Steven H. Stein - Incyte Corp.
Management
So, Jay, it's Steven. I'll start off, and then Barry will talk about the commercial opportunity. So, if you step back and look at graft-versus-host disease in its entire spectrum, you're dealing with multiple entities. So there's a steroid-refractory setting, which is where we started with the REACH1 study, and that's a single-arm study that will be delivering data first half of this year, looking at ruxolitinib monotherapy in a single-arm study with a 28-day endpoint in steroid-refractory acute graft-versus-host disease. To back up that study and with Novartis also to get approval ex-U.S. is REACH2, which is a randomized study of ruxolitinib in the same settings, steroid-refractory acute versus best available therapy. And then there's a completely different clinical entity, chronic graft-versus-host disease, which occurs more than 100 days post transplantation, has a different clinical phenotype in terms of it being more fibrotic disease and more skin manifestations. And you're right, ibrutinib has an approval there in that chronic graft-versus-host disease setting. Our randomized Phase 3 study, REACH3, is ruxolitinib versus best available therapy, which could include ibrutinib in that setting and the primary endpoint is response rate at month six. So that's the spectrum of the steroid-refractory setting. And then there's a completely different entity, which is upfront steroid-naïve graft-versus-host disease, so before high-dose dexamethasone is used. And if you remember, our proof-of-concept data with itacitinib, our JAK1 inhibitor, was strongest in the setting, and that's where we're conducting GRAVITAS-301, which is in steroid-naïve graft-versus-host disease in acute setting, 436 patients. It's a randomized study versus placebo in that setting with steroids, so 28-day response rate. If that study is ultimately successful, then itacitinib would be used upfront in the steroid-naïve setting, and that's a compound that's wholly owned by Incyte and is globally ours. And then rux would find its way more in the steroid-refractory setting, as I outlined above. I'll ask Barry to opine on the epidemiology.
Hervé Hoppenot - Incyte Corp.: Yeah. Hervé here. Before Barry speaks about the U.S., just to give you the perspective of the potential for us. So the first program is ruxolitinib, where obviously it is Incyte commercializing in the U.S. and our partner Novartis outside in steroid-refractory GVHD, and that is a number of patients that has been estimated, as shown on slide 11. It's around 3,500 new cases of acute GVHD in the U.S., and there is around 3,500 new cases of chronic GVHD also in the U.S. So that's the first thing where we do the work with Novartis, we will commercialize in the U.S., and that's a steroid-refractory setting. In the steroid-naïve GVHD, where itacitinib is developed, we estimate north of 10,000 new cases of acute GVHD between U.S., Europe and Japan, and it's important because it's a project where Incyte will be commercializing itacitinib across U.S., Europe, and Japan. So, Barry, I don't know if you want to speak a little bit about the specific U.S. short-term opportunity for us.