Revolution Medicines Q4 2024 Earnings Call Transcript

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Operator

Good day, and thank you for standing by. Welcome to the Revolution Medicines Q4 twenty twenty four Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer To ask a question during this session, you will need to press 11 on your telephone. You will then hear an automated message advising your hand is raised.

Operator

To withdraw your question, please press 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Brian Acy. Please go ahead.

Ryan Asay
Ryan Asay
SVP & Corporate Affairs at Revolution Medicines

Thank you, and welcome everyone to our fourth quarter twenty twenty four earnings call. Joining me on today's call are Doctor. Mark Goldsmith, our Chairman and Chief Executive Officer and Jack Anders, our Chief Financial Officer Doctor. Steve Kelsey, our President of Research and Development and Doctor. Wei Lin, our Chief Medical Officer will join us for the Q and A portion of today's call.

Ryan Asay
Ryan Asay
SVP & Corporate Affairs at Revolution Medicines

Certain statements we make during this call will be forward looking Because such statements deal with future events and are subject to many risks and uncertainties, actual results may differ materially from those in the forward looking statements. For a full discussion of these risks and uncertainties, please review our annual report on Form 10 K and our quarterly reports on Form 10 Q that are filed with the U. S. Securities and Exchange Commission. This afternoon, we released financial results for the quarter ended 12/31/2024, and recent corporate updates.

Ryan Asay
Ryan Asay
SVP & Corporate Affairs at Revolution Medicines

The press release is available on the Investors section of our website at revmed.com. With that, I'll turn the call over to Doctor. Mark Goldsmith, Revolution Medicine's Chairman and Chief Executive Officer. Mark?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thanks, Ryan. Good afternoon and thank you for joining us. Today, I'll cover highlights of progress with our pioneering RASON inhibitor pipeline and outline important priorities for 2025 as well as markers of progress we expect going forward as we pursue these priorities. Jack Anders will then summarize our financial results and provide a forward looking financial view. Our mission at Revolution Medicines, one that we have pursued for much of our ten year history, is to revolutionize treatment for patients with RAS addicted cancers through the discovery, development and delivery of innovative targeted medicines.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

This mission is anchored in three pillars: discovery, development and delivery. First, our innovative clinical stage RAS ON inhibitors have shown our discovery capabilities to be among the most productive in the industry. Our extensive original research in RAS biology and advances in our technology platform have given us critical know how and a deep pipeline of proprietary assets we expect will enable us to continue raising the bar for what's possible in treating patients with RAS addicted cancers. Second, our first rate development capabilities have advanced multiple assets through first in human studies and progressed our lead program into late stage development. We will continue strengthening these capabilities as we move into additional registrational studies across our portfolio and across a number of tumor settings and lines of therapy.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Third, we are preparing to deliver our novel therapies to patients by building strong commercialization capabilities in support of a successful launch, subject to regulatory approval for deraxonrasib. Supporting our mission is an ambitious strategic roadmap for maximizing the impact our RAS ON inhibitor portfolio can have for patients living with RAS addicted cancers, and our commitment to this level of ambition is reinforced by our track record of productivity and successful execution. We've been pioneers in the RAS space. Scientific innovation within RevMed has resulted in the first three clinical stage RASON inhibitors, a RASON multi selective inhibitor, a RASON G12C selective inhibitor and a RASON G12D selective inhibitor, each with a unique and promising clinical profile. Last month, we introduced the international non proprietary or generic names for these three compounds, each of which is centered on the shared phrase on RASib that alludes to the novel RASON mechanism of action for this new class of compounds.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Duraxon RASib or RMC6236, our groundbreaking multi selective RAS1 inhibitor Eliron RASib or RMC62991, our distinguished G12C selective covalent inhibitor and Zolzon RASib or RMC9805, our innovative G12D selective covalent inhibitor. In 2024, we built on our record of execution. We made substantial progress in advancing this portfolio of RAS focused investigational drugs. We reported compelling monotherapy clinical data with our first wave of RASAL inhibitors, particularly deraxonrasib in pancreatic ductal adenocarcinoma or PDAC and non small cell lung cancer and Zoldonrasib in PDAC. We also reported initial evidence of two promising combination strategies.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

First, we reported initial clinical proof of concept for the first of its kind RAS inhibitor doublet with a combination of EleuronRASib with DuraxonRASib. These data are highly encouraging and increased our confidence in the innovative RAS doublet concept more broadly. We've already completed dose escalation on a second RASon inhibitor doublet, ZOLDONRASib combined with DaxonRASib. We will study both RASON inhibitor doublets further as potentially compelling options for patients, particularly as we move into earlier lines of treatment. Second, we reported early safety and tolerability data for both Duraxonrasib in combination with Pembrolizumab and eileronrasib in combination with Pembrolizumab, observations that are highly encouraging and potentially enable a path to develop therapies for first line metastatic non small cell lung cancer.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

In addition, we also entered discovery and clinical collaborations designed to expand the range of treatment strategies we can bring to bear for patients with RAS addicted cancers. Such collaborations enable us to explore a range of combinations with inhibitors of novel targets, exemplified by a PRMT5 inhibitor under our agreement with Tango and novel approaches such as bispecific antibodies under our agreement with Aethon Therapeutics. We also formed collaborations with leading industry academia translational research partners such as the Breakthrough Cancer Organization that presents a valuable opportunity to uncover new patient centric scientific insights to further inform our ongoing commitment to transformative science. Last year, we also made progress in building the organizational capabilities needed for us to drive the next stage of our strategic plan. In particular, we deepened our late stage clinical development presence by launching our first Phase three registrational trial, reaching commercial scale manufacturing of deraxon RASib and strengthening our organizational capabilities in preparation for a potential first regulatory approval.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And we formed select partnerships to help us fulfill our tireless commitment to patients as we prepare to deliver our novel therapies to patients broadly. For example, to ensure that we keep patient needs at the forefront as we advance these medicines, we now have a relationship with Pancreatic Cancer Action Network or PanCAN, a distinguished organization devoted to improving the lives of people living with pancreatic cancer. And we ended 2024 in an exceptionally strong financial position, allowing us to continue our ambitious patient centric strategy. 2025 will be an important year for Revnet as we advance our strategy, aiming to maximize the impact we can have for patients with RAS addicted cancers. I'd like to outline the highest current priorities that we drive significant company transformation and value creation and to identify some of the markers of progress to follow.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Our first priority is to execute pivotal trials with deraxone RASib monotherapy in patients with previously treated metastatic pancreatic cancer and non small cell lung cancer. For the global Phase three RASOLUT-three zero two randomized controlled trial currently underway in patients with second line metastatic PDAC, enrollment is an important measure of progress. So far, we have seen very strong interest among patients and investigators with highly encouraging enrollment at the initial U. S. Investigation centers and we are actively opening new U.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

S. Sites in line with our plan. With regulatory clearances in The EU and Japan in hand, we are also activating ex U. S. Sites to support the global strategy.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We currently anticipate substantially completing enrollment in the trial this year to enable an expected data readout in 2026. For non small cell lung cancer, I'm pleased to confirm that activation of investigational sites is now ongoing in the Phase three RESOLVE-three zero one randomized controlled trial comparing Duraxon RASib to docetaxel in patients with previously treated metastatic RAS tumors. Our second priority is to advance Duraxon RASib into earlier line randomized pivotal trials in patients with PDAC. We expect to initiate a trial in first line metastatic disease comparing a reference arm of patients treated by chemotherapy to two investigational arms, one with patients treated with deraxonrasib monotherapy and one with patients treated with deraxonrasib plus chemotherapy. Based on single agent data and preliminary chemotherapy combination data, we are optimistic that both treatment arms containing deraxon RASib have the potential to become important therapeutic options for patients living with metastatic pancreatic cancer.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We plan to finalize the trial design later this year when we have sufficient safety and tolerability data from the currently ongoing DraxonRASib plus chemotherapy safety cohorts. Of course, we'll need to align with the relevant regulatory authorities, including the U. S. FDA before we can initiate the global randomized Phase three trial in patients with first line metastatic PDAC. As a further step in our ambition to serve patients with earlier stage disease, I'm also very happy to share that we are actively designing a registrational trial with deraxonrasib as an adjuvant treatment, patients with resectable pancreatic cancer who have undergone surgery and perioperative therapy, often including chemotherapy.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

This population constitutes approximately fifteen percent of newly diagnosed pancreatic cancer cases in The U. S. Each year. We expect to move quickly on developing this program in parallel with our work to finalize the pivotal trial in first line metastatic disease mentioned earlier. We anticipate that both of these pivotal trials will be initiated in the second half of this year.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Our third priority is to generate sufficient data to inform development priorities for the mutant selective inhibitors eileronrassib and Zoldonrassib and prepare to initiate one or more pivotal trials either as monotherapy or in a drug combination and a number of options are under consideration. For example, we continue development of Zoldonrasib, our innovative RASON G12D selective inhibitor for which the first in human clinical data, including a favorable tolerability profile and encouraging antitumor activity in RAS G12D PDAC were reported at the triple meeting last quarter. A key marker of progress against this priority is generating additional clinical data that help to qualify and prioritize these options and we expect to share additional clinical safety and antitumor activity on this exciting compound in the second quarter of twenty twenty five. Another example is our ongoing efforts to identify and advance rational combination strategies with our RASON inhibitors. We are data driven in prioritizing among multiple combination options for advancing into earlier lines of therapy.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

As noted earlier, we have already provided initial encouraging safety and tolerability data for both deraxonrasib and elironrasib in combination with pembrolizumab, thereby enabling potential combination paths to pivotal studies in first line metastatic non small cell lung cancer where pembrolizumab is the global standard of care. We also provided initial encouraging data on the combination of olearon RASib with Duraxon RASib in KRAS G12C colorectal cancer that provide initial validation of this innovative approach. We are actively enrolling and evaluating this RASON inhibitor doublet in combination with pembrolizumab that is as a triplet regimen in KRAS G12C non cell lung cancer as a potential chemotherapy sparing first line treatment. And a trial evaluating a doublet of ZoltonRASib with DaraxonRASib is currently in an expansion phase across a range of solid tumors at the anticipated single agent recommended Phase II dose for each agent. We plan to evaluate emerging data from multiple ongoing studies to help us prioritize among the range of potential monotherapy and combination clinical development plan options.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Based on this work, we expect to initiate one or more pivotal combination trials in 2026 that incorporate either aileronrasib or Zoldonrasib likely based on a RASON inhibitor doublet and anticipate sharing clinical data supporting these plans in the second or third quarter of this year. Our fourth priority is to progress our earlier stage pipeline, including advancing next generation innovations from our highly productive discovery organization. In particular, we currently expect to advance RMC5127, our RASON G12V selective inhibitor to a clinic ready stage this year. This will enable initiation of a first in human dose escalation Phase one clinical trial in 2026 and a subsequent evaluation of a RASON inhibitor doublet with Duraxon RASID. Based on a highly productive virtuous cycle between the preclinical and clinical sciences enabled uniquely by our platform and pipeline, we are excited about other promising next generation preclinical programs that will continue to be areas of investment for us to sustain our innovation pipeline beyond the current development stage assets.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Finally, we are growing our commercial and operational capabilities and increasing pre commercial activities in support of a potential launch. We have experienced and talented executives leading our commercial and medical affairs teams and these groups have already begun expanding our visibility in key settings, including clinical conferences to reach leading oncology practitioners. It is clear that our presence and growing leadership role are being felt. We continue to expand key aspects of our organization to support a commercial launch by adding top talent, including our U. S.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Field teams. We expect to continue to partner with translational and clinical experts and leading patient advocacy organizations to complement our internal capabilities. We are resourcing our efforts to ensure that we have the best strategies, tactics, operational capabilities and people to bring Duraxon RASib with urgency to patients with previously treated metastatic PDAC through a successful launch pending regulatory approvals. We see The U. S.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

As a core foundation and an important driver of potential long term shareholder value. We are committed to retaining control of U. S. Commercial rights as a main element of our current strategy. We also continue exploring strategies for serving patients outside The U.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

S, potentially including partnership opportunities to help us determine the best approach to ensure global access. We're excited about the continuing momentum and remarkable opportunity we have in front of us and look forward to reporting on markers of progress as we advance programs throughout the year. I'll now turn the call over to Jack Anders, our CFO, to summarize our fourth quarter financial results and forward looking guidance. Jack?

Jack Anders
Jack Anders
Chief Financial Officer at Revolution Medicines

Thanks, Mark. We ended the fourth quarter of twenty twenty four with $2,300,000,000 in cash and investments, which includes $823,000,000 in net proceeds from our upsized equity offering last December. We project that our cash and investment balance can fund planned operations into the second half of twenty twenty seven based on our current operating plan. This operating plan has been updated to reflect anticipated increased spend resulting from our growing confidence in the advancement of our clinical development programs. Turning to expenses.

Jack Anders
Jack Anders
Chief Financial Officer at Revolution Medicines

R and D expenses for the fourth quarter of twenty twenty four were $188,100,000 compared to $148,500,000 for the fourth quarter of twenty twenty three. Please note the prior year quarter included $13,100,000 in wind down cost associated with the EQRx acquisition. The increase in R and D expenses was primarily due to increases in clinical trial related expenses and personnel related expenses associated with additional headcount. G and A expenses for the fourth quarter of twenty twenty four were $28,200,000 compared to $32,200,000 for the fourth quarter of twenty twenty three. The decrease in G and A expenses was due to $13,800,000 in EQRx wind down costs in the prior year quarter.

Jack Anders
Jack Anders
Chief Financial Officer at Revolution Medicines

Excluding these non recurring EQRx costs, G and A expenses increased in the fourth quarter of twenty twenty four, which was primarily due to increases in commercial preparation activities and personnel related expenses associated with additional headcount. Net loss for the fourth quarter of twenty twenty four was $194,600,000 compared to $161,500,000 for the fourth quarter of twenty twenty three. Please note net loss for the prior year quarter included a total of $26,900,000 in ETRX wind down costs. The increase in net loss was due to higher operating expenses as described earlier. Full year 2024 financial results are available in our corresponding press release and also in our Form 10 ks that was filed with the SEC this afternoon.

Jack Anders
Jack Anders
Chief Financial Officer at Revolution Medicines

Turning to financial guidance for 2025, we expect full year GAAP net loss to be between $840,000,000 and $900,000,000 which includes estimated non cash stock based compensation expense of $115,000,000 to $130,000,000 The increase in expected GAAP net loss for 2025 is a result of increased expenses associated with the progression and expansion of our clinical development programs. In particular, the multiple ongoing and planned registrational studies we have outlined as priorities. We also expect higher expenses in 2025 as a result of increased commercial preparation efforts as we continue to build and expand our organizational capabilities in preparation for becoming a commercial stage company. That concludes the financial portion. I'll now turn the call back over to Mark.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thank you, Jack. In 2024, we continued to deliver compelling clinical observations and to build on our track record of effective execution. We have begun 2025 with the talent, capabilities and financial capital to fuel our vision to create an industry leading targeted medicines franchise for patients with RAS addicted cancers and to fulfill our responsibilities to patients, investors and employees. The foundation we have established sets us up for long term sustainable growth in support of our aim to revolutionize treatment for patients with RAS addicted cancers. With that, I'll turn the call over to the operator for the Q and A portion of the call.

Operator

Thank you. At this time, we will conduct the question and answer session. Each participant is encouraged to ask one question and a follow-up. Our first question comes from the line of Ellie Merly of UBS. Your line is now open.

Samantha Meadows-Ortiz
Samantha Meadows-Ortiz
Associate Director at UBS Group

Hi guys, it's Sam on for Ellie. Thanks for taking our question. I guess, can you walk us through the decision to move forward with the two Phase three studies in the earlier line PDAC? And I guess specifically what gives you conviction on the Phase three in the adjuvant setting? And can you talk a little bit about the role of RAS in this earlier line setting?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Thanks very much for your question. I think based on the data that we've already reported in pancreatic cancer, the monotherapy data, I think we have strong conviction that we ought to try to own the entire PDAC space across all lines of therapy. So we've indicated that previously and this is just further towards that goal. We've already previously announced that we intended to pursue a first line metastatic study and the question has always been what will be the composition of the various cohorts in that trial.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And we provide a little bit of clarity around that today and we'll continue doing so as the year progresses. The adjuvant is basically a study of patients who will have had their disease resected and represents an important opportunity to provide very significant long term clinical impact for those patients. And the proof of concept that supports pursuing that particular indication is already provided by the second line and third line data that we've shown previously with monotherapy. So I think both of these are very rational and appropriate things for us to pursue and will further our goal of completely owning the PDX space with this compound.

Samantha Meadows-Ortiz
Samantha Meadows-Ortiz
Associate Director at UBS Group

Yes, that makes a lot of sense. That's really helpful. And then I guess just a quick follow-up. Can you just touch on how the frequency of RAS mutations might differ in the adjuvant setting versus maybe like the advanced or metastatic disease and how you're thinking about the overall opportunity there?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

I don't know that there's any evidence that those patients would have any different representation of RAS drivers than all other patients, which is essentially almost all pancreatic cancer patients have a RAS driver. And so there's no reason to believe that those patients would behave any differently in response to Duraxone RASID.

Samantha Meadows-Ortiz
Samantha Meadows-Ortiz
Associate Director at UBS Group

Thank you so much.

Operator

Thank you. Our next question will come from the line of Eric Joseph of JPMorgan. Your line is now open.

Eric Joseph
Eric Joseph
Biotech Analyst at J.P. Morgan

Thank you. Thanks for taking the questions. The proposed TAVINOL study in the adjuvant setting is also interesting to us and expansive to what we've generally thought about as being in scope in pancreatic cancer. You noted, Mark, that respectable PDAC is about fifteen percent of overall cases, if I heard that correctly. Has this been a static metric?

Eric Joseph
Eric Joseph
Biotech Analyst at J.P. Morgan

I wonder if you see this proportion sort of expanding at all with perhaps early detection initiatives? And then as it relates to the pivotal study, how should we be thinking about the regulatory bar that would need to be satisfied for registration? Is it PFS OS? It would be great to hear your thoughts there. Thank you.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Hi, Eric. Thanks for your question. I don't think that we can comment today on the second part of the question since we really haven't engaged with regulatory authorities at the moment. So that will have to be something that we address in the future.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

But on the first question, I think I'll ask Doctor. Waiteland, our Chief Medical Officer, to comment on the estimated proportion of total PDAC cases that are currently considered resectable and whether that could evolve over time.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

Thanks, Mark. It's a great question. I think in the short term, we don't expect the number to change because that detection is largely driven by whether there is any screening. Unlike breast cancer, colorectal cancer, there is no mammography or colonoscopy and there is no pending test evaluating patients with pancreatic cancer. Now with blood tests for CTNA and so on, that's a much more long term to be established before it becomes standard care.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

That's why we don't probably in the short term, we don't see that number change.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And if I could just add to that, of course, there are efforts underway to try to develop such screening tools that are largely based on circulating tumor DNA. And to the extent that we can show further benefit to patients who are diagnosed earlier in their disease that I think will further promote those efforts, but those are future events to occur. And of course, the possibility of even clearing a tumor to the point of cures becomes credible in the context of resectable disease. And so if it becomes possible to diagnose patients much earlier, then the possibility of even greater impact, as you point out becomes much higher. But at the moment, we just have to focus on the patients who are diagnosed, and they do represent a significant fraction.

Eric Joseph
Eric Joseph
Biotech Analyst at J.P. Morgan

Okay, great. Thanks for taking the questions. I appreciate the color.

Operator

Thank you. Our next question comes from the line of Mark Fromm of TD Cowen. Your line is now open.

Marc Frahm
Marc Frahm
Biotechnology Equity Research Analyst at Cowen

Thanks for taking my questions. I wanted to start to follow-up on the questions about adjuvant design. Pancreatic docs also talk about borderline resectable disease, not just resectable. And then there's also within resectable, some patients get whipple procedures, others don't get whipples. Would you be looking to go after all surgeries or just kind of certain subsets there because there are some varying outcomes to pain point which one you fall in?

Marc Frahm
Marc Frahm
Biotechnology Equity Research Analyst at Cowen

And then similarly with the current trial in late line disease, you have this hierarchical analysis based on different RAS mutations. Would you also do that and enroll broadly or is that kind of introducing too much risk when you're moving lines, different subsets and different mutations in there?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thanks, Mark. Is the second question also relating to receptacle or was that referring to?

Marc Frahm
Marc Frahm
Biotechnology Equity Research Analyst at Cowen

Well, it's to adjuvant, but both first line and adjuvant for that second part of it.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

I see.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Okay, good. I think Wei can address both the definition of receptacle and what we're thinking about right now and then also testing and whether or not to stratify.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

Yes.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

So first question regarding the patient population. So first of all, I just want to caveat by saying that we have not had any L40 interactions. So the final design is still pending those interactions. But we would certainly like to offer deraximrasib as a new standard care for patients very, very to the broadest patient population possible. So that would really include as many patients that have had resection of their primary disease and then have any type of perioperative disease, typically chemotherapy, and that defined as broadly as possible.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

Now, I think the final design is still pending health related interaction, but that's our goal is to define the largest population where we believe drugs on RASFib can really benefit. And then the second question about the mutation specifically, this kind of it's piggyback on Mark's earlier comment. We do believe that RAS is the cancer initiating driver mutation. And so first of all, I think the prevalence is as far as we know, it's fairly consistent throughout the lines of therapy And then in the absence of setting or the early disease setting, our approach in developing duressonbrasib is similar in the metastatic setting, which is we aspire to cover as many patients that's actually eligible for our trial and then that's including a potential for our overcomer approach to the entire population of pain bladder cancer patients.

Marc Frahm
Marc Frahm
Biotechnology Equity Research Analyst at Cowen

Okay. That's really helpful. And then maybe just a more strategic view, Mark, just based on how you balance with all of these different combinations, also monotherapy opportunities to move forward into earlier lines. Just how do you balance moving quickly versus making sure you don't end up having to run too many redundant trials or setting bars that then make it difficult to get the best option for patients over the long term?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Well, that's a hard question. That's what we grapple with every day in our strategic considerations. I think our primary motivation here is to serve patients. And that means moving swiftly when we have something that we think will move the needle for patients, we really need to do so, given also the competitive environment from a business point of view.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

There's not a lot of opportunity for us to pause things and wait and see what we might offer that's better in place of that. I think we just have to move swiftly to try to deliver against the unmet needs. Of course, to the extent that we generate data that tells us what to prioritize, we'll use that information in making those prioritization decisions. But there could be certainly circumstances where we can't make such a decision, but we wouldn't hold off on pursuing a Phase three registration trial because that would leave patients unserved and or it would leave opportunities for competition to step in and just to create new bars for us. We'd rather be the ones to create the bar and then try to beat the bar ourselves rather than chasing someone else.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And given our current position, I think it's ours to lose. If we don't pursue these things, we will be setting ourselves up for a different scenario. We'd rather be first to the table where we can't be. So it's a challenging topic. It's falls into the category of an embarrassment of riches to a large degree because we can define multiple potential solutions to each of these situations.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And but we have to work in real time because for patients this is a pressing matter. It's not something that they can wait years for us to sort out.

Operator

Thank you. Our next question will come from the line of Michael Schmidt of Guggenheim. Your line is now open.

Michael Schmidt
Senior Managing Director & Equity Research Analyst - Biotechnology at Guggenheim Securities, LLC

Hey, thanks for taking my questions and congrats on all the progress. I had a follow-up on your first line metastatic pancreatic cancer strategy. So it sounds like you've now committed to doing a single three arm trial there for registration as opposed to two separate trials. How much more Phase I work needs to be done with the chemotherapy combination before initiating the study? And will you be able to share some of that data perhaps later this year be it as a monotherapy perhaps in first line or in combination?

Michael Schmidt
Senior Managing Director & Equity Research Analyst - Biotechnology at Guggenheim Securities, LLC

And secondly, what are your latest thoughts on how to incorporate SODAN RASID into your pancreatic cancer registration strategy perhaps relative to the rex en rapid? Thanks so much.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thank you, Michael. So the first question is, are we continuing evaluation of chemotherapy combination to support that third arm in the trial. And the answer to that is straightforward. Yes, we're doing that work now. We've collected some data, but we need more.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And it mainly has to do with what regimen we select to move forward with. And that's primarily around safety. It's really not at this stage about primarily driven by efficacy because we already have confidence in the efficacy based on the monotherapy second, third line data that we've already shared. So this is really just about safety and making sure that we can assure high enough relative dose intensity during treatments that there aren't long breaks. As you may know, even both forms, major forms of chemotherapy and pancreatic cancer often incur the liability of Grade three or higher adverse events that drive hospitalization that often results in discontinuation of anticancer treatment for some period of time.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And that's not ideal, particularly for a targeted therapy where as continuous coverage as possible is likely to have the greatest efficacy in the long run. So we just want to choose the best regimen or regimens to go forward with and we need some more data to drive that. But it still is our intention in 2025 to initiate that trial. So we're moving as quickly as we can to support that decision. The second question is zolomarasib.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Do you want to comment, Wei, on zolomarasib and pancreatic cancer and how we think about that relative to direct zone medicine?

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

Sure. Zolomarasib, as you know, G12b has has a prevalent rate of about forty percent of pancreatic cancer. So it's the most common graft mutation or specific mutation in general that's a driver of pancreatic cancer. So we had shared our earlier Phase I data, showing that it's a highly active agent. We're actually following on those results looking for the durability of these activities.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

And then I think our initial thinking is it will probably end up being a separate registration trial with a standalone registration path. And we're currently evaluating a combination with duraxon RASif, let's say, potential RASON doublet, a best in class option that could be substantially improved upon either monotherapy, as well as the chemotherapy plus standard care, with solosoromastib. So those are potentially two options we could really develop.

Michael Schmidt
Senior Managing Director & Equity Research Analyst - Biotechnology at Guggenheim Securities, LLC

Thank you.

Operator

Our next question comes from the line of Ben Burnett of Stifel. Your line is now open.

Benjamin Burnett
Benjamin Burnett
Director at Stifel Financial

Great. Thank you. First, just wanted another quick question on zoldanirasaib. I guess, is there any more color you can provide on the data update being contemplated in the second quarter? Specifically, what are the key learnings that you have to glean from these data?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Hi, Ben. Thanks for your question. We don't have any more color to provide on that today. We do intend to provide additional data on sold on RASID in the second quarter of this year.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And I think we'll just have to wait until those data are available.

Benjamin Burnett
Benjamin Burnett
Director at Stifel Financial

Okay, understood. And if I

Benjamin Burnett
Benjamin Burnett
Director at Stifel Financial

can maybe go back to sort of a previous question on the frontline metastatic pancreatic cancer, It feels like there's been some debate as to the combinability of doxoracinib with chemo. Sounds like you guys are pretty confident that there is some combinability potential here given the design that you're proposing in the frontline metastatic cancer setting. But I guess the question is like what are the overlapping tox signals that one should be concerned with when thinking about doxoracinib and the data that's been provided thus far with the various chemos being contemplated?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Ben, let me just clarify though. I don't know that there's been a debate about the combinability. That really I think is that statement has been made a number of times, but I haven't heard that debate. Really, the topic that we raised earlier this year is the one that I alluded to in one of the earlier questions, which is that chemotherapy alone is a very difficult thing for pancreatic cancer patients to go through because the disease is so aggressive, the chemotherapy has to be aggressive to go with it.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And that chemotherapy already today drives substantial side effects, adverse events that often result in holding the drug for some period of time and or hospitalization. And that in and of itself just for the chemotherapy, the standard of care chemotherapy alone could have implications for the ultimate efficacy of a combination of chemotherapy with the duresson or with any other targeted agent to be honest. So that's really the issue that we've raised. We haven't not sure that there really has been any meaningful public debate about whether or not they are combinable. And so I don't think we have anything to add to that because that hasn't really been the core issue.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Of course, we're evaluating that now. And we're optimistic that we can develop a regimen that combines them. But we're keeping in mind this fundamental issue that the chemotherapy itself is already essentially barely tolerated. And in fact, in most cases, not only results in some dose holds, but typically results in dose reductions as one moves from one cycle to the next. So that's the context for that.

Operator

Thank you. Our next question comes from Laura Prendergast of Raymond James. Your line is now open.

Laura Prendergast
Laura Prendergast
Vice President at Raymond James

Hey guys. I was wondering if you could provide

Laura Prendergast
Laura Prendergast
Vice President at Raymond James

a little bit more colorectal cancer data disclosure cadence. Should we be expecting any chemo combo data, eGFR inhibitor combo, doublet data this year? And then just any guidance on if

Laura Prendergast
Laura Prendergast
Vice President at Raymond James

or when there will be a registrational path for colorectal cancer and then maybe beyond the big three

Laura Prendergast
Laura Prendergast
Vice President at Raymond James

ks RAS driven tumors as well?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Hi, Laura. Thanks. Great question. We don't have any guidance provided yet on next disclosures about colorectal cancer.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We of course are studying colorectal cancer. In fact, just in December, we disclosed data from a study of the combination of oleronrasid with deraxonrasid in patients, quite advanced colorectal cancer patients who have been previously treated with a G12C inhibitor and really had no other options. And we showed significant activity from the combination of a liranrasib with daraxonrasib. So that was just weeks ago or two months ago. But we don't have any guidance to provide.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We continue to study this. There are a variety of different combination strategies that might be that might prove to be interesting, and we're evaluating them. And I think when we have information that starts to point to future strategies, we'll share that.

Laura Prendergast
Laura Prendergast
Vice President at Raymond James

Great. Thank you.

Operator

Thank you. Our next question comes from the line of Kelly Shih of Jefferies. Your line is now open.

Clara Dong
Clara Dong
Vice President - Biotechnology Equity Research at Jefferies

Hey, guys. This is Clara on for Kelly. Thanks for taking our questions. So for the Phase one study in PDAC, as of the last update, the median overall survival was so immature at the upper two d. So just wondering, do you have any plans to update the overall survival data this year?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Hi, Clara. Thanks for your question. Yes, what we showed before was two different ways of looking at the data. One was from an aggregate of multiple dose levels up to and including the 300 cohort.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And there we did show an overall survival estimate from the curves that was fourteen point five months. When we took just the subset of that, that was the three hundred milligram sort of subset, if you will, that particular dose cohort, because those patients have been enrolled more recently than had the patients on the earlier with the earlier doses, that those curves were not very mature. And so we didn't have an estimate of OS per se, but we did have information regarding the six month OS, which was quite high depending on which subset you looked at. It was in the ninety seven percent to 100% range, which I think provided some pretty good look about what's going to come as the EDA's data mature. But of course, we don't we didn't have those data.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

So those do continue to mature. And I'm sure at one point, at some point, we will have an estimate of that. We don't have that today and we don't have any information to share, but I would imagine at some point we'll share that information. We don't have a specific plan around it right now.

Clara Dong
Clara Dong
Vice President - Biotechnology Equity Research at Jefferies

Thank you. Appreciate it.

Operator

Thank you. Our next question comes from the line of Chris Shibutani of Goldman Sachs. Your line is now open.

Kevin Strang
Kevin Strang
Biotechnolgy Equity Research at Goldman Sachs

Hi, this is Kevin on for Chris. Thanks for taking our questions. I just wanted to clarify on the first line lung opportunity. You noted that you're exploring the potential for a chemotherapy free triplet combination here. Just in terms of your priorities here, would you potentially also pursue a non G12C frontline indication?

Kevin Strang
Kevin Strang
Biotechnolgy Equity Research at Goldman Sachs

Or do you still have plans to explore that? And then for the triplet, could that be one of the updates that we can expect in the second quarter or third quarter of this year? Thanks.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thanks, Kevin. I think we have Steve Kelsey, our President of R and D. Maybe he could comment on how we think about the first line of lung cancer. Certainly, there are kind of multiple subsets as you alluded to Essentially, G12 C has now been defined as a sort of a disease in and of itself. And then there's everything other than G12 C.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Maybe Steve could comment on that.

Steve Kelsey
Steve Kelsey
President of Research & Development at Revolution Medicines

Sure. We definitely divide the world of RAS mutant lung cancer into distinct sets depending on the type of RAS mutation. And I think that now G12C mutant lung cancer has established itself as a completely separate disease, probably requiring a G12C selective inhibitor. So right now, because we are acquiring and have presented preliminary data on the combination of a neuromyracib with deraxonyracib in G12C mutant cancers, we would plan to move that chemo free triplet into the G12C lung cancer space. And then the Duraxon, RASib would be prioritized for all other RAS mutant lung cancer without a G12C mutation, which is about probably somewhere in the region of seventeen percent to eighteen percent of all non small cell lung cancer right now.

Steve Kelsey
Steve Kelsey
President of Research & Development at Revolution Medicines

The so I think that addresses your first question. Can you remind me your second question?

Kevin Strang
Kevin Strang
Biotechnolgy Equity Research at Goldman Sachs

Just following up on that. So does that mean that Oh,

Steve Kelsey
Steve Kelsey
President of Research & Development at Revolution Medicines

data, data, yes, will we release yes, I don't think we've specifically guided with regards to when the data that justifies those clinical trials will be put together in a complete package. I mean, we are releasing data in tranches as we accumulate that data. We've already, I think, tried to persuade you that our RASON inhibitors are combinable with pembrolizumab, which of course is a fairly significant step on the road to starting first line trials in non small cell lung cancer is an almost absolute prerequisite now for the starting trials in first line non small cell lung cancer. And we can not only can we combine our RAS on inhibitors with pembrolizumab without incurring additional toxicity, but we can combine them at what we believe to be the full recommended Phase three dose. We don't have to take a haircut on the dose in order to combine with pembrolizumab like some of the other RAS inhibitors have had to do.

Steve Kelsey
Steve Kelsey
President of Research & Development at Revolution Medicines

So, the ultimately, we are, as you know, still aggressively enrolling the combination of the liramirassib and dexamirassib in both colorectal cancer and non cell lung cancer and waiting for the sort of durability to mature. As soon as that has matured, then we can tell you about it. But of course, because it's durability data, I can't really give you a timeline for the maturation of that data. And of course, just behind that data set will be the combination of Zolto miracid with direct somaracid in Ras mutant tumors as well. That was a little bit behind and that again, I don't have any guidance on when we can report that.

Steve Kelsey
Steve Kelsey
President of Research & Development at Revolution Medicines

But as soon as we have the trials, the trial designs ready for public disclosure, we will also have the supporting data ready for public disclosure.

Kevin Strang
Kevin Strang
Biotechnolgy Equity Research at Goldman Sachs

Great. That's really helpful. Thanks. I'll hop back in the queue.

Operator

Thank you. Our next question comes from the line of Jay Olson of Oppenheimer. Your line is now open.

Jay Olson
Research Analyst at Oppenheimer & Co. Inc.

Oh, hey, congrats on the progress and thank you for the update. For the study of Duraxonrasib in the adjuvant setting for resectable PDAC, how are you thinking about the dosing duration? And could that be guided by ctDNA? And then I have a follow-up question on small cell lung cancer.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

I think it's just a little bit early for us to get into the details of trial design since as we indicated we're now committed to working on the trial design. Those are obviously questions that we'll be addressing that they are core elements of the trial design. So I would say, hold that question and we ought to be addressing it in due course.

Jay Olson
Research Analyst at Oppenheimer & Co. Inc.

Okay, understood. And then in non small cell lung cancer, are you interested in earlier lines of therapy like the adjuvant setting or even neo adjuvant? And can you just talk about what your strategy might be there?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Well, I can answer the first part of your question. Yes, we're very interested. I mean, we obviously have a very rich pipeline that's going to be very relevant to RAS the RAS mutant portion of lung cancer, which represents about thirty percent of non small cell lung cancer and in all lines of treatment. And you've heard about from Steve just a moment ago about strategy around first line. And I think we've just shown with our disclosure about our intention to pursue an adjuvant trial pancreatic cancer that we are committed to moving to these earlier lines.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We don't have specificity around that right now. So it's a little hard to explain the strategy until we have it well sort of well articulated, well thought through. And the pancreatic cancer is just a little bit ahead of lung cancer because it really has taken off and the unmet need is so substantial and urgent that we're in a better position really to push things in all directions there. But you'll hear about lung cancer over time as we're able to do so. Of course, importantly, we just announced today that we've initiated our second line, third line non small cell lung cancer study as we expected to do in the first quarter of this year, but we're there now and that's happening.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

So that's the first step in the right direction. And as we develop both data and then the strategy that supports the data for various earlier lines, we will share that.

Operator

Thank you. Our next question comes from the line of Joe Catanzaro of Piper Sandler. Your line is now open.

Joseph Catanzaro
Joseph Catanzaro
Director & Senior Equity Analyst at Piper Sandler Companies

Great. Thanks so much for taking my questions. Maybe one quick one for me as it relates to your comment, Mark, that chemo alone and frontline PDAC is an aggressive regimen. So for the frontline chemo combo, are you thinking that you'll design the regimen as just continuous combination therapy until progression? Or is there potential to use an induction maintenance idea?

Joseph Catanzaro
Joseph Catanzaro
Director & Senior Equity Analyst at Piper Sandler Companies

And maybe what the pros and cons of each approach could be? Thanks.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thanks for your question, Joe. I think Wei can comment on that

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

question.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

Yes. Again, because we have not had the regular interactions, I think right now, we do not have the final study design. I think what we're doing right now in the exploratory studies in evaluating the combination is really combining adding BRAXANRASLIB to the current standard of care chemotherapy, either Jamvrexant or Fofirinox, right? I think as we've discussed earlier, our primary goal is really to protect the dose and intensity of dryclean glasses because we think that's going to deliver the maximum chemical benefit of patients.

Wei Lin
Wei Lin
Chief Medical Officer at Revolution Medicines

And so how one way or the other, what the final regimen that we develop will move into the other first line setting. So other than that, I think maybe it's too early to share.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Maybe if I could add a little bit to that. We do expect that one arm of that trial will be monotherapy direct on RASID. And so there really isn't an induction and maintenance phase. There's just a treatment phase and the patients will be treated as long as they're clinically benefiting from it.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

With the chemotherapy added, it does raise the question whether there's an initial phase and then a follow-up phase of whether you call that induction and maintenance or not, is doesn't matter so much. That's just nomenclature. But currently pancreatic cancer patients, first on pancreatic cancer patients typically try to pursue four to six cycles of chemotherapy, but many patients don't make it through four to six cycles of chemotherapy either because they can't tolerate it and so they stop or because their disease progresses and they stop. And so that's just something to keep in mind as we want to make sure that patients actually get through their initial period, whatever that is, because the potential for having long term benefit from Duraxone RASID is implied by or suggested by the data from the previously treated patients. So again, we come back to the notion that based on the history of that disease and how it's treated and the fact that we're now moving from sort of a generalized chemotherapy attempt to just kill cells to a more biologically driven disease modifying kind of strategy that will require a bit of a paradigm shift or it should require a paradigm shift in thinking about how you go about treating those patients.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And effectively, we'll think of that combination arm as the dexamabasib arm to which we've added some chemotherapy as opposed to the chemotherapy arm to which we've added some dexamabasib. And that's conceptually a very important thing to think about and may not, may or may not conform to the nomenclature we were using earlier. But that's again, as what I said, those are things that we're actively engaged in, thinking through and then of course we'll have to engage with regulators. Right now we're talking with advisors and trying to devise the most appropriate strategy.

Joseph Catanzaro
Joseph Catanzaro
Director & Senior Equity Analyst at Piper Sandler Companies

Okay, got it. That's helpful. That's all for me. Thanks.

Operator

Thank you. Our next question comes from the line of Alex Stranahan of Bank of America. Your line is now open.

Analyst

Hey guys, this is Matthew on for Alex. Thanks for taking our questions. Maybe first quick one from us. I think in 3Q you mentioned that you expect to disclose data from the oleron rasset pembro combo in 1Q. I know you had safety tolerability data in December.

Analyst

Just curious if there were any update plans still for 1Q or whether the next updates would come in the mutant selector inhibitor update in 2Q or 3Q?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Okay. I was processing your question and I realize now what you're alluding to. We actually moved that update from Q1 of twenty twenty five into Q4 of twenty twenty four. And so that was the update.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We provided it earlier. We weren't sure if we were

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

going to be able to do

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

that, which is why we alerted folks that might come in 2025, but it actually came in 2024. And it was primarily and it is primarily a safety assessment. The issue with efficacy is that the patients who were treated, the vast majority of those patients were actually previously treated patients who have already experienced pembrolizumab. So there really wasn't much potential for them to get a new boost of antitumor activity by retreating them with pembrolizumab. And so looking at efficacy in that context, if you're thinking about it as additive pembro plus doraxonrassib, what you'd really just be seeing is the doraxonrassib activity.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

This contrasts with where it would actually be used, which is in first line patients who have not seen Duraxon RASib or pembrolizumab before, and that would be a more appropriate setting for assessing efficacy.

Analyst

Makes sense. And then maybe a quick one on how you think about entertaining potential collaboration opportunities with the racks on RASM or any of your other assets?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. I mean, we certainly are both entertaining and actually engaged in collaborations.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

There have been many years of preclinical collaborations that have been underway and continue and have published papers and so on. And there are actually active clinical collaborations. We've mentioned, for example, that Tango Therapeutics will conduct a study of their PRNT5 inhibitor with one or several of our RAS inhibitors, including direct sunracid, And that is a clinical collaboration. And we would imagine that that range of combinations will be expanded over time.

Operator

Thank you. Our next question comes from the line of Ami Fadia of Needham and Company. Your line is now open.

Poorna Kannan
Biotech Equity Research Associate at Needham & Company

Hi, this is Poona on for Amoni. Thank you for taking our question. On Zolzangracis, what additional data do you need to see that would give you confidence to initiate the pivotal combination trial? And would anything update into data from other indications such as gastric and CRC?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Unfortunately, we can't hear you very well. So we're not sure what those two questions were. Could you repeat that and maybe if we could get the volume adjusted up that would be helpful?

Poorna Kannan
Biotech Equity Research Associate at Needham & Company

Sorry. I was asking what additional data do you need to see for Zolto on gas that would give you confidence to initiate the pivotal combination trial? And would any of these updates include data from other indications such as gastric and CRC?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Okay. So the question is really about pivotal trials of solvarnasib in combination context. Well, we are currently evaluating solvarnasib in combination with Duraxoniracib, which we think is justified by the previous observations that Eliraniracib plus Duraxoniracib delivered compelling differentiated initial evidence of antitumor activity. And so we believe that same concept may hold for zolodonracib and we're evaluating it. We're also evaluating zolodonracib in combination with other agents, other standard of care agents that would be appropriate for lung cancer or for colorectal cancer or for pancreatic cancer.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

So I think we have to generate that information. We've indicated that this is a high priority for this year. The work much of that work is already underway. We expect to share some additional clinical data on zolodomrasib mid year And we expect to develop at least one pivotal trial concept based on a new selective inhibitor, which could as well be zolon RASID for 2026 and beyond.

Poorna Kannan
Biotech Equity Research Associate at Needham & Company

Okay. Thank you.

Operator

Thank you. Our next question comes from the line of Peter Lawson of Barclays. Your line is now open.

Analyst

Hey, good afternoon. This is Alex on for Peter. Thanks for taking my question. And so I joined late, so sorry if this was addressed already. But how are you thinking about completion of the second line PDAC study and potential approval?

Analyst

And how could that impact if that could impact the control arm in your first line trial and the ability to show an OS benefit?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. Yes. Thanks for your question. There's always a downside to anything that has an upside. So rapidly completing that trial does create new barriers for a different trial.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

That doesn't stop us though. We want to move forward as quickly as possible to complete that trial. And it is a very important opportunity for us to demonstrate an OS benefit from deraxonrassib, which we believe is a credible thing based on data that we've shown so far. There's broad interest in this study. You're not talking about the three zero two, ARESOLUT study.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

There's broad interest in that study by patients and investigators. The currently active sites, enrolling sites are enrolling quite actively. We're very pleased with the progress there. We're also opening new sites in The U. S.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

According to our plan. Consistent with our plan, we're opening sites in The U. S. Right now. We do expect and are highly confident that we can complete enrollment of this study in 2025.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

There may be some stragglers from countries outside The U. S. That could roll over into 2026. But largely, we do expect to complete enrollment in that trial with CRM. We're moving as fast as we possibly can.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

As you point out, it does put pressure on that first line trial. And frankly, we think it will put pressure on every future first line trial. That's sort of part of the intention here is to deliver changes in treatment benefit for patients that moves the needle. That's what we want to achieve. But we are fighting ourselves a little bit on this, which means getting to an answer on our final trial design for the first line trial as quickly as possible is important to do.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

We feel that urgency and we currently expect to be able to do so to initiate the trial by the end of this year.

Analyst

Okay. Thank you. And do you see any potential for an accelerated approval of some sort based on PFS in the first line setting?

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Yes. That's a question probably best addressed to regulators. I think that there is a widespread belief and understanding that the FDA is not wild about accelerated approval in pancreatic cancer for a number of reasons. One of which is that the OS readout doesn't come that long after the PFS readout. And so they're not particularly enthusiastic about giving somebody an approval and then finding out a month later that does or doesn't meet the OS bar, just to exaggerate a little bit.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

So I think generally speaking, we don't assume that there's an accelerated approval path based on PFS. On the other hand, there hasn't really been a drug that's moved the needle based on PFS

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

really ever in any meaningful way.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

And our ambition is to be able to deliver such data that will be determined by what the data show. But based on the Phase onetwo data, which we've shown so far, we're encouraged by that possibility and how a regulatory body might look at those results, we don't we of course can't predict. We've designed the trial really around the bolus, which means that it's overpowered for PFS. And the timing of the analyses, the first analysis is actually driven by the number of OS events. And so it's an OS event driven trial, but it is possible to achieve success on the PFS without having reached the mark on OS or maybe being partially on the way there with evidence of a trend towards it without having reached it yet, in which case there would be a subsequent assessment of the data after with a greater chance of achieving the OS at that point.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

What happens in that interim period? I think we'll just have to leave dangling because that's not really entirely up to us. In fact, it's not really up to us very much at all.

Operator

Thank you. I am showing no further questions at this time. So I would like to turn it back to management for closing remarks.

Mark Goldsmith
Mark Goldsmith
CEO, President & Chairman at Revolution Medicines

Thank you, operator, and thank you to everyone for participating today and for your continued support of Revolution Medicines.

Operator

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

Executives
    • Ryan Asay
      Ryan Asay
      SVP & Corporate Affairs
    • Mark Goldsmith
      Mark Goldsmith
      CEO, President & Chairman
    • Jack Anders
      Jack Anders
      Chief Financial Officer
    • Wei Lin
      Wei Lin
      Chief Medical Officer
    • Steve Kelsey
      Steve Kelsey
      President of Research & Development
Analysts
Earnings Conference Call
Revolution Medicines Q4 2024
00:00 / 00:00

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