be activated through bypass pathways. And as Bill mentioned in his opening remarks, this data has been recently presented at the AACR. And in a very complementary fashion, an independent group of researchers from Mayo Clinic looked into the concomitant use of TT fields and KRAS inhibitors, and also repeated these same preclinical effects and reported even a synergy when the two therapies were used concomitantly. So we are very encouraged by that.

speaker
Bill Doyle
Executive Chairman

Yeah, and if we take a step back, we have always maintained that with tumor-treating fields, there's an opportunity to use with whatever the prevailing pharmacological therapy may be. We've never seen anything less than additivity, and in certain circumstances, we see the synergy. And now we've seen synergy with checkpoint inhibitors, and we're pursuing that strategy with our keynote D58 trial in newly diagnosed GBM. And we can see a future here where synergy with RAS inhibitors is also a very interesting treatment strategy for these very difficult to cure cancers.

speaker
Vijay Kumar
Analyst, Evercore ISI

That's helpful. Maybe one big picture question. When I look at the stock, clearly you're not getting any benefit or credit for some of the positive data you've had, whether it's lung or pancreatic. I'm curious, maybe the street wants to see a revenue acceleration rate. When I look at your assumptions here for GBM and pancreatic, could no cure get back, double-digit growth in fiscal 27? Generally, talk about big picture, how we should be thinking about the revenue profile for this company going forward.

speaker
Frank Leonard
Chief Executive Officer

Thank you, Vijay. I'll comment first on big picture themes around the GBM. business and the bank launch. And I'll turn it to Christoph to talk a little bit more about how we think about the long-term financial forecast. So first, you know, we're very pleased to see growth last year in our GBM business, not just international growth and opening new markets, but also in the core original business in the U.S. growing. And, you know, as we've said before, we believe there are many more patients that can benefit from the therapy as we currently have a penetration rate in our active markets of around 40%. And so what we've continued to do is invest into our GBM business, both the capabilities on the sales and marketing side to essentially dual cover doctors. So if we have a call in a community practice for pancreatic cancer, that same rep is now able to reach the community doctors to detail on GBM. We've also improved our sales operations and targeting capabilities. And we really do feel like we've in our core businesses and particularly in the U.S., we have the right team and the right skill sets in place right now to continue driving growth. And so we think that foundation alone is really an exciting way to think about the next few years. And what we've seen in Pank right now gives us really an incredible amount of confidence that we can turn this into the second major revenue pillar for the company in the coming years.

speaker
Christoph Brockman
Chief Financial Officer

Yeah, and maybe just to add to this, so to reiterate, our strategy is very clearly to get to double-digit revenue growth and also to profitable growth and to profitability. Now, we gave you a revenue guide for this year that is ranging from 5% to 8% at a mid-point 7% growth with what I would classify as very initial contributions from new indication launches. with more material contributions from new indication launches, we expect to get into the double-digit revenue growth in the future.

speaker
Vijay Kumar
Analyst, Evercore ISI

That's helpful. Thank you.

speaker
Operator
Conference Operator

And our next question will be coming from the line of Lawrence Bigelson of Wells Fargo. Lawrence, your line is open.

speaker
Lawrence Bigelson
Analyst, Wells Fargo

Good morning. Thanks for taking the question. I wanted to ask, of course, about pancreatic, the pancreatic launch. You know, when we look at newly diagnosed GBM, I mean, we only have one quarter here, but it looks remarkably similar on prescriptions, you know, better on active patients. I know it's early, but what can you say when comparing, you know, prescription launch in the U.S., you know, and active patient ramp, you know, for newly diagnosed GBM to pancreatic? You know, let me just, I'll just ask all my questions up front. Was there any pent-up demand in Q1 for panc? And then just OUS timing, remind us of that, please. Thank you.

speaker
Frank Leonard
Chief Executive Officer

Larry, this is Frank. Thank you for the question. I would say, you know, we are, we haven't really focused on comparing PANC to our GBM, our prior GBM launch for a technical aspect, which is simply that in GBM we had been approved in second line therapy and had existing relationships, and then in first line therapy, You know, the data had been out for over a year before the FDA approval, so it sort of, on a technical basis, becomes difficult to pick an exact comparison point. So what I would anchor back to is the, you know, almost 900 prescribers who sought certification in the first month of commercial, you know, availability. That was, you know, as we said before, that was multiples of the certification levels that we saw in our lunar launch. We do think that reflects some pent-up demand, but I would absolutely not describe it as a bolus of patients waiting and that it then normalized to a different level. We do just see really strong interest from the community in using Optune packs to treat their locally advanced pancreatic cancer patients. And OUS? Oh, yes. I'm sorry. Thank you. In terms of OUS, Krzysztof, can you remind me of the timing?

speaker
Christoph Brockman
Chief Financial Officer

Yeah, so we said second half for both TUV approval as well as for Japanabu.

speaker
Bill Doyle
Executive Chairman

Yeah, and all the applications are in. We're now just sort of waiting for those submissions. And if everything proceeds as expected, we would launch in the second half in those regions.

speaker
Lawrence Bigelson
Analyst, Wells Fargo

I mean, just maybe one follow-up, Frank. I mean, do you think pancreatic could ultimately be bigger than GBM overall? I think you've said that in the past.

speaker
Frank Leonard
Chief Executive Officer

Well, I certainly, so I think that pancreatic, I think in our current indication in locally advanced pancreatic cancer, you know, we believe there's around 16,000 patients, which is already bigger than the eligible patient population for Optune Geo. As we build our evidence base out and, you know, when we're able to secure those additional FDA approvals, it just keeps growing from there. So we are absolutely committed to success in this indication. And, you know, we think it has tremendous, as I said before, to have a tremendous potential to be our second major revenue driver. And ultimately, the population is bigger than the population for our current business.

speaker
Jessica Fai
Analyst, JP Morgan

All right. Thank you, guys. Thank you.

speaker
Operator
Conference Operator

And our next question will be coming from the line of Emily Bodner of HC Wainwright. Your line is open, Emily.

speaker
Emily Bodner
Analyst, HC Wainwright

Hi, good morning. Thanks for taking the questions, and congrats on a strong first quarter. I'm curious if you could comment a bit on your confidence for converting the full 169 prescriptions to active patients, and if you can kind of comment on what the average timing has been to converting patients from prescription to active therapy.

speaker
Frank Leonard
Chief Executive Officer

Thank you. Yeah, I appreciate the question because, you know, it was a big difference between prescriptions and active patients, and that simply reflected the timing of having one month at the very end of the quarter. So we don't intend to give the number of starts every quarter, but what I will highlight is that we had, you know, we had 90 starts, which led to that active patient number. And we saw typically about two weeks a little bit less than two weeks from a prescription to a start. And so, you know, those, you know, that 163 reflects a lot of prescriptions right at the very, very end of the quarter that we'll be talking about on the next earnings calls.

speaker
Christoph

Thanks.

speaker
Emily Bodner
Analyst, HC Wainwright

And maybe on metastatic pancreatic cancer, obviously you have the Penova 4 data, and then you also touched on kind of potential synergy with RAS inhibitors. So, Maybe just kind of talk about general strategy moving forward for the metastatic setting.

speaker
Ori Weinberg
Chief Innovation and Medical Officer

So, thank you for the question. Yeah, we were very pleased to read out the results of the PANOVA4 study. As a reminder, our single arm study in metastatic pancreatic cancer patients using a combination of gemcitabine and Abraxane. atezolizumab, ROS, PD-L1 inhibitor, and the TTIP fields. The primary endpoint was MET. The primary endpoint was the disease control rate, and it was significantly increased as a result of using the therapeutic regimen in Panova 4 from the historical 48% into 74% I think that the most important message and takeaways from the PANOVA-4 study is seeing, again, the relevance of PT fields therapy as a therapeutic approach to be developed in the metastatic setting in pancreatic adenocarcinoma. And following our demonstration of the clinical effectiveness in locally advanced pancreatic cancer in the PANOVA-3 study and the approvals, And that paves the way to continue the studies and development in this space. And the population used the ttFILS therapy at a very desirable usage rate. They use it for the entire protocol indicated duration of treatment. So, again, a great evidence of TTC's role in metastatic pancreatic cancer, and we continue to explore directions and may come back to this regimen at a later point in time.

speaker
Christoph

Great. Thank you.

speaker
Operator
Conference Operator

And our next question will be coming from the line of Jessica Fai of JP Morgan. Jessica, your line is open.

speaker
Jessica Fai
Analyst, JP Morgan

Hi, guys. Thanks for taking my question. This is Tanmay on for Jess. I wanted to ask for option facts. You mentioned the backlog of staff from the funnel. So I was wondering if the conversion from prescriptions to patients on therapy is going on as expected, and what do you expect the ultimate truth to be from those getting prescriptions to those patients who eventually initiate on therapy? Thank you.

speaker
Frank Leonard
Chief Executive Officer

Thank you for the question. You know, we, again, we wanted to be clear that with one month of, essentially one month and a few days of activity where we could take prescriptions and convert to starts, you know, it's hard to give definitive answers around trends about the rate at which prescriptions will convert to starts. But the consistency I want to emphasize is that we are very pleased with the results so far. In particular, I'm really proud of our team who helps the patients, our technical support team that's helping our patients. This is a new patient population for them, and I think the main takeaway in that first month is that we can execute quickly to move from prescription to start. And as I mentioned, we had a good, strong correlation between active patients at the end and the starts that occurred in the quarter, which means we're giving them the right support to make the

speaker
Christoph

the treatment feasible and practical.

speaker
Operator
Conference Operator

Thank you. And I'm showing no further questions at this time. I would like to turn the conference back to Bill Doyle for closing remarks.

speaker
Bill Doyle
Executive Chairman

Thank you. I'd like to end the call today by noting that NovoCure was able to maintain the momentum of the fourth quarter last year with strong and consistent execution in Q1. We're very pleased to see growth in both double-digit growth in both active patients and net revenue compared to Q1 last year, and very promising early signals both from our lunar launch in Japan and, of course, from our Optum Pax launch in the U.S. Our 2026 catalysts remain on track. We look forward to continued reporting on the developments in the commercial business, as well as the top line data from Trident up next in next quarter. We didn't talk about it much in this call, but our company remains focused not only on achieving the double-digit growth that Christoph underlined, but also on bringing the company to profitability. And we were also very pleased with our numbers in that regard. And we are focused as we have updated in our guidance on our path to profitability. So thanks to the team at Novacure, thanks to our patients and clinicians. And it's an exciting time to be at the company, and we look forward to reporting our progress in the next quarters.

speaker
Operator
Conference Operator

And this concludes today's program. Thank you for participating. You may now disconnect.

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