Olema Pharmaceuticals (OLMA) FY Conference Transcript
2025-05-27 22:00
Summary of Olema Pharmaceuticals (OLMA) FY Conference Call - May 27, 2025 Company Overview - **Company**: Olema Pharmaceuticals (OLMA) - **Focus**: Development of palazestrant, a complete estrogen receptor antagonist, for the treatment of breast cancer Key Points Clinical Trials and Data - **OPRA O1 Trial**: - Focuses on palazestrant for second and third line HER2 negative metastatic breast cancer - Enrollment for the dose-ranging part completed late last year, with data collection ongoing [6][8] - Top-line data expected in 2026, with more precise timelines to be provided in the second half of 2025 [8][10] - **ASCO Presentation**: - A trial progress poster will be presented, focusing on part two of the OPRA O1 trial, which may attract interest from investors and potential trial participants [12][14] - **Comparison with Other Trials**: - Data from EMBER three and Veritec two trials will be analyzed to assess palazestrant's potential for success [16][18] - OPRA O1 aims to show better progression-free survival (PFS) in ESR1 mutant and wild-type populations compared to existing therapies [19][20] Market Potential - **Market Opportunity**: - The second and third line treatment market for wild-type patients is estimated at $5 billion, depending on PFS duration [49] - Differentiation in the mutant population could enhance market capture [49] Cat 6 Inhibitor Program - **Mechanism**: - Cat 6 is an epigenetic target that affects chromatin structure, potentially enhancing the efficacy of anti-estrogen therapies [52][53] - **Preclinical Data**: - Olema's Cat 6 inhibitor shows promising preclinical results, particularly in combination with palazestrant, which may enhance anti-tumor activity [54][58] - **Future Data**: - Data from monotherapy dose escalation may be available by the end of 2025, with ongoing trials in various solid tumors [57][59] Differentiation and Competitive Landscape - **Molecular Characteristics**: - Palazestrant is positioned as a complete estrogen receptor antagonist, distinguishing it from other SERDs and SERMs in the market [24][25] - **Investor Perception**: - The company believes that investors may overlook the unique molecular properties and potential of palazestrant compared to other drugs in the same class [61][62] Pipeline and Future Directions - **Upcoming Trials**: - The initiation of the OPRA O2 trial is expected in the second half of 2025, contingent on data from OPRA O1 [44][48] - **Broader Applications**: - Interest in exploring Cat 6 inhibitors in non-small cell lung cancer and castration-resistant prostate cancer [59] Conclusion - Olema Pharmaceuticals is advancing its clinical trials for palazestrant, with significant market potential in breast cancer treatment. The company is also exploring innovative approaches with its Cat 6 inhibitor program, positioning itself as a key player in the oncology space. Investors are encouraged to consider the unique attributes of Olema's therapies as they differentiate from competitors.
Vir Biotechnology (VIR) FY Conference Transcript
2025-05-27 21:30
Summary of Vir Biotechnology (VIR) FY Conference Call Company Overview - **Company**: Vir Biotechnology (VIR) - **Date of Conference**: May 27, 2025 - **Key Speakers**: Marianne DeBacker (CEO), Mika Derink (Executive VP of Therapeutic Oncology) Core Areas of Focus - **Hepatitis Delta Infections**: - Significant unmet need as patients with hepatitis B can rapidly progress to liver cirrhosis or hepatocellular carcinoma - ECLIPSE program is in registrational trials with no approved treatments in the US for hepatitis delta infection [3][4] - **Metastatic Solid Tumors**: - Development of a masked T cell engager platform showing promising data - Proof of concept established in two clinical studies targeting HER2 and PSMA, with a third program targeting EGFR set to start [4][5] Pipeline and Financial Position - **Pipeline Strength**: - Differentiated PRO X10 dual masking technology enhances safety and therapeutic index - Seven preclinical programs initiated alongside ongoing clinical studies [5][6] - **Financial Position**: - Approximately $1 billion in cash, providing runway into mid-2027 to advance key programs [6] Strategic Partnerships - **Acquisition of Pro X10 Platform**: - Acquired worldwide rights from Sanofi for oncology and infectious disease applications - Deal included upfront payment of $100 million and additional milestone payments [9][10] Clinical Trials and Data - **PSMA Targeted T Cell Engager (VIR 5500)**: - Early dose escalation data showed a 58% PSA50 response rate and an 8% PSA90 response rate in heavily pretreated patients [17][18] - No prophylactic steroids required, indicating a favorable safety profile [18][22] - **HER2 Program (VER 5818)**: - Combination with pembrolizumab showed a 50% tumor shrinkage rate in HER2 positive patients, with a 33% confirmed response rate in colorectal cancer subset [38][39] - Ongoing evaluation of dosing schedules and safety [39][45] - **EGFR Program (VIR 5525)**: - Anticipated first-in-human dosing in the first half of the year, with promising preclinical data [46] Hepatitis Delta Program - **ECLIPSE Trials**: - First patient dosed in ECLIPSE one trial, targeting completion of enrollment by the end of the year - Primary completion date for ECLIPSE one is December 2026, with potential data from ECLIPSE two available around the same timeframe [47][48][49] Regulatory Designations - The hepatitis delta program has received breakthrough designation, fast track designation, prime designation, and orphan drug designation, indicating a high unmet need and expedited development process [49] Conclusion - Vir Biotechnology is strategically focused on addressing significant unmet medical needs in hepatitis delta infections and metastatic solid tumors through innovative therapies and a strong financial position, with ongoing clinical trials expected to yield important data in the near future [50][51]
Nuvalent (NUVL) FY Conference Transcript
2025-05-27 21:00
Summary of Nuvalent (NUVL) FY Conference Call - May 27, 2025 Company Overview - **Company**: Nuvalent (NUVL) - **Industry**: Oncology, specifically focusing on targeted therapies for ROS1 and ALK non-small cell lung cancer Key Points and Arguments ROS1 Program 1. **Upcoming Data Release**: Nuvalent is preparing to release pivotal data for TKI pretreated ROS1 patients in the first half of 2025, with plans for a standalone press release and full data at a future medical meeting [4][20] 2. **Zidosanthanib Profile**: The drug aims to address limitations of existing therapies like crizotinib, particularly in brain penetrance and ROS1 resistance mutations, offering a selective treatment option for ROS1 patients [5][35] 3. **Patient Enrollment**: As of December 2024, 430 patients were enrolled in the study, with 330 in the phase two cohorts, indicating strong interest from investigators and patients [6][7] 4. **Data Strategy**: The initial dataset will focus on previously treated ROS1 patients, with plans to follow up with data from TKI naive patients [9][12] 5. **Safety and Efficacy**: The company emphasizes the importance of a well-tolerated safety profile to keep patients on therapy longer, which is a significant differentiator from existing treatments [12][15] Market Opportunity 6. **Commercial Potential**: The market for ROS1 lung cancer treatments is significant, with crizotinib generating approximately $400 million in sales, but Nuvalent believes it can outperform crizotinib due to its limitations [33][35] 7. **Competitive Landscape**: Nuvalent acknowledges the challenges faced by other drugs in the ROS1 space but believes zidosanthanib's differentiated profile will allow it to capture market share [36][37] ALK Program 8. **Regulatory Strategy**: Nuvalent is developing a program for ALK non-small cell lung cancer, aiming to create a drug that can work in the third-line setting where current options are limited [41][45] 9. **Clinical Development**: The ALK program is designed to address both second and third-line treatment needs, with a focus on achieving better durability and response rates than existing therapies like lorlatinib [52][53] 10. **Study Design**: The company plans to conduct a randomized study comparing its ALK drug to the standard of care, alectinib, to establish its efficacy [53][60] HER2 Program 11. **Emerging HER2 Program**: Nuvalent is also developing NVL-330 for HER2 exon 20 lung cancer, focusing on creating a drug with high brain penetrance to address unmet needs in this area [62][66] 12. **Current Status**: The HER2 program is in the dose escalation phase, with no specific timeline for data release yet provided [67] Additional Important Insights - **Regulatory Engagement**: Nuvalent is committed to maintaining open dialogue with regulators to expedite the approval process for its drugs [30][31] - **Market Perception**: There is a growing recognition of the potential in the ROS1 market, with Nuvalent emphasizing the importance of addressing patient needs to create commercial opportunities [32][33] - **Pricing Strategy**: While it is too early to comment on pricing, Nuvalent will consider precedents in the market when determining the price for zidosanthanib [40] This summary encapsulates the key discussions and insights from the Nuvalent conference call, highlighting the company's strategic focus on developing innovative therapies for ROS1 and ALK non-small cell lung cancer, as well as its emerging HER2 program.
Relay Therapeutics (RLAY) FY Conference Transcript
2025-05-27 20:30
Summary of Relay Therapeutics (RLAY) FY Conference Call - May 27, 2025 Company Overview - **Company**: Relay Therapeutics (RLAY) - **Event**: Sixth Annual Oncology Innovation Summit - **Key Speakers**: Sajeev Patel (President and CEO), Don Bergstrom (President of R&D), Peter Romer (Chief Commercial Development Officer) Key Industry Insights - **Focus Area**: Oncology, specifically targeting hormone receptor positive, HER2 negative breast cancer with PI3K alpha mutations - **Market Size**: Approximately 40% of patients with hormone receptor positive, HER2 negative breast cancer have a PI3K alpha mutation, indicating a significant patient segment that is poorly treated [7][8] Core Data and Efficacy - **Drug in Focus**: RLY2608, a selective PI3K alpha inhibitor - **Clinical Data**: - Previous data showed a median progression-free survival (PFS) of 9.2 months with RLY2608 compared to 5.5 months for the control (TruCap) [4][5] - Objective response rate (ORR) for RLY2608 was 39%, with 67% in kinase mutant patients [5][10] - Upcoming ASCO presentation expected to show over a year of follow-up data, aiming to confirm the durability and consistency of these results [6][50] Clinical Trial Insights - **Phase III Trial**: Focused on CDK4 experienced patients, with a randomized design of 540 patients comparing RLY2608 to capivasertib [41][42] - **Patient Population**: Primarily second-line patients, with potential inclusion of first-line patients who have received adjuvant CDK4 inhibitors [17][29] - **Exclusion Criteria**: Patients with prior PI3K pathway inhibitors will be excluded from the trial [48] Competitive Landscape - **Current Treatments**: Previous generation non-selective PI3K inhibitors have shown limited efficacy, with PFS typically between 5.5 to 7.5 months [8] - **Market Dynamics**: The approval of Roche's triplet therapy presents competition, but RLY2608's data suggests a strong position in the market [28] Financial Position - **Cash Position**: As of Q1 2025, the company reported a cash position of $710 million, sufficient to fund the phase III trial and other ongoing studies through 2029 [85][86] - **Partnership Considerations**: The company is open to partnerships, especially given current capital market conditions [87][88] Additional Considerations - **Vascular Malformations**: The company is also exploring RLY2608 for vascular malformations, with an estimated 170,000 patients in the U.S. having PIK3CA-related conditions, of which 5,000 to 15,000 are within the PROS population [64][65] - **Regulatory Landscape**: The failure of a confirmatory study for a competing drug (Alpalocep) leaves Relay Therapeutics in a favorable position as there are currently no fully approved agents for vascular malformations [66] Conclusion - The upcoming ASCO presentation is critical for Relay Therapeutics to validate its clinical data and establish its competitive edge in the oncology market, particularly for patients with PI3K alpha mutations in breast cancer. The company is well-positioned financially and strategically to advance its clinical programs and explore potential partnerships.
Ocular Therapeutix (OCUL) 2025 Conference Transcript
2025-05-27 20:02
Summary of Ocular Therapeutix (OCUL) Conference Call Company Overview - **Company**: Ocular Therapeutix (OCUL) - **Event**: 2025 Conference on May 27, 2025 - **Key Speaker**: Praveen Dugal, Executive Chairman, President, and CEO Core Industry Insights - **Industry**: Ophthalmology, specifically focusing on treatments for retinal diseases - **Market Context**: The anti-VEGF (vascular endothelial growth factor) market has been established for over 20 years, with ongoing unmet needs for longer-duration treatments [7][10] Key Points and Arguments 1. **Need for Innovation**: There is a significant need for improved treatment options in the anti-VEGF market, as nearly 40% of patients drop out of treatment within the first year due to the unsustainability of frequent injections [10][11] 2. **Product Technology**: Ocular Therapeutix's product, ex-Paxley, is a tunable, completely dissolvable hydrogel that has shown to be safe and efficacious based on consistent data [4][5] 3. **Regulatory Pathway**: The company has a clear regulatory path forward, having received Special Protocol Assessment (SPA) from the FDA for their studies, which aligns with the latest FDA guidelines [5][40] 4. **Treatment Paradigm Shift**: ex-Paxley is positioned to potentially replace existing anti-VEGF treatments as a first-line agent due to its efficacy and the ability to provide longer-lasting results [22][23] 5. **Patient Selection**: The company emphasizes the importance of proper patient selection in clinical trials, aiming to identify patients who will benefit most from the treatment [30][31] 6. **Study Design**: The company has designed two complementary studies (SOLAR and SOLA-one) to gather comprehensive data, with a focus on patient stability and response to treatment [44][45] 7. **Market Opportunity**: The market for retinal disease treatments is vast, and Ocular Therapeutix is confident in its ability to capture significant market share due to its innovative product and strong regulatory support [60] Additional Important Insights - **Retention Rates**: The company has reported unprecedented patient retention rates in their studies, which they attribute to the quality of patient selection and the nature of the treatment [54] - **Regulatory Collaboration**: Ocular Therapeutix has established a strong collaborative relationship with the FDA, which has facilitated a smoother regulatory process for their studies [50] - **Future Outlook**: The company is optimistic about the future of ex-Paxley and its potential to dominate the market once the macroeconomic environment stabilizes [59][60] This summary encapsulates the critical insights and developments discussed during the conference call, highlighting Ocular Therapeutix's strategic positioning within the ophthalmology industry and its innovative approach to addressing unmet patient needs.
Coherus BioSciences (CHRS) FY Conference Transcript
2025-05-27 20:00
Coherus BioSciences (CHRS) FY Conference Summary Company Overview - Coherus BioSciences has transitioned into an innovative oncology company, divesting its biosimilar assets, including Lucentis, Yosemir, and UDENYCA, generating approximately $800 million in total from these divestitures [3][4] - The company has paid off $480 million in long-term debt and added $250 million to its balance sheet [3] Key Developments Loktorzi - Loktorzi is a central asset in Coherus' strategy, with ongoing pivotal trials for additional indications [4][5] - The launch for nasopharyngeal carcinoma (NPC) showed good growth in Q4, but Q1 was flat due to supply interruptions and sales team distractions [10][11] - The focus is on increasing the breadth of physician prescriptions, depth of market penetration, and ensuring patient duration on the product [12][13] Partnerships and Clinical Studies - Coherus announced a partnership for combination studies with STC 15 from Storm Therapeutics, targeting RNA methyltransferase activity, which has shown promise in solid tumors [16][17] - The goal is to drive label expansion for Torapalumab, a next-generation PD-1 inhibitor, through these partnerships [20][21] CHS 1 114 (Treg Depleter) - CHS 1 114 targets CCR8 to selectively deplete tumor-resident Tregs, showing promising early clinical data with significant Treg depletion and CD8 T cell infiltration [23][25][26] - The combination with Torapalumab in late-line head and neck cancer patients has shown early signs of activity, with ongoing studies to evaluate its efficacy further [27][28] Casdozoketug - Casdozoketug is an IL-27 antagonist showing promising results in liver cancer, with a 17% complete response rate in early studies, which is significantly higher than reported rates in phase three studies [41][42] - The company is planning to progress with studies in both liver and lung cancers, with data expected next year [44][46] Financial and Strategic Outlook - Coherus is focused on execution and leveraging its strong track record in development, regulatory affairs, and commercial success [48][49] - The company anticipates promising results from ongoing clinical trials and partnerships, positioning itself for growth in the oncology market [8][49] Additional Insights - The company is actively exploring other tumor types for CHS 1 114, indicating a broadening of its clinical focus [29] - The strategic emphasis on enhancing the commercial story and execution capabilities is expected to drive future success [48][49]
Apellis Pharmaceuticals (APLS) 2025 Conference Transcript
2025-05-27 19:32
Apellis Pharmaceuticals (APLS) 2025 Conference May 27, 2025 02:30 PM ET Speaker0 Hey, good afternoon, everyone. I'm happy to have Appellis as the next fireside chat. So we have Cedric Francois with us, CEO and Tim Sullivan, CFO. And recognizing that you are a broader C3 complement inhibitor company, I am stating the obvious that this is an ophthalmology conference. And so maybe we can just start out and level set and talk about your ophthalmology franchise, the commercial prospects, the pipeline pursuits an ...
Exelixis (EXEL) FY Conference Transcript
2025-05-27 19:30
Exelixis (EXEL) FY Conference Summary Company Overview - **Company**: Exelixis (EXEL) - **Event**: Sixth Annual Oncology Innovation Summit - **Date**: May 27, 2025 Key Points Commercial Performance - **Cabo Performance**: Cabo had a strong Q1, with increasing prescriptions and market share in renal cell carcinoma (RCC) [4][8] - **Clinical Trials Orders**: Clinical trials orders fluctuated between 4 million and 22 million per quarter historically, with a recent order of 12 million [4] - **Net Approval**: The approval for neuroendocrine tumors (NET) occurred late in the quarter, impacting tracking metrics [5][8] Market Dynamics - **IQVIA Tracking Issues**: IQVIA's tracking was inaccurate this quarter, attributed to the complexity of real-world data and seasonality [6][12][13] - **Gross to Net Dynamics**: The gross to net ratio was higher in Q1, influenced by the phase-in of the rebate period under the IRA [14][15] Future Projections - **Revenue Growth**: Exelixis anticipates Cabo's revenue to grow from approximately $2 billion to $3 billion by 2030, driven by the NET launch and continued momentum in the base business [15] - **Rebate Impact**: A 1% rebate phase-in under the IRA is expected to have a minimal impact on overall business [16][26] NET Launch Insights - **Patient Dynamics**: The launch of Cabo for NET is expected to be steady rather than a bolus due to the advanced state of patients [30][31] - **Broad Label Impact**: The broad label for Cabo is anticipated to positively affect a wide range of patients, with no specific pockets of accelerated uptake identified [32][33] Competitive Landscape - **Lutathera Comparison**: Lutathera presents unique challenges for patients, and Cabo is positioned to capture market share from oral cytotoxics rather than directly competing with Lutathera [36][37] - **Somatostatin Analogs**: Cabo is expected to be used alongside background somatostatin analogs, enhancing its therapeutic impact [39] Pipeline Developments - **ZENZA Study**: The Stellar 303 study has elevated liver metastases patients to a co-primary endpoint due to differentiated event rates observed [40][41] - **Head and Neck Cancer Trials**: The Stellar 305 study aims to evaluate Zanza in combination with Keytruda, learning from previous trial outcomes [45][46] - **Early Pipeline**: The bispecific program (628) has generated significant interest, focusing on combining PD-L1 and NKG2A mechanisms [61][62] Regulatory and Market Considerations - **Non-Clear Cell RCC Study**: The ongoing study aims to establish a new standard of care in the non-clear cell RCC segment, with results expected later this year [55][56] - **Collaboration with Merck**: Exelixis is collaborating with Merck on various studies, with details to be shared as trials progress [58][60] Additional Insights - **Market Research**: Continuous market research and KOL engagement are crucial for understanding patient dynamics and optimizing marketing strategies [37][38] - **Regulatory Landscape**: The evolving regulatory environment, particularly regarding rebates and pricing, will impact future revenue and market strategies [19][20] This summary encapsulates the key insights and developments discussed during the Exelixis FY Conference, highlighting the company's commercial performance, market dynamics, future projections, and ongoing pipeline developments.
STAAR Surgical Company (STAA) 2025 Conference Transcript
2025-05-27 19:00
Summary of Star Surgical Conference Call Company Overview - **Company**: Star Surgical - **Industry**: Medical Devices, specifically focusing on Intraocular Collamer Lens (ICL) technology Key Points Share Buyback Program - Star Surgical announced a $30 million share repurchase program, which was not included in previous cash guidance [2][4] - Management believes the current stock valuation is not reflective of the company's potential, prompting the buyback decision [4][5] - The board has only authorized this single repurchase, indicating it may not become a regular part of the capital allocation strategy [6][7] Inventory and Revenue Expectations in China - The company expects to reach contractual inventory levels with Chinese distributors by June [11] - Anticipated revenue of $27.5 million from one distributor is expected in Q3, with no changes to this expectation [13] - Revenue guidance for Q2 is cautious, with expectations of minimal revenue but a gradual ramp-up anticipated [15][16] - The company is managing inventory closely with distributors to align with actual demand [18][19] Market Trends in China - Demand for ICLs in China appears to be stabilizing, with Q1 showing flat to slightly up procedural volumes compared to the previous year [22][23] - The company is optimistic about long-term growth in China, despite some softness in Q2 [24][37] - The company is not affected by military refractive demands, which are not part of their business model [26][27] Competition and Product Differentiation - Star Surgical faces competition from Ibrite's FakeCIC IOL, but the company believes its unique collagen-based material offers a significant advantage [39][40] - The market for ICLs is large, with over 1 billion people still using glasses or contacts, indicating room for growth despite competition [47] - The company is focused on understanding pricing strategies of competitors and how they will affect market dynamics [44][45] Financial Guidance and Market Outlook - Star Surgical withdrew its 2025 revenue guidance due to uncertainties, including tariff risks and macroeconomic concerns [50][51] - The management team is committed to transparency and aims to provide clearer insights into market opportunities and risks [49][52] - Long-term growth expectations remain positive, with a focus on disciplined capital allocation and market share growth [61][62] Research and Development Opportunities - The company is exploring the use of its collagen material in other therapeutic areas, particularly within ophthalmology [57][58] - R&D spending is significant, but the company aims to focus on projects that can yield meaningful results in a timely manner [58] U.S. Market Strategy - The U.S. market remains critical for Star Surgical, with a current market share in the low to mid-single digits for EVO [60][61] - The company achieved over 50% market share in Japan, indicating potential for growth in the U.S. when market conditions align [62] Additional Insights - The management acknowledges past challenges in meeting revenue expectations and aims to set more realistic future guidance [61][62] - The company is prepared for the upcoming high season in China with adequate inventory positioned for demand [34][35]
Mersana Therapeutics (MRSN) FY Conference Transcript
2025-05-27 19:00
Summary of Mersana Therapeutics Conference Call Company Overview - **Company**: Mersana Therapeutics - **Event**: Sixth Annual Oncology Innovation Summit - **Key Participants**: Marty Huber (President and CEO), Brian Deschuytner (COO and CFO) Core Industry Insights - **Industry**: Biotechnology, specifically focused on oncology and antibody-drug conjugates (ADCs) Key Points and Arguments Data Updates and Efficacy - Mersana has provided updates on their phase one data for EMILI, an ADC targeting b7-H4, showing a differentiated safety profile with effective doses and minimal side effects like neutropenia and neuropathy [4][5] - The overall response rate (ORR) for EMILI has improved from 23% to 31% across all tumor types, indicating compelling efficacy, particularly in triple-negative breast cancer (TNBC) patients who are late-line and highly refractory [5][6] - The company is focusing on the unmet need in patients who have previously received topoisomerase (topo) inhibitors, where the response rate is typically low [6][7] Regulatory Designations - Mersana has received fast track designations for EMILI in TNBC and certain breast cancer patients post-topo, indicating regulatory recognition of the unmet need in this area [7] Upcoming Presentations - The ASCO presentation will provide additional follow-up data from the ESMO breast presentation, focusing on all enrolled tumor types and more details on non-breast cancer patients [9][10] Patient Management and Protocol Adjustments - The company has implemented protocol amendments to mitigate proteinuria, a treatment-related adverse event, allowing for continued dosing in asymptomatic patients [13][17] - Early feedback from physicians indicates satisfaction with the new protocol, as it allows for better management of patients who are responding well to treatment [17][18] Dose Expansion Strategy - Mersana is exploring high-dose regimens, with a focus on increasing exposure while managing side effects. The rationale for dose selection is based on observed tumor reductions in initial datasets [25][26] - The company aims to confirm initial responses and improve the overall response rate by avoiding treatment interruptions due to adverse events [31][32] Patient Population and Biomarkers - The target population for dose expansion includes TNBC patients with prior chemotherapy, particularly those who have received at least one prior ADC [34][36] - Mersana is using a consistent assay for b7-H4 expression across different study phases, which is crucial for identifying the appropriate patient population [37][38] Trial Design Considerations - Mersana is considering a randomized pivotal trial rather than a single-arm study, as randomized trials are preferred by regulatory agencies and provide critical control data [42][45] - The company aims for a minimum response rate of 20% in the pivotal trial, significantly higher than the 5% response rate observed in control arms of previous studies [46] Additional Important Insights - The company is aware of the challenges in enrolling patients who have previously received topo inhibitors, as many investigators are hesitant to include these patients due to the lack of consistent clinical benefits [40][41] - Mersana's approach to managing adverse events and optimizing dosing schedules reflects a commitment to improving patient outcomes in a challenging therapeutic area [18][25]