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]

Summary of Nuvation Bio Conference Call Company Overview - **Company**: Nuvation Bio - **Focus**: Development of innovative therapies, particularly in oncology, with a strong emphasis on ROS1 inhibition for non-small cell lung cancer [1][2] Key Points and Arguments Drug Development and FDA Approval - Nuvation Bio is on the verge of receiving FDA approval for its first drug, **telotrectinib**, a ROS1 inhibitor targeting ROS1-driven non-small cell lung cancers [3][4] - The New Drug Application (NDA) was submitted last year and accepted with priority review, with a PDUFA date set for **June 23** [4][9] - Telotrectinib shows an **overall response rate of 89%** and a **progression-free survival (PFS) of 46 months**, significantly outperforming standard care options [5][10] Patient Outcomes - The drug has demonstrated long-term PFS, with some patients remaining progression-free for **up to nine years** [6][10] - The average age of patients with ROS1 lung cancer is around **50 years**, with a significant number developing brain metastases early in the disease [4][5] Competitive Landscape - Nuvation Bio is the only ROS1 agent in development with **breakthrough designation** in both first and second-line settings [8][36] - The company has a robust safety database with over **400 patients** and a follow-up time of up to **nine years** [37] Market Opportunity - The potential market for telotrectinib is estimated at nearly **$4 billion annually** based on current DNA testing, with expectations to exceed **$5 billion** once RNA testing becomes standard [24][25] - The company anticipates commanding a significant share of this market due to its favorable drug profile [25] Launch Preparations - The commercial team is fully prepared for an immediate launch upon FDA approval, leveraging prior experience from successful launches at Medivation [18][20] - The team is confident in the drug's value proposition and market opportunity, despite acknowledging that launches can be challenging [23] Regulatory Changes - Recent updates to NCCN guidelines now contraindicate the use of immunotherapy for patients with ROS1 mutations, which is expected to shift treatment dynamics significantly [14][15] Pipeline and Future Developments - Nuvation Bio is also developing **safacitinib**, a mutant IDH1 inhibitor, which has shown promising response rates in glioma [39][40] - The company is exploring the potential of safacitinib as a new generation oral immuno-oncology agent [42] - The drug-drug conjugate platform, including candidate **1511**, is currently in clinical trials for various difficult-to-treat cancers [45] Financial Position - Nuvation Bio has **$62 million** on its balance sheet and expects to access an additional **$250 million** in non-dilutive capital upon approval [47] - The company is actively seeking new opportunities to bolster its pipeline, with a focus on innovative deals [48] Additional Important Insights - The launch in China has been positively received, with endorsements from medical organizations, indicating strong potential for international markets [32][33] - The company is committed to increasing awareness and testing rates for ROS1 mutations, which could further enhance patient identification and treatment rates [28][29] This summary encapsulates the critical insights from the Nuvation Bio conference call, highlighting the company's strategic positioning, drug development progress, and market opportunities.

Financial Data and Key Metrics Changes - For Q1 2025, the company reported R&D expenses of $24.6 million, reflecting continued investments in lead assets and clinical stage pipeline [31] - SG&A expenses were $35.4 million, primarily driven by pre-commercial build-out, including personnel-related expenses tied to commercial hiring [31] - The net loss for the quarter increased compared to the prior year, with a cash position of $461.7 million at the end of the quarter, not including proceeds from a recent financing agreement [32][34] Business Line Data and Key Metrics Changes - The company is preparing for the potential approval of telotrectinib, a next-generation ROS1 inhibitor for non-small cell lung cancer, with a PDUFA date set for June 23, 2025 [6][18] - Telotrectinib has demonstrated a confirmed overall response rate (ORR) of 89% in treatment-naive patients and a median progression-free survival (PFS) of 46 months [10][12] - The drug's safety profile is favorable, with a low discontinuation rate of 6.5% due to treatment-emergent adverse events [16] Market Data and Key Metrics Changes - ROS1 positive non-small cell lung cancer is estimated to affect approximately 2% of newly diagnosed non-small cell lung cancer patients, translating to about 3,000 new patients each year in the U.S. [24] - First-generation ROS1 TKIs like crizotinib and entrectinib generate less than $150 million in annual U.S. net sales, indicating significant unmet needs in the market [25] Company Strategy and Development Direction - The company aims to challenge the status quo in cancer treatment by providing better drugs that impact efficacy, safety, and convenience [7] - The commercial strategy focuses on ensuring quick access to telotrectinib for patients and maximizing long-term value through its impressive clinical profile [24][30] - The company has secured a $250 million non-dilutive financing agreement to support the launch of telotrectinib and advance its broader pipeline [20] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the strength of the data supporting telotrectinib and the readiness of the team for the upcoming launch [39] - The new NCCN guidelines are expected to serve as a tailwind for the drug, emphasizing the need for ROS1 therapies over traditional IO chemotherapy [49] - The company believes that the market is ready for new alternatives, with telotrectinib positioned to reshape the ROS1 landscape if approved [19] Other Important Information - The company is also developing saclucitanib for diffuse IDH1 mutant glioma, with early clinical data suggesting deeper responses than other agents in this class [20][21] - The company is preparing to move saclucitanib into pivotal development this year, indicating a strong pipeline beyond telotrectinib [21] Q&A Session Summary Question: Can you discuss the tailwinds for the launch and how you prioritize them? - Management highlighted that duration of response and progression-free survival are key metrics for patients and physicians, positioning telotrectinib favorably against historical oncology agents [44] Question: What is the pricing strategy for telotrectinib? - Management indicated that pricing discussions are ongoing, with plans to announce the price shortly after the anticipated approval [50] Question: What is the targeted account strategy for ROS1 patients? - Management refrained from disclosing specific strategies but expressed confidence in their approach and the team's experience [58] Question: How does the company plan to address physician education regarding telotrectinib? - Management acknowledged the importance of physician education and emphasized that the drug's compelling data will incentivize prescriptions [70] Question: What are the expectations for the expanded access program (EAP)? - Management does not expect a large bolus from the EAP but remains confident in the overall launch strategy [85]

Financial Data and Key Metrics Changes - For Q1 2025, the company reported R&D expenses of $24.6 million, reflecting continued investments in lead assets and clinical pipeline [29] - SG&A expenses were $35.4 million, primarily driven by pre-commercial build-out and hiring [30] - The net loss for the quarter increased compared to the prior year, as expected due to these investments [31] - The company ended the quarter with $461.7 million in cash, cash equivalents, and marketable securities, not including proceeds from a recent financing agreement [31][33] Business Line Data and Key Metrics Changes - Telotrectinib demonstrated a confirmed overall response rate (ORR) of 89% in treatment-naive patients and a median progression-free survival (PFS) of 46 months [9] - In the second-line setting, telotrectinib had a confirmed ORR of 56% with a median PFS of 10 months [11] - The drug's safety profile showed low rates of significant neurological issues, with a discontinuation rate due to treatment-emergent adverse events (TEAEs) of just 6.5% [14] Market Data and Key Metrics Changes - ROS1 positive non-small cell lung cancer (NSCLC) is estimated to affect approximately 2% of newly diagnosed NSCLC patients, translating to about 3,000 new patients annually in the U.S. [23] - First-generation ROS1 TKIs like crizotinib and entrectinib generate less than $150 million in annual U.S. net sales, indicating significant unmet needs in the market [24] Company Strategy and Development Direction - The company aims to position telotrectinib as a best-in-class therapy for ROS1 positive lung cancer, focusing on early use and long-term persistence [25] - The commercial team is preparing for a potential launch, leveraging the drug's impressive clinical profile and the recent changes in NCCN guidelines that favor ROS1 therapies [46][47] - The company is also advancing its broader pipeline, including saclucitanib for IDH1 mutant glioma, which has a larger market opportunity than ROS1 positive lung cancer [19][20] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the strength of the data supporting telotrectinib and the readiness of the team for the upcoming PDUFA date [37] - The company believes that the market is ready for new alternatives, with telotrectinib positioned to reshape the ROS1 landscape [18] - Management highlighted the importance of addressing the underdiagnosis and undertreatment of ROS1 positive lung cancer patients [35] Other Important Information - The FDA has granted breakthrough therapy designation for telotrectinib in both first and second-line settings, the only ROS1 drug in development to receive such designation [16] - The company has secured a $250 million non-dilutive financing agreement to support the launch and advancement of its pipeline [19] Q&A Session Summary Question: Can you discuss the tailwinds for the launch and how you prioritize them? - Management emphasized that duration of response and progression-free survival are key metrics for patients and physicians, positioning telotrectinib favorably [43] Question: What is the pricing strategy for telotrectinib? - Management indicated that pricing discussions are ongoing and will be announced closer to the approval date [48] Question: What is the targeted account strategy for ROS1 patients? - Management refrained from disclosing specific strategies but expressed confidence in their experienced team and approach [56] Question: How do you expect telotrectinib to be used in relation to CNS disease? - Management clarified that the primary focus is on first-line treatment, leveraging the drug's strong CNS activity to prevent disease progression [61] Question: What are the learnings from the launch in China? - Management noted that while the markets are different, there is excitement in the community about the drug in China, but the dynamics of reimbursement differ significantly [106]