Steven H. Stein - Incyte Corp.
Management
So, Reni, I'll do your first two questions, but the second part of your second one, I'll let somebody else address in terms of its potential commercial value. But the PI3 kinase delta program, in a nutshell, the way we view it is it's a second generation inhibitor and all the data we have to-date by removing one of the chemical moiety that are in the first-generation compounds, like idelalisib and duvelisib, we've been able to, for the most part, get rid of any liver signals. So, we're not seeing transaminitis to-date in the program and we think it's because of that adjustment to the chemistry. But beyond that, these are, as a class very, very active compounds as monotherapy. The real issue becomes long-term tolerability particularly as you get out beyond the 140, 150 days, and that's where our challenge is now. We know we have an active compound. We presented data at ASH last year across B cell malignancies a very high efficacy. What we need now is working internally and then with our investigators and ultimately with the Agency to come up with dose and the schedule modifications that help retain the efficacy, but then give you long-term tolerability. And that's in the monotherapy setting. I think in combination, we've been cautious and going slowly. We have numerous combinations ongoing in terms of safety enabling, but we have to be very focused on toxicity and appropriate prophylaxis. So, it's a little early to comment on combination with standard therapies in B cell malignancy. With the delta program in general, there are numerous internal combinations of interest that we're investigating internally with various doublets that I doesn't have the time to go into now. Essential thrombocythemia, as Barry said in the upfront remarks, we're looking at a post hydrea (01:02:41) population where there is an unmet need, there's an approved drug in anagrelide? We have a Phase 2 that's published in 39 patients with rux in that setting that already show in a Phase 2 setting we can lower platelet count, we can lower white cell count and in a few patients who had a large spleen three or four of them had a reduction in that splenomegaly. So, the design of our pivotal study here is using a composite endpoint around the hematologic parameters for which we've data that implicates that we have a good chance of success because we have proof of concept there. In terms of the commercial opportunity, I'll let either Barry or Hervé address it.