Summary of Nuvalent's Presentation at the 44th Annual JPMorgan Healthcare Conference Company Overview - **Company**: Nuvalent - **CEO**: Jim Porter - **Focus**: Development of precisely targeted therapies for cancer, leveraging expertise in chemistry and structure-based drug design [2][3] Industry Context - **Industry**: Biopharmaceuticals, specifically targeting non-small cell lung cancer (NSCLC) - **Key Areas**: Kinase inhibitors, with a focus on ROS1 and ALK mutations in NSCLC [2][3] Core Products and Programs Zidesamtinib (ROS1 non-small cell lung cancer) - **Target**: ROS1 mutations in NSCLC - **FDA Designation**: Breakthrough Therapy Designation - **NDA Status**: Submitted and accepted by the FDA, with a PDUFA date set for September [5][34] - **Clinical Data**: - 44% response rate in heavily pretreated patients - 62% of patients still in response at the 18-month mark - 85% intracranial response rate in patients with CNS disease [17][19][20] - **Market Potential**: Expected to grow the ROS1 market to $1.5 billion-$2 billion, aligning it closer to the ALK market [22] NVL-655 (ALK-positive non-small cell lung cancer) - **Target**: ALK mutations in NSCLC - **FDA Designation**: Breakthrough Therapy Designation - **NDA Status**: Expected submission in the first half of 2026 [34][42] - **Clinical Data**: - 31% overall response rate in previously treated patients - 46% response rate in lorlatinib-naïve patients - 53% of patients still in response at the 18-month mark [31][32] - **Market Potential**: The ALK market is currently valued at over $2 billion, with potential for significant growth [33] NVL-330 (HER2 lung cancer) - **Target**: HER2 mutations in lung cancer - **Development Stage**: Early pipeline, with ongoing studies [35][49] - **Market Opportunity**: Potential to expand beyond lung cancer due to HER2's role in various tumor types [50] Strategic Insights - **Patient-Centric Approach**: Emphasis on understanding physician and patient needs to address limitations of existing therapies [3][7] - **Synergies in Development**: Leveraging relationships with physicians and sites across multiple lung cancer programs to enhance commercial opportunities [6][7] - **Commercial Infrastructure**: Building a robust U.S. commercial organization to support product launches and market access [38][46] Financial and Operational Highlights - **Team Size**: Approximately 240 employees [8] - **Funding**: Well-capitalized with a runway into 2029, allowing continued investment in development [8] - **Enrollment Success**: Over 1,000 patients enrolled in clinical trials, indicating strong demand for therapies [37] Future Outlook - **Milestones**: Anticipated approvals for Zidesamtinib and NVL-655, with ongoing studies for NVL-330 [34][35] - **Long-Term Vision**: Aim to build a sustainable company capable of discovering, developing, and delivering innovative cancer therapies [36][39] Additional Considerations - **Market Dynamics**: The company is positioned to learn from existing players in the market to optimize its commercial strategy [46] - **Global Expansion**: Plans to explore commercialization opportunities beyond the U.S. market [39] This summary encapsulates the key points from Nuvalent's presentation, highlighting the company's strategic focus, product pipeline, and market potential in the oncology space.

Core Insights - Nuvalent, Inc. is a clinical-stage biopharmaceutical company focused on developing precisely targeted therapies for cancer, specifically targeting clinically proven kinase targets [3]. Company Participation - The CEO James Porter, Ph.D., and CFO Alexandra Balcom will participate in a fireside chat during the UBS 2025 Virtual Oncology Day on October 1, 2025, at 3:30 p.m. ET [1]. Webcast Information - A live webcast of the event will be available on the company's website and archived for 30 days post-presentation [2]. Company Overview - Nuvalent is advancing a robust pipeline with investigational candidates for ROS1-positive, ALK-positive, and HER2-altered non-small cell lung cancer, along with multiple discovery-stage research programs [3]. - The company leverages expertise in chemistry and structure-based drug design to develop innovative small molecules aimed at overcoming resistance, minimizing adverse events, and addressing brain metastases [3].

Core Viewpoint - Nuvalent, Inc. has initiated a rolling New Drug Application (NDA) submission for zidesamtinib, a novel investigational ROS1-selective inhibitor, targeting TKI pre-treated patients with advanced ROS1-positive non-small cell lung cancer (NSCLC), with completion expected in the third quarter of 2025 [1][2]. Group 1: Zidesamtinib Development - Zidesamtinib is designed to overcome limitations of existing ROS1 inhibitors and is intended to remain effective in tumors with resistance mutations, including G2032R [4]. - The drug is also formulated for central nervous system (CNS) penetration, aiming to improve treatment options for patients with brain metastases [4]. - Zidesamtinib has received breakthrough therapy designation for patients with ROS1-positive metastatic NSCLC previously treated with two or more ROS1 TKIs [4]. Group 2: Clinical Trial Insights - The ARROS-1 Phase 1/2 clinical trial is currently investigating zidesamtinib in patients with advanced ROS1-positive NSCLC and other solid tumors, with the Phase 1 portion focusing on safety and tolerability [5]. - The ongoing Phase 2 portion is designed for TKI-naïve and TKI pre-treated patients, with registrational intent [5]. Group 3: Regulatory Engagement - The FDA has accepted the NDA for zidesamtinib under the Real-Time Oncology Review (RTOR) program, allowing for earlier submission of efficacy and safety results [2]. - The company is actively engaging with the FDA regarding potential opportunities for line-agnostic expansion [2]. Group 4: Market Need - There is a significant need for new treatment options for patients with ROS1-positive NSCLC, especially those who cannot tolerate existing TKIs or have disease progression with brain metastases or resistance mutations [3].

Core Insights - Nuvalent, Inc. has initiated a rolling NDA submission for zidesamtinib targeting TKI pre-treated patients with advanced ROS1-positive NSCLC, aiming for completion in Q3 2025 [1][5] - The company has also started the ALKAZAR Phase 3 trial for neladalkib in TKI-naïve advanced ALK-positive NSCLC, with pivotal data expected by year-end 2025 [1][4] - Financial results for Q2 2025 show a net loss of $99.7 million, with R&D expenses at $80.9 million and G&A expenses at $23.7 million [10][15] Pipeline Achievements - The NDA submission for zidesamtinib is based on positive data from the ARROS-1 Phase 1/2 trial, which included 104 patients as of June 16, 2025 [5] - The ALKAZAR trial will randomize patients 1:1 to receive either neladalkib or alectinib, reflecting input from physician-scientists and regulatory agencies [4] - Preliminary data for neladalkib in ALK-positive solid tumors will be presented at the ESMO Congress 2025 [1][9] Business Updates - Jason Waters has been promoted to Senior Vice President, Commercial, to enhance the company's commercial strategy [2][10] - The company has a strong cash position of $1.0 billion as of June 30, 2025, expected to fund operations into 2028 [10][15] - Christy Oliger has been appointed to the board of directors, bringing over 30 years of experience in the pharmaceutical industry [10]

Core Viewpoint - Nuvalent, Inc. has initiated the ALKAZAR Phase 3 trial to evaluate neladalkib for TKI-naïve patients with advanced ALK-positive non-small cell lung cancer (NSCLC), comparing it to the standard of care, ALECENSA® [1][2] Group 1: Clinical Trial Details - The ALKAZAR trial aims to enroll approximately 450 TKI-naïve patients, with a 1:1 randomization to receive either neladalkib or alectinib [2] - The primary endpoint of the trial is progression-free survival (PFS) assessed by Blinded Independent Central Review (BICR), with several secondary endpoints including overall survival and intracranial response metrics [2][3] Group 2: Neladalkib Profile - Neladalkib is designed to address treatment limitations of existing ALK inhibitors, particularly for patients with brain metastases and resistance mutations [5] - The drug has received breakthrough therapy designation for patients with locally advanced or metastatic ALK-positive NSCLC previously treated with two or more ALK tyrosine kinase inhibitors [5] Group 3: Company Overview - Nuvalent, Inc. focuses on developing targeted therapies for cancer, leveraging expertise in chemistry and structure-based drug design [6][7] - The company is advancing a pipeline that includes investigational candidates for ROS1-positive, ALK-positive, and HER2-altered NSCLC, along with multiple discovery-stage research programs [7]

Core Insights - Nuvalent, Inc. announced positive pivotal data for zidesamtinib, a novel ROS1-selective inhibitor, in TKI pre-treated patients with advanced ROS1-positive non-small cell lung cancer (NSCLC) from the global ARROS-1 Phase 1/2 clinical trial [1][2] Group 1: Clinical Trial Progress - The company completed a pre-New Drug Application (NDA) meeting with the FDA and plans to initiate a rolling NDA submission in July 2025, targeting completion in the third quarter of 2025 [2][4] - Zidesamtinib demonstrated an overall response rate (ORR) of 44% in 117 TKI pre-treated patients, with a durability of response of 78% at 12 months and 62% at 18 months [4][10] - In a subset of 55 patients treated with one prior ROS1 TKI, the ORR was 51% with a durability of response of 93% at both the 12- and 18-month landmarks [4][12] Group 2: Efficacy and Safety - Zidesamtinib showed intracranial responses and activity against tumors with a ROS1 G2032R resistance mutation, with a well-tolerated safety profile [4][17] - The most frequent treatment-emergent adverse events (TEAEs) included peripheral edema (36%), constipation (17%), and fatigue (16%) [18][20] - Dose reductions due to TEAEs occurred in 10% of patients, and only 2% discontinued treatment due to TEAEs [20] Group 3: Future Development - The company is advancing clinical startup activities for the ALKAZAR Phase 3 trial, which will evaluate neladalkib, a novel ALK-selective inhibitor, against alectinib in TKI-naïve ALK-positive NSCLC patients [5][27] - Zidesamtinib has received breakthrough therapy designation for ROS1-positive metastatic NSCLC and orphan drug designation for ROS1-positive NSCLC [25][28] - The ongoing ARROS-1 trial is designed to evaluate zidesamtinib in both TKI-naïve and TKI pre-treated patients with advanced ROS1-positive NSCLC [26][30]