管理層發言
Good morning, and good evening, everybody. My name is Kyahn Williamson, SVP of Investor Relations and Corporate Communications at Telix, and it's my pleasure to welcome you today to our H1 2026 Interim Results Presentation and Call. You'll have seen our documents lodged on the ASX earlier this morning. Next slide, please. Today, on our call, we'll be joined by Dr. Christian Behrenbruch, Managing Director and Group CEO; Darren Smith, our Group Chief Financial Officer; Kevin Richardson, CEO of the Telix Precision Medicine business; and Dr. David Cade, Chief Medical Officer. Following prepared remarks, we will open up the call to Q&A, starting with calls on the conference line. If we don't get your questions during the call, we will respond to you after the call is finished. Just to move to the next slide, please. Brief note, please note that today's presentation includes forward-looking statements, including within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 that relate to, among other things, anticipated future events, financial performance, plans, strategies and business developments. These forward-looking statements are based on current information, assumptions and expectations of future events that are subject to change and involve risks and uncertainties that may cause the actual results to differ materially from those contained in forward-looking statements. These and other risks are described in our filings with the ASX and SEC, including our half year and annual reports. You are cautioned not to rely on these forward-looking statements, which are made only as of today's date, and the company disclaims any obligation to update such statements. Please refer to the disclaimer slide included in the presentation accompanying this webcast for further information. With that, I'd now like to hand over to Chris.
Thank you very much, Ky. Good morning, and good evening, everyone. Before I go into our strategic priorities for this year, let me take a moment to remind everyone about our competitive advantages and what it takes to lead this field. We are a pure-play radiopharmaceutical firm, and our strength is based on five core pillars of activity. Firstly, our therapeutic pipeline is highly differentiated and built around significant unmet medical need. We're advancing innovative therapies in areas that have seen little to no innovation for decades, with either first-in-class or best-in-class candidates. Our portfolio is diversified with multiple shots on goal, further derisking commercial success. We've also built in-house R&D capabilities that enable us to develop and optimize both targeting agents and their radioactive radioisotope payload tailored to the specific biology of each disease. As we've said many times before, we are agnostic to the targeting agent in radioisotope. We let science guide these decisions. We are not wed to a narrative around a specific platform or approach. Earlier this year, we announced a collaboration with Regeneron that combines our expertise in radiopharma with Regeneron's leadership in biologics and antibody engineering. This highly complementary partnership positions us to accelerate the development of next-generation candidates and really puts us in a good place to lead in the therapeutic space in the future. Our Precision Medicine business is our third core pillar that's generating close to $1 billion in revenue and enables us to reinvest the significant capital into the business to continue this growth trajectory. The Precision Medicine business has enabled us to establish a presence across global markets where we continue to strengthen and guide our clinical activity. We've built a specialist commercial organization, a team that represents some of the strongest talent in the industry and is our fourth core pillar in differentiating us from competition. We've invested and continue to invest in our manufacturing and supply chain capabilities. The RLS transaction last year has significantly strengthened our control over the entire value chain from production and quality assurance to the final dose delivery. It's brought us closer to the customer, enabled us to meet growing demand and positioned us well to deliver therapeutic solutions down the road. Earlier this year, we shared three areas of focus, and I wanted to show the progress we're making against them. On the commercial front, we delivered approximately $390 million in precision medicine sales, up 27% year-on-year. This is driven by the successful launch of Gozellix and continued growth of Illuccix. We are now tracking towards the upper end of our guidance, very close to $1 billion in revenue. On the regulatory front, we've completed the submissions for Pixclara and Pixlumi in both the U.S. and Europe, with a PDUFA date now assigned in the U.S. of the 11th of September. In terms of Zircaix, we received a corrected complete response letter from the FDA and the resubmission process is tracking against agreed timelines with the agency. We're putting the final touches on the package and ensuring that the resubmission fully addresses all outstanding items before filing, particularly third-party manufacturing deficiencies. And this, of course, remains one of our top priorities for the year. On the Therapeutics front, we've advanced three Phase III candidates with full alignment with the FDA on Part 2 for TLX591, our prostate cancer therapeutic and started dosing patients for the other programs. And David will go into this in more detail later in the presentation. The BiPASS biopsy Phase III study is close to completing the targeted enrollment. The study has the potential to significantly increase the market and change the treatment paradigm in prostate cancer, and Kevin will share more on this game-changing program later in the presentation. Next slide, please. This slide illustrates our growth since 2024. As you can see, we've continued to develop the business, doubling the revenue since the first half of 2024 and delivered approximately 22% year-on-year growth, really eclipsing the growth of peer firms and recent financial results. We've demonstrated market leadership with two approved and reimbursed products, strong market penetration and continued commercial execution. This really shows that our strategy works. The strategic transactions and R&D investments we've made are starting to pay off. The acquisition of RLS has also, as I've mentioned, further diversified our revenue streams and allowed us to maintain a stable third-party revenue stream since the acquisition last year. We are committed to building out full product suite capability of RLS as an independent pharmacy network, including third-party product solutions that benefit from one of the most capable distribution networks in North America. Next slide, please. As our global footprint has grown, so has our manufacturing and distribution network. This is particularly important in the field of radiopharma, where the half-lives and shelf lives of products require just-in-time manufacturing and a highly specialized supply chain to avoid disruptions or delays to patients. Last year, we expanded manufacturing and distribution capabilities in the U.S. and Japan, and these are investments that are critical to establish the foundation for a scalable infrastructure in the future. This year, we also opened up our new translational research site in Melbourne. This site offers an integrated platform housing R&D and patient care under one roof, and is designed to accelerate the development and delivery of theranostics through rapid derisking and proof-of-concept development. And this is really a capability that's unlike any other found elsewhere. We continue to make CapEx investments at various sites, including Seneffe, Yokohama and RLS, where we're building out the manufacturing capabilities for therapeutics delivery, very important clearly to our next phase of growth. This includes increasing clean room capacity, installing cyclotrons, and making sure that the RLS network is equipped and licensed to do things like dispense lutetium therapeutics drugs. With that, I'll hand over to our CFO, Darren Smith, who will provide an update on the financials. Over to you, Darren.
Thank you, Chris, and hello, everyone. Moving to the financials for the first half of this year. We reported revenue of $477 million, up 22% compared to the first half of '25. This was achieved through robust commercial execution that delivered strong demand on our precision medicine products. Kevin will speak to this later in the presentation. EBITDA improved 146% year-on-year to $52 million, and net profit after tax was up to $38 million, reflecting strong business performance and continued control of operating expenditure. Our R&D investments represented 26% of our revenue, focused on accelerating near-term growth opportunities and developing our late-stage assets. Gross margin for our Precision Medicine business was 65%, an improvement of 1% year-on-year. We also successfully increased our cash balance to $252 million through the refinance of our convertible bonds, a successful transaction with better terms. We are well placed with the financial capacity to accelerate growth. Next slide, please, and turning to our income statement. As previously mentioned, we delivered double-digit growth both on the top line and the bottom line of our group P&L. Gross margin for the consolidated group improved 2% to 55%. This was supported by our strong growth on the top line, and we continued our healthy investment into our product development pipeline with a focus on near-term commercial opportunities in Phase III clinical studies for a number of our therapeutic candidates. At the same time, we have maintained a disciplined approach to managing our operating expenditure, reducing it by 1% as a percentage of sales. Next slide, please. Moving to our Sankey diagram. This clearly illustrates how we generate our funds and how they flow through the business. On the left side of the chart, it shows that in the first half of 2026, Telix generated revenue and income of $523 million from our Precision Medicine business, TMS and Regeneron collaboration. The middle sections of the chart show that after covering cost of sales, OpEx and finance costs, Telix reported a commercial profit of $153 million, a 29% return on revenue and income generated, demonstrating the strength of the business. I want to reiterate that we have a highly profitable business with strong cash-generating capabilities. But as we have said many times, rather than maximizing near-term earnings, we are reinvesting capital into growth opportunities that will drive long-term shareholder value. We continue investing our earnings into the business for the remainder of this year and the next year. From this financial position and as illustrated on the right side of the Sankey graph, we have made a decision on how much we invest into our R&D development and how much we bank a profit. Again, I cannot overstate the importance of the investment we are making today and the significant value that will drive in the long term. Next slide, please. Our Precision Medicine business continues to deliver double-digit growth, up 27% year-on-year from our differentiated products. Both Illuccix and Gozellix continue to drive strong demand across all market segments. Kevin will comment on this later. Gross margins of 65% improved 1% year-on-year, driven by a disciplined pricing and manufacturing and distribution efficiencies. R&D investment increased year-on-year, driven by Pixclara, Zircaix and BiPASS investments that will drive meaningful commercial uptake near term. As Chris mentioned, we are significantly expanding our market across our portfolio, including prostate cancer imaging with BiPASS, brain metastases imaging from Pixclara, and renal mass imaging with Zircaix. Overall, that is in excess of 1 million scans that our customers will meaningfully benefit from. EBITDA grew 26% year-on-year to $132 million. While we expect healthy EBITDA growth to remain, we remain committed to reinvesting the capital into the business in our pipeline, as I've mentioned earlier. Now moving to TMS. TMS generated third-party revenues of $89 million, up 10% year-on-year by RLS. Since the acquisition of RLS, we have maintained a stable base of third-party revenue, further diversifying our revenue streams. We have also successfully been driving manufacturing and supply chain efficiencies for RLS by selling a higher proportion of our own assets through them. Internal revenues of $57 million improved 70% year-on-year, representing Illuccix and Gozellix distributors for RLS. This means RLS is now our second largest distributor of our products. We also continue to invest in our manufacturing sites at Seneffe, Yokohama and selected RLS sites to ensure the global readiness to deliver our precision medicine and therapeutic candidates. Next slide, please. Our full year revenue guidance of between $950 million and $970 million is maintained for 2026. We do, however, expect that to land at the upper end of the range, and we expect continued growth in excess of 20% year-on-year of our Precision Medicine business. Please note, our full-time guidance does not reflect unapproved products, providing the potential for upside. We updated our R&D guidance to a range of $230 million to $270 million, primarily reflecting new investment across the development program discussed today as well as our collaboration with Regeneron. Given the strength of our commercial business, we believe that we are well positioned to support and accelerate near-term growth. I'll now hand you over to Kevin Richardson, our Precision Medicine CEO.
Thank you, Darren. First slide, please. As we've talked about before, we've continued to grow our PSMA business through a very pragmatic strategy focused on clinical differentiation and customer economics. We launched our two-product strategy to address the different needs of our two major customer segments, and that's proven to be the right approach. As a result, we've now delivered growth every quarter with our strongest growth rates coming in the two quarters following the launch of Gozellix. That performance has enabled us to increase both unit share and revenue share for the 16th consecutive quarter. In the second quarter, we delivered $202 million in revenue, up 9% quarter-over-quarter, following $186 million in the first quarter, which was up 16% quarter-over-quarter. Those results reflect not only our continued market demand, but also strong execution by our commercial, operational and customer-facing teams. The launch of Gozellix has been very successful. Demand was strong from day one, and the adoption we've seen reinforces that our two-product strategy is delivering exactly what we've intended. More importantly, it positions us well to continue innovating in the PSMA market with programs such as BiPASS and AlFluor as we expand our ability to meet the evolving needs of physicians and patients. At the end of the day, demand for our products comes down to a few things that we work on every day. We meet customers where they are. We provide a high level of service and reliability. We clinically differentiate our products. We make them easy to order. We deliver on time every time. We maintain a consistent pricing strategy, and we invest heavily in education around both the science and the reimbursement of PSMA imaging. That combination continues to matter. Our PSMA imaging agents have demonstrated fewer indeterminate bone lesions and higher inter-reader agreement compared with F-18-based agents, giving physicians greater confidence in clinical decision-making. When you combine that with the clinical performance and operational reliability and strong customer support, it continues to drive adoption across the market. Next slide, please. Moving on to global expansion. We continue to execute well internationally with our PSMA portfolio now launched or initiated across 24 countries. At the same time, we are making progress in two of the most important pharmaceutical markets in the world, China and Japan. In China, we submitted our NDA earlier this year and are awaiting review by the NMPA. In Japan, we've completed enrollment in our registration-enabling study, one of the fastest recruiting studies of its kind with more than 100 patients enrolled. We are now preparing our NDA submission while also awaiting feedback on conditional approval, which could support an accelerated path to market. These are important milestones because China and Japan represent two of the largest pharmaceutical markets globally and significant opportunities for Telix over the long term. More broadly, our international expansion strategy is about much more than near-term diagnostic revenue. Every market that we enter allows us to build relationships with regulators, payers, physicians and health systems while establishing the commercial and operational infrastructure we need for future therapeutic launches. In many ways, the Precision Medicine business is creating the foundation that will support the broader Telix portfolio for years to come. Next slide, please. Moving on to Pixclara and Zircaix, our two most important near-term launches, starting with Pixclara. We've made significant progress over the last several months. As you've heard, we've been assigned September 11 PDUFA date in the United States and have also submitted Pixlumi in Europe. In addition, Pixclara has now been included in both NCCN and international clinical guidelines, further validating the importance of this imaging agent and the need it addresses. With the regulatory submissions behind us, our commercial, medical affairs, market access and supply teams are launch ready and positioned to move quickly upon approval. What's particularly encouraging is the feedback we're receiving from the market. Our research continues to indicate strong physician interest and a high level of awareness of the unmet need. We're also continuing to expand the opportunity for Pixclara. Earlier this year, we announced an IND submission in brain metastasis, an indication with a substantially larger addressable patient population than our initial target indication and one that further demonstrates the platform potential of this asset. Now turning to Zircaix. As a potentially first-in-class radiolabeled biologic to reach the market, it underscores both the significance of this imaging agent and the substantial unmet need in clear cell renal cell carcinoma. Importantly, our confidence in the opportunity remains unchanged. Zircaix has received Breakthrough Therapy designation and Fast Track designation. It's supported by a strong ZIRCON clinical data package and is increasingly recognized within major international clinical guidelines. As a result, Zircaix remains one of our highest strategic priorities for 2026, and we remain fully committed to bringing this product to patients. So when you step back, both Pixclara and Zircaix are first-in-class imaging agents addressing areas of significant unmet clinical need and further strengthening Telix leadership in precision medicine imaging. Zircaix is particularly important as the first radiobiologic imaging agent to help establish a regulatory pathway for this emerging class of products, creating opportunities not only for Telix, but the future of molecular imaging more broadly. Next slide. Moving on to the current state of the PSMA market. Today, the PSMA imaging market is over 600,000 annual scans and is estimated to be approaching two-thirds penetrated. The majority of scan volume is concentrated in biochemical recurrence with initial staging representing the second largest indication. We also have approval for patient selection for patients receiving radioligand therapy, although this remains a relatively small contributor to the overall scan volumes. And we've discussed previously, there are opportunities to continue expanding utilization through guideline updates, increased physician adoption and additional clinical evidence and treatment response or monitoring indications. However, those opportunities are largely incremental and not expected to fundamentally change the size of the market. So while we continue to see growth and market expansion, the current PSMA market remains primarily driven by biochemical recurrence and staging, which together account for the majority of scans performed today. Next slide, please. Moving on to BiPASS. BiPASS has the potential to fundamentally change where PSMA imaging is used in the prostate cancer journey. Today, most PSMA imaging is performed at initial staging following biochemical recurrence. BiPASS could move PSMA imaging to diagnosis, bringing it to the very beginning of prostate cancer diagnosis, which has the largest patient population. And if successful, we believe BiPASS could approximately double the existing PSMA imaging market by creating a new pre-biopsy market segment for Telix PSMA. As we've discussed before, approximately 800,000 prostate biopsies are performed annually in the U.S., with roughly 75% proving negative. BiPASS has the potential to reduce unnecessary biopsies while improving confidence in patients who ultimately proceed to biopsy. In addition, up to 200,000 patients delay or decline core needle biopsy each year because of its invasive nature. We believe patients are increasingly seeking less invasive approaches to prostate cancer diagnosis when supported by strong clinical evidence. But importantly, our confidence in BiPASS is supported by PRIMARY and PRIMARY2 studies, which demonstrated that PSMA PET, combined with MRI, improved prostate cancer detection and showed the potential to reduce unnecessary biopsies. Strategically, BiPASS is important because it has the potential to anchor Telix PSMA at the beginning of the patient's prostate cancer diagnosis. If a physician adopts BiPASS, we believe they will increasingly prefer to use the same PSMA imaging agent throughout the patient's cancer journey, from diagnosis through staging, recurrence and ongoing monitoring. Consistency of imaging and interpretation becomes increasingly important as the patients move through the continuum of cancer care. That's what makes this opportunity so compelling. BiPASS doesn't simply expand the market, it has the potential to redefine and redistribute it. Through scientific innovation and clinical evidence, Telix has the opportunity to create and lead a new category of PSMA imaging in the pre-biopsy setting, possibly displacing the existing indications over time. Advancing science that reduces unnecessary procedures, reduces risk and increases patient outcomes is true market leadership. And with that, I'll hand it over to our Chief Medical Officer, Dr. David Cade.
Thanks, Kevin, for a great opportunity. Next slide, please. Well, this is our pipeline slide. And as you can see, our two primary areas of focus are within urologic and neurologic oncology. Within urologic oncology, we have our two late-stage programs in prostate and kidney cancer, but also follow-on alpha therapy candidates in earlier stages of development. Looking at neuro-oncology, which is our other key area of focus, this is a field in which new drug innovation has really largely been stagnant over the past couple of decades. Here, against that background, we have a Phase III candidate, TLX101, that's shown promising data to date as well as an alpha therapy candidate utilizing astatine also in early development. Within our other tumors domain, we're exploring different targets, including our TLX400 candidate targeting fibroblast activation protein or FAP, that's expressed within the tumor microenvironment across a very broad range of tumors. And therefore, this asset has pan-cancer potential. I'd like to also briefly mention the imaging agents and how we think about these. So for every therapeutic candidate, we develop an imaging agent. And in many cases, these are true theranostic pairs. With imaging agents developed at the forefront, we generate significant clinical data before making additional investment decisions in the corresponding therapeutic program. So by the time we advance a therapeutic candidate, we've already developed a strong understanding of its biodistribution and its selectivity for the intended target, which significantly addresses the level of risk in the therapeutic development pathway. Let's go to the next slide, please. On this slide, I wanted to highlight a few programs that we're focused on and where we've made significant progress through the first half of this year. Starting with ProstACT Global, this is our Phase III candidate for metastatic castrate-resistant prostate cancer. We recently announced that the FDA had completed its review of the safety data from Part 1 of the study and that we've also fully aligned with the FDA on the protocol design for Part 2 of the study. So essentially, our next step is to amend the IND that we have and align the regulatory submissions for the U.S. with the European Medicines Agency. Outside of the United States, we're also pleased with the progress we're seeing in Part 2 of ProstACT Global. We're currently enrolling patients in seven countries, and we look forward to providing an update on the preplanned interim analysis of radiographic progression-free survival, which is the primary endpoint, when that becomes available, remembering that this is a milestone that's event-driven. In other words, needing 81 disease progression events to trigger this first analysis. Now before I move away from prostate cancer, I'd also like to highlight TLX597, our next-generation small molecule candidate that's shown some promising early data. We presented some of that data earlier this year, demonstrating a very low radiation dose to the salivary glands and the kidneys, while at the same time, delivering a high dose to the tumor. So this favorable dosimetry profile, high to tumors and low to normal tissues makes it an ideal candidate in the early metastatic hormone-sensitive prostate cancer setting. There are currently two Phase II studies ongoing where enrollment is completed in OPTIMAL-PSMA in metastatic castrate-resistant prostate cancer. And we've now also started dosing patients in OPTIMAL-e in metastatic hormone-sensitive prostate cancer. We're also advancing TLX090 in a Phase I study for the palliation of bone pain from skeletal metastases that occurs in patients with very advanced disease. TLX090, I think, fits very well within our urology domain, given most patients with metastatic prostate cancer will ultimately develop bony metastases. Now moving on to IPAX BrIGHT. This is our Phase III study in glioblastoma. This study is evaluating TLX101 in combination with the chemotherapy agent, lomustine, and it continues to progress well. We're currently dosing patients in the first cohort, which commenced at the highest planned dose levels. Now if the combination demonstrates an acceptable tolerability profile, we'll advance into the expansion cohort to further characterize the safety of this combination of TLX101 plus chemotherapy. Now moving on to LUTEON. This is our monotherapy study for renal cell carcinoma using a CA9, or carbonic anhydrase 9, targeting antibody. LUTEON is being run under a Phase III protocol in Australia, and it forms part of our global development program for TLX250, which also includes the Phase II LUTEON ATLAS study in the United States and Europe. We've advanced this study through its site activation and it has begun dosing patients. And lastly, I wanted to highlight the collaboration we entered into earlier this year with Regeneron. Now this partnership builds on our well-established expertise across radiopharmaceutical development, and it reflects our shared commitment to advance the next generation of candidates with a focus on alpha therapies. We believe that we're uniquely positioned to drive innovation in this emerging field of alpha therapies and to have the opportunity to play a leading role in the future of precision oncology. Let's move to the next slide, please. Now this is a slide you may have seen before, but I believe it's valuable to describe how we are thinking about the therapeutic cascade across the continuum of prostate cancer care. TLX591, as I mentioned, uses a radio antibody drug conjugate to deliver the therapeutic payload. It has a long tumor retention with limited radiation exposure to healthy organs as well as a convenient two-dose regimen that really facilitates its combination together with a backbone of standard of care. This candidate is well suited for the first-line and second-line metastatic castrate-resistant prostate cancer setting, which is a more advanced disease state that may benefit from a therapy with a more convenient dosing regimen that better enables it to be layered on top of the ongoing use of a standard of care backbone of therapy. Now moving to TLX597, our small molecule candidate. This is a highly targeted next-generation small molecule radioligand therapy, which has demonstrated the highly favorable dosimetry profile I talked about earlier, which really makes it uniquely positioned for use in earlier metastatic hormone-sensitive prostate cancer where efficacy while maintaining quality of life in that early stage of disease is of other paramount importance. We believe the preliminary data are compelling, and we look forward to providing an update on the various trials once the data are sufficiently mature. As patients' disease will almost always progress, we're studying the use of an actinium-based alpha therapy, TLX592, in the later line setting as we view that alpha therapies are sequential to beta therapies at this point in their development, so after beta therapies. Now finally, our portfolio approach also captures our bone pain palliation candidate, TLX090. As I mentioned earlier, when cancer metastasizes to the bone skeleton, in most cases, it results in pain and a significant degradation in quality of life. We see pain palliation as an equally critical component in late cancer care. And with that, I'll hand back to you, Chris, for some final remarks.
Thanks very much, David. So to conclude, we entered the year with a strong lineup of catalysts. And at the halfway point, the list has expanded quite a bit. This is a significant and impactful year for the company for sure. We continue to successfully navigate the regulatory processes and advance our programs with two near-term launches. And as I said earlier, Zircaix is a top priority to us and will be refiled very soon. We have three pivotal therapeutic trials that have generated readouts and continue to advance towards important upcoming clinical and regulatory milestones, and you can expect plenty of clinical touch points in the coming months. We have a strong pipeline of new assets advancing behind. These are assets that have generated some very compelling data, as David has outlined. Our international expansion is progressing well and remains a critical component of our strategy to establish the needed infrastructure for future therapeutic launches. And overall, I believe that we're in a strong position with positive momentum across the business and multiple important catalysts ahead in the second half of the year. I also wanted to note that we'll be hosting an R&D Day in New York on September 22, where we'll provide an overview of our pipeline assets and go into a bit more detail around the data. In addition to having our management there, you'll get an opportunity to hear perspectives from leading key opinion leaders in the space. So we're really excited to showcase all the progress we've made over the last 12 months. And I'd very much like to acknowledge the efforts of my executive team who internalized some of the setbacks we've had last year and really rewired the way in which we approach our development and clinical activities. Before we move to Q&A, I'd like to take a moment to thank my colleagues and all of our employees. Their dedication, hard work and commitment every day are what enables us to advance our mission of delivering life-changing treatments to patients. And so with that, I'll hand it over to the operator for Q&A.
分析師問答
The operator provided instructions for the Q&A session. Your first question comes from Chris Cooper from JPMorgan.
I guess market share has been an important factor for you this year with the PSMA imaging portfolio. We now know that TruVu has the reimbursement code coming into effect on the 1st of October. Just your latest thinking on how you expect that market share development to progress through the balance of the year, please, given that.
Well, we don't really expect a huge amount of impact unlike Gozellix and Illuccix, which are two very different products that are delivered simultaneously to the market. Based on the information that's been put out into the public domain, TruVu has really been positioned more as a manufacturing improvement. As a consequence, it will be a product that will have to get rolled out across all segments of the market rather than be a market segmentation strategy that we've undertaken with our two-product strategy. So we haven't modified our guidance. Our guidance bakes in what we think is going to be the realistic outcome for the year and nothing has changed from our perspective. I don't know, Kevin, if you want to add anything?
I would just add that we see it as a similar product and our approach to the market has been very pragmatic, and we manage that across all segments, and we believe that the two-product strategy was the right one and has proven to be very successful for us. And so we'll continue that.
And second one, please, just on the Zircaix. I mean, good to see the extension was granted, although probably a bit disappointing it was necessary. You say you're making good progress. And I think you just said there, Chris, the resubmission is going to happen very soon. I presume that means now the next couple of months, but we've also been assuming that for a while. How much of that is within your own control at this stage?
All of it.
Okay. And so it's correct to assume the resubmission should occur in the next month or two?
That would be a reasonable assumption.
Your next question comes from Laura Sutcliffe from Citi.
I have one on the BiPASS trial, please. I think target recruitment was increased for a second time earlier this year, which we understand is because there was a need to increase the statistical powering of the trial. Is that right? And if so, could you tell us a bit more about what motivated the need for the increased powering?
I think there's been a lot of chatter about statistical powering, and it's not something that we've spoken really openly about. When we started the trial, there are a number of design assumptions, and as the trial has matured, so too has our approach to recruitment. Actually, the most interesting dynamic of the study was that we had a huge amount of uptake. We rapidly onboarded a lot of sites. In fact, the trial essentially recruited in five months, which I think is about the fastest study. Because of the backlog of patients that we had in the study, we elected to fulfill the backlog. So it's not as simplistic as a statistical plan or a statistical analysis. It's more about the dynamic of the study itself. I don't know, Dave, if you want to add anything to that.
Just really, all I would add, Laura, is that it was a very close and collaborative dialogue with the FDA. The FDA understands the background of the PRIMARY and the PRIMARY2 studies that came from Australia, and they were large multicenter investigator-initiated trials, generating data not ultimately fit for an FDA filing. So the FDA really understands that background, and BiPASS is an industry-sponsored study that builds on those studies with agreed endpoints and an agreed statistical analysis plan intended to support a regulatory filing, as Kevin has so nicely articulated.
Hopefully that answers your question, Laura.
And then just to come back to Zircaix. I heard the comment you made in response to Chris' question just now about resubmitting in the next one to two months. Does the extension that you have from FDA come with any specific time frames or deadlines? And is its existence a consequence in any way of the corrective CRL that you received, which seems to say that the regulator failed to consider some CMC data that you submitted a year or so ago? Or are they unconnected?
They're unconnected. There wasn't any additional actions that came out of the delayed CRL. That was an administrative matter on the FDA side. So from our perspective, nothing really changed. And just to be clear, there's been a lot of chatter about deadlines and dates, but we're not quite sure where this really comes from. There's nothing that's restricted us from being flexible on the date of resubmission.
Your next question comes from Andy Hsieh from William Blair.
Congratulations on continued solid commercial execution. Two macro questions, if you don't mind. One, maybe against the backdrop of your comment on being modality agnostic and the Regeneron collaboration, it's a pretty animated discussion at the ASCO radiopharma session about antibody modality, looking on a negative perspective. So I'm curious, Chris, if you can kind of opine on that or rebut against that. Secondarily, Lantheus is, I guess, in the process of being merged with Curium. And I'm curious, just against that backdrop, do you see a difference in terms of your strategy or do you continue everything as planned?
I think for the first question, data always speaks for itself. The rebuttal from the floor was actually pretty vibrant as well. Nuclear medicine has a history of being developed in budget-conscious academic environments where there wasn't ability to consider experimenting with a biologic, and so there's a lot of prejudice that isn't driven by data. It's really driven by capability, and I think that exists to the present day. At the end of the day, what we care about is what's the pharmacology of the drug, how does it interact with the target, how does it deliver a payload. We obviously wouldn't be investing money into programs when we have an agnostic approach if we didn't feel that there was a merit to doing so. I would encourage anyone interested in debating that further to come to our R&D Day, which would be the place to go deep rather than an investor half year results call. Regarding the second question, it will be disappointing not to have a competitor reminding us of their 2% growth compared to our 22% growth on their earnings calls, but I'm not sure that's something we'll miss as a comparison. It mystifies us a bit why you would bother acquiring a company with such a flat growth outlook. Nonetheless, we see it as business as usual for us, and it will be interesting to see what happens in the future in the space.
Your next question comes from David Low from UBS.
Congrats on the quarter. I just want a couple of questions on the BiPASS study. It seems like enrollment is going very fast. Could you just provide some early feedback from physicians' enthusiasm on the study so far? And what successful outcomes will look like for that study?
I think, Dave, that's your wheelhouse. Do you want to pick that one up?
We were pleasantly surprised. This multicenter international trial—essentially United States and Australia—had the first site in Melbourne start to kick the study off. They enrolled a very significant proportion of patients quickly. What that showed was there's clearly a significant physician desire to add the benefits of gallium PSMA PET imaging on top of MRI imaging because investigators believe, from their experience on study, that it furnishes the clinician with more useful information about whether to biopsy or not, and if to biopsy, what type of biopsy to do—a template biopsy or an image-directed biopsy. That early experience and rapid enrollment rate indicates investigators' positive feelings towards the clinical performance of the asset under study. That then propagated when we were able to open the study at the sites in the U.S., and as Chris said, it enrolled within about five months for the total sample size of roughly 350 patients.
I would just add that our lead investigator for the U.S. is going to be at the R&D Day as well to talk through that. So it would be a good time to hear his opinion about your question.
Hopefully that answers your question, Dave.
Your next question comes from David Stanton from Jefferies.
Just one from me. Can you give us an update in terms of potential timelines for Pixlumi in terms of the marketing authorization application has been accepted? When might we hear a decision on that, please?
We haven't given updated timelines because there's an early review of the package that can lead to clock stops and other steps we haven't crystallized. If you follow the review timeline to the letter from submission, it's around an 18-month process. It can go a little bit faster or slower depending on clock stops and review times. I don't think there's anything in our submission that's particularly controversial, and we're not expecting any major issues. When we submitted the Pixlumi package, we had the benefit of having had it reviewed by a major regulator already, so we submitted with a high degree of confidence in the package. We'll certainly keep you updated on timelines.
Your next question comes from Melissa Benson from Barrenjoey.
I just had two. The first is to clarify on David's comments around ProstACT Global and the progress there. So you had a successful June FDA meeting we heard back there around Part 2. Have you now filed the formality of the IND amendment paperwork? So we're kind of on track for U.S. sites this half? And then similarly, you mentioned European progress. Last year, you talked about a clinical trial application over there, the European regulator to review that for European sites. Any update on whether you've submitted a CTA for them to review?
We had the review of Part 1 data treated as an end of Part 1 meeting rather than a pre-Phase III meeting. We have one more engagement coming up with the FDA in a couple of weeks, and then we'll be filing the IND on the back of that. That's a standard process as we go into Part 2 to finalize the full scope of the IND amendment and it's courtesy to have that pre-submission meeting. Regarding the European submission, our priority has been to get U.S. patients into the study this year. Once we're over the hump on the U.S. side, then we'll turn to a broader focus. We do have Eurosphere jurisdictions already in the study, including the U.K. and Turkey, and we'll add other European countries that are keen to be involved once the FDA submission is in.
I did have one other, and this was actually on revenue guidance. So you've maintained the $950 million to $970 million, but noted that you're on track for the top end. Given the strength in the second quarter in the PSMA PET franchise, is your conservatism in not updating the guidance deliberate? Or are you factoring in anything dynamic around seasonality or the Lantheus TruVu launch we should be aware of?
We've given guidance, and we're maintaining our guidance.
Your next question comes from Dennis Hulme from Taylor Collison.
I also have a question about BiPASS. If we assume the trial results are positive—two questions. Can you talk about the label claim that you expect to ask for BiPASS? And secondly, if it is approved, how do you see it being used? We saw in the PRIMARY2 trial that there's a strong benefit in patients who have a PI-RADS score of 3 or less. Do you think initial use is likely to be targeted in that patient population, or could it be used more broadly, including in patients who have higher PI-RADS scores?
I'll let Dave comment on the clinical utility. We don't typically give label guidance until we've negotiated a label with the regulator. But the spirit of the study is to help guide decision-making around biopsy utilization. So that will be the context of the label. The goal of the study is to make sure the right patient gets a biopsy. It's not about eliminating tissue sampling or taking away the value of pathology in cancer diagnosis, but it's about ensuring that the large proportion of patients who won't benefit from biopsy aren't subjected to that unpleasant and expensive procedure. Dave, do you want to add anything in terms of the PI-RADS question?
Yes. In agreement with the FDA, BiPASS will enroll PI-RADS 1, 2, 3 and 4, but not 5. PI-RADS is the 1 through 5 scoring system a radiologist uses to score the MRI scan. PI-RADS 1 is typically not seen in a 65-year-old man; PI-RADS 5 is prostate cancer. Even though we don't need to enroll PI-RADS 5, the FDA will consider the totality of the data and treat it as covering all PI-RADS scores. At a high level, the study objective post approval is to halve the number of prostate biopsies that need to be done while not missing patients with clinically significant prostate cancer who then need a biopsy. So obviating the need for biopsy in half the population of patients that currently get biopsy, and in those that do require a biopsy, shifting from a template biopsy of 12 to 20 needles to a single targeted image-guided biopsy. In short: none and done for half of patients today who get biopsies, or one and done for those who do require biopsy. We believe this will drive significant clinical uptake so that PSMA PET is done alongside MRI before biopsy.
That's very helpful. And quickly on TLX597: can you talk about what the next step will be after the OPTIMAL-PSMA and OPTIMAL-e trials?
We're waiting for the first chunk of data to read out. Our priority right now from a prostate trial perspective is to complete recruitment of 591, which is our major program. We have some Phase II data to read out and once we have that in hand it will inform our longer-term plans for the asset.
That concludes our questions. I'll now hand back to Dr. Christian Behrenbruch for any closing remarks.
Well, thank you very much, everyone. Hopefully that was a useful update. Again, a very strong quarter from a commercial perspective and lots of great clinical outcomes. We look forward to seeing you at the R&D Day in New York in a few weeks' time. I'll leave it there and wish you all a good day. Thank you.