Summary of Nuvation Bio (NUVB) FY Conference Call - May 28, 2025 Company Overview - **Company**: Nuvation Bio (NUVB) - **Focus**: Oncology, specifically targeting ROS1 positive lung cancer with the drug telotrectinib Key Industry Insights - **Upcoming Events**: Important PDUFA date for telotrectinib on June 23, 2025, and presentation at ASCO meeting regarding TRUST datasets [5][6] - **Market Dynamics**: Changes in NCCN guidelines have shifted treatment recommendations, potentially increasing the use of ROS1 agents [19][20] Core Data and Findings - **TRUST Studies**: TRUST one (China) and TRUST two (global) datasets show consistent efficacy and safety across different ethnic groups, with response rates of 89% in TKI naive patients and 52% in pretreated Asian patients [6][7][10] - **Comparative Efficacy**: Telotrectinib demonstrated a 58% reduction in risk of disease progression and a 52% reduction in risk of death compared to Roslitech, and a 52% reduction in PFS and 66% reduction in risk of death compared to crizotinib [11][12] - **Intracranial Response Rates**: 77% in naive patients and 66% in pretreated patients, highlighting the drug's effectiveness in addressing CNS metastases [16][17] Market Opportunities and Challenges - **Sales Growth**: TKI sales have increased by 20% since the new NCCN guidelines, indicating a growing market for ROS1 agents [20][21] - **Tolerability Issues**: Oktyra has faced challenges due to tolerability, with a 30% dropout rate per quarter, emphasizing the importance of good tolerability for long-term use [21][22] - **Patient Switching Dynamics**: Patients on first-generation TKIs may switch to telotrectinib if they experience intolerable side effects or disease progression [34][36] Regulatory and Approval Insights - **FDA Interactions**: Positive and responsive interactions with the FDA under breakthrough designation, with expectations for approval by the PDUFA date [37][38] - **Labeling Discussions**: Ongoing discussions regarding labeling, with no advisory committee required for approval [39][40] Future Plans and Partnerships - **European Market**: Actively seeking partnerships in Europe, with existing partnerships in Japan and China for telotrectinib [50][51] - **Pricing Strategy**: Anticipated pricing to be similar to existing competitors, with a monthly cost around $30,000 [53] Additional Research and Development - **IDH1 Mutant Product**: Ongoing phase two study for glioma, with plans for a pivotal study based on upcoming data [57][62] - **Response Rates in Glioma**: Previous ORR in low-grade glioma was 33%, significantly higher than the INDIGO study's 11% [59][60] Conclusion - **Commercial Focus**: Nuvation Bio is committed to launching telotrectinib effectively, leveraging experienced teams and focusing on patient therapy metrics as key indicators of success [47][48]