SNDX

Good day, everyone, welcome to the Syndax first quarter 2026 earnings conference call. Today's call is being recorded. If you would like to ask a question following the company's prepared remarks, please press star five during the call. At this time, I would like to turn the call over to Sharon Klahre, Head of Investor Relations at Syndax Pharmaceuticals.

Great. Thank you, operator. Welcome, thank you all for joining us today for a view of Syndax's first quarter 2026 financial and operating results. I'm Sharon Klahre, with me this afternoon to provide an update on the company's progress and discuss financial results are Michael Metzger, Chief Executive Officer; Steve Closter, Chief Commercial Officer; Dr. Nick Botwood, Head of R&D and Chief Medical Officer; and Keith Goldan, Chief Financial Officer. This call is accompanied by a slide deck that has been posted on the Investor page of the company's website. You can now turn to our forward-looking statements on slide two. Before we begin, I'd like to remind you that any statements made during this call that are not historical are considered to be forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.

Actual results may differ materially from those indicated by these statements as a result of various important factors, including those discussed in the Risk Factors section in the company's most recent quarterly report on Form 10-Q, as well as other reports filed with the SEC. Any forward-looking statements made represent our views as of today, April 30th, 2026, only. A replay of this call will be available on the company's website, www.syndax.com, following its completion. With that, I'm pleased to turn the call over to Michael Metzger, Chief Executive Officer of Syndax.

Thank you, Sharon. Good afternoon, everyone, and thank you for joining us. Starting with slide three. In the first quarter, we continued to make strong progress advancing our commercial objectives and pipeline programs designed to unlock the full potential of our first two medicines. On the commercial front, we delivered over $100 million in combined sales of Revuforj and Niktimvo, underscoring robust demand for both medicines and advancing the company towards profitability. Revuforj net revenue totaled $49 million in the first quarter, highlighting our leadership position in menin inhibition and strong adoption across both indications. Revuforj net revenue grew by double digits quarter-over-quarter, primarily driven by new NPM1 patients.

Adoption in NPM1 has been strong and growing steadily since Revuforj was added to the NCCN guidelines for relapsed/refractory NPM1 mutated AML in September of 2025, followed by the FDA approval of our expanded label in October of 2025. We are the leaders in the relapsed/refractory space in both NPM1 and KMT2A, and well-positioned to drive further growth and unmatched efficacy data and expanding prescriber base, excellent payer coverage, and multiple evolving treatment dynamics that should ultimately extend the average duration of therapy, including a growing number of KMT2A patients proceeding to transplant after receiving Revuforj. Notably, recent analysis indicates that Revuforj is enabling nearly half of KMT2A patients to receive a potentially curative stem cell transplant, a significant increase from our prior estimates of 33%.

This growing transplant rate gives patients the best chance for durable remissions, ultimately driving longer treatment durations as an increasing number of patients return to therapy post-transplant. This step change, compared to the 25% transplant rate we observed in our clinical trial, aligns with what we have expected as Revuforj is used earlier in the treatment paradigm and often in combination with other therapies in the real world. The pool of patients on Revuforj post-transplant is expanding each quarter, although that growth continues to be obscured by the large number going to transplant. While the robust transplant rate seen with Revuforj has a short-term impact on the business, it is first and foremost a very positive outcome for patients and will translate into durable and sustainable growth as an increasing number of patients return to therapy.

This is an important and unique growth driver of our KMT2A business. Turning to Niktimvo and chronic graft-versus-host disease, or GVHD. Niktimvo delivered $55 million in net revenue in the first quarter. This result reflects consistent new patient starts, partially offset by natural attrition among the large cohort of predominantly later-line patients who started Niktimvo during the first quarter of launch last year. Notably, the same dynamic was also seen during the same period of the launch of Rezurock, as well as other rare disease therapies. Looking ahead, we expect strong growth with multiple drivers supporting the business, including a broad prescriber base and increasing uptake in the third line, which should extend the average duration of therapy. Turning to our pipeline. We've made excellent progress advancing the programs that will fuel the next phase of growth for the company, including our pivotal frontline trials of revumenib.

We are well-positioned to be the first to get a menin inhibitor approved in frontline AML with strong global site activation and patient enrollment underway in our pivotal trials. We will continue to expand the body of evidence supporting our medicines with multiple important data readouts anticipated in the second quarter and throughout the year. Similar to past years, we will have a major presence at ASCO, EHA, and ASH with new data from multiple studies of Revuforj across the acute leukemia treatment continuum, including new maintenance data, which will be highlighted in an oral session at ASCO. These upcoming datasets will continue to advance our leadership in menin inhibition and highlight Revuforj's best-in-class profile across multiple acute leukemia subtypes and settings.

We are also nearing two potentially transformative Niktimvo readouts in the fourth quarter. Including phase II data in idiopathic pulmonary fibrosis or IPF and in newly diagnosed chronic GVHD patients treated with Niktimvo plus Jakafi. Data from these trials could further unlock Niktimvo's multi-billion dollar potential in chronic GVHD, IPF, and beyond. From a position of strength, we are delivering long-term and sustainable growth and advancing innovative treatments that can significantly improve the lives of patients. We have a world-class R&D and commercial organization with a proven track record of delivering breakthrough medicines to patients. We have two products poised for future label expansion, important upcoming data readouts, and the expertise necessary to continue delivering innovative medicines. We are well-funded to invest in the successful commercialization and further development of Revuforj and Niktimvo, and on our way to reaching profitability with growing revenue and a stable expense outlook.

I'll now turn the call over to Steve to discuss our commercial results in more detail. Steve?

Thank you, Michael. Starting with Revuforj on slide four. Revuforj is now a little over a year into launch, and by any measure, it has been an exceptional commercial success, with net revenue now annualizing at nearly $200 million. We continue to track well above launch benchmarks set by other AML therapies and expect to continue to outpace other drugs and redefine success in this space. Two factors underpin our conviction, our ability to target a substantially larger population than other mutation-directed AML therapies and multiple treatment patterns that are expected to extend the average treatment. In the first quarter, we delivered approximately $49 million in Revuforj net revenue and double-digit quarter-over-quarter growth across all key metrics, including net revenue, total prescriptions, and new patient starts. Two drivers of our business, new patient starts and patients returning to therapy post-transplant, and both are building nicely.

We added about 330 new patients in the first quarter, up approximately 10% compared to last quarter, with the growth driven by new NPM1 patients. New patient starts have increased even more significantly compared to the 200-250 patients we were adding per quarter prior to the expansion of the Revuforj label to include patients one year and older with relapsed/refractory NPM1-mutated AML. We've continued to gain momentum and reach new highs, demonstrating the durability of Revuforj's strong market position, even with the launch of a second menin inhibitor approved for adult NPM1 patients. Early indicators suggest at least 40% of new starts in the first quarter were NPM1 patients, up significantly from 10% of new patients prior to the NCCN guideline update in September 2025.

Between the NPM1 patients who started in the first quarter and those continuing on therapy from prior months, we estimate NPM1 accounted for at least 30% of the $49 million in net revenue. We're positioned to be the market leader in NPM1 with the strongest clinical profile. In recent market research, HCPs who treat our target population ranked efficacy as the most important factor in their treatment decision, followed by safety and tolerability, availability of long-term efficacy data, personal experience with the drug, and inclusion in clinical guidelines. Notably, more HCPs strongly favored Revuforj over the other approved menin inhibitor on the top five most important factors, as well as nearly all other factors, including ease of access, drug-to-drug interactions, peer or KOL endorsement, ease of administration, flexible dosing, to name a few. Turning to slide five.

We have a strong foundation to support the continued expansion of our KMT2A and NPM1 business, including a world-class team with excellent customer relationships and favorable listings in the NCCN guidelines, the most influential guidelines for clinicians as well as payers. Our already robust prescriber base has continued to expand following our approval in NPM1, including our activation of Tier 1 and Tier 2 accounts, the highest volume centers in the U.S. who treat 2/3 of our target population. Over 85% of these accounts have now ordered, up from 70% prior to the label expansion. The total number of accounts that have ordered has also increased quarter-over-quarter and is now well over 500 accounts, reflecting growing adoption in centers of all sizes, including community practices.

Our growing prescriber base reflects physicians' enthusiasm to use Revuforj for their NPM1 patients and positions us to drive further penetration in both indications. We also have nearly perfect payer coverage, and physicians can access the menin inhibitor they prefer without any meaningful barriers. Revuforj's formulary coverage stands at 97% of all covered lives, including all commercially covered lives, Medicare, and Medicaid, a coverage position that leads the class. We have engaged and educated payers extensively, and they recognize the value of Revuforj and its status as the only menin inhibitor approved for multiple acute leukemia subtypes. While the class leader in NPM1 will be determined by HCP preference, not price or recommendations from payers, I will note that payers understand the two menin inhibitors are priced at parity, with Revuforj actually costing less for the large percentage of patients on CYP3A4 inhibitors.

This was made clear in a recently updated IPD Analytics monograph, which no longer suggests use of one menin inhibitor over another based on price alone, clearing up a point that had led to temporary confusion among a small handful of plans representing less than 1% of all covered lives. Turning to slide six and the multiple factors that will drive further Revuforj growth. The first is our continued expansion into relapsed/refractory NPM1-mutated AML. Of the 4,500 patient annual incident population, we estimate that less than 10% of patients have received a menin inhibitor, highlighting the substantial opportunity for further growth. Compared to KMT2A, where we saw a steep uptake curve due to the lack of other approved therapies, we expect our NPM1 business will build over time because there are other options that physicians may consider for this population, depending on their co-mutations, for example.

With 2x to 2.5x as many NPM1 patients as KMT2A patients, we expect NPM1 will become a major component of our business over time. With strong physician support and unmatched efficacy data in a disease where efficacy is the most important attribute to physicians, we expect to have dominant market share in NPM1 and KMT2A. The second factor is the growing number of KMT2A patients who are proceeding to transplant after receiving Revuforj and then returning to therapy post-transplant. As Michael noted, the transplant rate has been building over time, with recent analysis indicating that nearly half of KMT2A patients are proceeding to transplant after receiving Revuforj. Around 45% have restarted after pausing treatment for one to two quarters, a percentage we expect will grow over time.

While the pool of patients in Revuforj post-transplant is expanding, that growth continues to be obscured by the large number going to transplant each quarter. Importantly, we expect to observe a meaningful step up in post-transplant use after leading institutions report on their experience using revumenib as maintenance in the second quarter. Long-term, we expect up to 70%-80% of transplanted patients will ultimately be put back on therapy for one to two years based on our clinical trial experience and feedback directly from physicians. The third factor is use of Revuforj in early lines of treatment and in combination with other therapies. Claims data show about 70% of use in the second and third line, even as we've added more NPM1 patients to our mix.

This is encouraging because when patients are treated earlier, you expect to see higher response rates, longer durations of response, and more patients proceeding to transplant, as we now see playing out. Claims data also show about 40% combination use. While Revuforj is approved and promoted as a monotherapy, the significant combination use highlights physicians' comfort with the Revuforj profile, and that could extend treatment durations. All these evolving treatment patterns will drive an increase in the average treatment duration, especially the growing number of KMT2A patients proceeding to transplant and then returning to therapy. This group of patients is already approaching nine months of therapy on average, with this duration expected to meaningfully increase over time.

We are confident in our ability to continue building a sustainable business with our first two indications for Revuforj, which together represent a $2 billion-plus market opportunity, as shown in slide seven. Turning to Niktimvo on slide eight. Building on an excellent launch year, Niktimvo delivered $55 million in net revenue in the first quarter of 2026 and is now annualizing at over $200 million. In the first quarter, about 5,000 infusions were administered and approximately 300 new patients started, even with severe weather impacting patient access to infusion drugs in the first quarter. Performance this quarter reflects strong and consistent new patient starts and solid persistency, partially offset by natural attrition among the large cohort of predominantly later line patients who started Niktimvo during the first quarter of launch last year.

This dynamic was also seen at a similar point in the Rezurock launch, a drug which reached $500 million in annual U.S. net sales within the first four years of launch in the same indication. All indicators of demand suggest we will resume growth next quarter as we continue to steadily add new, less advanced patients. Turning to slide nine. The fundamentals of our Niktimvo business remain strong with multiple drivers for continued growth. The first is continued adoption in the fourth line and growing usage in the third line. Within one year of launch, Niktimvo has captured 32% the third line plus market with the majority of use in the fourth line and increasing uptake in the third line as providers gain experience. As the patient mix shifts more towards third-line patients with less advanced disease, we expect this will extend the average treatment duration.

Second, this is a chronic disease with the potential for patients to stay on therapy for long periods. Of the patients who started Niktimvo at launch in the first quarter of last year, 60%-70% remained on therapy in the first quarter of this year, highlighting the potential for extended durations of therapy, especially as our patient mix shifts more towards third-line patients. Our clinical trial experience shows the duration of therapy can be measured in years for a meaningful proportion of patients. Third, Niktimvo has a broad and productive prescriber base and strong commercial synergies for both Syndax and Incyte. Virtually every bone marrow transplant center in the U.S. has prescribed Niktimvo, and all have become repeat customers. Physician feedback is very positive.

They continue to report strong activity in multiple organs, with particularly notable results observed in patients with lung and skin fibrosis, some of the most challenging to treat manifestations of the disease. All these drivers put us in a strong position to expand our impact third line plus chronic GVHD, the $2 billion U.S. market opportunity, as we can see on slide 10. In summary, our quarterly results underscore the strong demand for Revuforj and Niktimvo and the substantial commercial opportunities we have with both products. We have the right medicines, the right team, and the right strategies to continue delivering for patients and driving strong and sustainable growth. With that, I'll hand the call to Nick to discuss our development programs.

Thank you, Steve. Starting with revumenib on slide 11, we've made significant progress advancing our pivotal frontline trials and our integrated evidence generation plan designed to establish revumenib as the menin inhibitor of choice across the acute leukemia treatment continuum. I'd like to highlight a few key points. First, we're focused on advancing enrollment in our pivotal frontline trials, which have the potential to support additional FDA approvals and the registration of revumenib outside the U.S. We are well-positioned to be the first to deliver pivotal frontline data for a menin inhibitor. Global site activations and patient enrollment are well underway in these trials, which were informed by a robust body of clinical evidence, allowing optimization of endpoint assumptions and other aspects of the study design.

We've also been able to leverage the strong relationships we've built with leading investigators and patient advocacy groups around the world through our work pioneering this new class of therapy. To support these collaborations and rapid enrollment, we have a team of highly qualified and well-connected MSLs located in key geographies, including Asia, fully focused on revumenib. As a reminder, EVOLVE-2 is the phase III trial of revumenib plus venetoclax and azacitidine in newly diagnosed unfit NPM1 or KMT2A AML patients. This trial, conducted in partnership with the highly regarded HOVON Network, was the first pivotal frontline trial of a menin inhibitor to begin enrolling patients. EVOLVE-2 has dual primary endpoints of complete remission and overall survival, both in the NPM1 population to support the potential for accelerated and full approval respectively.

REVEAL is the phase III trial of revumenib plus intensive chemotherapy in newly diagnosed fit NPM1 patients, including adults and children 12 years of age and older. REVEAL also has dual primary endpoints of MRD negative CR and event-free survival to support the potential for accelerated and full approval respectively. In the fit KMT2A population, we are pursuing a novel and differentiated approach. In addition to generating further data in combination with intensive chemotherapy in partnership with the National Cancer Institute, we are progressing the RAVEN trial with leading clinical researchers. RAVEN is a phase II trial of revumenib plus Ven/Aza in newly diagnosed KMT2A patients who would be considered fit for intensive chemotherapy.

The design of RAVEN is supported by the strong activity observed with revumenib plus ven-HMA in KMT2A patients and growing physician interest in moving from 7+3 intensive chemotherapy backbones to more tolerable ven-HMA backbones. The second point I would like to highlight is that we will continue to advance our scientific leadership in menin inhibition with a major presence at key medical meetings, including at least 15 revumenib abstracts accepted for presentation at ASCO or EHA. The volume and breadth of the data we will present underscore physicians' interest and commitment to revumenib with its differentiated profile and strong activity across multiple genetic subtypes. I'd like to highlight now some of the key datasets we expect to report in the second quarter of 2026. First, we expect new real-world evidence with revumenib.

This dataset will build on the first real-world evidence that another group, Moffitt Cancer Center, presented for revumenib and the therapeutic class at ASH last year. Moffitt reported a 77% overall response rate and 75% MRD negativity rate among relapsed/refractory NPM1, KMT2A, and NUP98 acute leukemia patients who primarily received revumenib as part of combination therapy. In addition to showing compelling clinical activity, revumenib was well-tolerated as a monotherapy and in combination with standard-of-care therapies. We also expect new post-transplant maintenance data, including a dataset accepted for oral presentation at ASCO. These will be important datasets given physicians' growing interest in using revumenib post-transplant. The upcoming data will build on retrospective data presented by MD Anderson at ASH last year from 10 pediatric KMT2A or NUP98-rearranged patients. They reported that revumenib was well-tolerated in the post-transplant setting with encouraging early efficacy.

Notably, all patients were alive and 90% were relapse-free at a median follow-up of 19 months. Additionally, we expect updated data from our phase I trial of revumenib plus intensive chemotherapy in newly diagnosed NPM1, KMT2A, or NUP98 AML. You will first see an abstract with a data cutoff that is similar to the preliminary seven or eight data we presented at ASH last year, showing high rates of response and MRD negativity along with a favorable safety profile. Data with longer follow will be presented at the meeting. We also anticipate updated data from the relapsed/refractory cohort in the SAVE trial of revumenib plus venetoclax and decitabine as well as azacitidine in NPM1, KMT2A, or NUP98 acute leukemias.

This update will build on the compelling data previously reported from SAVE, which shows overall response and MRD negativity rates above 80% in heavily pretreated patients. Finally, we expect additional relapsed/refractory NUP98 rearranged data from our AUGMENT-101 trial and expanded access program. NUP98 rearrangements, which are found in up to 5% of AML cases, are associated with a poor prognosis and high unmet need with no approved targeted therapies. Last year at EHA, we presented the first and only data to our knowledge showing compelling activity with a menin inhibitor in NUP98 patients.

This data was met with strong enthusiasm by clinicians. We are already seeing academic centers treating relapsed/refractory NUP98 patients with revumenib, underscoring the benefit of having one menin inhibitor with activity across multiple subtypes. NUP98 is one of several subtypes associated with acute leukemias associated with upregulation of HOX genes that may be sensitive to revumenib. Altogether, more than 50% of AML patients may have a genetic alteration which is susceptible to revumenib. The body of evidence supporting revumenib will continue to grow throughout 2026, with additional data expected in the second half of the year, including an update from the BEAT AML trial of revumenib plus Ven/Aza in newly diagnosed NPM1 or KMT2A AML. We also expect an update from a phase I trial of revumenib plus gilteritinib in relapsed/refractory patients with a FLT3 mutation and an alteration associated with HOX overexpression.

Early data presented at ASH last year showed the combination appeared tolerable with early signs of efficacy, supporting continued evaluation. For the subset of relapsed/refractory NPM1 patients with FLT3 co-mutations, a menin plus FLT3 inhibitor combo is one of several potential options that physicians may consider depending on patient-specific factors. I'd now like to turn to axatilimab development on slide 12. This will be an important year with two upcoming data readouts. We are now expecting top-line data from the phase II trial of axatilimab plus ruxolitinib in the fourth quarter, a timeline which pulled in due to faster than anticipated accrual. Data from this trial could inform the potential for axatilimab in earlier lines of chronic GVHD and potentially pave the way to a steroid-sparing approach. We also expect top-line data from our phase II MAXPIRe IPF trial in the fourth quarter.

Earlier this year, we completed enrollment and actually exceeded our original enrollment target of 135 patients due to the number of patients put into screening as we neared the end of enrollment. This speaks to investigator enthusiasm for axatilimab and the desire for new treatment options in IPF. Given a high interest in this program, I will highlight the evidence support in the scientific rational for CSF1R inhibitions and outline the trial design. Moving to slide 13. Significant evidence points to CSF1-dependent monocyte-derived alveolar macrophages as a promising new target in IPF. These cells are believed to play a key role in driving lung fibrosis. Multiple studies implicate the CSF1R pathway in IPF and provide strong mechanistic rationale for our program.

For instance, high CSF1R levels are observed in IPF patients versus healthy controls, and higher levels of CSF1R and monocytes predict shorter survival among IPF patients. Turning to slide 14. Axatilimab is an IgG4 monoclonal antibody which is optimized for diseases with an inflammatory and fibrotic component. It binds to the CSF1 receptor on the surface of monocytes and macrophages, preventing their activation by CSF1 and IL-34. This reduces the levels of circulating pro-fibrotic and pro-inflammatory monocytes and monocyte-derived macrophages and inhibits the activity of these pathogenic macrophages in tissues. Based on these observations, axatilimab has the potential to make a more pronounced impact on the fibrotic process by targeting pathways that sit upstream of the pathways engaged by currently available IPF therapies. The IPF program is supported by the remarkable activity observed with axatilimab in chronic graft-versus-host disease.

Responses were observed across all organ studies, including organs with fibrotic manifestations of the disease, such as the lung and skin. Among patients with lung involvement who received axatilimab at the dose we are studying in MAXPIRe, nearly 50% achieved a lung response and over 90% reported improvements in shortness of breath at rest. These data, together with the strong mechanistic rationale, are driving strong physician support for axatilimab's potential in IPF. Slide 15 shows the design of MAXPIRe, a phase II randomized, double-blind, placebo-controlled trial of axatilimab in approximately 135 IPF patients. This is a well-designed trial that has the potential to provide robust proof-of-concept data for axatilimab in IPF to inform a registrational program. The inclusion criteria is similar to other recent IPF trials.

Background anti-fibrotic therapy is allowed but not required, and the primary endpoint is the annualized rate of decline in forced vital capacity, or FVC, measured at 26 weeks. In summary, we have a data-rich period ahead and are laser-focused on executing our pivotal programs. We are just starting to demonstrate our ability to translate promising science into novel medicines for patients with hard-to-treat diseases. With that, I will hand the call to Keith to discuss our financials.

Thank you, Nick. Earlier this afternoon, we reported detailed first quarter 2026 financial results on our Form 10-Q, and I'll now highlight a few key points on slide 16. Total revenue for the first quarter was $64.9 million, up 224% over the same period last year. Demand for Revuforj remains strong with $48.9 million in net revenue, up 144% from the same period last year. We achieved these results even with typical first quarter dynamics, including severe winter storms, which had a transient impact on both products in February, and a growing number of KMT2A patients temporarily pausing Revuforj to proceed to transplant. Inventory levels remain within the two to three-week range we have previously guided.

We expect continued growth over the coming quarters as adoption in NPM1 increases and the average duration of therapy extends as Revuforj is used earlier in the treatment journey and the number of patients on therapy post-transplant continues to build. Now I want to turn to Niktimvo, which continues to be an important cash flow contributor to Syndax with our 50% share of the net commercial profit totaling $15.9 million in collaboration revenue in the first quarter. The collaboration revenue that we reported was 29% of the Niktimvo product revenue reported by Incyte within the range of 25%-30% that we've been guiding to. Our collaboration revenue for the first quarter is a significant step-up from the $0.2 million in collaboration loss we reported from the first two months of sales of Niktimvo in the first quarter of 2025.

We continue to expect our Niktimvo margin contribution, defined as a collaboration revenue recorded by the company as a percentage of Niktimvo net sales, to be in the 25%-30% range in the near term and increase longer term as sales grow while much of the expense base stays largely fixed. We anticipate continued growth throughout the year as Niktimvo is increasingly used in the third line and duration of therapy extends. With regard to expenses, guidance remains at total R&D plus SG&A expenses in 2026 of approximately $400 million, excluding the impact of $50 million in estimated non-cash stock compensation expense. We are well-funded to continue investing in our commercial and development priorities with $352.1 million in cash equivalents, and marketable securities as of March 31st, 2026.

With this robust balance sheet, growing revenue from two medicines, and stable expenses, we are on our way to reaching profitability. With that, I will hand the call to Michael for closing remarks.

Thank you, Keith. Looking ahead, we are focused on driving revenue growth and delivering on the milestones shown on slide 17, which will fuel further innovation and support value creation. We are in a strong position with multiple near and long-term growth drivers supporting both of our medicines. Revuforj is poised for further growth as we expand into NPM1 and continue to penetrate the KMT2A market, a segment where Revuforj is the only approved therapy. A growing number of KMT2A patients are proceeding to transplant, outpacing our near-term expectations and returning to therapy post-transplant, which will extend the average treatment duration and drive durable and sustainable growth.

With the broadest label and best efficacy profile of the menin class, we have the unique opportunity to cement Revuforj as the menin inhibitor of choice in relapse refractory disease and ultimately be the first to frontline, unlocking a $5 billion-plus market opportunity. Niktimvo continues to be a meaningful contributor to our bottom line. We have ample opportunity for further growth in our first indication as our patient mix evolves and important rate readouts later this year in frontline chronic GVHD and IPF that could open transformational multibillion-dollar markets in the near term. I will close by thanking everyone who has made it possible for us to deliver breakthroughs for patients, especially the individuals and clinicians who have chosen to participate in our clinical trials, as well as our dedicated Syndax team and the long-term investors.

With that, I would like to open the call for questions. Operator?

At this time, I would like to remind everyone that in order to ask a question, press star and then the five on your telephone keypad. If you would like to withdraw your question, press star and the five once again. We'll pause just a moment to compile the Q&A roster. Okay, the first question is from Anupam Rama from JPMorgan. The line is open.

Hey, guys. Thanks so much for taking the question. Just a quick one on Revuforj. I know that later this quarter you're gonna have data from that multi-center real-world study that you highlighted in your opening comments. What should we be looking for in that presentation beyond what we learned in that Moffitt study that you highlighted? Looking for data points that might help us understand how physicians are using the product and how we should think about extrapolating to the revenue trajectory of the product moving forward. Will this real-world study include both the KMT2A and NPM1 experience?

Anupam, thanks for the question. Yeah, very important new data coming, so we're excited about that, and I'll pass it to Nick to give you a little bit more detail.

Yeah. Thank you. I'm not gonna talk about the data specifically, but I'll give you a flavor of the things to look for as you would anticipate in these types of dataset. I mean, one is we're expecting, you know, broad coverage across the genetic subtypes, including NUP98. As previously seen, what we're seeing in the real world is extensive use in combinations of therapy. That's clearly not part of our current indication, but given the data we've generated, we know that physicians like to use it in combination in early lines of therapy. I think the other things I would say to look out for is, you know, the number of patients that are progressing to transplant because of those catalysts and factors for that, the number of patients that are able to get to transplant.

I think that'll be an important data point to look for. Of course, the ability to get patients onto maintenance. Now, that's not, again, something we're promoting on, but it's an important part of patient care. Physicians are wanting to do it. We wanna provide data, we are observing it in the real world. Those are the things I'd be looking out for as we generate more real-world evidence.

Thanks so much for taking our question.

Thanks, Anupam.

The next question is from Corinne Jenkins from Goldman Sachs. The line is open.

Sorry, I was muted. Good afternoon, guys. Maybe quickly from us, is there a way that you can kind of help us quantify the headwinds to revenue or patients you're facing in a given quarter if 50% of the KMT2A population is going to transplant, recognizing that that normalizes once you reach a steady state of KMT2A penetration? Maybe on that note as well, I think you commented at the end of four Q, you were at about 50% penetration in the KMT2A market. Is there an update on that front as well? Thanks.

Thanks, Corinne, for the question. I'm gonna hand it over to Steve. Maybe I'll handle the second part of the question first, which is sort of the state of the KMT2A market, which is certainly growing. We had gotten to, roughly, you know, approaching 50% penetrated on an incidence population of about 2,000 patients, last year, and we continue to see that progressing. Certainly the impact on maintenance is a big growth driver for that business. We do think we'll get, you know, nicely north of 50% this year, but I do believe that the maintenance piece is such a you know, considerable part of what grows in the future as more patients are now going to transplant.

We have about 50% of patients going to transplant and right around that number coming back. I think that's likely to grow considerably in the coming year or so, and that's driven by what we hear from physicians and all the data that will be coming out. Nick mentioned some should help that with that growth rate. That's, that's KMT2A, very healthy piece of our business. Maybe I'll turn it over to Steve for the other.

Yeah. I think it was the same question around KMT2A. I think the first part of the question was just headwinds, and maybe that's around bringing patients back in that post-transplant setting. I think what we've looked, and some of the numbers we've updated this quarter are using claims data, and we look back and we realize there's a greater percentage going to transplant and this increasing number coming back post-transplant. The way to think about it is average is probably three to four months to get patients back, but the longer run market, we realize there's patients that may be six months or more off treatment from that transplant to when they get back on. The timing's gonna be important. We've seen that grow as an important piece of our business.

It's a little slower to build than it would be just bringing new patients in, which is, you know, driving the business right now on the NPM1 side. You know, in terms of that, because it all lands on duration of treatment, which is something we've seen extend, and I think we had this in our notes. The patients that do come back, particularly those that start in the first seven months of launch, they're already at nine months and longer in terms of duration of treatment. That, that will extend, and there'll be more folks in that group over time, which is why we expect the duration of treatment to grow considerably over 2026.

Thanks.

Thanks, Corinne.

The next question is from Phil Nadeau from TD Cowen. Phil, your line is open.

Good afternoon. Thanks for taking our questions. Two from us, one commercial and one on the pipeline. In terms of the NPM1 penetration, what do you think is gating for increasing that penetration? Is this simply time on market, or are there datasets that could be important, such as the FLT3 combo data that's expected later this year? That's first. Second, on the pipeline, the data you present from lung involvement in cGVHD is very impressive. What is the time course of the responses in GVHD? Is 26-week duration likely to be sufficient in IPF? Thanks.

Great. Thanks, Phil, for the question. The first question related to sort of what's gating relative to the growth of NPM1, maybe I'll turn it over to Steve to make a comment there and maybe to Nick for the pipeline question.

Yeah. NPM1, it's, you know, clearly we're at the front end of that population, Phil, there's a lot more patients to grab. I think when you think about our own business, there's been step-ups in the business, it really began for us in that Q3 timeframe, right? At the end of September, we got NCCN guidelines then obviously the full indication for the fourth quarter. We've seen big step-ups in our own business, roughly in the 250 range in Q3 of new patients. A big step up in Q4, another step up in Q1. Our average is, you know, we're looking at 330 new patients in the quarter. That'll build. It's a different market. You know, KMT2A was obviously our launch. Lots of patients came in. Rev is already the standard of care.

Patients had no other options. We know for NPM1 they do. There's FLT3 mutation. It's a little bit more complex. The patient tends to be older. We're not gonna see as much likely transplant and then restarts in that population. We're gonna give it time, and the time to peak will just be a little bit longer in the NPM1 population relative to KMT2A.

I'll just add that the profile that we're showing for NPM1 is best in class. I think we feel very confident. Physicians tell us that time and again that we have, you know, as Steve said in his remarks, broad, you know, broad advantages across the profile. We feel very confident that we'll continue to build that market, build that business and have dominant share over time. Now the next question was related to IPF, and I'll turn it over to Nick to answer that.

Thank you, Phil. Happy to take that question. First thing I'd say, this is a very robust and statistically rigorous proof of concept study in IPF, and we're very confident in the 26-week endpoint. There have actually been some other previous POCs that have even looked at 12 weeks. We think 26 weeks is a very good compromise in terms of it being too short, but enough time to be able to detect a difference. We actually annualize that. We'll report annualized rates of FVC decline using, you know, standard FDA-approved models for modeling that out to 52 weeks. This will be a very rigorous proof of concept to inform a phase III program.

If you look at previous phase III studies, if you actually look at the graphs for separation, you see very clear separation by week 26. We're confident that 26 weeks will be sufficient to detect a difference and inform a phase III.

Perfect. Thank you.

Thanks, Phil.

The next question is for Brad Canino from Guggenheim. Brad, your line is open.

Just following on the previous question of the transplant maintenance dynamic continuing to be more of a temporary headwind for now. My question is really simply when will this start to flip to a tailwind? It sounds like there's two levers now, and you're pointing to flat quarterly patient starts, so you're refilling the population. How much higher than a 50% transplant rate can even be possible in this population? Are you topped out there, and now you can grow that maintenance restart? Are you confident in that six-ish month now wait to the restart for maintenance, or could that even extend too to be, you know, patients starting seven, eight, nine months later and push out the time to that start of the tailwind as well?

Separately, it looks like you lost about 14 points of year-over-year growth due to gross to net. Is there a chance that reverses back later this year? Can it get worse, or should we think about that being a neutral effect for the rest of the year? Thank you.

Great, Brad. Thanks for the questions. I think you're right about the maintenance dynamic is, as today is a bit of a headwind. I mean, obviously a great opportunity for patients, many more going to transplant. It's far exceeded our expectations. You've probably heard us talk about the fact that maintenance could or rather transplant could get as high as 50%, that's essentially where we're at. I think that happened a little bit faster than we expected, but that's probably where it'll be. I don't expect it to be much higher than 50%, I do think that has sort of topped out. We will ultimately see, but that's point number one.

Point number two is the effect on restarting and how long we're gonna need to wait until that really becomes a big factor. We have talked to many physicians. Obviously, the work that we've done seems to indicate that we'll get to 70%-80% of patients restarting maintenance, and we've seen that accelerate as every quarter has gone by. I think that's an important milestone or important bogey for us. Whether that takes another quarter, two quarters, a year, we'll see. We ultimately think that's where we'll be at steady state, so that'll be an important driver of growth as we go forward here, and that's the dynamic we see playing out.

We do see patients, as Steve mentioned, that over a six-month period of time, as you wait to come back at engraftment for maintenance, it's a little bit longer than we expected. We are picking up patients now in the claims that, it's not three, four months of engraftment and restart. It's more like five, six months, maybe even longer. That, again, that is a, you know, a piece of this. I don't think that's the vast majority of patients. I think that's some of the patients. Again, we do expect in future quarters to start to see some of the compounding effect as we sort of peaked at our 50% transplant rate, and then we'll have more patients coming back. That's the dynamic to look forward to. Maybe, Keith, do you wanna talk about, gross to net?

Yeah. Brad, with respect to gross to net, I would just say, not sure exactly of your math, but I would say that, you know, we've consistently guided since we launched that we expect gross to nets to settle in the 20%-25% range. We're still squarely within that range, and you know, I'm not changing our guidance at this time. We did see, you know, what I would call typical 1Q seasonality impacts on the gross to net just due to the high deductible, mostly due to the high deductible commercial resets and the Part D donut hole. The, you know, the impact was still landed us within the guided range.

Thank you. The next question is from Stephen Willey from Stifel. Stephen, your line is open.

Hey, good afternoon. This is Josh on for Steve. Thanks for taking our question. Do you think that the data from the phase II Axa-Rux combo trial would be sufficient to potentially support a compendial listing for frontline GVHD? How do you think data from this trial will serve to inform or de-risk, if at all, the phase III trial looking at AXA in combo with steroids in the frontline setting?

Thanks, Josh. Good question. Let me turn it over to Nick to handle both of those, I think.

I think it's a well-designed study and a very interesting hypothesis that you might be able to avoid steroids in the frontline setting, so this is a potential steroid-setting approach. It's 120 patients, about 40 patients per arm, and is basically I mean, it's a noncomparative randomized study, but really the benchmark for this is about a 40% response rate using standard NIH criteria at around six months. If you see a meaningful improvement on that, let's say 60%, which is kind of aligned to where the study would be, I think that could not only inform clinical practice, but potentially also compendial listing just because of the morbidity associated with long-term dexamethasone.

We will also look at a number of other clinically meaningful endpoints in that study, like the time to actually have to reintroduce steroids, and if you can really delay that, again, I think clinically that's significant. Duration of response and time to events or other endpoints, and I think when we look at the totality of those, it'll be very informative both to practice and compendia and could inform future registrational studies. The dexamethasone combination phase III study that you mentioned is a different hypothesis. This is where the axatilimab can actually add to dexamethasone. So it's a slightly different hypothesis, and that could offer an alternative standard of care. They have quite complementary mechanisms of actions, and that is a pivotal phase III study.

Thank you. The next question is from Faisal Khurshid from Jefferies. Faisal, your line is open.

Hello, this is Ananchon for Faisal. I wanted to follow up on the progress in the first-line AML phase III trials. Where do you see yourself relative to the competition there? Maybe a little more on EVOLVE-2 and how you see that stacking up in the end. Thank you.

Thanks, Anan. Let me first comment. I'll let Nick make the other comments. The progress on the trials, we're doing quite well. I think as Nick remarked, or in his written remarks, you know, this is a period of standing up our trial, standing up sites, enrolling patients. Everything is on track and going quite well. We feel we are, you know, going to be first at frontline. We feel confident in everything that we're doing to execute against our timelines. Everything's on track. I'll turn to Nick, maybe more about EVOLVE-2.

Yeah. No, thanks. I mean, simply this is one of the highest focuses for my teams. It's a very high priority, and we're spending a lot of time on this, and we have two different approaches. EVOLVE-2, again, this was the first study to start enrolling, so it's been enrolling now for nearly a year. We're working with HOVON, which is giving us a fantastic network of sites across U.S., and we are also now entering sites in the U.S., making a lot of progress with site activations and indeed patient enrollment. In fact, some of the metrics around patients per site per month are actually in somewhat in excess of what we modeled, and that's quite exciting because I think it speaks to the physicians' enthusiasm and the support of the HOVON group to enroll this study.

Because we've generated such a body of evidence with Ven/Aza, we actually feel very confident in the design and some of the statistical assumptions of that study. It's moving along very nicely, and our expectation is to be first with the readout for that trial. Likewise, REVEAL, we've made a lot of progress. As you know, we recently confirmed the dose at 162.70 in combination with intensive chemotherapy, which is great. We're working with a leading CRO internationally. We're busy setting up sites in Asia and activating sites, and again, we're running very much to track. We're feeling very confident about that study as well, and more on that to come. No, the teams are feeling confident, and we're in a good place.

Thank you so much, guys. Appreciate the call.

Thank you.

Thanks, Anan.

The next question is from Mayank Mamtani from B. Riley. Mayank, your line is open.

Yes. Good afternoon. Thanks for taking our question and congrats. A lot's going on for you guys. Just any chance you are able to share, you know, the absolute number of patients launched to date that have returned post-transplant? On the 300 new patients added in track quarter, you know, if you can give any color on the mix NPM1 and KMT2A versus what we saw in the prior quarter and if anything on the NPM1 you can share on duration and co-mutation use, you know, relative to what you had maybe initially expected last quarter. That would be great to hear. I will follow up.

Yeah, Mayank, thank you for the question. On the absolute number of patients, I think, maybe I'll ask Steve to make a comment if we have, if we have that data.

We can estimate. We don't have exact numbers.

Yeah.

that I would share right now. We know we've treated 1,400 patients roughly from launch date through now.

Yeah.

Break it down by KMT2A and NPM1 patients. It's probably at least a few hundred at this point. More.

Yeah. Yeah. I mean.

We can come back with.

Part of what the challenge of breaking down KMT2A versus NPM1 is it doesn't work like that in claims, so you have to make some certain estimates. You know, that's a little bit trickier. Your question about co-mutations was, you know, what % of patients have co-mutations. I think that was my interpretation of your question. I think, you know, broadly speaking, NPM1, you know, a high degree, 85% of patients have co-mutations. You know, about half of those have FLT3 mutations. We're running trials to look at combinations and things like that in terms of the FLT3 population. Other patients have IDH mutations as well.

It breaks down as a, you know, multifaceted population of patients that you have to deal with combinations or, with, in some cases, we use venetoclax and azacitidine to combine our drug with in order to handle all of that. I think that's, you know, that's the extent of, you know, the co-mutation question. We'll leave it there for now.

Duration. Thank you, Mike. Duration in NPM1, could you comment on that?

Yeah, thanks. Duration, I mean, we had talked about duration of NPM1, you know, over time being in the roughly seven to nine-month range. You know, I think it's early days to look at, you know, and have a duration calculation specifically for NPM1. We had talked a little bit more about the KMT2A population and how that's kinda coming together with the impact of more patients going to transplant and returning for maintenance. As Steve mentioned in his remarks, patients who have actually received a transplant and have gone on to maintenance are on average out to nine months and counting. That's a very positive forward indicator of where that business is going. I can think that, you know, NPM1 is certainly tracking with patients staying on drug for multiple months.

Some will get transplant, most will not. That'll be an impact, you know, a factor in how duration ultimately plays out. We expect patients to do quite well and, you know, be on drug for months.

Got it. On the azacitidine plus drug study, the phase II, you know, timeline got pushed up. Is the phase III steroid study that, you know, Nick, you just mentioned, is that also tracking ahead of plan? I believe you said early 2028 readout. If you can clarify that. Thanks for taking our questions.

Yeah, I know. That timeline's the same. Nothing's moved out. They're independent of one another, as you know, Nick mentioned, the trials are different trials. Everything's different about them. No, I wouldn't assume that timeline has changed.

Gotcha. Thank you.

Thank you.

The next question is from Etzer Darout from Barclays. Etzer, your line is open.

Great. thanks for taking a question. maybe if you could just provide any color commentary or even guideposts on 2026 revenue guidance, and then any color as well or commentary on commercial dynamics with just different NPM1 call points with Revuforj on the market. Anything you can provide there would be great as well. Thank you.

Sure. Thanks for the question. First, maybe I'll turn to Keith on how we're approaching revenue guidance, which is gonna be easy to answer.

Easy to answer. Sorry. Etzer, we don't provide revenue guidance. You know, we're early in the launch of NPM1. There's competition out there, so probably wouldn't be responsible for us to go out and give guidance at this point.

Right. Then anything on the commercial dynamics between us and our competitor? I think that was the genesis of the question there. Steve?

Yeah, I mean, dynamics we can share. Competition's always good for us to be at our best. I think importantly, menins are exciting. You know, lots of physicians are interested. Awareness is there. It's an obvious path in KMT2A. We've done very well and met and probably exceeded physician and patient expectations. The NPM1 patient's different. I think you can see by the nature of these calls, there's co-mutations. It'll build differently over time. We think it's a good thing that there's another menin player in the market, raising awareness, finding a place for menins. We've shared, and Michael's shared thoughts on just our profile, how physicians think about it. We've got a better profile in NPM1, so anything that's done on behalf of the class will have benefit to us as the market leader in NPM1 and in KMT2A.

We'll see how it rolls over the coming months, but we think it's a good thing, and we think ultimately we'll benefit from it.

Yeah. I would just say that, you know, NPM1 is a very considerable piece of our business, it's growing. We feel very good about our competitive position. Steve's organization is, you know, essentially, you know, built us into the market leader, and we expect to continue to build that piece of the business, competition or no competition.

Okay. Thank you.

Thank you.

The next question is from David Dai from UBS. David, your line is open.

Great. Thanks for taking my questions. Just on the Niktimvo IPF, what levels of investigator or payer interest are you seeing today in Niktimvo's anti-fibrotic potential? How might positive IPF data change the commercial opportunity long term?

Thanks for your questions, David. Two questions related to Niktimvo. One, Excuse me, payer interest around IPF. I think that was the first question. Steve, do you have a comment on that?

I really don't. I mean, this is handled. We know there's interest. There's clearly unmet need. The drugs that are there don't work incredibly well, so you're gonna see payer interest serving that population. Work is generally done by Incyte.

I mean.

To handle that piece.

Yeah.

What I would just add is that, I mean, this remains an area of high unmet need. It's poorly served by currently approved therapies. I mean, there are three, maybe four therapies approved. None of them are very satisfactory. The survival and prognosis of these patients is very poor, and no drug to date has really impacted the natural history of the disease. There really is, like, a great need for a drug that could potentially impact the natural history of the disease. You know, that's the hope with axatilimab, that it might be able to do that.

You know, from an investigator and physician perspective, the support we've had from investigators and their desire to contribute in a potential phase III is very high, which I think speaks to their interest in a novel and differentiated approach to the treatment of IPF. We're feeling very good about that.

As you know, the market opportunity here is quite large. We're talking about 150,000 patients or thereabouts in the U.S. This would be a new mechanism for this disease. If we're able to show in this trial meaningful impact on the efficacy endpoints and safety as well, we'll, I think, have a very interesting and compelling proposition in IPF to serve patients. It could be a, you know, sort of a, I'd call it a game changer relative to market size. I mean, GVHD is considerable as we've laid out. We think we have a very compelling proposition in GVHD alone. Once you add in IPF, it's a, you know, obviously a completely different size of opportunity in the U.S. for us to get involved. Excited about that.

Thank you so much.

Thank you, David.

The next question is from Yigal Nochomovitz from Citi. Yigal, your line is open.

Hi. Great, thank you for taking the question. On RAVEN, I had a question. If that study, that phase II looks good, would you then consider a phase III, given the regulatory pathway is a little less well worked out relative to what you're doing with REVEAL-ND? That's my first question. I was also interested, you know, you mentioned that you're guiding to 50% to transplant, up from the 33%. You're still restarting about 70%-80% on Revuforj. I was just wondering if, you know, why that number was staying the same. If you're increasing the number going to transplant, I thought perhaps maybe you'd get even more restarting, but maybe that's not the right logic.

Just curious to how you think about that part too. Thank you.

Thanks, Yigal. Let me just clarify on the second question. We had said that we're getting to about 50% patients transplanted, that was correct. What we expect as the target is 70%-80% of patients to come back. Not everybody will come back for maintenance, but the vast majority we expect to get to that point. Right now, we're not there yet, right? We're at kinda approaching half of the patients coming back for maintenance. That number will grow. It'll grow based on our confidence from the data that we've put together, some of which will be presented in the coming weeks at some of the medical conferences. We've heard from physicians, this is what they expect. Expect to put patients back on maintenance. They feel very strongly about that.

This is what we expect will happen, and we feel very confident in that over time, but we're not quite there yet. That's the dynamic we're experiencing. It's great for patients. Many more going to transplant. The funnel, the actual funnel of patients who are available for maintenance is expanding, and so that's all very positive driver of business going forward. The second question related to RAVEN, and I'll turn it to Nick.

Yeah, happy to take that question, and we're excited about this hypothesis because this is a bit of innovation in an area where, you know, patients could potentially get an alternative and a better-tolerated approach. You know, these patients would normally get intensive chemotherapy in order to try to get them to transplant, and the hypothesis here is by giving them venet and revumenib, you can get these, you know, fit KMT2A patients, many of them quite young, to transplant without all of the morbidities. Now, in terms of its intent, clearly that's a high, you know, an area of high unmet need. We haven't talked about the specifics of the study design yet.

Clearly a compelling result that you get high rates of transplant and good outcomes with a much better tolerated regimen would certainly be, you know, informing a clinical practice, potentially guidelines, and we would even be thinking about, you know, how would that support a registrational approach given the totality of the data we're gonna be generating in the frontline setting. More on that to come, but we think it's a very differentiated and innovative approach to this patient population.

Thanks.

Thanks, Yigal.

The next question is from Jason Zemansky of Bank of America. Jason, your line is open.

Good afternoon. Congrats on the progress, and thanks for taking our questions. Two, if we may. Wanted to return to the subject of Revuforj access. There was some discussion last year in the community that some plans were requiring step edits through one menin inhibitor. You mentioned there was some confusion over the relative cost of Revuforj. Was curious as to whether or not this was related and, can you speak to whether or not you're seeing any step edits throughout the universe? I guess secondarily, you mentioned that about 45% of KMT2A patients were resuming therapy post-transplant. I think last quarter you cited a range of 40%-45% of patients. Just curious, what kind of gets you through that barrier of, I guess, 45%?

Is this a case of sort of fast adopters and very cautious adopters? You know, really what's it take to get more of those docs on board? Thanks.

Thanks, Jason. Good question. Let me start with your question about access, which I'll turn to Steve, and he can address.

Yeah. As you know, the access is great. You know, 97% across both indications. Not only a high number, it did it very quickly. Plans have been reimbursing Revuforj since the launch. Your point about step edits, and I did mention this in my comments, there's literally three plans that have step edits in place, and it's really restricted just to the 270 mg dose. It's not a lot of patients. It's less than 1% of the overall. Some of that came about on a monograph, which I also referenced in my prepared comments.

A monograph that came out later part of 2025 and just had some incorrect information and made some assumptions just based on dosing, that if you were to exclusively prescribe the 270 mg dose, you would have a higher WAC than the other menin inhibitor. We know that that is not the case. In fact, most patients, 75%-80% of them are not on that dose. The WAC ends up being lower, about 15%-20% lower than our competitor at the one dose that they have. Since the monograph has been adjusted, they've corrected the fact base, they've removed the guidance on a step through our competitor at that dose, and the recommendation is no longer there. Plus, they updated it for other reasons, clinical, non-clinical, so the information is there.

The step that is in place is practically ineffective, and physicians get to choose what they want to. According to our information, there's not one patient that has had to walk through a step for Revuforj to date, and we don't expect that to continue moving forward.

Great. Thanks, Steve. I guess the second question relates to maintenance and how do you increase maintenance beyond the 45%? I'll just remind you that we've actually increased the use of maintenance throughout last year. You saw it kind of go from about, you know, a third of patients all the way up to 45%. It is steadily increasing. We do, as I said earlier, that, you know, data and real-world evidence will ultimately drive it. We have a robust strategy in place to deliver to get to this steady state, 70%-80% point, which will happen at some point in the future. We can't predict exactly when. I was a little off on my 50% prediction.

I thought that would happen later, and it happened more quickly. We are very, you know, bullish on the fact that we will get there. All the data that we have coming out, and we're very focused on this, should help physicians think through how best to dose patients and at what interval. You know, they're just. Some are very cautious about patients coming back from transplant, as you can expect. Their engraftment period varies by patient, and physicians want to make sure that count recovery is well underway and that they're managing patients really effectively. We help them with that, where there's lots of data that's coming out, and ultimately, getting to that 70%-80% should be quite achievable. Thank you.

Great. Thanks for the color.

Thank you.

Once again, if you have a question, you may press star five on your telephone keypad. The next question is from Salim Syed from Mizuho. Salim, your line is open.

Hey, great. Congrats on the quarter, guys, and progress. I guess two from us. One on just MAXPIRe, and then just the other one on the Revuforj chart you provided on slide four. On MAXPIRe, Nick, could you maybe remind us, I understand it's a robust study, but could you remind us what your power to show the 26-week time frame? I presume the powering was done on the 26-week and not the 52-week that you plan to model to. And then what the variability or standard deviation you're assuming on the primary endpoint? That's question one. And then question two, just on Revuforj.

I guess, like, one of the dynamics here, it looks like from this chart, which I thought was super helpful here, it looks like on KMT2A, you guys actually, like, maxed out sort of at this 200 new patients per quarter pretty quick. Are you anticipating the same sort of dynamic on NPM1 to max out with, you know, new patients per quarter within, I guess, like, maybe three quarters here or so, four quarters? What would be the underlying dynamic why you would max out so quickly? Thank you.

Wanna answer the, Nick?

Yes, Salim, thank you for the question on MAXPIRe. It's a good question. What I would say is, I don't want to go into the specifics of the statistical assumptions, but I would say it's a very well-powered study. We plan to recruit 135 patients. We actually slightly over-enrolled because of the physician support, we over-enrolled by about 10 patients. It's a 2:1 randomized study with an FVC primary endpoint. It is well-powered, and we'll look at an annualized rate, and we'll use the standard statistical modeling to report out the annualized rate. You know, rather than what it's powered for, what I would suggest to you is, you know, what we would want to see, because we're actually looking for a fairly significant difference, you know, in order to inform a phase III design.

We're not looking for small incremental differences. You know, in terms of the rate of decline, somewhere in the region of a 40% improvement in terms of the reduction in the rate of decline would be really meaningful. That's the kind of, you know, based on historical controls, the sort of figures looking at the totality of the data we'd wanna be looking at to inform a phase III. The study is well-powered to be able to show that type of difference. We'll let it read out and look forward to reporting those data in the fourth quarter.

Salim, I think your second question about dynamics on Revuforj. You know, I'll just simply say that when you think about KMT2A and NPM1, we have not maxed out. I think KMT2A is continuing to grow, as I mentioned earlier, incidence population of about 2,000 patients. It's a rare disease. You need to find the patients, I think we are, you know, getting as many as are available. We're the only menin in that space. We have the best profile, physicians are recognizing that the drug works very well for these patients. We expect to continue to build that market share well beyond what we're at. You know, every quarter is going to be a little bit different, I feel very confident about that.

NPM1, same thing. You know, there's no. It's a much bigger market, as you know. It's about 2x to 2.5x the size of KMT2A, and the opportunity there is large. We expect to, you know, cover the whole universe and get as many patients as possible. This should continue to grow. In NPM1, it's all about new patients. In KMT2A, it's about adding incremental patients quarter-over-quarter, new patient starts. I would say the increase in maintenance is in transplanted, as we talked about in maintenance, is going to be a big driver of growth for that segment as well.

I guess my question is more at the rate that they're coming in. It looks like that's what's maxed out, not the number of total patients. The rate that they're coming into, it seems pretty consistent here.

We've talked about.

You know?

Yeah, we've talked about consistent, a consistent rate of new adds, right? I wouldn't say we've, you know, we'll continue to penetrate and build. It will be a steady new rate of patients coming for KMT2A. NPM1 should be, you know, slightly different, larger market, and new patient starts will be more, certainly in the early stages of launch, be, you know, more dramatic. I think the, you know, the businesses and the way the business actually accrue revenue are slightly different, as we talked about.

Sure. Okay. Got it. Super helpful. Thanks so much, guys.

Thank you.

Our final question today is from the line of Andres Maldonado from H.C. Wainwright. Andres, the line is yours.

Hi, guys. Thanks for taking my questions, and congrats on the progress. Just two quick ones from me. First, a quick follow-up on axatilimab and IPF. I guess, could you provide a little bit more color on how we should be thinking about the phase II readout as primarily an all-comer FVC study? Or is there a biological subgroup, such that patients with maybe more monocyte/maybe macrophage-driven inflammation, where you expect to break out just based upon the fact that the CSF1R mechanism is stronger there? Maybe an underlying question for Revuforj.

I guess, you know, as we look at, you know, the NUP98 kind of opportunity, I guess, what would you need to see clinically to treat this as distinct, you know, expansion opportunity rather than just a scientifically interesting but commercially smaller subset? Thank you very much.

Hi, Andres, thank you very much for the questions. I'm gonna let Nick get into the IPF question.

Yeah, it's a very interesting and, you know, relevant question. Of course, we'll analyze the intent to treat population. Our expectation is that we'll see a benefit, you know, across all comers. These patients are treated on a background of antifibrotics, so we have stratified for by the type of antifibrotic they're on, whether it's nintedanib, pirfenidone or, you know, no anti-fibrotic. We will look at that, and we'll look at those subgroups. Given that we know that patients that have high levels of monocytes and high levels of CSF1R, we are expecting that and that that is correlated with a poor prognosis in IPF. We are expecting that the benefit would be seen across the intent-to-treat population. That would be our expectation and what we'd be planning to do with the phase III.

Certainly we will look at subgroups excepting in a smallish phase II, it's difficult to tease out differences in subgroups. I'm happy to talk a little bit about NUP98-

Sure, please.

...as well, just to start. Just from a clinical perspective, we have, as you already know, presented data on a small subset of NUP98, where we showed that three out of five patients had a form of morphological remission, which was very encouraging. We are planning to present additional data this year. I mean, biologically, it makes complete sense for these patients with NUP98R that they should benefit from Revuforj. You know, we've seen that across the spectrum. As we, you know, we plan to publish further data this year. Certainly, considerations for submitting for the consideration of NCCN guidelines would be something we would be thinking about. You know, that's the plan based on the data we've seen for this subset.

We probably estimate it to be somewhere around 5% of the baseline for, of AML. It's not an insignificant subset and clearly an area of higher met need because these patients tend not to do very well.

Yeah, I think that's, you know, as Nick said, 5%, it seems to be a somewhat underdiagnosed area. We hear this from physicians regularly now that Revuforj could be a good option for them. We've been following the HOX gene signature, which has, you know, kind of yielded NPM1, and now NUP98, and there may be other subsets. The ability to expand even beyond, call it 50% of AML is potentially possible. You know, we feel like we're, you know, on the cutting edge to make this part of, hopefully part of the portfolio. We're, we'll follow up on that. Thanks for the question.

This concludes our question-and-answer session. I will now turn the floor over to Mr. Michael Metzger for any additional comments or closing remarks.

Thank you, operator. Thank you all. We appreciate everyone tuning in today to discuss our recent progress and the exciting milestones ahead. We look forward to seeing many of you at the upcoming ASCO and EHA medical conferences and, of course, several investor conferences in the second quarter as well. With that, have a great evening, everyone.

Good day, everyone, and welcome to the Syndax Fourth Quarter 2025 Earnings Conference Call. Today's call is being recorded. [Operator Instructions]. At this time, I would like to turn the call over to Sharon Klahre, Head of Investor Relations at Syndax Pharmaceuticals.

Thank you, Operator. Welcome, and thank you all for joining us today for a review of Syndax's Fourth Quarter and Full Year 2025 Financial and Operating Results. I'm Sharon Klahre, and with me this afternoon to provide an update on the company's progress and discuss financial results are Michael Metzger, Chief Executive Officer; Steve Closter, Chief Commercial Officer; Dr. Nick Botwood, Head of R&D and Chief Medical Officer; and Keith Goldan, Chief Financial Officer. This call is accompanied by a slide deck that has been posted on the Investor page of the company's website. You can now turn to our forward-looking statements on Slide 2. Before we begin, I'd like to remind you that any statements made during this call that are not historical are considered to be forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these statements as a result of various important factors, including those discussed in the Risk Factors section in the company's most recent Form 10-K as well as other reports filed with the SEC. Any forward-looking statements made represent our views as of today, February 2026 only. A replay of this call will be available on the company's website, www.syndax.com, following its completion. With that, I am pleased to turn the call over to Michael Metzger, Chief Executive Officer of Syndax.

Thank you, Sharon. Good afternoon, everyone, and thank you for joining us. Starting with Slide 3. I'm pleased to share our fourth quarter and full year financial results following a transformational year that positions Syndax for continued growth in 2026 and beyond. In 2025, we demonstrated the exceptional strength of our commercial and R&D capabilities, successfully launching 2 first and best-in-class medicines and achieving our third FDA approval within the span of approximately 1 year. 2025 was a remarkable year for Syndax, and we have only just started to unlock the potential of our first 2 medicines. Let's dive into our commercial results for Revuforj. In the first full year of sales, we generated robust top line results, delivering $125 million in Revuforj net revenue in 2025 and further solidifying our leadership in menin inhibition. Notably, we ended the fourth quarter with 38% growth in Revuforj net revenue and 35% growth in prescription quarter-over-quarter, showing strong demand and momentum heading into 2026. Two main factors drove this impressive increase in demand. First, continued growth in our KMT2A business as the number of patients on therapy post-transplant begins to meaningfully stack. Second, growing uptake in relapsed/refractory NPM1 mutated AML following the FDA's approval of our expanded label at the end of October. Our launch into NPM1 is off to an excellent start, building on the solid foundation we established through our launch in KMT2A, including a robust prescriber base that has extensive experience and comfort using Revuforj. We are confident we will win in NPM1 with a best-in-class product profile, including the broadest label and unmatched efficacy data, together with strong customer relationships and excellent market access. Turning to Niktimvo and chronic graft-versus-host disease or GVHD. Fourth quarter results were strong with a 22% increase in Niktimvo net revenue quarter-over-quarter. This continued growth reflects a steady stream of new patient starts and a high percentage of patients staying on therapy. Niktimvo net revenue for 2025 reached $152 million in the first 11 months of launch, tracking ahead of the 1-year benchmark set by Sanofi's REZUROCK, which reached $500 million in annual U.S. net sales within the first 4 years of launch in the same indication. Niktimvo's outperformance highlights its unique ability to address both fibrosis and inflammation. As we expected, Niktimvo contributed significantly to our bottom line in 2025. Our 50% share of the Niktimvo product contribution totaled $42 million in collaboration revenue to Syndax in 2025. As Niktimvo sales continue to ramp, while much of the expenses -- the expense base stayed largely fixed, we expect to retain an even larger proportion of Niktimvo revenue over time. Altogether, Syndax revenue reached $172 million in 2025. Achieving this result in our first year as a commercial company underscores the significant unmet needs we are addressing and our ability to execute at the highest level. We remain confident in the continued success of both launches supported by multiple growth drivers that Steve will discuss shortly. Importantly, we remain well funded to continue investing in our strategic priorities to fuel the next phase of growth. This includes advancing our life cycle and frontline programs to expand our patient impact and unlock more than $10 billion in total addressable market opportunity. On the clinical development front, we made significant progress advancing our pipeline in 2025 and recent months. In addition to achieving a second FDA approval for Revuforj, we were also the first company to initiate enrollment in a pivotal frontline trial of a menin inhibitor, positioning Syndax to be the first to frontline. We also delivered the first real-world evidence for a menin inhibitor, among many other achievements that advance our scientific leadership and the body of evidence supporting our medicines. More recently, we completed enrollment in MAXPIRe, a robust Phase II trial of axatilimab in idiopathic pulmonary fibrosis, or IPF, a disease with high unmet need, which affects a large patient population. This trial has the potential to demonstrate axatilimab's utility in IPF and provide further rationale for its mechanism in a disease -- in a number of diseases with similar manifestations. We've made remarkable strides advancing our mission and building Syndax into a leading oncology company with 2 successful commercial launches gaining momentum, important upcoming data readouts and multiple exciting opportunities for label expansions, we are positioned to make a major impact on patient care and deliver long-term and sustained growth. With that, I will turn the call over to Steve to discuss our commercial progress in more detail. Steve?

Thank you, Michael. Starting on Slide 4. Now as Michael noted, we reported strong results from our launch of Revuforj. In the first full year of the launch, we delivered $124.8 million in Revuforj net revenue, well above launch benchmarks set by other AML therapies, even though KMT2A translocations are less prevalent than some other targetable mutations in AML. As we enter year 2, we expect to continue to outpace other therapies and redefine success in this space. Our conviction is supported by our recent label expansion, which enables us to now target a substantially larger population than other AML therapies as well as multiple dynamics that are expected to meaningfully extend treatment durations. In the fourth quarter, demand for Revuforj accelerated throughout the quarter, resulting in $44.2 million in Revuforj net revenue, up 38% from the prior quarter. New patient starts were up about 20%, driven primarily by uptake in NPM1, bringing us to approximately 1,050 patients treated commercially since launch. With the vast majority being KMT2A patients, we approach 50% penetration of the KMT2A incident population within the first year of launch, which really is an outstanding result. Total prescriptions were up approximately 35% from the prior quarter. The increase was driven by new NPM1 patients and continued growth in KMT2A as the pool of patients on therapy post-transplant expands. The percentage of Tier 1 and Tier 2 accounts that have ordered Revuforj also increased in the fourth quarter with more than 80% of these accounts now activated, up from 70% in the third quarter. In addition to an increase in the number of the largest academic centers ordering, the overall number of accounts ordering also increased, reflecting growing uptake in academic centers of all sizes and community practices. The growth in our prescriber base following the label expansion reflects physicians' enthusiasm to prescribe Revuforj to their NPM1 patients and positions us to drive further penetration in both NPM1 and KMT2A. Turning to Slide 5. There are multiple factors that will drive continued Revuforj growth in the near term. The first driver is growing uptake of Revuforj in relapsed/refractory NPM1 mutated AML, our second indication, which triples the size of our annual addressable patient population to a total of 6,500 patients. Our launch into NPM1 is off to a fantastic start, building on our broad and growing prescriber base and excellent market access coverage. Physicians are enthusiastic about our data in NPM1 and the results they've seen with Revuforj in their patients. Like we achieved in KMT2A, we rapidly established reimbursement in NPM1 with formulary coverage now complete at 97% of all lives covered just 4 months after approval well ahead of typical industry time lines. Regarding our ramp in NPM1, we began to meaningfully add new NPM1 patients following the addition of Revuforj to the NCCN guidelines for relapsed/refractory NPM1 mutated AML towards the end of September. The latest available data suggests we exited the third quarter with NPM1 patients representing about 20% of our new patient starts. That's up from our original estimate of approximately 10% across the third quarter. Now while data are still maturing, early indicators suggest that at least 30% of new starts in the fourth quarter were, in fact, NPM1 patients. Looking ahead, we will continue to expand our NPM1 business and are confident we will capture dominant market share and further cement our leadership position in menin inhibition. Our confidence is underpinned by our unmatched efficacy data, excellent customer relationships and a growing body of clinical data that differentiates Revuforj, including real-world evidence. The second driver is the robust transplant rate in KMT2A and growing use of revumenib post-transplant. We estimate that approximately 1/3 of KMT2A patients treated with Revuforj have proceeded to a stem cell transplant with physicians putting their patients back on Revuforj after a 3- to 4-month pause for engraftment. And the latest claims data suggests that approximately 40% to 45% of these patients have now restarted Revuforj, and that's up from 35% to 40% reported last quarter. We expect this percentage will continue to increase as more patients complete the engraftment period and additional data is reported by leading institutions that are building experience with Revuforj in the post-transplant setting. Based on what we observed in our clinical trials and feedback from physicians, we expect patients could stay on therapy for 1 to 2 years post-transplant, given the high risk of relapse and the favorable tolerability of Revuforj. The third driver is continued use of Revuforj in early lines of treatment and growing use in combination with other therapies. Claims data show that approximately 70% of usage is in the second and third line among patients treated for active disease. This is important because when patients are treated earlier, you expect to see higher response rates, longer durations of response and a higher percentage of patients proceeding to transplant. Claims data also show about 40% of usage in combination with other therapies, and that's up from 33% in the third quarter. While Revuforj is approved and promoted as a monotherapy, the growing combination use highlights physicians' comfort with the Revuforj profile and could extend treatment durations. All these evolving treatment dynamics have an important impact on the average duration of therapy. In 2025, the first full year of the launch, the average treatment duration was in the 4- to 6-month range. As treatment patterns continue to mature in the second year of the launch, we expect this to extend to 6 to 12 months. We have everything we need to continue building a sustainable business with our first 2 indications for Revuforj, which together represents a $2 billion-plus market opportunity, as you can see on Slide 6. Turning to Niktimvo on Slide 7. The fourth quarter was another strong quarter for Niktimvo with $56 million in net revenue, up 22% from the prior quarter. 2025 net revenue reached $151.6 million, surpassing first year launch benchmarks set by REZUROCK. From the start of the launch through the end of the fourth quarter, approximately 13,500 infusions have been administered to more than 1,400 patients. We continue to receive excellent feedback from HCPs on the rapid and durable impact they are seeing with Niktimvo on fibrosis and inflammation across organ systems. Turning to Slide 8. There are multiple drivers for continued Niktimvo growth in 2026. First, continued adoption in the fourth line and growing usage in the third line. In the first 11 months of the launch, we estimate that we captured approximately 20% of the third line plus chronic GVHD market. While this is excellent progress, we still have significant room to continue growing and bringing the benefits of Niktimvo to more patients. Second, this is a chronic disease with the potential for patients to stay on therapy for long durations. Persistency rates are high, with approximately 60% to 70% of patients who started Niktimvo in the first quarter of 2025 remaining on therapy at month 10. Our clinical trial experience shows that the duration of therapy can be measured in years for a meaningful proportion of patients. Third, we have a robust prescriber base, and Niktimvo has strong commercial synergies for both Syndax and Incyte. 90% of bone marrow transplant centers in the U.S. have prescribed Niktimvo with all centers placing repeat orders year-to-date. With multiple drivers for further growth, we are well positioned to expand our impact in third-line plus chronic GVHD, a $2 billion U.S. market opportunity as shown on Slide 9. In summary, we've made tremendous progress in our first year as a commercial company. We successfully delivered 2 novel medicines to thousands of patients and advanced the company towards profitability in the process. This is just the start of the impact we can make for patients with Revuforj and Niktimvo. With that, I'll hand the call over to Nick to talk about our pipeline.

It's a pleasure to be on the call today to discuss the important milestones ahead and update on our pipeline. So if you turn to Slide #10, we're laser-focused on executing the programs that will characterize the full therapeutic potential of our medicines. Starting with revumenib. We are advancing an integrated evidence generation plan to rapidly deliver practice-changing data across the acute leukemia spectrum as well as leading global registration programs in the newly diagnosed setting. Some of the key trials are shown on this slide, and I would like to highlight a few key points. First, global enrollment is underway in our pivotal frontline trials of revumenib, and we are positioned to be first to the frontline with pivotal data. Importantly, our frontline strategy is supported by compelling Phase I/II data showing high rates of response, MRD negativity and favorable tolerability with revumenib in combination with low or high-intensity chemotherapy regimens. Among the patients who are eligible or unfit for intensive chemotherapy, enrollment is underway in EVOLVE-2. This is a Phase III trial of revumenib in combination with venetoclax and azacitidine or ven/aza newly diagnosed NPM1 or KMT2A patients. EVOLVE-2 has dual primary endpoints of complete remission and overall survival based on the NPM1 population to support the potential for accelerated and full approval, respectively. In the fit NPM1 population, enrollment is underway in REVEAL, the Phase III trial of revumenib in combination with intensive chemotherapy. REVEAL has dual primary endpoints of MRD-negative CR and event-free survival to support the potential for accelerated approval and full approval, respectively. In the fit KMT2A population, we are pursuing a novel approach. In addition to generating further data with intensive chemotherapy, we are progressing the RAVEN trial in collaboration with clinicians at the forefront of menin clinical research. This innovative Phase II trial will evaluate revumenib in combination with ven/aza in newly diagnosed KMT2A patients who would be considered fit for intensive chemotherapy. This trial builds on the strong activity observed with revumenib in combination with venetoclax and hypomethylating agent in KMT2A patients. RAVEN has the potential to advance the standard of care for fit KMT2A patients if the efficacy outcomes are similar or superior to what is typically seen with intensive chemotherapy combinations, but without the associated toxicity. The second point I'll highlight is that 2026 will be another year in which Syndax will demonstrate a strong presence and scientific leadership at every major medical meeting in our field. Specifically, we expect to report additional data from the ongoing Phase Ib/II trials of revumenib combinations in the frontline setting, including an update from the BEAT AML trial in the second half of the year. We also look forward to additional data presentations on the clinical use of revumenib in the post-transplant maintenance setting, an area of growing scientific interest as well as further real-world evidence collaborating with leading institutions across the United States. At last year's ASH, we saw the first of what we expect will be a growing body of data from centers looking at outcomes with revumenib in a post-transplant maintenance setting. Investigators from MD Anderson presented real-world data from 10 pediatric patients with KMT2A or NUP98r acute leukemia who received revumenib as maintenance after their stem cell transplant. They reported that revumenib was well tolerated with encouraging early efficacy. At a median follow-up of 19 months, all the patients were alive and 90% were relapse-free. Also at ASH, investigators from the City of Hope presented the design of a Phase I trial evaluating the safety and preliminary efficacy of revumenib given as maintenance for 2 years post-transplant in adult and pediatric patients with NPM1 or KMT2A acute leukemia. This trial and others will provide important data to inform future research and clinical practice. With over a year of commercial use, we and our collaborators are well positioned to deliver impactful real-world evidence supporting revumenib clinical use. Investigators from Moffitt Cancer Center presented the first real-world evidence for revumenib and the menin therapeutic class at ASH. Their data showed an overall response rate of 77% and MRD negativity rate of 75% among patients with relapsed/refractory NPM1, KMT2A, NUP98r acute leukemia who received primarily revumenib as part of a combination therapy. This usage highlights the clinical value of having a therapy with activity across multiple genetic subtypes, a differentiating feature of revumenib's profile as well as physicians' comfort combining revumenib with standard of care therapies. They also reported patients proceeding to stem cell transplant and the majority resuming revumenib post-transplant. In addition to observing excellent clinical activity overall, revumenib was well tolerated. We expect Moffitt to report further data this year as well as other centers with extensive experience using revumenib in clinical practice. These will be important data sets that help -- that further help to differentiate the breadth of revumenib use and provide practice-informing data to physicians. Turning now to axatilimab, I'll highlight 2 key points. First, in partnership with Incyte, we are working to expand axatilimab's impact in chronic GVHD with 2 ongoing trials in newly diagnosed patients. One of these trials is a Phase III of axatilimab in combination with corticosteroids with top line data expected in early 2028. The other is a Phase II trial of axatilimab in combination with ruxolitinib with top line data expected in early 2027. Second, we continue to make progress advancing the development of axatilimab beyond chronic GVHD. Earlier this year, we completed enrollment in our Phase II trial of axatilimab in idiopathic pulmonary fibrosis, or IPF, and are on track for top line data in the fourth quarter of 2026. Given the high interest in our IPF program, I will review some of the key evidence supporting this program and outline the Phase II MAXPIRe trial design. So turning to Slide 11. Monocytes and monocyte-derived macrophages are a promising target in IPF. A growing body of evidence supports that circulating monocytes migrate to the lung and become pro-fibrotic inflammatory alveolar macrophages, which drive the fibrotic process. Research has shown that these monocyte-derived profibrotic macrophages are CSF-1 dependent. Axatilimab is an IgG4 monoclonal antibody, which was specifically optimized for diseases with an inflammatory and fibrotic component. It blocks a specific extracellular domain on the CSF-1 receptor on the surface of monocytes and macrophages, preventing their activation by CSF-1 and interestingly, IL-34. This reduces the levels of circulating pro-fibrotic and pro-inflammatory monocytes and monocyte-derived macrophages and therefore, inhibits the activity of pathogenic macrophages in tissues. By targeting B cells, axatilimab has the potential to provide a more pronounced impact on the fibrotic process than other therapies that target alternate pathways. Slide 12 outlines the multiple lines of evidence that support the potential for axatilimab in IPF. Firstly, it has been shown that higher monocyte levels are associated with shorter overall survival in IPF and other fibrotic diseases. In addition, preclinical bleomycin mouse models of IPF show reduction in lung fibrosis with CSF1R inhibition. Most notably, we observed remarkable antifibrotic activity with axatilimab in chronic GVHD patients. Responses were observed across all organ studies, including organs with fibrotic manifestations of the disease, such as the lung and skin. Among patients with lung involvement who received axatilimab at the dose we are studying in our IPF trial, nearly 50% achieved a lung response and over 90% reported improvements in shortness of breath at rest. Leading experts in IPF with whom we have consulted, including some who are also participating in the trial are enthusiastic about axatilimab's mechanism, the compelling results in chronic GVHD and its potential in IPF. Slide 13 shows the design of the MAXPIRe, a Phase II randomized, double-blind, placebo-controlled trial of axatilimab in approximately 135 patients with IPF. The inclusion criteria are similar to other recently reported IPF trials. The primary endpoint is the annualized rate of decline in forced vital capacity or FVC measured at 26 weeks. This is a well-designed Phase II trial that has the potential to provide robust proof-of-concept data for axatilimab in IPF to inform a pivotal registrational program. We have an exciting year ahead as we continue to pioneer the broad development of menin and CSF1R inhibition 2 mechanisms that hold tremendous promise for patients. With that, I will hand the call to Keith to discuss the financials.

Thank you, Nick. Earlier this afternoon, we reported detailed fourth quarter and full year 2025 financial results and I'll highlight just a few key points on Slide 14. Total revenue for 2025 was an impressive $172.4 million, consisting of $124.8 million in Revuforj net revenue, $42.4 million of Niktimvo collaboration revenue and $5.1 million in milestones and royalties. In the fourth quarter, Revuforj net revenue increased by 38% compared to the third quarter. This growth was driven by demand as inventory levels remained within the 2- to 3-week range we previously guided to. We expect continued growth over the coming quarters with the fourth quarter approval in NPM1 and an increasing average duration of therapy in KMT2A patients. Turning to Niktimvo. It was a meaningful cash flow contributor to Syndax in 2025. From the $151.6 million in 2025 Niktimvo net revenue reported by our partner, Syndax recorded $42.4 million in collaboration revenue after deducting the cost of sales and commercial expenses. We expect the Niktimvo margin contribution, defined as collaboration revenue recorded by Syndax as a percentage of Niktimvo net sales to be in the 25% to 30% range in the near term and increase longer term as sales grow while much of the expense base stays largely fixed. We expect continued robust sales growth given the high unmet need Niktimvo is addressing and the potential for patients to stay on therapy for extended durations. As previewed at the JPMorgan Conference in January, we expect 2026 expenses to be stable compared to 2025. We have guided to total R&D plus SG&A expenses in 2026 of approximately $400 million, excluding the impact of $50 million in estimated noncash stock compensation expense. And we expect expenses throughout the year to be relatively flat quarter-to-quarter. Turning to the balance sheet. We are well funded to continue investing in our commercial and development priorities with $394 million in cash, equivalents and marketable securities at the end of 2025. With a robust balance sheet, growing revenue from 2 medicines and stable expenses, we expect to reach profitability without the need for additional capital. With that, I will hand the call to Michael for closing remarks.

Thank you, Keith. 2025 was a landmark year for Syndax in which we solidified our scientific and commercial leadership. Looking ahead, we are laser-focused on driving revenue growth and delivering on the clinical milestones shown on Slide 15 that will fuel further innovation and value creation. We are in an excellent position to deliver on our commercial objectives with multiple drivers for near- and long-term growth of both medicines. Demand for Revuforj is accelerating as we expand into a second larger patient population and the number of patients on therapy post-transplant begins to stack. Revuforj is uniquely positioned to be the menin inhibitor of choice in the relapsed/refractory setting and the first menin inhibitor approved in the front line, unlocking a $5 billion-plus market opportunity. Niktimvo is annualizing at over $200 million and is a meaningful contributor to our bottom line within the first 11 months of launch. We have ample opportunity for further growth in our first indication and trials are underway in frontline chronic GVHD and IPF that could be -- could open transformational multibillion-dollar markets for Niktimvo. I will close by expressing my deep gratitude to the patients in our trials, our dedicated Syndax team, collaborators and long-term investors. Their unwavering support has made it possible for us to advance our mission at this -- to this point and continues to power Syndax's long-term success. And with that, I would like to open the call for questions. Operator?

[Operator Instructions] Our first question will come from Anupam Rama with JPMorgan.

This is Priyanka on for Anupam. So last month at the JPMorgan Healthcare Conference, it was noted that usage in the KMT2A maintenance setting post-transplant was in the 30% to 40% range. Today, we're seeing about 40% to 45% having resumed treatment post-transplant. So what factors are driving the increase in such a short time?

Priyanka, thanks for the question. Look, the growth in KMT2A has been fantastic. And I think the post-transplant maintenance has been a big factor in the growth here. And we're talking about patients that are going to transplant right now at about 1/3 of patients going to transplant and then more patients continue to come back for maintenance. And so that is a growing phenomenon, and we've gone from 35% to 40% and now 40% to 45%. So it's continuing to step up quarter after quarter. And that's what we would expect. We would expect this to continue to grow, get us to even a higher watermark. This is something physicians want to do and believe in, and we're seeing the results quarter-over-quarter.

Your next question will come from Corinne Johnson with Goldman Sachs.

You mentioned that about 30% of patient starts are coming from NPM1 in terms of like the early data reads through this quarter. I guess, what do you think that should be at steady state? And then maybe separately, you obviously completed that enrollment in the IPF study. But could you remind us what you're looking for in order to determine a go-forward decision on that indication? And how does that decision get made between you and your partner Incyte?

Great. Thanks, Corinne, for the question. So maybe the first part, I'm going to make a comment and turn it over to Steve. Right about now 30% plus NPM1 as a percentage of new patient starts. We do expect that to grow. I mean we're off to a fantastic start. We have best profile really anchored by efficacy and great tolerability. Physician awareness is high. So we're feeling that, that number will grow meaningfully throughout this year. And Steve, I don't know if you make any other comments.

I mean the only thing to add is we've seen a progression of this. We know in previous quarters, it was a much lower percentage, the NCCN guidelines. We talk about third quarter, which is probably closer to 20% new patient starts, Corinne. So 30% is our best estimate based on the data we have. It is going to go up meaningfully. We know the NPM1 population is larger than the KMT2A population. So it will likely pretty quickly go to 50-50. In the end, it's going to be more NPM1 patients simply because there's more out there. But to reiterate what Michael said, we love the start. We love the reaction we've gotten in the fourth quarter. We haven't had a full quarter yet of promotion. We're seeing more accounts prescribed. Formulary access is, as I mentioned on my prepared comments, at 97% that's just a couple of quarters -- a couple of months in, the same as it is on KMT2A. So in a great spot, a lot of momentum at the end of the year carrying over into January.

Great. And Corinne, your second question related to IPF. I'm going to let Nick make some comments about what will essentially put us in a good position come the readout on IPF, Nick.

Yes. And first, I would just say it's a very well-designed and robust Phase II study. So it will give us a clear proof of concept that will inform. And we'll obviously look for both statistical significance, but also clinical relevance against historical controls. The primary endpoint of the study is forced vital capacity or FVC. In terms of absolute measures, just based on what we've seen from recent studies, something of the order of 40 mls difference at the 26-week primary endpoint annualized to about 80 to 100 ml when you analyze that out. Or if you benchmark it against Fibrnir, which showed across its 2 dose levels, a relative difference of about 23% to 38% something in excess of 40% would be both statistically significant and clinically meaningful. But we are really looking for some sort of incremental change that would be extremely competitive versus currently approved standards of care. And based on all of the preclinical and clinical data that I went through in the prepared comments, we're feeling really quite confident in both the design and the outcome of this currently double-blind, placebo-controlled study that we hope to read out at the end of this year. So those are the sort of benchmarks we'll be looking for.

Yes. And lastly, I'd add that I think you had a question about our partner and how do we make the decision to go forward beyond the data. But I would just say that our -- both us and our partner are eagerly awaiting the results of this trial, and we're in a great position to elect to go forward. And I expect that upon a positive result, both Syndax and Incyte will work together on the rest of the program, Phase III and launching that.

Your next question will come from Claire Dong with Jefferies.

So just kind of a follow-up question on the IPF trial. Let's say, if it reads out positively in the fourth quarter, can you talk about what's the fastest and realistic path to a pivotal trial and eventual approval? And then if the data is positive, how are you thinking about the next indication? And what criteria are you using to prioritize for the next indication?

Thanks for the question. I'll just make a comment and turn it over to Nick. Look, we would be as expeditious as possible in designing the next trial and executing on that. We haven't guided yet in terms of time lines for the next trial, but obviously, this would be a very important result for the franchise. And so we look to start a trial very quickly. Nick?

Yes. And just a few additional considerations. One is that we would be planning a Phase III with a subcu regimen. We have a subcu regimen of axatilimab in development. We feel that, that would be an important element of a future Phase III and approval. Based on the robustness of the Phase II design, we are only anticipating the need for one pivotal Phase III in IPF. We feel that would be sufficient to confirm what we see in proof of concept, assuming the study is positive. And obviously, our intent is to have Phase III enabled for as soon as we possibly can after the end of Phase II. So we are planning for success, all of the enabling work that we can do ahead of time we are doing whilst we await that signal. So we haven't guided, as Michael says, to the start of the Phase III, but those would be some considerations. The one other point I would make, of course, is that we'll have a very good statistical sense of the margin of benefit, which allows us to power Phase III appropriately, and I hope quite aggressively on the basis that we're really looking for a step change in clinical benefit.

Your next question will come from Josh Bowen with Guggenheim.

This is Josh on for Brad. So as you guys continue to capture patients earlier on in the disease course, you have more patients on combinations and more making maintenance, should we think about the overall contribution of each of those components to the trajectory towards that 6 to 12 months duration range you guys are noting for 2026?

Josh, thanks for the question. As you noted, combination use is growing. So we're seeing about 40% of our patients, and that's up from prior quarters, about 40% of our patients treated in combination, which is a great sign that we're treating them also earlier in the treatment regimen, which, of course, as was noted in, I think Nick's comments or Steve's comments, as you treat patients earlier, they tend to do better and stay on drug longer, and that's a recipe for success. Combinations allow that to be possible. So we do believe that, that number will grow over time. But of course, monotherapy is the basis of our approvals and how we're anticipating the drug will continue to be used as well. So a big part of our future. But as you approach frontline, that's really where combinations are going to become even more important. And we have, of course, the most data in the field around combinations at this point, and the drug has been very well tolerated and also showing great efficacy. So we're in a particularly good spot there.

Your next question will come from Phil Nadeau with TD Cowen.

Congrats on the progress. Two from us. So first, in terms of maintenance therapy, I think we're hearing at ASH that there was some question on the appropriate dose of Revuforj in maintenance. It seems like with use increasing, maybe those questions are subsiding. So are physicians comfortable with what dose they should be using in maintenance? And then second, on the strategy for moving Revuforj into newly diagnosed fit KMT2A patients, you talk about that a little bit more? It seems like you're betting on the Revuforj plus ven/aza trial. Is that a little risky in that intensive chemotherapy seems to be the standard of care today. So why not do a registration trial in combination with IC?

Yes, Phil, thanks for the question. First part of the question was related to maintenance therapy and our physicians now comfortable with the dose, given that maintenance use is increasing, I would say, yes, right? That's an easy one to answer. And I do think that we've done a lot in the field to look at real-world data and other publications in order to support the use of maintenance. And I think the specific dose has come up as a question, and we're trying to answer that, and we'll continue to answer that. Nick, you might want to comment on that.

Yes No, thanks, Phil. And actually, we had a trial in progress, you may recall at ASH last year from Dr. Ball, City of Hope. We hope that data to read out this year. This is a Phase Ib/II study actually looking at the optimizing the dose in the maintenance setting. It's dose escalating, we should be able to report that out. Currently, the standard dosing for maintenance is the same as our approved dose and indeed, it is the same dose that we take in combination with either ven/aza or intensive chemotherapy, which is the 160, 270 dose. Of course, physicians are allowed to dose modify as they need to, to manage any cytopenias in the maintenance setting. But I think that Phase Ib will be informative when it reads out in terms of the optimization of dose and maintenance. But that's where we stand with that. And then maybe I jump to fit KMT2A. Why don't you handle it.

So Phil, the thinking with RAVEN, and firstly, we -- I would say that we have by far the broadest data set with KMT2A in combination with both intensive chemotherapy and HMA regimens. And it was really the basis of the compelling nature of those data that we set out our program in the front line that really includes all of the areas. So recall that we have a randomized study planned in collaboration with the NCI, which will be with intensive chemotherapy for the KMT2A. And we think that's a very valuable collaboration building on their Phase I experience. As you know, we reported data from Phase I with the NCI at ASH. So that will be happening. Recall, of course, that KMT2A patients are included also in our EVOLVE-2 study. The primary endpoint is powered for NPM1 because, of course, for unfit patients, NPM1 is the predominant population, but KMT2A patients will be included, and we will be doing a sensitivity analysis that includes KMT2A. And then really based on the evolving or changing perhaps clinical practice for fit KMT2A, we really wanted to innovate and felt we were in a good position to do that, working with leading academic centers. And there was some interest in combining with ven/aza even for fit patients to reduce morbidity because we really believe you will be able to get those patients to transplant in the same way as you would with intensive chemotherapy, but perhaps without all of the associated morbidity and toxicity that you might get from an IC plus menin combination. So that is an innovative approach that we really feel could move the standard of care forward, and that's what we are focused on, and we really want to continue to innovate with the thought leaders in this space.

Maybe just a follow-up. So could the NCI trial or EVOLVE-2 result in a label for first-line in combination with IC?

Yes. It's very much data dependent. I mean those could be practice informing, guideline informing or potentially label informing. It's going to depend on the outcome. It's going to depend a little on the patient population. So it will depend. We have, as I say, a broad program, including KMT2A, and it will depend on what we see.

Your next question will come from Stephen Wiley with Stifel.

I guess it looks like Niktimvo's sequential growth here in 4Q hasn't really slowed that much relative to 3Q, which seems to be a bit interesting for a second mover IV drug. So what anecdotes are you seeing? And are you thinking any differently about how long you might be able to see double-digit sequential growth for this franchise? And then I just have a follow-up.

Stephen, thanks for the question. Yes, we agree Niktimvo is off to a -- it's had a great first 11 months exceeding benchmarks, and we see continued growth into this year for sure. So we're feeling quite good about quarter-over-quarter. But Steve, do you want to make something?

Yes. Great question, and the drug is off to a great start. I think the reason why it's serving unmet need that hits what hallmarks of the disease with fibrosis and inflammation, you've got an account base that there's not that many BMT centers in the country. Nearly all of them are writing and the effort that we have against it between Incyte and Syndax is pretty tight, but these are priority accounts and we support them, and we're seeing good dynamics, not just in new patients, but also in terms of persistency. So this is how these brands grow. There's a wide swath of patients at launch and then the goal is to bring in as many new patients as possible on a monthly basis, and we're consistently doing that. So it's going to feed itself and the product is going to perform as expected. We'll start to see durations increase. It's not uncommon for ultimately patients to be on for not months, but years. So those are the dynamics we'll see at play. So I would expect to see steady growth, if not increasing in the near future.

Okay. And then I know you and Incyte made a presentation. I think it was at ATS last year, looking specifically at Niktimvo and BOS chronic graft versus host disease for AGAVE. And just wondering if you can talk a little bit about the biological similarities and dissimilarities between that indication and IPF. Is one more fibrotic? Is one more inflammatory than the other? I'm just trying to think about how that data set should bode for translation into IPF.

Yes, excellent question. Thank you, Steve. I'm going to turn it over to Nick.

Yes. Actually, there's a lot of underpinning similarities in terms of the biology. I mean both are associated with both inflammation and fibrotic changes. Both of them are associated with increased numbers of circulating monocytes and macrophages. So whilst as you rightly point out, GVHD, pulmonary manifestations tend to be more obstructive in their pattern. You get a more restrictive pattern in IPF. We feel a high degree of confidence that what we saw in those bronchiolitis obliterans syndrome, pulmonary manifestations of GvHD is quite a good analog for IPF. We've also seen axatilimab cause really quite remarkable reductions in inflammatory cytokines like TNF, TGF-beta, IL-10, et cetera, which is also very encouraging. Interestingly, there are some recent publications, Blood 2025 for some of the currently approved drugs in IPF that have shown activity in GVHD as well. And that kind of cross reference does suggest that there are some common underlying pathologies, which we believe is the case that gives us a lot of confidence that what we've seen both preclinically and clinically with axatilimab will translate very well into IPF.

Your next question will come from Mayank Mamtani with B. Riley.

Congrats on the progress. Maybe I can stay on the IPF topic, if I may. So you are testing the lower dose here, at least relative to the 1 mg per kg GVHD trial. So maybe just comment on what you have seen in the dose response maybe from the AGAVE study before. And I also noticed you stratified by pirfenidone or nintedanib exposed patients. So how you expect to have sort of that powering between the 2 stratification? And is the Phase III trial also potentially going to be 26 weeks versus maybe the 52 weeks you usually see in IPF?

Yes. Go ahead, Nick.

So maybe start with the last one first. So a planned Phase III would have a standard FDA and other regulatory authority endpoint at 52 weeks. That would be the standard. So that's straightforward. We've annualized our Phase II, which is an accepted methodology, and we have a very robust statistical model for doing that. That's the first question. Your second question related to dose.

Dose response.

The dose response, yes, sorry. Yes, this is actually very good because we had a very clear dose exploration in the AGAVE study where we explored 3 different doses and clearly showed that the lower dose 0.3 mg per kg was the most well tolerated, but also interestingly the most effective. And that applied equally in the patients that had bronchiolitis obliterans syndrome, which we've actually presented those data, where if you look at the 0.3 mg per kg, nearly 50% of the patients actually had a response using standard NIH criteria and 90% of those patients at the lowest dose had an improvement in their symptoms at rest, which is very encouraging. So we feel pretty confident that the dose that was approved for GVHD is the appropriate dose to be testing in IPF as well.

Your next question will come from Etzer Darout with Barclays.

Just quickly going back to an earlier comment. Just wondered what you're seeing with regard to the most common combo agents being used currently? And then also exiting sort of the quarter, what average duration of therapy are you seeing? And how does it differ in NPM1 patients versus KMT2A patients?

Yes, Etzer. Thanks for the question. So first, the combination agent, I think it's -- we're being used in combination with ven/aza probably most often. We're seeing with other combination agents as well. IC is another, obviously, with chemotherapy. So -- but I think we'll start to see that expand as time goes on. But right now, I would say the majority of the combination use is more often with ven/aza. Then in terms of average duration of therapy, I think we talked about 2025 would be in the 4- to 6-month range for rev, and that's squarely where we were. So I think we're not going to comment on this year yet. We're in this quarter, but we're encouraged by what we're seeing. We said that would extend to 6 to 12 months, and we feel good about that as well. So I think that's the average duration of therapy. Was there a third question?

Your next question will come from David Dai with UBS.

Perhaps on the quarter. So we're a little bit encouraged to see the post-transplantation maintenance use increased to 40% to 45%. So what do you think would be a reasonable percentage at steady state? And then just on the IPF, axatilimab, how should we think about the competitive landscape, especially given that we have Tyvaso as well as Insmed, TPIP, both are inhalation. How do you think axatilimab could differentiate among the competitors?

Thanks, David, for the question. So first, in terms of increased -- the movement in increased post-transplant maintenance, now at 40% to 45%, up from 35% to 40%. So that was last quarter. Look, I think this is -- it's a great question, where could this go? We would expect this number to meaningfully increase over quarters. And so could be 70%, 80% of patients based on what physicians tell us, they want to put all their patients back on maintenance. However, we know that there are extenuating circumstances where some patients won't be able to go on maintenance. But we expect somewhere in the order of 70%, 80% of patients could go back on maintenance in this setting. And that's obviously a sea change. Nothing has ever been able to -- no drugs have been able to accomplish that, certainly for KMT2A patients. NPM1 patients will receive less -- fewer transplants and of course, in turn, less maintenance as well. But overall, that would be a very meaningful change for these patients. And then in terms of IPF, Nick?

Yes. I mean I think the first thing to say is that, I mean, IPF remains an area of high unmet need. The benchmark is not very high, and we have optimism that axatilimab may actually bring a degree of disease modification, delaying early inflammation, potentially preventing fibrosis, maybe even reversing fibrosis, which you'll see. We have some evidence from certainly wound healing that there seems to be some reversal of both inflammation and some of the fibrosis you see in some of the sclerotic changes of the skin. So the bench is not very high. Most of the currently approved standards of care just delay the deterioration in FVC to an extent. We have to recognize as well, axatilimab has a very unique mechanism of action. It's really targeting the macrophages as we talked about, most of the other agents are targeting fibroblasts. So that brings a very differentiated profile. And then as I mentioned, if we -- as we plan for the Phase III, we would be planning for a subcu regimen. It would be Q2 or Q4 potentially based on the data we generated. Some of the other currently approved agents are quite difficult to prescribe inhalation, sometimes 4 puffs 3 times a day, I mean, they're quite onerous for patients. So we think a subcu regimen in Q2 or Q4 could be really quite competitive in terms of its profile. So I think those are the things which would differentiate us at the end of Phase II with a positive signal.

Your next question will come from Yigal Nochomovitz from Citigroup.

I just had a question on the real-world dynamics. So the combo use of 40% and the 70% second line or higher, are those percentages sort of steadily growing? Or do you see that as relatively stable for the time being until you generate evidence from those settings in the clinical trials?

Thanks, Yigal, for the question. So look, I think it's very encouraging what we're seeing in the real world. And I think the combo use 40%, I would -- we would expect that to grow, right? And then in terms of -- Nick, do you want to comment on that?

Well, I would just say that we will be presenting some updates from the real-world data we presented at ASH at Moffitt through this year and also some further real-world series from other leading academic centers across the U.S. And what I can say is that the trend from those centers at least is that there is a desire to use it in combination because we've seen a higher response rate in CR/CRh. And for physicians and patients that can tolerate a combination, there is a desire to give them a combination because of those increased response rates. And I think as we generate more data and we present more experience from the real world, that will drive increased use because of those better outcomes. And we've also established it's very tolerable to give in combination.

Okay. And just one follow-up. Is it fair to assume that those metrics, the 40% and 70% are roughly similar across KMT2A and NPM1 or are there any notable differences there?

In terms of combination, I think we're about the same. I think we would think they would be the same. 70%, it could be very high relative to how many patients go back on from transplant, yes, similar.

Your next question will come from Salim Syed with Mizuho.

A couple from us. Just one, I appreciate the commentary on the 30% of your new starts are NPM1. Could you help us just reconcile that from a share perspective? So if every 10 NPM1 patients coming into the funnel eligible for menin how many are you getting versus current right? Do you have any sense or any idea of what your share is there? And then just on the additional data that we'll be getting this year kind of related to Yigal's question, could you help us quantify what you think the halo effect might be in terms of uptake once you present that data for revumenib?

Great. Thanks. So maybe the first question, I'll turn to Steve about the market share dynamics.

Yes, Salim, thanks for the question. This is things we'll look at over time. It's going to take us a little bit of time to parse that out. So it's just too early to know. I mean our data points are the same ones you have, which is what they provided as sales volume last year, which we know was on the low side. Some of that's by stocking. Some of that presumably is demand, but it's very small. I mean that we do know. Physicians have a choice, and we know that they're going to pick Revuforj based on the profile, the dynamics, the experience, formulary access and use they've had in this NPM1 patient population. So our focus is on broadening the patient population for Revuforj to the biggest number of patients as possible regardless of a competitor or not.

And your second question, Salim, just maybe restate it, if you don't mind.

Yes, sure. Just kind of related to Yigal's question. Just when we got this additional data that you plan on presenting for Revuforj this year and some of the combination data, just sort of how you're quantifying the halo effect you can see commercially in terms of uptake?

Very important. I mean, look, we're continuing to pursue lots of collaborations. We have -- we talked about Beat AML. We talked about SAVE. We talked about several of these real-world evidence trials that we're generating with combinations, both in the fit and unfit settings. All of that, how we use the drug, maintenance, all of that is exceptionally important when it comes to utilization, whether we have indications there or not. And that will build as we get to the front line. We're enrolling very significant frontline trials. We expect to be first to frontline, and we'll have all the data supporting that with potential -- a potential for guidelines even before we get to frontline. So we have a very robust plan and as you say, a halo, which should accrue to us as we are the leaders here in this space.

Your final question will come from Jason Zemansky with Bank of America.

Congrats on the quarter. Just a quick -- 2 quick follow-ups, if I may, for me. In terms of your growth in NPM1 patients, can you -- or do you have a sense of how much of that represents a bolus of patients prior to the approval? And then I guess, secondarily, given that your competitor has been on the market just for a few months, can you at least qualitatively comment on whether or not you've seen an impact at all on your prescribing?

Yes. Jason, thanks for the questions. So maybe I'll let Steve address this question about growth in NPM1, kind of where we started and where we've kind of found ourselves. And then I'll come back to your competitor question in the end.

Yes, Jason. So in terms of bolus of patients, which you can see at launches of drugs, we certainly saw it at the launch of initially with KMT2A, there's this broad selection of patients that are on market that are available. And I think the best analogy I have for Revuforj, if you can consider KMT2A and the launch of the drug, it's a car to stop light, light turns green, you go with NPM1, it's a little different. You're kind of on an on-ramp getting on a highway and you're accelerating. So there's not going to be as pronounced of an effect on NPM1, meaning we've already captured some patients, and we know that an elevation of 10% in prior quarters of NPM1 use within Revuforj that accelerated in Q3 up to probably around 20%, and we're at least at 30%. So that's the ramp. I will say this, the number of new patients, we were pleased with what we saw. We continue to see that momentum roll into the first quarter of '26. So I feel like we're in a good spot.

Yes. And I'd just add relative to competition, look, we feel we have -- we're in a -- as Steve said, we're in a fantastic place. I can't say we felt much of an impact. We had a great fourth quarter relative to our competitor, what their sales were. So we expect, honestly, to dominate this space. We have a superior product profile, and I expect we'll have superior execution. So we're, again, going into the year with very strong enthusiasm about what we can achieve, and we're in a fantastic spot.

This concludes our question-and-answer session. I will now turn the floor over to Mr. Michael Metzger for any additional comments or closing remarks.

Well, thank you all, and we appreciate everyone tuning in today to discuss our recent progress and the exciting milestones ahead. We look forward to seeing many of you at the upcoming conferences, TD Cowen, Jefferies, Leerink and Barclays. And so with that, have a great evening, everyone, and thanks for tuning in.