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spk_0: interstate you can be a lot more sensitive looking for recurrence of you can look at much larger numbers of mutations are just much more of signal to look for and so when we looked at they it at the market today with cancer recurrence we looked at the segments and we saw it as a of the different types of cancer breast and prostate cancer survivors are a really large fraction of the overall cancer recurrence of monitoring market and they and yet those are cancers where there's not a lot of mutations it's not zero but that is just a much lower mutational burden and those cancers then something like melanoma are lung cancer and so in other the tends to be not as much signal to look at if you only have sequence for the smaller panel up front the we realize several years ago that we could actually get around that by using whole genome sequencing from the cancer there are a number of fairly serious technical challenges and that that we think were largely overcoming those now and the of the all of experience we have are doing whole genome sequencing with the be a strictly helped i helped us think about that and so by leveraging for genome sequencing from the tumor we would expect to be able to identify a typically over a thousand mutations from i even from a breast or prostate cancer so that large number of mutations it gives us a lot of signal to look for in this so for a dna after surgical reception
spk_1: or after
spk_0: a patient has had a complete response to drug therapy and so the next person or product will be intended to look for that large signature ah and to build identify that signal and and to be really sensitive because of that and we also think that in the monitoring space it's important not just at tell whether a cancers coming back or not that's that's a really important application but that for many of the people being monitored the cancer is back there isn't a question of know whether it is people know it is and the cancerous being actively managed and that case you really didn't know how the is changing and so the ability to see no escape mutations or things like that in the tumor am when those begin to happen that's all part of the monitoring aspect and so we think next will be pretty comprehensive across the board with those and it will leverage this capability with the whole genome sequencing as the the front him
spk_2: i'm a quick one and just a corollary to what you're just talking about his is the as i would think is the paper that do not agree the family published with the checkpoint any better
spk_3: you treatment
spk_2: so how is the it out how can you develop that market because obviously there's a lot of people out there who are trying to you know ah understand how to treat some of these patients who can not respond to checkpoint in a bit of that population keeps an increasing
spk_4: so
spk_2: is is this at a segment of the market that you know you're gonna be going after our you already have said and orders in place from such books
spk_0: so suddenly many of the customers we have in the pharmaceutical world are people who have them developing checkpoint and have it earns may work with many of the companies in that space out and a lot of them adapt our platform because of our ability to look at all the genes which is what's really required to be able to say and new antigens and now with this new biomarker at our our ability to tell which mutations maybe antigen jannik ah that's a really differentiate capability in in in theory other people can generate an exxon scale cancer as say that they won't be able to tell which of the mutations actually could generate an immune response and that's something we worked on since two thousand and fifteen and the snaps paper as agree eight example of the the real and clinical testing of that
spk_2: and thank you john thanks for taking requests
spk_5: thank you
spk_6: your next class is from like massaro of bp i d line is now open a guy thanks for taking my question and apologize i'm hopping on different call tonight as i may have met some of the earlier comments but i'm kick can you give us on our thought process on your reimbursement framework on the so obviously night as you're starting to sort of transition from a research more more into the clinical ah side of of diagnostics on can you give us a framework for our whether or not you plan to sort of effectively crosswalk to existing code and the market or are you know any any i commentary you can make about discuss
spk_0: since ah that you might have had with palmetto more that would be helpful our so that a child sag and were not able to talk about ah you know the specific conversations like that yet but i would say they they the concept of is that we've developed our next platform so that it can both look at new state of the art biomarkers like me off which nobody else as that it and also be well validated for the known biomarkers they're already rambus verse and so we would expect to be able to the reimbursed for years of the next he acts test based on those conventional biomarkers because next has been designed specifically to be able to see them really well as you may know they add next platform is does not have the same sequencing coverage everywhere it's of over three hundred x sequencing coverage across the whole exxon but then in the genes the capture the server traditional targeted therapy targets and we boost the sequencing coverage app it ends up at over a thousand x step so we're really sensitive and those that those chains and so that gives us a a clinical utility that aligns with the kind of reimbursement that's or been well established by others so that gives us a baseline of reimbursement and and then we can leverage leave additional broader capabilities we have both to attract customers who have a interested in the combined research and clinical aspect and also ultimately who are interested and leveraging novel by
spk_6: wow workers like naps that nobody else may be able to offer okay and then you know i am just curious for any additional clarity on the v a so i i believe you said earlier that you do expect further order by the end of september on that hasn't come in yet yet you still maintain the guide for the year so i did it say
spk_0: a to say that your degree of confidence is high ah that you expect another order to come in for key for and then and we think about beyond que for and into twenty twenty two on what is your degree of confidence ah in that the eighth i desire to continue the program at similar level sure let's see i can say that we've been working with the be a now that we've received orders every year since two thousand and twelve i think the the only time we didn't receive an order in september was one year was actually dated in september we didn't receive it till october i think this here you know especially are they were would probably come and by the end of august but again there can be delays and asked the paperwork on throw at us receiving have so that's why we're confident about september it other be a is always looking at ah it's spending on a variety of different areas and i think we benefit both from the budget which has been specifically set aside for that million veterans program but actually there's a lot of enthusiasm for the program inside the vi and south to the extent that there are fun as it were set aside for other things that maybe didn't get completely spent if they're able to read purpose that towards mvp era in the past we've seen that they've done that kind of thing and so that's part of the reason that the orders tend to come a day at the end of the government fiscal year so
spk_7: so i i i would think it would be completely normal for us to say it and kind of late august or even end of september this year of that sort of that's how it's always work with them with them he i think we're very confident that will happen based on the conversations we've had and then in terms of the commitment to the program going forward as that the guy that i'd have mentioned in the
spk_0: in the remarks which we see this being a long term commitment at the v a when we talk with people there you know they're talking about their much to the first million and yelled there goes to have two million and so you know that will probably take a decade at the current rate of a of acquiring a new new veterans banger and in the program are we get a sense you know they're headed for at that's the that's the goal in a way them started working on this the early planning started back in two thousand and six seven that people who are working on this for shift ten years they're almost to the first million collected you have sequenced over one hundred thousand one hundred and twenty five thousand genomes so i think they're saying it's working there the number one population sequencing project and the us and you know that they feel like that's taken a lot of work and they're gonna they're in a keypad adnan and do that so we have every indication that they'll do that certainly the budget process we see happening whether you know they've budget authorization for the vs that's going through congress now for f y twenty two they will fight administration proposed a thirteen percent increase in their research budget at the vi and the white house specifically in their announcement about this highlighted the fact that this was the largest percentage increase in the the a research budget in recent memory and and we will look back almost twenty years not saying of that scale sex i think there is a strong support that only for the vi but for research and the v a because i think they see
spk_6: the a has a unique ability to do certain kinds of research that you really can't there is no other place you can do that kind of research and that's super helpful and thought i noticed another other emerging genetic testing company ah recently hired odd two or three people out of illumina ah to fortify i get it if you want to conquer population sequencing initiatives and so can you may be to talk about ah any changes to i'd that sizing of a market that you know the number of opportunities or or maybe even just competitive dynamic
spk_0: as as maybe you more than one company start bidding on some of these ah global contract yeah to that question that has there been a number of people competing on these guys of contracts over the years and the a that includes ah in a in any are up there has been some betting on on that kind of thing and at the sap in the middle east as well so it i think there are opportunities like that but for some of these large projects that these are very large amounts of money they're going to be spending and they've spent years collecting these samples so they offer want to be really confident in the quality of the data that it's gonna mass what's considered the standard and the industry today and to have somebody that that it has the experience has actually done it that isn't just talking about it for the for the future and and personnel us has more experience in that category than anybody in the world and so from that standpoint i think we're in a good position to cook it for those kinds of things will or will continue to be cognizant of a by a hooker the a competitor but we've had competitors in the past and at least in the
spk_6: the a business with brita in spite of the fact that there are other bidders purcell as one in every single case so we intend to continue being aggressive in that space but with the grab a great if a worker for enough years and have enough experience now that i think there really are they are by far the most experience company that space
spk_0: it's really helpful thanks very much thanks you're not i would say it one more item on that is the is that we the because these groups are looking for there's a lot of value and as statistics having very large numbers of patients you see the the i try to go from two million patients and so forth the cost of the sequencing matters a lot and that and so they
spk_8: that the other are other groups that are proposed various things and think it's important to be able to vague and not only that the quality but but it is important a bill to compete on the holocaust and so personnel us has worked a lot with aluminum over the years all of the sequence you have done for the be as been using they alone on a platform and and and i think that
spk_9: yeah that's how this in good stead so that you know if others are going to enter the space and there have been others that have better the space using like the oxford nana for platform it as it's not clear that the all those other competitors can match in terms of both quality of sequence and and costs i think those of a those will be challenges for the future
spk_5: for those companies
spk_6: not that site strong
spk_10: sent of cowan you're lying is smoking
spk_6: ah good afternoon guys and thank you for i've taken my questions are might my first is an ethic that question on china the other than some recent changes in regulations
spk_0: recently in various industries such as technology and food you know as as we talk to others in i'm our industry and and more probably ah across health care it does seem like there are some concerns that yes similar types of changes could i'm occur on in our field ah that that maybe point where eastern from said a bit of a disadvantage i'm i'm just wondering how you're thinking about these things and then know specifically to the partnership with buried deep feel that that puts you in a position where i'm yard your better position and maybe some others you know based on that partnership arm and be able to navigate any regulation changes now thanks to it's i did step land area that way we look at carefully and he that the at home that into partnership with barry definitely helps us in that regard and save in another aspect of this is that if we were only going to do clinical diagnostic testing i'd saved another are going to be chinese cup today's that direction is companies that provide that and affection sequencing based clinical diagnostic testing inside china and so the chinese government could have an incentive to you know tilt the playing field and in favour of they the home players you know this is a little different case because our business there it is really and it aimed at this point at working with international pharmaceutical companies and in those cases the vast majority of the clinical trials that are being run is actually being run outside of china and what farmers looking for is somebody who can provide the same technology both outside china and inside china and so a laboratory that only operated inside china for example cooked in a in principle try to compete for the business but it that it largely wouldn't be able to have they occasional unless there was a lab like that that had capabilities in any us and europe and so forth as well it wouldn't really real ah provide that other parts of i do think that purcell was a position as a company where we've been focusing on genetic analysis specifically for farmer and that's been the target customer for us and
spk_6: in china is a is a major held and the chinese government has a real incentive for their to be an international pharmaceutical companies having their drugs approved in china and so i think there's a dozen a different incentive that may help us through this kind of potential they call it right yeah literary slash protects us are you don't worry that there might be that is different from the situation right adventure if this was purely a genetic diagnostic business where were also the of if if you're diagnostic business you could be a diagnostic business only inside china and that be fine yeah yeah there's not as much benefit to also having the the business outside china thanks to that to an end just ah completely unrelated op op regarding next personal and next liquid biopsy yep commitments five development efforts you've been talking about for a while and get their very our personality like you know more markers more content for you know not up a whole lot money if not a lot more money if if anything it at the same price
spk_10: it as we move into clinical with these products over time
spk_6: good i know you appreciate this but you're gonna need to do more than just include more contact right yeah you need to demonstrate equal or better performance the content arguably matters less than how the outfits perform and that the utility in a clinical contacts the you guys know that as well as anyone and and commercially you're you're gonna need to be
spk_0: yeah as good if not better than the comments especially you're you're playing catch up so again nothing controversial there and just curious yeah assuming you don't disagree or went to we see more clinical data and and how do you envision differentiating and been better than others when it comes to test performance i'm in terms of utility not just breath idea now so i guess i'd say that they when i them is peter next personally in particular we think that that will be a product that has substantially better performance and a dimension that matters a lot on the clinical side which is sensitivity for detection so we see other groups publishing clinical results are you in and detecting a cancer when it's coming back at a tenth of a percent a little frequency or are you know of any a fraction of that you know what we're aiming at apart from million and of level so this is hundreds of times more sensitive than the other products that we see on the market and it directly impacts how
spk_5: early can you see the whether the cancer is coming back or not and so we think that's a a very differentiating great clinical feature so it's it is sense not just about more content than a sense for research perspective it it directly ties into the metric that are ah clinical customers we think will will care a lot about ah you're right that we will need to have the other elements of this my commercial standpoint the you know the salesforce the reimbursement all the other elements and that's that's absolutely front of a of my now and at the club more to say about that as we go through and through the air and enter
spk_11: into next year but we're we're very aware of the of those other challenges not only that technical performance
spk_0: thank you thank you the next consume and like that either i'm your line is not helping yeah good afternoon thanks for taking my question so i had one about his recent data on the yeah in the op's biomarker ah so you know with pete pdl one i used to compare against the up predictability up immunotherapy response and are if not at their plan for study that not sure i fully understand that the question of stairs or my p i want to me to has to chemistry as a biomarker but the and maybe she could restate the question of the health yeah sure so i guess you but that how compared to pm be but i was wondering if the author looked at how your bar mother compared to pdl one in terms of predicting immunotherapy response and so that the study that we've published was specifically can play against other direct and genetic biomarkers as opposed to have a protein ballmer her like pdl one a i think that they're a little that orthogonal and so they could complement each other in general we have cases where customers are interested in getting one i see testing along with our next platform so we see the to working together and it in a way it's a and example of that thing we've been talking about that individual by a scan the individual biomarkers often are not as productive as a what's we would call a composite biomarker and so the composite biomarker that we have and naps combines both the nail antigen burden but also the immune escape elements of that of the tumor but that you could see how that of that could also be further combined with things like that the pdl one as staining we do see that that pity or one standing although it's indicative in end some cancer types is not required for a physician to years the drug i think it's it tends to be mildly indicative but it's a it's a bit challenging as a different pity all one marker for almost every checkpoint inhibitor and so i had i think that as consider to be a fairly unsatisfactory biomarker this point and it doesn't really reflect the core mac and some of action of these drugs which has to do with the the nail antigens and so that's what we've been aiming at all the same as been to get at what's the real underlying mechanism of action of these drugs and so if that if you can see the details of that mechanism of action it really lets you be more definitive about whether patient will respond or not and and we also expect that now the op's will be something that will change over time as a patient evolves the the tumor of also be more mutations which would be more nail antigens but there can also be more loss of if i'm a chalet which is a different kind of escape mechanism so we see this will bring this out to start with our tissue platform but you can imagine mind to look at that from a a liquid biopsies went over time to okay thanks and then you and forest the up goes by the it was something that would be used for your former customers or would it would you also operate for clinical use yes said at the answer is he asked about the it's actually available to our pharmaceutical customers are now and they can use of both and their research studies and if appropriate they could they could use it as with as they're on a companion diagnostic development i would be inappropriate biomarker for that kind of thing there are of gear they they they the low hanging fruit has largely been taken now and that checked my have it or space and the other challenges now or and as a never cancer types for which ah the checked by inhibitors are either have not been approved or they're not first line therapy and so it up just biomarker that's a bit discriminatory on the patients might help advance and and and let those am check by amateurs get approved in places where they otherwise have not been side say from a farmer standpoint you know that's a that would be the attractive
spk_5: opportunity for them
spk_2: and then of on the from a clinical standpoint we report out layoffs as an investigational biomarker already to on our next he acts test and as we ramp up the the diagnostic volume on that test and it will a more and more people using that and ah
spk_12: i think that old the will begin to see i'm a interest in it's one of the things that were really differentiate the platform because so many patients to they are getting checked lantern have it or drugs and medical receive those drugs don't benefit from them setting physicians are very aware of that problem and are are looking for something that might at least give them an indication of about it over with which patients really look like they're they're the best candidates for that those therapist
spk_0: okay great thanks
spk_11: you're not score some from particularly f c d line and power
spk_0: thanks to him questions guys i'm just hoping to talk a little bit about and i imagine a little bit but on a pop seek your pipeline outside be a can you talk about i guess how active the i pointed elsa just timing you've you've always talk about start have some relationships and twenty two but just the and terms of natural award decision in the gods is what should be eaten about that opportunity and even the magnitude if if you want yeah so that i would say that they and in general the programs way we talk to your in our people looking at many many thousands of of patients and they end up being hit home a million dollar programs can be can be larger than that in some cases they and a number of the groups are ah
spk_11: in exploring how they're gonna go for some groups already have samples that they collected some groups are just beginning to collect samples others different countries are it in a kind of different stages i would say that they advance of covered has not helped and that regard because
spk_12: i'm in even as much as covered as a challenge and i'd say it's it's even more of a challenge in the some of the other countries and some of the countries that that have interesting population sequencing projects from our point of view of have also had very serious covered outbreak since i think they those discussions are ongoing but young people try to work true at in the midst of a a challenging pandemic and so and if the timing of that we do see it as a twenty twenty two and kind of average hundred and there are programs that are that are interested in moving forward on this kind of thing that are collecting samples and the a will have to compete for that at of thing but i do think it's her and something where as we go through twenty two and wouldn't be surprised to be
spk_0: the say to announce in assam awards in that area some of them have a competitive bids will have to go through that kind of thing but we've been pretty competitive on that kind of thing in the us in the past so he would certainly aimed to have a competitive internationally as well not helpful arm and then to certain back on the and on a lot but it seems like a majority in messer focuses on a given him the time a year can you can talk to the mechanics of getting getting a new agreement in place is it just kind of all and wait and see ah any discussions get me if you could bring by the current for a minute just it get your conference level and what timing how she expects all progress over the next few weeks a couple months and again a talked a bit about it but the more clarity the better on yeah that would be great i mean we have a relationship with people on the be a who worked on this program and many the people he were kids today are the same people even working with since back in two thousand and twelve on we started so it's a pretty long lasting relationship you get to know the people pretty well a young they're are able to save so much until they're actually is an award but in terms of the mechanics there is no competitive that this hear the serbia and new task or that would be issued on the contract we already have and there are no milestones they need to clear i've been a wicked get an email tomorrow that says here's you know order and that would be the whole thing and so we don't think there are any additional steps we need to take on that we have had discussions with the v i brought a variety of of ways in which we could advance the service we provide to them that could be that they could leverage i'm on a exists ten contract at this quite a bit of interest in some of those and so at a glad to see what they end up deciding they want to the fun in bed and say the of the overwhelming sense is that the know this has been an effort they been working on sense collecting samples since two thousand and eleven so it's been a decade already collecting samples they have some
spk_6: thing like three hundred people working on the project it sort of the shining star i in and some so the vi research or in and so you know we get every every sense that they intend to continue this until they get through the to at least two million patients and i'd say if anything there's an interest in say
spk_13: seeing more clinical ah content to this and eventually transition is into something that's used on an ongoing basis with all veterans so that's her even that's perhaps a more aspiration old unfunded at this point that we do see strong funding support and when we speak with people on the the political side of the world
spk_0: we also see that there's strong support for this program ah amongst both democrats and republicans and so it's not it's not a controversial program politically it's been something that's been was well supported under the trump administration and is now well supported another bite and ministration so i think as a great sense of this is an important national program it's a probably be twenty years and the in the process of building the whole thing we're about halfway through that now and i think everybody has their heads down an intense thirty to continue driving for that's really helpful their internal timing there are certain date were after day passes starting at a little concerned if you don't hear you get an email like he said justice week
spk_14: the timing
spk_15: i've had sex or expectation is that they the order probably would be signed in an august it could be in september i think august but but sometimes there is we have seen but i've described sort of a paperwork delay between when things are signed inside by whoever see of the appropriate person is inside
spk_5: the vi and when we actually get that news and can share it with the world so it i think it's probably fair to say we were thinking about september if we got to the end of september didn't have something we would certainly want think about that but but we're in touch with people at the piano in a fairly ongoing basis so if there was some a change or some and of a major issue in i would expect that people pick up the phone we'd be talking about it it's not just that just waiting i think there's an ongoing when we were still delivering thousands and thousands of genomes to the be and is all kinds of just the ongoing operational discussion there are so we're in contact with those folks and and i every indication we have is everything sort
spk_16: the new at this point and they
spk_5: i think we'll see how it goes with time it's it is the of issue at all like to just know what what the results are an and and move forward but i think guy and and a month or two here will have that answer
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