Nuvalent Details FDA Timelines for ROS1, ALK Drugs as $1.4B Cash Fuels Global Launch Plans

Core Insights - Nuvalent is advancing its drug development programs for ROS1 and ALK-positive non-small cell lung cancer (NSCLC), focusing on differentiated drug profiles and regulatory strategies to enhance market opportunities [1][4][11]. ROS1 Program - The FDA accepted Nuvalent's New Drug Application (NDA) for zidesamtinib in TKI-pretreated ROS1-positive NSCLC, with a PDUFA date set for September 18 [4]. - The company is prioritizing a broader, line-agnostic ROS1 label, having aligned with the FDA on a six-month follow-up post-response for previously treated patients, which supports an earlier submission [2]. - As of June last year, Nuvalent enrolled 104 patients in the frontline cohort, exceeding requirements and maintaining enrollment due to strong interest [2]. ALK Program - Nuvalent completed a pre-NDA meeting with the FDA for NVL-655 in TKI-pretreated ALK-positive NSCLC and plans to submit an NDA in the first half of the year [3]. - The company is conducting the phase 3 ALCAZAR study in TKI-naïve ALK patients, with a focus on demonstrating durability and safety [3][8]. - Porter highlighted that NVL-655 shows greater durability compared to lorlatinib, with over 60% of patients still responding at 1.5 years [8]. Commercial Strategy - Nuvalent is shifting its strategy to pursue global commercialization independently, citing the importance of maintaining flexibility and optionality in a changing pricing environment [11]. - The company ended the previous year with approximately $1.4 billion in cash, providing operational runway into 2029, although it has not confirmed full funding for its global expansion plans [13]. Market Outlook - The ROS1 market is projected to grow to resemble the current ALK market, estimated at over $2 billion, while the ALK market could expand to be 2-3 times larger than the EGFR market [14]. - Historically, ALK and ROS1 have seen a high share of sales outside the U.S., with 65%-70% attributed to international markets [15]. Pipeline Development - Nuvalent's lead candidates include NVL-520, a selective RET inhibitor, and NVL-655, targeting KRAS G12D mutations, with ongoing efforts to ensure clear clinical narratives for their HER2 program [17][18][16].