MRNA Moderna, Inc.

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Moderna, Inc. Q3 F2026 Earnings Call Transcript

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Kevin
Conference Operator
Good day and thank you for standing by. Welcome to Moderna's third quarter 2026 conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there'll be a question and answer session. To ask a question during the session, you'll need to press star 1-1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1-1 again. Please be advised, today's conference is being recorded. I would like to hand the conference over to your speaker today. Lavina Talukdar, please go ahead.
Lavina Talukdar
Investor Relations, Moderna
Thank you, Kevin. Good morning, everyone. And thank you for joining us on today's call to discuss Moderna's third quarter 2026 financial results and business updates. You can access the press release issued this morning, as well as the slides that we'll be reviewing by going to the investor section of our website. On today's call are Stéphane Bancel, our chief executive officer, Stephen Hoge, our president, Jamie Mock, our chief financial officer, and David Berman, our Chief Development Officer. Before we begin, please note that this call will include forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Please see slide two of the accompanying presentation and our SEC filings for important risk factors that could cause our actual performance and results to differ materially from those expressed or implied in these forward-looking statements. With that, I will turn the call over to Stéphane.
Stéphane Bancel
Chief Executive Officer, Moderna
Thank you, Lavina. Good morning or good afternoon, everyone. Thank you for joining us. I will start today with a review of third quarter, Jimmy with Vancouver Financial Results and Outlook, followed by Stephen with our current business updates in infectious diseases. David will then review our clinical progress in oncology and rare diseases. And I will come back quickly for a close on our key value drivers before Q&A. The Moderna team delivered a great third quarter, generating $1.3 billion in revenues, representing 29% growth year over year. Importantly, this strong commercial performance translated into $200 million in net income for the quarter. We also ended the quarter with a strong balance sheet with $8 billion in cash and investments, reflecting a combination of solid operational and commercial execution, along with a highly successful convertible debt financing. And we continue to demonstrate financial discipline across the company, reducing cash costs by 10% compared to the third quarter of last year. Together, these strong results underscore our ability to deliver strong commercial performance while maintaining financial discipline and strengthening our financial position. During the quarter, we achieved several important milestones across our pipeline and our business. USFD approval of mFluciva, making Moderna's fifth approved product and the first mRNA-based influenza vaccine to reach the market. In Canada, we secured approvals of both mFluciva and mCoFlu yesterday, the local brand name for mCombriax, further expanding our respiratory portfolio internationally. In oncology, we are very proud to present positive phase 3 data for intismaran autogen, are individualized cancer therapy being developed in partnership with Merck. The result demonstrated a significant clinical benefit with a 42% reduction in the risk of recurrence or death in patients with resected melanoma. An additional analysis suggesting an even greater benefit of 49% reduction in the risk of recurrence of death in patients who received at least one dose of intismoran as planned. Importantly, this marked the first combination immunotherapy regimen to demonstrate additional benefits over ketudra alone in the adjuvant melanoma setting. We're presenting a significant milestone for melanoma patients and their families around the world. David will discuss these results in greater detail. We also took an important step to further strengthen our financial position. During the quarter, we raised $3 billion for a 0% convertible no-debt. securing long-term capital on highly attractive terms. After accounting for the purchase of cap calls designed to mitigate potential future dilution and fees, we raised approximately $2.6 billion in net proceeds. These financing strengths are our ability to invest in the growth of oncology business, a key strategic priority for Moderna as we approach candidate important clinical milestones. In global health, Our Ebola vaccine candidate, mRNA-1469, developed in collaboration with CEPI, was selected to advance into Phase II-III following a recommendation from the WHO Technical Advisory Group. I am extremely proud of the performance delivered by the team in Q3. Strong sales growth, profitability, approval and quick launch of flu in the U.S. in Tismoran positive Phase III and the converted financing. I'm also very pleased and happy to welcome back Juan Andres to Moderna Executive Committee. Many of you will remember Juan for his previous time at Moderna, where he played a critical role in building and scaling our global manufacturing network during the pandemic. He also led the scale-out of individualized manufacturing for Intismaran Autogen. He knows our company, our technology and our culture extremely well. As we enter this next phase of Moderna's growth with an expanded commercial portfolio and important opportunities ahead in oncology, having Juan back on the team will be invaluable. I am personally very excited to be working with him again, and I know the entire Moderna team is delighted to welcome him back. With that, I turn to Jamie.
Jamie Mock
Chief Financial Officer, Moderna
Thanks, Stéphane, and hello, everyone. Today, I'll begin with a review of our third quarter financial performance followed by an update on our 2026 financial framework. Let me start with our commercial performance on slide eight. We delivered a strong third quarter with revenue of $1.3 billion bringing our year-to-date revenue to $1.8 billion. Our geographic mix for the quarter was approximately 60% U.S. and 40% international. Both the U.S. and international markets delivered stronger than expected revenue in 3Q driven by a mix of increased demand, operational execution, and timing of shipments between the third and fourth quarters. As mentioned in prior calls, we forecasted two primary growth drivers in 2026, increased MNEXT spike adoption and growth in our strategic partnerships in the UK, Canada, and Australia. In the U.S., while the vaccination season is still ongoing, we have seen increased uptake of MNEXT spike and vaccination rates have been relatively stable versus the prior year. Internationally, our teams have executed well, particularly in the UK and Canada. Year-to-date international revenue of $900 million is already $200 million ahead of the full year we delivered in 2025. Based on the strong start to the season, combined with the visibility we have into the fourth quarter, we are increasing our full-year revenue framework to a range of 15% to 25% growth, which exceeds our prior framework of up to 10% growth. We continue to expect an approximately even split between U.S. and international revenue for the full year. Now let me turn to our third quarter financial performance on slide nine. As I just mentioned, total revenue was $1.3 billion for the quarter, up 29% from last year, primarily driven by higher COVID sales. Cost of sales for the quarter was $318 million, representing 24% of total revenue for the quarter. This was a 54% increase in our cost of sales from Q3 last year, primarily driven by higher product sales volume and other manufacturing-related costs. We remain on track to drive significant gross margin improvements in 2026, excluding the $900 million litigation charge. R&D expenses for the quarter were $583 million, down 27% from last year. driven by completion and wind down of studies in our infectious disease portfolio, as well as efficiency gains across the organization. SG&A expenses for the quarter were $282 million, a 5% increase year over year. We continue to maintain cost discipline across the organization while investing for growth. Our income tax provision was immaterial in both periods. Net income for the quarter was $162 million, and improvement of $362 million compared to last year. Diluted earnings per share was 38 cents compared to a loss per share of 51 cents last year. We ended the quarter with cash and investments of $8 billion up from $6.9 billion at the end of the second quarter. The increase was primarily driven by $2.6 billion of net proceeds from our convertible note issuance and capped call transaction partially offset by a $950 million litigation settlement payment, as well as the seasonal impact to working capital. Now let's turn to our financial framework for 2026. For total revenue, as I mentioned in my earlier remarks, we are improving our revenue outlook to a range of 15% to 25% growth, which exceeds our prior framework of up to 10% growth. Cost of sales is unchanged at $1.7 billion, which includes $0.9 billion of expense related to the previously announced litigation settlement charge. We are lowering our R&D expense by $200 million to $2.7 billion due to further wind down of studies and continued operational efficiencies. SG&A expenses are still expected to be approximately $1 billion flat versus the prior year. Similar to last year, we expect higher SG&A expenses in the fourth quarter primarily due to commercial-related activity. In aggregate, excluding the $0.9 billion litigation charge, we are expecting total gap operating expenses of $4.5 billion and $3.8 billion of cash costs, which excludes stock-based compensation, depreciation, and amortization. Each reflect a $200 million improvement compared to our previous framework. We expect taxes to be negligible in 2026, and we are lowering our capital expenditure estimate to $200 million from our previous range of $200 to $300 million. Cash and investments are now projected to be between $8.1 and $8.3 billion at the end of 2026. Excluding the $2.6 billion net proceeds from the convertible note and cap call transaction, our cash projection would be $5.5 to $5.7 billion. which is an improvement from our previous framework of $4.7 to $5.2 billion. The increase in our cash projection is due to our improved revenue outlook and reductions in both our cash cost and CapEx projections. Our cash cost framework does not assume any additional drawdown from our remaining $0.9 billion undrawn credit facility. With that, I will now turn the call over to Stephen.
Stephen Hoge
President, Moderna
Thank you, Jamie, and good morning or good afternoon, everyone. I'll now take you through our recent business updates. As a reminder, slide 12 outlines our multi-year revenue growth strategy, which continues to be anchored in two key drivers, geographic expansion and portfolio expansion through continued pipeline advancement. We are building a more diversified portfolio with new opportunities across respiratory vaccines, oncology, and rare diseases. while expanding our commercial footprint in markets around the world. We're making tangible progress against this strategy with several important milestones achieved during the quarter. Starting with M. fluciva, we recently received FDA approval for adults age 50 to 64 and accelerated approval for adults age 65 and older in the U.S. In Canada, we secured approvals for both M. fluciva and M. coflu, the local brand name for Incumbriac. for adults aged 60 and older. For Mnex Spike, we saw approvals for the annual strain updates in the United States, Canada, Japan, and Taiwan for the 2026-2027 vaccination season. And for Imresvia, we continued to make progress in the US and international markets. We expanded our international presence with a five-year agreement signed with a local manufacturer in Mexico to support COVID-19 vaccine supply. And finally, in oncology, We presented positive phase three data for antismorin in adjuvant melanoma at the ESMO Presidential Symposium, as highlighted earlier. These milestones demonstrate continued execution against our strategy to drive revenue growth. Turning to our approved infectious disease portfolio, we continue to make progress across our five commercial products, starting with our COVID vaccine, As I mentioned earlier, Mnex Spike received approval for the updated XFG strain for this coming vaccination season in the United States, Canada, Japan, and Taiwan, with additional regulatory reviews and filings underway. Spikevax has also received approval for the updated strain in these markets and also in the European Union. Deliveries of our updated COVID-19 vaccines are now underway globally. Turning to RSV, MResvia is approved in 44 countries. We also received published results from a Phase 3 study evaluating revaccination with MResvia in adults age 60 and older who had previously received a protein-based RSV vaccine. The study demonstrated robust immune responses comparable to those seen following the initial vaccination with MResvia, with no new safety concerns identified highlighting the potential for MResvia in revaccination. A link to the study can be found on this slide. For mFluciva, our seasonal influenza vaccine, we have approvals in the United States and now Canada with reviews ongoing in the European Union, Australia, and Taiwan. In the US, the American Academy of Family Physicians has recommended mFluciva for adults age 65 and older as an enhanced influenza vaccine. And finally, for mCombriax, our combination influenza and COVID-19 vaccine, We now have approvals in Europe and Canada. The product remains under review in Japan, the United Kingdom, Australia, and Switzerland, with a decision on filing in the United States subject to further discussion with the FDA. Turning to US respiratory vaccination trends. Overall demand remains strong, as I said before. Through late October, approximately 44.1 million flu, COVID-19, and RSV vaccinations have been administered in the retail and long-term care channels, a 3% increase over the comparable period last year. Flu vaccinations are trending slightly ahead of last year, and COVID-19 vaccinations are trending slightly behind, but momentum in October suggests vaccinations may end up flat year over year in the channel. These trends demonstrate the healthy demand for seasonal respiratory vaccines in the United States. Turning to our late-stage infectious disease pipeline and our norovirus vaccine program, mRNA-1403. As a reminder, as previously disclosed, the Phase 3 study did not meet the statistical criteria for early success at its interim analysis. Following a review of the program, we have decided not to enroll an additional cohort this coming winter season. Instead, we are engaging with health authorities to determine the next steps for the program. And we'll provide further updates following those discussions. With that, I'll turn the call over to David to review our oncology and rare disease pipeline.
David Berman
Chief Development Officer, Moderna
Thank you, Stephen. Hello, everyone. I will review the progress across our oncology and rare disease pipeline, starting with Entismoran autogene, our individualized cancer therapy, which is being developed in partnership with Merck. Last month, we presented the positive phase 3 intrapath 001 melanoma results at the Presidential Symposium at ESMA, and I'll discuss these in greater detail shortly. A link to the ESMA presentation can be found at the bottom of this slide. Beyond melanoma, our antismoran development program continues to advance across multiple tumor types and stages of disease. In non-small cell lung cancer, the adjuvant phase 3 study is fully enrolled. Two additional Phase 3 studies in non-small cell lung cancer continue to enroll patients. One, Phase 3, is in patients who did not have a pathologic complete response following neoadjuvant therapy. And the other Phase 3 is in stage 1 disease evaluating in Tismoran, both as a monotherapy and in combination with Keytruda Culex. Phase 2 studies in adjuvant renal cell carcinoma and muscle invasive bladder cancer are fully enrolled. Both of these studies are randomized against Keytruda and are event-driven studies. We continue to enroll Phase II clinical studies in non-muscle invasive bladder cancer, metastatic melanoma, and metastatic squamous non-small cell lung cancer. Phase I studies in pancreatic and gastric cancer are fully enrolled. At ESMO, we presented a poster highlighting encouraging translational data from the Phase I pancreatic cancer study. Despite the low tumor mutational burden, typically seen in pancreatic cancer, we were able to generate neoantigen-specific T-cell responses in all 19 evaluable patients. A link to the poster is at the bottom of the slide. Now let's review the Phase III melanoma results. In the INTRAPATH-001 trial, the primary endpoint was relapse-free survival. Entismoran plus pembrolizumab demonstrated a Significant 42% reduction in the risk of recurrence or death compared with pembrolizumab alone. The hazard ratio was 0.58 and p-value below 0.001. These remarkable results were observed at the first interim analysis of this large randomized phase 3 trial enrolling more than 1,100 patients with resected stage 2b through 4 melanoma. At two years, Recurrence-free survival was 82.2% in the combination arm compared with 70% for pembrolizumab alone, representing a 12 percentage point absolute improvement. These results represent two important firsts. The first positive phase three trial for an individualized cancer vaccine and the first positive phase three trial demonstrating benefit over anti-PD-1 therapy in adjuvant melanoma. This is a summary of the phase two results at three different follow-ups. That study also tested in Tismoran plus Pembrolizumab versus Pembrolizumab monotherapy and also had an RFS primary endpoint. What's particularly remarkable is the consistency between the phase two hazard ratio of 0.56 and the phase three hazard ratio of 0.58 at the primary analyses were both had similar follow-up. In our phase two study, the RFS hazard ratio improved from 0.56 to 0.51 at three years, and that benefit was maintained through five years of follow-up.
Jamie Mock
Chief Financial Officer, Moderna
We are optimistic about the potential to see similar strengthening of the treatment benefit in phase three as the data matures.
David Berman
Chief Development Officer, Moderna
This optimism is further supported by sensitivity analyses from the phase three trial. In the Phase 3 trial, we conducted pre-specified sensitivity analyses that provide additional insights into the treatment to benefit. One of these analyses evaluated the modified intent to treat, or MITT, population, which evaluates only patients who received the intended intismorant or placebo injection. Patients were randomized and received pembrolizumab, but either relapsed or withdrew prior to the first dose of intismarin or placebo as planned were excluded. In other words, while the ITT analysis shows the results of a phase three clinical trial, the MITT analysis by limiting to patients actually treated with the blinded vaccine shows the true treatment effect of intismarin. In this MITT analysis, we observed an even greater treatment benefit with a 49% reduction in the risk of recurrence or death compared with the 42% reduction observed in the primary ITT. Notably, the hazard ratio of 0.51 is consistent with what we observed in phase two at the three and five-year follow-ups. At two years, the recurrence-free survival was 84.2% with the combination compared with 70.4% for Pembrolizumab alone, representing nearly a 14 percentage point absolute improvement. Together, the ITT and MATT analyses reinforced the strength and consistency of the efficacy between phase 3 and phase 2. The degree of benefit for the combination over pembrolizumab monotherapy, which itself is a great drug, is one reason that I am optimistic intizmoran will work in other tumor types. The combination of intizmoran plus pembrolizumab was generally well tolerated. with findings consistent with the known safety profiles of the individual therapies. Adding Entismaran did not meaningfully increase pembrolizumab-associated adverse events of interest, which occurred in 36% of patients receiving the combination compared to 35% of patients receiving pembrolizumab alone. And adverse events associated with Entismaran were also consistent with its expected safety profiles. The most common adverse events in the combination arm were parexia, injection site pain, and fatigue. These events were generally low-grade, transient, and were managed with standard supportive care. These findings are encouraging, particularly in the context of the significant improvement in relapse-free survival demonstrated in the study. I'll now turn to our broader oncology portfolio. Outside of Entosmoran, we continue to advance a diversified portfolio of oncology programs across cancer antigen therapies, T-cell engages, and cell therapy enhancement. Starting with mRNA-4359, our cancer antigen therapy, we have an ongoing phase two study in first-line metastatic melanoma, second-line or later metastatic melanoma, and first-line metastatic non-small cell lung cancer. Our mRNA-4194 program is progressing in a Phase 1-2 study in Lynch syndrome, with Phase 1 dose escalation ongoing. We also continue to advance mRNA-4106 and mRNA-4200, with Phase 1 studies dosing patients currently. Turning to our T-cell engager program, mRNA-2808 is in a Phase 1 study in multiple myeloma. The initial clinical results have been selected for an oral presentation at the upcoming ASH annual meeting in December, and we look forward to presenting the data and advancing this program. Finally, in collaboration with Ematics, we continue dosing in the phase one study of our cell therapy enhancer, mRNA-4203, in combination with AnzuCell. Across these programs, We're evaluating several distinct therapeutic approaches and continue to generate clinical evidence to guide further development. Turning briefly to our rare disease pipeline, our registrational trial in propionic acidemia, or PA, is on track, and we look forward to the results later this year. For methylmalonic acidemia, or MMA, we've deferred the decision to initiate a pivotal trial until after the PA readout. With that, I'll hand the call back to Stéphane.
Stéphane Bancel
Chief Executive Officer, Moderna
Thank you, David, Stephen, and Jamie. Looking ahead, we continue to see important value drivers across our commercial business, financial performance, and pipeline. We have raised our full year 2026 revenue growth expectations to between 15% and 20% growth, exceeding our previous revenue growth expectation of up to 10%. We also continue to execute with financial discipline, lowering our adjusted cash cost target by another $200 million to approximately $3.8 billion for fiscal year 26. And we have raised our year-end cash and investment outlook to between $8.1 and $8.3 billion. On the commercial side, we continue to pursue additional regulatory approvals to expand the global reach of our respiratory vaccine portfolio. Turning to our pipeline. 2026 has been a landmark year for oncology, highlighted by our positive Phase III melanoma results for intismoron and the presentation of encouraging early pancreatic cancer data at ESMO. Looking ahead, key milestones include our event-driven Phase II renal cancer readout, the intismoron BLS submission, the presentation of mRNA 2808 at ASH, and our registration without improprietic acidemia, or PA, our most advanced rare genetic disease program. Our priorities remain clear. Grow our commercial business, maintain financial discipline, and advance our pipeline toward important clinical and regulatory milestones. I'm very proud of what our team have accomplished this year and excited about the opportunities ahead for Moderna. We look forward to hosting the investment community next week at our upcoming Analyze Day on November 12th. The event will be held in person at our Antismaran manufacturing site in Marlborough, Massachusetts, where attendees will have also the opportunity to tour the site. A webcast of our presentation will be available for those joining remotely. I want to close by thanking our teams around the world for their dedication and execution. This has been an important year for Moderna, and our progress reinforces what we can accomplish when we combine both science with disciplined execution.
Conference Operator
Operator / Q&A Moderator
Our platform is delivering.
Stéphane Bancel
Chief Executive Officer, Moderna
Five approved infectious disease vaccines around the world, positive phase III for antismoron, and a new modality with mRNA-2808 proof of concept in multiple myeloma for T-cell engagers. Our mission remains at the heart of everything we do to deliver the greatest possible impact to people through mRNA medicine. With that, we'll be happy to take your questions.
Kevin
Conference Operator
Thank you, ladies and gentlemen. If you have a question or a comment at this time, please press star 1-1 on your telephone. If your question has been answered and you wish to move yourself from the queue, please press star 1-1 again. We will pause for a moment while we compile our Q&A roster. Our first question comes from Salveen Richter with Goldman Sachs. Your line is open.
Salveen Richter / Courtney Breen
Analyst, Goldman Sachs / Analyst, Bernstein
Thank you. Good morning. Two questions for me. One is could you frame your confidence into the interim data in renal cell carcinoma, particularly as we think about the statistical plan with regard to the number of events that needs to be hit around that interim? And then if you could also touch on the fact that there's been some questions in the contribution of the LNP to immunogenicity with regard to the melanoma trial and maybe just help frame that for us as well. Thank you.
Conference Operator
Operator / Q&A Moderator
Hi, Selvin. Thank you very much for the question.
David Berman
Chief Development Officer, Moderna
In terms of the timing, it's event driven for the RCC trial, so it could be end of this year or early next year. In terms of the confidence for that, why I'm confident, I would say probably a couple of reasons. First is that we know that RCC is an anti-PD1 sensitive tumor. Anti-PD1s work by T cells, by reactivating T cells. We work by generating novel T cells. And so it's a T cell sensitive disease. And so that's confidence number one. Confidence number two derives from the fact that in our phase two trial, we saw efficacy in the melanoma population at both that was equivalent for high TMB and for low TMB patients. And if you overlap the low TMB spectrum in the melanoma, it actually does overlap with RCC. And then finally, the treatment benefits that we saw in the primary analysis, hazard ratio 0.58 versus pembrolizumab alone, that was the same treatment effect that pembrolizumab alone saw versus placebo in their keynote 54. And then we know went on to be positive in RCC as well. So those are the reasons why I have confidence or believe that we are likely potentially to have a positive result. I don't say anything more about the statistical analysis plan. In terms of the LNP immunogenicity question, this is a question that's been going on for a while. Just to orient everyone, it came up a few years ago when MD Anderson published a retrospective analysis It wasn't a randomized trial. It was just an observation, and they suggested that patients who got an mRNA LNP vaccine had better outcomes to immunotherapy. That data from MD Anderson has subsequently been repeated and not been repeated by different groups. In fact, most recently, Memorial Sloan Kettering, which is the other large cancer center in the U.S., came out with their own analysis showing that actually there was no treatment effect by the addition of mRNA LNP. So I don't think that that answer is clear. I don't think the evidence is strong enough to claim it. And I don't think L&T can generate such an incredibly strong hazard ratio in the adjuvant setting.
Conference Operator
Operator / Q&A Moderator
Thank you. One moment for our next question.
Kevin
Conference Operator
Our next question comes from Terrence Flynn with Morgan Stanley. Your line is open.
Terence Flynn
Analyst, Morgan Stanley
Great. Thanks so much for taking the question. I was just wondering, I know you're not going to guide on price at this point for INT, but was just wondering if you could talk through some of the inputs that you and Merck are considering as you think about pricing that therapy. And then the second question I had is just on the Phase II RCC study, if those data are positive, do you think that can support a registration in that setting? Thank you.
Stephen Hoge
President, Moderna
Thank you. Look, this is Stephen. I'll take the first part of it on price, and then I think hand it over to David. On price, look, it's premature at this point. We're working on getting a submission done this year and obviously working towards approval. We will always look to price our products to represent the value they create in healthcare systems, and obviously we're thrilled by the data, but it is premature at this point to say anything more, and we'll work closely with Merck on that process.
David Berman
Chief Development Officer, Moderna
Thanks, Stephen. Terrence, in regard to your second question, look, it's a pretty large, randomized, well-controlled Phase II with 282 patients, but it is a Phase II. So at a base case, I would say it can be practice-informing, especially with compendium listing if it's positive. In an upside, if the results are very strong, I think we can consider taking it to FDA, but it will be data-dependent.
Conference Operator
Operator / Q&A Moderator
Thank you. One moment for our next question.
Kevin
Conference Operator
Our next question comes from Ellie Merle with Barclays. Your line is open.
Ellie Merle
Analyst, Barclays
Hey, guys. Thanks so much for taking my question. On the back of the pancreatic data at ESMO, can you elaborate on how you're thinking about potential next development steps here? Would you study in combo with PD-1, with chemo, or both? and then just a quick one on RCC. If the study is not successful on the first interim, is that something you'd disclose if it moves on to additional analyses? Thanks.
David Berman
Chief Development Officer, Moderna
Ellie, so with regard to the PDAC, look, the good news is that in this low TMB tumor, we were able to generate cassettes from the patients and in all of the valuable patients, we were able to see T-cell reacting to this neoantigen. So I think that's a really good sign. And we did it in combination with the standard of care, which is fulfirinox. So it informed us that it can safely be given with chemotherapy, which I think we probably assumed it could, and that we can still generate T-cell reactivity in the face of the addition of chemotherapy. I think for next steps, we're actively discussing that with Merck right now. I think It could be in the same regimen that we studied. It could be in combination with the RAS inhibitor. I think we need to do a little more thinking about that because the standard of care is changing. In terms of the disclosure, I don't think we've decided yet how we're going to handle that.
Kevin
Conference Operator
Thank you. One moment for our next question. Our next question comes from Edward Tenhoff with Piper Stanley. Your line is open.
Edward Tenthoff
Analyst, Piper Sandler
Great. Thank you very much, and congrats on all the progress. My questions are just on the VLA for Antismaran. What still has to happen, and are you working collaboratively with Merck on that? Are they driving the bus? And then just trying to get a sense for when we might get data from the lung cancer studies and maybe you can kind of break out sort of how those different studies might read out. Thanks so much.
Stephen Hoge
President, Moderna
Hey, Ted. Stephen, I'll take the first part of that and then hand it over to David to speak through the lung cancer work. So we're working intensely with our partner Merck, as we said earlier, as Stéphane mentioned a moment ago, we are working to make sure that submission with the BLA happens. This year, and if everything goes well, as has been said before, we would hope to see approval next year. There are lots of steps, as you know, pulling those things together, including getting ready for pre-approval inspections and everything. And I can assure you, working around the clock to make sure that not only the submission happens on time, but the review is facilitated with the FDA because our goal here ultimately is approval. But working very closely with Merck together on that as we speak. David?
David Berman
Chief Development Officer, Moderna
Thanks, Stephen. The lung cancer adjuvant program is actually really comprehensive. We announced that we have just about completed, we have completed enrollment in the intrapath 002, which is adjuvant after chemotherapy with no neoadjuvant therapy. In fact, this was the fastest enrolling, one of the Merck's fastest enrolling trials, just to give you a sense of the excitement. We are still ongoing in enrollment in patients who had who had neoadjuvant Pembroke chemo and did not have pathologic complete response. That's still enrolling, so it's too soon to know what's going to happen in terms of timing there. And then we have the really exciting high-risk stage one lung cancer phase three where for the first time we're testing in Tismoran monotherapy in one of the arms, also still enrolling there. In terms of readouts and timings, I think it's a little too soon. We just finished to predict. We just finished enrolling. and so now we need to start monitoring events and then we'll have a better idea about timing.
Conference Operator
Operator / Q&A Moderator
Thanks, Stephen.
Kevin
Conference Operator
One moment for our next question. Our next question comes from Alex Renahan with Bank of America. Your line is open.
Alex Renahan
Analyst, Bank of America
Hey, guys. Thanks for taking our questions. Two from us, one on 2808 and one financial question. Looking forward to the data at ASH. I guess Thank you. Thanks. Thanks.
David Berman
Chief Development Officer, Moderna
Alex, with regard to your program, thanks for highlighting 2808. It is actually one of the exciting early stage programs we have. You know, there have been obviously lots of T cell engagers in myeloma. There have been some that are targeting two antigens. This, of course, is the first time ever that three antigens have been targeted, and that's why we're excited this is going to be an oral presentation. The data cut is later for the oral than it was the abstract, so you can expect more patients, longer follow-up. and evaluation of whether we can get a deeper response and activity in patients who had prior BCMA and GPCR5D. In terms of the broader implications, this is testing a hypothesis we have that one of the benefits of our platform is that we can multiplex. And so we're multiplexing care against different tumor antigens in the form of three T-cell engagers, but it can also show that we can multiplex on the other side. going after different T cell stimulation approaches as well. So the fact that this works shows that we can multiplex, we can generate systemic proteins to treat cancer. And I think that's a very important proof of principle.
Jamie Mock
Chief Financial Officer, Moderna
Thanks, David. Yeah. And Alex, thanks for the question. So we're encouraged that this is really broad-based growth this year. It is both U.S. and international. And I just go back to some of my prepared remarks, which was We came into the year with two key growth drivers, MNEXT Bike, that is performing extremely well in the U.S. But in addition to that, in the U.S., vaccination rates are stable, which Stephen walked through on his chart. Internationally, we came in thinking about the strategic partnerships, and those have all performed extremely well also. So when we look to 2027, I go back to what Stephen presented in terms of there are still four growth drivers out there. Flu is relatively immaterial right now for us in 2026, and we expect to grow next year. Europe opens up for us, Latin America partnerships. Hopefully we will have INT approved. So we're quite encouraged. So again, it was a broad-based growth in 2026, and the two primary growth drivers are going well for us.
Kevin
Conference Operator
Thank you. One moment for our next question. Our next question comes from Myles Minter with William Blair. Your line is open.
Myles Minter
Analyst, William Blair
Hi, congrats on the quarter and all of the updates for the Internet 001. I actually had just a question on Norovirus. I think at your last quarterly update, you indicated you were going to enroll another cohort. Now you're not, and you're going to the regulators, just wondering what changed there and what you're hoping to get out of those regulatory discussions. Thanks very much.
Stephen Hoge
President, Moderna
Yeah, Myles, thank you for the question. At this point, I don't have much more to say than we already did. You're correct. We did not meet the criteria for early success, and we were going forward with a cohort initially. But as we've reviewed the program, we think the most appropriate next step is not to go forward with that cohort, but instead consult with regulators. And at this point, it's premature for me to guide any further on that. But once we've had those discussions with them about the potential next steps to the program, we'll be able to provide an update more broadly. We'll have to have those conversations before I can offer anything more.
Myles Minter
Analyst, William Blair
No worries. Thanks.
Kevin
Conference Operator
One moment for our next question. Our next question comes from Tyler Van Buren with TD Catwin. Your line is open.
Tyler Van Buren
Analyst, TD Cowen
Hey, guys. Thanks so much for taking the questions, and congrats on the quarterly results. So the melanoma INT results are clearly stellar, but regarding the next readout in RCC, some KOLs have brought up research suggesting that RCC immunogenicity may be driven in part by HIF-regulated endogenous retroviral elements. So can the current INT antigen selection process identify and incorporate those types of non-canonical antigens and how might that impact the probability of success?
Conference Operator
Operator / Q&A Moderator
Hi, Tyler.
David Berman
Chief Development Officer, Moderna
Thanks for the question. Yeah, it's an interesting hypothesis that has been put out there. I think it's a hypothesis and it's a question whether endogenous retrovirals play a role or not. What I do know is that our algorithm does include insertion deletions in DELs, which are actually strongly demonstrated to be important in RCC, as well as neoantigens and single-point neoantigens, that is. And then I'll also point you out to a publication recently from Dana-Farber where they did their own personalized cancer vaccine and were able to identify sufficient neoantigens without the addition of endogenous retrovirals. So the ERVs are interesting, they're speculative, and I think more research needs to be made before we include them.
Conference Operator
Operator / Q&A Moderator
Great. Thanks, David. One moment for our next question. Our next question comes from Andrew Tsai with Jefferies.
Kevin
Conference Operator
The line is open.
Andrew Tsai
Analyst, Jefferies
Hi. Good morning. Thanks for the updates. As we think about the BLA submission for melanoma with INT, can you talk about whether you would need some kind of special FDA approval on the algorithm side on top of the drug side? And secondly, if the power of AI continues to improve rapidly, can you just maybe talk about why competitors, hypothetically speaking, can't catch up to you on the algorithm side? Why do you think you have a protective mode? Thank you.
Stephen Hoge
President, Moderna
Thank you for that question. So first of all, yes, obviously the algorithm for selection, in fact, the entire front end process for designing an INT for an individual patient is a part of the drug. Effectively, there is software in it. And that is a proprietary feature of our platform, our technology. It's not something that will be readily available. The important question maybe is the second part of yours, which is then how does that play forward? And we're incredibly excited by what we've learned in our clinical trials. And bear in mind, the randomized data we have on immunogenicity from the phase two was in about 150 people, about 100 people who received INT. It has now been followed through five years. And at ASCO this year, we presented some of the update data at a recent ESMO event. We presented some of that. We learned a tremendous amount from the 34 neoantigens that we put into those people in that study. What is remarkable is, you know, with the melanoma study that's just read out, we've taken the number of patients up that we have that experience with by almost a factor of 10. And if you look across the other nine studies that are up and running, we'll go another factor of five again. So we're starting to develop a tremendous amount of real experience with what sorts of neoantigens are generating T cell clones. What are the features of that T cell clonality that we think is really valuable for neoantigen vaccine and individualized neoantigen vaccine? And we are constantly looking to bring that back into how we predict and design INTs for individuals going forward. That data is a goldmine. We had, I think we presented this, 5,000 neoantigens across the 100 plus participants in that first study, the phase two. It's gone up by a factor of 10. And we will be, with our partner, deeply going through that data and continuing to treat that proprietary information. It's one of the really as we continue to try and make IMTs more and more effective going forward in the decades ahead. So we think we're at the very beginning of a scientific revolution and we're excited to be in the lead and to have that proprietary information.
Kevin
Conference Operator
Thank you. One moment for our next question. Our next question comes from Michael Yee with UBS. Your line is open.
Michael Yee
Analyst, UBS
Hey, guys. Thanks. Good morning. Two questions. On INT, the clinical trial protocols are available for renal cell and bladder cancer, and we understand that they are an alpha spend, one-sided alpha of 0.10, very much like you nicely designed your Phase II melanoma study and very much the same assumptions. Do you stand by that protocol and can confirm that those assumptions are correct. And the second question is, as it relates to filing in melanoma, is there a general timing guidance for that, just so we can think about the gating steps and all the things that need to be done there in terms of the filing? Thank you.
David Berman
Chief Development Officer, Moderna
Hi, Michael. We're not aware of the protocols that you cite and obviously can't comment on it, so I'm going to have to pass on that. In terms of the BLA, we're obviously working closely with Merck on that, and stay tuned for our next message on that.
Conference Operator
Operator / Q&A Moderator
Thank you. One moment for our next question.
Kevin
Conference Operator
Our next question comes from Courtney Breeden with Bernstein. Your line is open.
Salveen Richter / Courtney Breen
Analyst, Goldman Sachs / Analyst, Bernstein
Hi, Moderna team. Thanks so much for taking the question. A couple from me. I did want to zoom back to the pancreatic cancer study, the phase one data that you presented at ESMO this year. Obviously, we saw the neoantigen generation, the T-cell expansion, et cetera, that you've spoken to. There was also a small swimmer plot of kind of performance for these patients and recurrence details for these patients. Can you just help us understand what you're taking from that advocacy data so far. We see it as relatively early compared to kind of what performance can be generated with for-faring equinox on its own. But just want to understand kind of what you're already able to take from those insights and the potential to move forward, or do you need more time to assess that data before you would move forward? And then just the second question, just a really practical one on that revenue generation. Can you just talk a little bit about the XUS components here and how much of that is coming from kind of commitments, how much of that is coming from pure demand, and we're just trying to figure out how we kind of appropriately carry some of this forward. Thank you so much.
David Berman
Chief Development Officer, Moderna
Courtney, thank you very much for this, David. Thank you for the pancreatic question. It was very exciting data because we can generate T cells reactive to neoantigens that are present. in the PDAC patients, which is something that actually was not really necessarily given. In terms of the swimmer plot that you noticed, yes, I think I agree that it's probably too early, point number one. And point number two, this was a mix of patients. Some of them had neoadjuvant treatment. Some of them didn't. And so it's really hard for us to discern an efficacy signal. I'm always careful about Discerning Efficacy Signals in Single-Arm Time-to-Event Analyses. I think the immunogenicities data are great, the safeties are great, and we'll have to figure out the next step.
Jamie Mock
Chief Financial Officer, Moderna
Question on international. So I would say a significant portion is very durable. We've talked about these strategic partnerships, and it comprises over 50% of our revenue, for sure. But I think what's also great about our international growth is One, we're playing in a lot of other markets outside of these strategic partnerships that we have been for some time, and we are increasing share to some degree, as well as I think, as I mentioned earlier, the vaccination rates are improving in a lot of these markets as well. So I think we are seeing a shift year over year globally that vaccination rates have become more stable. So we hope that that is pretty durable moving forward.
Conference Operator
Operator / Q&A Moderator
Thank you.
Kevin
Conference Operator
One moment for our next question. Our next question comes from Alexandria Hedman, Wolf Research. Your line is open.
Alexandria Hedman
Analyst, Wolfe Research
Hey, guys. Thanks for taking the question. So on IMT, what learnings have you guys been able to take in regard to the optimal number of new antigens coded? Do you think 34 is a sweet spot, or do you think essentially next-generation assets or of your internal kind of platform could encompass more? I guess what kind of has the data demonstrated about how much of the breadth of these new antigens and payload matters? is more always better, or could a smaller number of really highly immunogenic neoantigens be more favorable? Thank you.
David Berman
Chief Development Officer, Moderna
I love the science question, and I'm happy to take it and expound on it. You're asking the exact question, right, which is what makes an optimal neoantigen, how many you need. These are things that we are now looking into because we have a randomized phase three trial, and you need the efficacy in order to Go back to how many neoantigens you actually need. So in melanoma, which has several hundred neoantigens to choose from, we know that 34 selected is enough. We can see that roughly one out of three of them generate a T cell response, although that may be higher. And actually we're learning that we may actually have more immunogenicity than we actually thought we did. So I'm not sure more is better, because I'm not sure a hazard ratio of 0.58 or 0.51 in the MITT is pretty good. Against Keytruda, it's really, really good. So would more have been better? It's hard to imagine more would have been better, but I don't know.
Conference Operator
Operator / Q&A Moderator
These are things we now need to decode with our Phase III data. Thank you. One moment for our next question. Our next question comes from Jess Five with J.P. Morgan.
Kevin
Conference Operator
Your line is open.
Jess Fye
Analyst, J.P. Morgan
Hello, guys. Thanks for taking my question. Just following up on Alex's question there, you mentioned now you have the sort of treasure trove of Phase III data. If I recall from the Phase II, the translational work we saw at ASCA, there were like seven patients to work with, and it was maybe a little hard to draw conclusions based on the small sample size. Do you have the actual samples and You know, data that you need to run that analysis to figure out those answers about sort of optimal number of new antigens.
David Berman
Chief Development Officer, Moderna
Jess, thanks. So the seven patients that you talk about is correct, the N equals seven, because in order to do very deep immunological monitoring, you have to withdraw a decent amount of blood. And not all patients are willing to do that. And in this case, there were seven patients willing to do that. We do have more patients available from across the trial, so that's point number one. And secondly, we have developed really exciting novel ways to decode T-cell reactivity from just looking at the expression data from the whole blood gene analysis, TCR beta. We have a way that we're beginning to learn to try to decode back neoantigen specificity. I mean, that's part of the holy grail. So I am hopeful that we will be able to get insights from the phase three that we didn't have in the phase two. I think that it remains to be seen how far we can go, but that is certainly the goal.
Conference Operator
Operator / Q&A Moderator
Thanks.
Kevin
Conference Operator
One moment for our next question. Our next question comes from Lucas with RBC. Your line's open.
Luca Issi
Analyst, RBC Capital Markets
Oh, great. Thanks so much for taking my question. Congrats on all the progress. Maybe, David, one more on RCC and the upcoming phase two. Could you just maybe talk about the stratification strategy there? It looks like you're stratifying patients by either clear cells versus papillary histology, as well as by high versus low disease risk. I guess what I'm trying to ask is, are there any specific subpopulations within RCC that are maybe more immunologically active that you're more optimistic that this approach can work, or do you think that this can work kind of across the board and then maybe related to it, are you tracking the blinded event rate for progressions in debt and are they on track with internal expectations or not? And then maybe separately, Steve, any update on the ongoing conversations with the FDA and the timelines for COVID plus flu in the US? Thanks so much.
David Berman
Chief Development Officer, Moderna
Yeah, in terms of the tracking of the events, we don't comment on that. In terms of the What subpopulations? I think we believe this can work in multiple subpopulations. I think that was one of the insights we made from the phase two and the phase three study that pretty much all of the subsets we looked at have had a trend or a point estimate in favor of antismorine, including high stage versus low stage, high TMB versus low TMB. Some subtypes, papillary renal cell, obviously is different than clear cell RCC, but that's why we're stratifying against that. But as long as they have new antigens, we think that we can generate novel T cell phones and that can potentially have benefits. So I don't think I would narrow it down to a population right now. Thank you.
Stephen Hoge
President, Moderna
And then I'll, sorry, just on the question on the flu COVID combo vaccine for the US. We, you know, as we said before, we're waiting for the approval in August. That was just two months ago. and then the launch of the flu and COVID vaccines in the U.S. And that was our key to then start the process of engaging with the FDA. That will take some time. There's a lot going on right now across our whole portfolio. And so we will in the next number of months be able to sit down and understand better what the U.S. FDA expects in terms of submission of the 1083 program. And once we have that information, we'll obviously provide an update. Thanks so much, guys.
Kevin
Conference Operator
Ladies and gentlemen, this concludes the Q&A portion of today's program. I'd like to turn the call back over to Stéphane for any further remarks.
Stéphane Bancel
Chief Executive Officer, Moderna
Well, thank you, everybody, for joining us today. We really appreciate it. We're looking forward to seeing many of you in person next week for Annual Analyst Day, November 12. And we're very excited for you to tour and to discover the Intismaran manufacturing site. Have a nice weekend. Thank you, ladies and gentlemen. That's conclude today's presentation.
Kevin
Conference Operator
We thank you for your participation. You may now disconnect and have a wonderful day.