Summary of Tectonic Therapeutic (TECX) Conference Call Company Overview - **Company**: Tectonic Therapeutic (TECX) - **Event**: 2025 Conference at Cantor Healthcare Conference - **Date**: September 04, 2025 Industry Context - **Industry**: Biopharmaceuticals, specifically focusing on relaxin therapies for heart failure and pulmonary hypertension Key Points and Arguments Eli Lilly's Data Impact - Eli Lilly's recent trial results have negatively impacted Tectonic Therapeutic, referred to as "triple jeopardy" due to three separate impacts from the trial [4][3] - Eli Lilly's trial involved patients with decompensated heart failure, which is a challenging population to treat, leading to concerns about fluid retention and sodium avidity [5][6] - Tectonic's approach differs as they focus on stable patients who are not fluid overloaded, emphasizing the importance of euvolemic status before treatment [7] Tectonic's Phase 1B Data - Tectonic reported positive Phase 1B data showing a **35% reduction in pulmonary vascular resistance** and a **20% reduction in pulmonary artery pressure** [11] - The study indicated a **3 mm drop in pulmonary capillary wedge pressure**, which is significant as it suggests improved hemodynamics [21] - The increase in cardiac output by **almost 20%** was unexpected and indicates effective treatment [21] Future Studies and Patient Population - Tectonic is focusing on a specific patient population with combined pre- and post-capillary pulmonary hypertension (CP-CPH), aiming to reduce pulmonary vascular resistance [37] - The company plans to enrich for patients with high pulmonary vascular resistance (PVR) in their studies, with **70% of patients in the Phase 2 study required to have PVR greater than 3 WU units** [12][13] Competitive Landscape - AstraZeneca has an ongoing relaxin program, which provides reassurance to Tectonic as it indicates continued interest and potential in the relaxin space [16][18] - Tectonic believes that the presence of other therapies, such as Merck's sotatercept, could open the market for their product, as there is currently no approved therapy for CP-CPH [39][40] Regulatory Considerations - The primary endpoint for Tectonic's studies is the **six-minute walk test**, which is considered sufficient for regulatory approval [48] - There is potential for composite endpoints in future studies, including cardiovascular death and hospitalization [48] Upcoming Data and Trials - Tectonic plans to release additional data in the second half of October, focusing on patients with reduced ejection fraction heart failure [30] - A Phase 2 study for pulmonary hypertension associated with interstitial lung disease (PH-ILD) is in the planning stages, with a focus on a small cohort of 20 patients [49][50] Market Positioning - Tectonic aims to be the first systemic therapy for PH-ILD, addressing a significant unmet need in the market [52] - The company is considering testing their therapy in combination with existing treatments if initial studies show efficacy [52] Conclusion - Tectonic Therapeutic is navigating a challenging landscape following Eli Lilly's trial results but remains optimistic about its unique approach and upcoming data releases. The focus on specific patient populations and the potential for regulatory approval through established endpoints positions the company favorably in the biopharmaceutical market.