ADC Therapeutics SA (ADCT)
NYSE: ADCT · Real-Time Price · USD
3.940
-0.020 (-0.51%)
At close: Apr 24, 2026, 4:00 PM EDT
3.988
+0.048 (1.22%)
After-hours: Apr 24, 2026, 7:28 PM EDT
← View all transcripts

Jefferies 2024 Global Healthcare Conference

Jun 6, 2024

Chris Martin
CEO, ADC Therapeutics

Happy to present a company overview for you today. So if you look at our company, we're overall, we're in, one of the pioneers in the antibody-drug conjugate space. We have a robust set of tools in our toolbox and an integrated set of capabilities. We have an approved product already on the heme side in ZYNLONTA, and a really robust early-stage pipeline on the solid tumor side. We have a cash runway that goes into the middle of 2026, with multiple catalysts that are going to happen throughout this year and the first half of next year. Just diving deeper into our portfolio, our portfolio is really split into two parts: hematology and solid tumor.

Within the hematology side, as I mentioned, we have an approved product, ZYNLONTA, which is approved currently in a small indication as a single agent, third line, plus DLBCL, but with multiple opportunities to expand, which I'll talk about later, both in earlier lines of DLBCL as well as in indolent lymphomas. We also have a compound in phase 1, our ADCT-602 compound. It's an anti-CD22 being studied in ALL. On the solid tumor side, we have our lead compound, 601, targeting AXL, which is currently being studied in sarcoma and pancreatic cancer, and will soon move into lung cancer. And then an emerging early-stage pipeline using our novel exatecan-based platform, going after four different targets, NaPi2b, Claudin-6, PSMA, and ASCT2. So just diving deep into ZYNLONTA.

Right now, we're playing in that lower left-hand box, the third-line plus DLBCL market, again, as a single agent. Typically, most of DLBCL is combination treatment, whether it's front line, second line, or third line. The majority of the treatments are really combination-based, but we're already approved as a single agent. One of the few. Actually, it's really only CAR T therapies, bispecific, and our product that are approved as single-agent therapies. So while we play in this small space today, the opportunity to grow is significant. We have two different key opportunities, our LOTIS-5 study and our LOTIS-7 study, which I'm going to talk about, which will help us move in combination therapy into earlier lines of DLBCL, as well as two studies going on to move us into relapsed/refractory follicular lymphoma, as well as relapsed/refractory marginal zone.

Now, just taking a step back to orient you on the overall landscape within DLBCL. In the front-line setting, there is a true standard of care. It's basically either R-CHOP or Polivy, R-CHOP. And over 80% of patients are going to get one of those two therapies. Essentially, anyone who has a fitness level to get it is going to get one of these therapies, and these therapies are curative in about 60% of patients, so they work quite well, and there's a standard of care that is pretty consistent, whether you're treated in an academic center or in the community. Once you start progressing into later lines of therapy, this is where the treatment paradigm starts to shift. Once you move to the second line, if you're treated in an academic center, the majority of those patients are going to get a CAR- T.

So roughly, of the 35% treated in an academic center, just over half are going to get a CAR T therapy, roughly 20% of the 35%. Some patients are going to get transplant, a small percentage, some are going to get clinical trials, and others will get some of the other novel therapies. In the community, it's very different because CAR T, if you're not referred, you see that the patient population grows in the academic as patients get referred, but if you're not referred, there's just over 100 CAR T-accredited centers in the U.S. So if you're not able to get treated in one of those, you're not going to get a CAR T, and then there, the landscape is really wide open.

When you look at the CR rates of CAR T, they're significantly better than many of the other therapies, roughly 70% CR rates. When you look at the other therapies currently approved, the best CR rates are roughly 40% when you look at the other available therapies. So there's a big delta right now, big room for improvement to establish a clear standard of care in that second-line plus setting for those patients who are not getting a CAR T. So for the 80% of patients not getting a CAR T, there's a real room for improvement. When you look overall at the progression, too, and you just add up the sales around the CAR T market, it's basically starting to plateau.

So that 80% of that patient opportunity is still really open for something for a regimen to close the gap between that 40% and that 70%, and that's where we're playing. Then in the third-line setting, you see again, fragmentation. In the academic center, bispecific have definitely been gaining quite a bit of share. You see a lot of post-CAR T use of the bispecific. But in the community, the bispecific use so far has been more limited. We estimate probably roughly 10% of community accounts currently are using a bispecific. Some others are referring to do the full dosing in an academic center, but the majority of community patients don't really have access to a bispecific today.

Then you see a number of different regimens, including still R-based chemo, both in the second-line and third-line plus setting, that are still mainstays. There's still a lot of chemo use and recycling of an anti-CD20-based chemo use throughout every line of therapy in DLBCL. So what are we doing about it? How are we studying? We're going, one, we have our LOTIS-5 study. This is our pivotal phase III study that will complete enrollment by the end of this year, which is looking at ZYNLONTA plus rituximab in this second-line plus indication. We also have a bispecific trial where we're combining ZYNLONTA plus glofitamab. These are now the two most potent single-agent drug classes in DLBCL combining, and I'll share some data with you on the dose escalation. We're now in dose expansion with that combination.

We think the combination of these two trials will help position us to establish a standard of care in that second-line plus setting.... So LOTIS-5, this, as I mentioned, is our pivotal phase 3 study. We're looking at second-line plus DLBCL patients, which are transplant ineligible, so that's the portion of the patient, that's the majority of patients. It's a confirmatory study combining with rituximab, comparing to R-GemOx. Right now, the PFS is the primary endpoint, but as you can see, we have a number of different secondary endpoints. The majority of these patients are enrolled, and as I said, we're on track to complete enrollment this year.

This is, of course, an events-driven trial, so you can't predict the exact timing, but assuming we enroll by the end of this year, which is our projection, we would expect to see a readout in late 2025, which could mean an approval in late 2026. Now, turning to LOTIS-7, this is a study that's in phase 1 right now. We recently completed part 1 of the study, which is dose escalation. In that part 1 of the study, we looked at not only the combination of ZYNLONTA plus glofitamab, but also the combination of ZYNLONTA plus mosunetuzumab. We did this across three different lymphoma types, DLBCL, follicular, and marginal zone, to establish a dose and establish the safety of these regimens. I'll share with you that safety data, but overall, the data looked very promising from a safety standpoint.

Now, we've moved into part two of the study, which is dose expansion, where we're focusing on the combination of ZYNLONTA plus glofitamab in second-line plus DLBCL patients. Now, one of the important things that we did in the glofitamab arm is we're using ZYNLONTA as a debulking agent. So typically, right now, if you look at the label of glofitamab, obinutuzumab is given on day one, and then glofitamab, step-up dosing starts on day eight and then given every three weeks for a fixed duration of one year. We're now adding the ZYNLONTA as a debulking agent as well. So you get, day one, you get obinutuzumab, day two, you get ZYNLONTA, day eight, you get glofitamab, and then every three weeks you're going to get ZYNLONTA plus glofitamab. The ZYNLONTA's fixed duration, up to eight cycles, glofitamab, up to a year, per the label.

In the dose escalation, we studied all three doses. We studied three different dose regimens of ZYNLONTA with the approved dosing of glofitamab, and all three doses cleared, no DLTs, and so we're moving forward now on the expansion with the two higher dose levels in the expansion arm. You look at just some of the safety data that emerged from our LOTIS-7 study. You know, you look at the glofitamab arm, efficacy is obviously very strong. In third line, roughly 40% CR rates, but comes with a liability of high CRS levels. Roughly 70% in the label, including some Grade 3 and Grade 4 CRS. And so what we saw with this debulking strategy in that glofitamab arm, this arm E, ZYNLONTA plus glofitamab, you could see 33% CRS levels, but no Grade 3 and Grade 4, no high-grade CRS.

We saw no ICANS, and there were no DLTs in the study at any of the dosing arms. So that's really important to see. In contrast with the mosunetuzumab arm, we actually didn't dose it before. We dosed at the same time. We didn't use it as a debulking agent. You see CRS levels that are more consistent with the mosun arm on its own, with the mosun label. So in terms of how we're moving forward, given that glofitamab and ZYNLONTA are both approved agents currently in, DLBCL, the two most potent approved agents outside of CAR T, we're doing the combination, and we're currently in an expansion. We plan to enroll 40 patients by the end of this year, 20 in each of the dosing arms, and we will share data for all patients available with 12-week scans.

So it'll be a subset of the 40 patients, and then the first half of the year, we'll have all 40 patients that we'll be sharing the data from. We're also studying ZYNLONTA in indolent lymphomas. This is data from an oral presentation that was at ASH this past December. We looked at the combination of ZYNLONTA plus rituximab in high-risk relapse/refractory lymphoma patients. The majority of these patients were POD24, meaning patients that progress within 24 months. Typically, a follicular lymphoma patient is progressing after roughly five years. So these are the highest-risk patients, highest progressive patients. In the first 27 evaluable patients, this is a study that we're looking at 100 patients right now, multicenter study, there's a 96% overall response rate, 85% complete response rate.

This compares very favorable when you look at the other regimens that are either approved or in guidelines, and there isn't a lot, particularly for these high-risk patients. That's where the data typically doesn't look as good, where there's even a higher unmet need. So as we enroll in this study through this IIT out of University of Miami, 100 patients, the pathway, assuming the data looks good, continues to look good, will be to both meet with regulatory authorities around this narrow patient population, as well as compendia. There's also an IIT out of University of Miami for relapsed/refractory marginal zone lymphoma patients. Here again, there's an unmet need. This is an indolent lymphoma, so it's not just about efficacy, it's also about the safety profile.

Ultimately, just like in DLBCL, across all these lymphoma, patients and physicians want to move away from systemic chemotherapy and towards fixed-dose regimens that have a tolerable safety profile and a fixed duration with high efficacy and durable efficacy. In this patient population, there's not a lot of approved regimens. In fact, there's only two approved regimens and a number of others that are in the guidelines. The best CR rates, when you look at the data that was submitted for either approval or for the guidelines, is roughly 29% CR rates... So there's still room to do much better. And then in addition, when you look at one of the most commonly used class of drugs, BTK inhibitors, of which there's one approval and many in the guidelines, these are treat to progression.

So the patient is staying on the therapy until they progress, which could be 12 months, 18 months, 24 months. So it's for a long period of time that the patient has to stay on this therapy, which is not only a burden for the patient, but also when you think these are Medicare Part D drugs, it's also some financial toxicity for the patient as well. So there's clear unmet need in this patient population. In the first 15 patients of evaluable, 13 achieved a CR, one achieved a PR. Importantly, all of the patients at the time of data cutoff, which was the end of March, were still maintaining the response. So we have to see more patients, we have to see more durability, but that's the study that's going on now. It's a 50-patient, multicenter study that we'll continue to read out as the data progresses.

We think there's a real opportunity for us. When you look at the data sizes that either led to approval or led to the compendia, roughly 30-70 patients. So it's not a big data set that has either led to approvals or into the NCCN guidelines. This is a 50-patient study, so we think we're the right size, and if this data persists, we will again go to both to the FDA as well as to NCCN guidelines to pursue both pathways in parallel. Now, turning to our solid tumor portfolio, our lead asset is ADCT-601. This is targeting AXL. This is using a PBD-based payload, which is a very potent payload in solid tumors. We know AXL is overexpressed not only in sarcoma, but pancreatic cancer and non-small cell lung cancer.

And so far, we're really encouraged about this opportunity because when you look at the expression levels, you can see the high expression levels in the lung, which is the smallest, it's still 20-25%, but you get higher levels when you get to pancreatic and sarcoma. But when you look at all expressers, and especially given the potency of this payload, this may be able to work also in low expressers. You can see with something like sarcoma, you get up to 90%. We did a dose escalation in sarcoma patients to get to the recommended dose level of 13 mg. In that dose escalation, and these were heavily relapsed refractory patients. Multiple lines of prior therapy failed, in most cases, all available therapies.

And in that dose escalation, we saw a couple of partial responses, and also in combination with gemcitabine, we saw a couple of partial responses. And this is in a patient population where what we've heard from the investigators is stable disease would be considered good because these patients, when you get to that really relapsed refractory setting, typically have an overall survival of three to four months. So the unmet need is extremely high. So to get these level of responses in the dose escalation was encouraging, at least, that there is anti-tumor activity. We're seeing a good therapeutic index, and now we've gotten to dose optimization and dose expansion. We're doing that in sarcoma. We've already started dosing patients in pancreatic, and the next step will be moving into lung cancer. For sarcoma, this is an all-comers with pancreatic and non-small cell lung cancer.

It's also using a biomarker approach. We expect to share data from this, quickly in sarcoma and in pancreatic cancer by the end of this year. Potentially have some initial lung data, but that's certainly by the first half of next year, we'll have robust data across all of these different tumor types. Then if you look at our research platform, we've really expanded. So we started off the platform of this company started off largely with PBD-based payloads, but we've expanded to several other payloads, linkers, conjugation technologies to really expand, and also antibody platforms, to expand the whole toolbox across the company that we're working with. The most advanced payload that we're going after is a novel exatecan-based approach. I think everyone's aware with DXD, which has had, you know, very strong data in a number of compounds, particularly in HER2.

DXD is a derivative of exatecan because exatecan is highly hydrophobic. It's tough to work with, and so you need a very novel hydrophilic linker to be able to stabilize the payload and be able to work well. So we've developed one internally, a novel hydrophilic linker that we're attaching exatecan to. What we're seeing when we do head-to-head studies preclinically between exatecan and DXD is better potency, better bystander effect, and with a better safety profile where we don't have, for example, some of the liability, like interstitial lung disease. We've now tested three of our four molecules in monkeys, and we haven't seen that, where that was seen with DXD, even preclinically. So we think there's a real advantage. We see efficacy with single doses at the low mgs per kg dosing level, and we've been able to safely dose up to 40 mgs per kg.

So the therapeutic index is roughly 15. So it's a very, very large therapeutic index for us to work with as we move forward our different programs. 4 targets that we're going after, NaPi2b, CLDN6, these are both already completed the Development Candidate stage, are now in IND-enabling stages. From DC to IND typically takes about 18 months, and PSMA and ASCT2, which are now nearing the Development Candidate stage. Now, in terms of our capital allocation approach, we're focusing most of our capital on the Heme part of the portfolio. We know this ZYNLONTA, with all the expansion opportunities, has the opportunity to get our company towards profitability for the Heme part of our business. And so we're allocating a lot of capital to the expansion opportunities we have with LOTIS-5, with LOTIS-7, and the indolent lymphomas.

Together, we think this represents an opportunity of over $500 million. But even if you look at our current cost base, where we burn about $50 million a quarter, $200 million a year—getting to revenues of $250 million would get this company towards profitability. So with all the opportunities that we have, we think with our cash runway to mid-2026, we already start having an eye towards profitability at that stage. That's why we're so focused on the heme side. We commercialize in the US, we have partners for ex-US, and then with our solid tumor side, while we're progressing things forward, the goal is to partner many of these assets.

So to take these forward, you know, either preclinically or through phase 1 to generate some data, at least for certain assets, and then be able to partner, given the number of solid tumor trials and number of indications. And then over time, we may expand our presence in solid tumor. So we have a clear case towards building towards profitability with our heme side of the business, while we're playing out a number of different earlier bets in solid tumor that we have the opportunity to partner and also get more non-dilutive capital as we play out different solid tumor bets. Overall, if you look at our different achievements so far this year, as well as the upcoming catalysts, we completed the dose escalation, as I mentioned, with LOTIS-7. All doses cleared with no DLTs, and now we're already in the expansion stage.

We had encouraging early data that was shared over the last 6 months for both follicular and marginal zone from the IITs in those studies. For AXL, we completed the dose escalation, and now our dose optimization and expansion. The research platform, we unveiled that really at the beginning of this year and then had a research day to go through the details of our research platform and the 4 lead candidates. And then we completed a financing in the past month to extend our cash runway into mid-2026, which allows us to read all these other catalysts by mid-2025. So this year, we will have commercial brand profitability, meaning the sales we generate will offset the total commercial and medical affairs cost and infrastructure of the company, so that all of our uses of capital are for essentially R&D.

LOTIS-7, as I mentioned, we've already started the expansion in part two with the glofitamab combination. We plan to enroll 40 patients by the end of this year. We'll have a subset of that data available by the end of this year and the full data set in the first half of next year. LOTIS-5 will complete enrollment by the end of this year. For both of the IITs, as the data matures, up to the 100 patients with follicular and the 50 patients in marginal zone, there will be presentations at upcoming medical congresses this year and next year to share more data on larger numbers of patients, as well as more durability. Our 602 compound, our anti-CD22, we'll be sharing data. We just did a dose escalation, and we'll be sharing more data from that compound by the end of this year.

For AXL, we've initiated not only the dose expansion and optimization in sarcoma and pancreatic, of which we'll have data by the end of this year, initial data. We'll have more robust data on those, as well as lung data in the first half of next year. Then with our research platform, we continue to advance things through the DC stage and IND-e nabling stage as we will progress one forward on our own into the clinic, and also continuing a number of different active partner discussions that we're having right now. Then finally, we'll execute across all these in a way where we're using our capital, as I said, primarily for R&D, while we also try to access non-dilutive capital to pursue a broader set of solid tumor targets. So with that, I thank you all very much for attending.

Just diving deeper into our portfolio, our portfolio is really split into two parts: hematology and solid tumor. Within the hematology side, as I mentioned, we have an approved product, ZYNLONTA, which is approved currently in a small indication as a single agent, third line plus DLBCL, but with multiple opportunities to expand, which I'll talk about later, both in earlier lines of DLBCL as well as in indolent lymphomas. We also have an compound in phase one, our ADCT-602 compound. It's an anti-CD22 being studied in ALL. On the solid tumor side, we have our lead compound, ADCT-601, targeting AXL, which is currently being studied in sarcoma and pancreatic cancer, and will soon move into lung cancer. Then an emerging early-stage pipeline using our novel exatecan-based platform, going after four different targets: NaPi2b, Claudin-6, PSMA, and ASCT2.

So just diving deep into ZYNLONTA, right now, we're playing in that lower left-hand box, the third line plus DLBCL market, again, as a single agent. Typically, most of DLBCL is combination treatment, whether it's front line, second line, or third line. The majority of the treatments are really combination-based, but we're already approved as a single agent, one of the few. Actually, it's really only CAR T therapies, bispecifics, and our product that are approved as single-agent therapies. So while we play in this small space today, the opportunity to grow is significant. We have two different key opportunities, our LOTIS-5 study and our LOTIS-7 study, which I'm going to talk about, which will help us move in combination therapy into earlier lines of DLBCL, as well as two studies going on to move us into relapsed/refractory follicular lymphoma, as well as relapsed/refractory marginal zone.

Now, just taking a step back to orient you on the overall landscape within DLBCL, in the front-line setting, there is a true standard of care. It's basically either R-CHOP or Polivy, R-CHOP. And over 80% of patients are going to get one of those two therapies. Essentially, anyone who has a fitness level to get it is going to get one of these therapies, and these therapies are curative in about 60% of patients, so they work quite well, and there's a standard of care that is pretty consistent, whether you're treated in an academic center or in the community. Once you start progressing into later lines of therapy, this is where the treatment paradigm starts to shift. Once you move to the second line, if you're treated in an academic center, the majority of those patients are going to get a CAR T.

So roughly, of the 35% treated in an academic center, just over half are going to get a CAR T therapy, roughly 20% of the 35. Some patients are going to get transplant, a small percentage, some are going to get clinical trials, and others will get some of the other novel therapies. In the community, it's very different because CAR T, if you're not referred, you see that the patient population grows in the academic as patients get referred, but if you're not referred, there's just over 100 CAR T-accredited centers in the U.S. So if you're not able to get treated in one of those, you're not going to get a CAR T, and then there, the landscape is really wide open.

When you look at the CR rates of CAR T, they're significantly better than many of the other therapies, roughly 70% CR rates. When you look at the other therapies currently approved, the best CR rates are roughly 40% when you look at the other available therapies. So there's a big delta right now, big room for improvement to establish a clear standard of care in that second-line plus setting for those patients who are not getting a CAR T. So for the 80% of patients not getting a CAR T, there's a real room for improvement. When you look overall at the progression, too, and you just add up the sales around the CAR T market, it's basically starting to plateau.

So that 80% of that patient opportunity is still really open for something to—for a regimen to close the gap between that 40% and that 70%, and that's where we're playing. And then in the third-line setting, you see, again, fragmentation. In the academic center, bispecifics have definitely been gaining quite a bit of share. You see a lot of post-CAR T use of the bispecifics. But in the community, the bispecific use so far has been more limited. We estimate probably roughly 10% of community accounts currently are using a bispecific. Some others are referring to do the full dose—to do dosing in an academic center, but the majority of community patients don't really have access to a bispecific today.

And then you see a number of different regimens, including still R-based chemo, both in the second-line and third-line plus setting, that are still mainstays. There's still a lot of chemo use and recycling of an anti-CD20-based chemo use throughout every line of therapy in DLBCL. So what are we doing about it? How are we studying? We're going, one, we have our LOTIS-5 study. This is our pivotal phase 3 study that will complete enrollment by the end of this year, which is looking at ZYNLONTA plus rituximab in this second-line plus indication. We also have a bispecific trial where we're combining ZYNLONTA plus glofitamab. These are now the two most potent single-agent drug classes in DLBCL combining, and I'll share some data with you on the dose escalation. We're now in dose expansion with that combination.

We think the combination of these two trials will help position us to establish a standard of care in that second-line plus setting. So LOTIS-5, this is, as I mentioned, is our pivotal phase 3 study. We're looking at second-line plus DLBCL patients, which are transplant-ineligible, so that's the portion of the patient, that's the majority of patients. It's a confirmatory study combining with rituximab, comparing to R-GemOx. Right now, the PFS is the primary endpoint, but as you can see, we have a number of different secondary endpoints. The majority of these patients are enrolled, and as I said, we're on track to complete enrollment this year. This is, of course, an events-driven trial, so you can't predict the exact timing, but-...

Assuming we enroll by the end of this year, which is our projection, we would expect to see a readout in late 2025, which could mean an approval in late 2026. Now, turning to LOTIS-7, this is a study that's in phase 1 right now. We recently completed part 1 of the study, which is dose escalation. In that part 1 of the study, we looked at not only the combination of ZYNLONTA plus glofitamab, but also the combination of ZYNLONTA plus mosunetuzumab. We did this across three different lymphoma types, DLBCL, follicular, and marginal zone, to establish a dose and establish the safety of these regimens. I'll share with you that safety data, but overall, the data looked very promising from a safety standpoint.

Now, we've moved into part two of the study, which is dose expansion, where we're focusing on the combination of ZYNLONTA plus Glofitamab in second-line plus DLBCL patients. Now, one of the important things that we did in the Glofitamab arm is we're using ZYNLONTA as a debulking agent. So typically, right now, if you look at the label of Glofitamab, obinutuzumab is given on day 1, and then Glofitamab, step-up dosing starts on day 8, and then given every 3 weeks for a fixed duration of 1 year. We're now adding the ZYNLONTA as a debulking agent as well. So you get, day 1, you get obinutuzumab, day 2, you get ZYNLONTA, day 8, you get Glofitamab, and then every 3 weeks you're gonna get ZYNLONTA plus Glofitamab. The ZYNLONTA's fixed duration, up to 8 cycles, Glofitamab, up to 1 year, per the label.

In the dose escalation, we studied all three doses. We studied three different dose regimens of ZYNLONTA with the approved dosing of Glofitamab, and all three doses cleared, no DLTs, and so we're moving forward now on the expansion with the two higher dose levels in the expansion arm. You look at just some of the safety data that emerged from our LOTIS-7 study. You know, you look at the Glofitamab arm, efficacy is obviously very strong in, in third line, roughly 40% CR rates, but comes with a liability of high CRS levels. Roughly 70% in the label, including some grade three and grade four CRS. And so what we saw with this debulking strategy in that Glofitamab arm, this arm E, ZYNLONTA plus Glofitamab, you could see 33% CRS levels, but no grade three and grade four, no high-grade CRS.

We saw no ICANS, and there were no DLTs in the study at any of the dosing arms. So that's really important to see. In contrast with the mosunetuzumab arm, we actually didn't dose it before. We dosed at the same time. We didn't use it as a debulking agent. You see CRS levels that are more consistent with the mosunetuzumab arm on its own, with the mosunetuzumab label. So in terms of how we're moving forward, given that Glofitamab and ZYNLONTA are both approved agents, currently in DLBCL, the two most potent approved agents outside of CAR T, we're doing the combination, and we're currently in an expansion. We plan to enroll 40 patients by the end of this year, 20 in each of the dosing arms, and we will share data for all patients available with 12-week scans.

So it'll be a subset of the 40 patients, and then the first half of the year, we'll have all 40 patients that we'll be sharing the data from. We're also studying ZYNLONTA in indolent lymphomas. This is data from an oral presentation that was at ASH this past December. We looked at the combination of ZYNLONTA plus Rituximab in high-risk relapse/refractory follicular lymphoma patients. The majority of these patients were POD 24, meaning patients that progress within 24 months. Typically, a follicular lymphoma patient is progressing after roughly five years. So these are the highest-risk patients, highest progressive patients. In the first 27 evaluable patients, this is a, of a study that we're looking at, 100 patients right now, multi-center study. There's a 96% overall response rate, 85% complete response rate.

This compares very favorable when you look at the other regimens that are either approved or in guidelines, and there isn't a lot, particularly for these high-risk patients. That's where the data typically doesn't look as good, where there's even a higher unmet need. So as we enroll in this study through this IIT out of University of Miami, 100 patients, the pathway, assuming the data looks good, continues to look good, will be to both meet with regulatory authorities around this narrow patient population, as well as compendia. There's also an IIT out of University of Miami for relapsed/refractory marginal zone lymphoma patients. Here again, there's an unmet need. This is an indolent lymphoma, so it's not just about efficacy, it's also about the safety profile.

And ultimately, just like in DLBCL, across all these lymphoma, patients and physicians want to move away from systemic chemotherapy and towards fixed-dose regimens that have a tolerable safety profile and a fixed duration with high up and durable efficacy. In this patient population, there's not a lot of approved regimens. In fact, there's only two approved regimens and a number of others that are in the guidelines. The best CR rates, when you look at the data that was submitted for either approval or for the guidelines, is roughly 29% CR rates. So there's still room to do much better, and then in addition, when you look at one of the most commonly used class of drugs, BTK inhibitors, of which there's one approval and many in the guidelines, these are treat to progression.

So the patient is staying on the therapy until they progress, which could be 12 months, 18 months, 24 months. So it's for a long period of time that the patient has to stay on this therapy, which is not only a burden for the patient, but also when you think these are Medicare Part D drugs, it's also some financial toxicity for the patient as well. So there's clear unmet need in this patient population. In the first 15 patients evaluable, 13 achieved a CR, one achieved a PR. Importantly, all of the patients at the time of data cutoff, which was the end of March, were still maintaining the response. So we have to see more patients, we have to see more durability, but that's the study that's going on now. It's a 50-patient, multicenter study that we'll continue to read out as the data progresses.

We think there's a real opportunity for us. When you look at the data sizes that either led to approval or led to the compendia, roughly 30-70 patients. So it's not a big data set that has either led to approvals or into the NCCN guidelines. This is a 50-patient study, so we think we're the right size, and if this data persists, we will again go to both to the FDA as well as to NCCN guidelines to pursue both pathways in parallel. Now, turning to our solid tumor portfolio, our lead asset is ADCT-601. This is targeting AXL. This is using a PBD-based payload, which is a very potent payload in solid tumors. We know AXL is overexpressed not only in sarcoma, but pancreatic cancer and non-small cell lung cancer.

And so far, we're really encouraged about this opportunity because when you look at the expression levels, you can see the high expression levels in the lung, which is the smallest, it's still 20%-25%, but you get higher levels when you get to pancreatic and sarcoma. But when you look at all expressers, and especially given the potency of this payload, this may be able to work also on low expressers. You can see with something like sarcoma, you get up to 90%. We did a dose escalation in sarcoma patients to get to the recommended dose level of 13 milligrams. In that dose escalation, and these were heavily relapsed refractory patients. Multiple lines of prior therapy failed, in most cases, all available therapies.

In that dose escalation, we saw a couple of partial responses, and also in combination with gemcitabine, we saw a couple of partial responses. This is in a patient population where what we've heard from the investigators is stable disease would be considered good because these patients, when you get to that really relapsed refractory setting, typically have an overall survival of 3-4 months. So the unmet need is extremely high. So to get these level of responses in the dose escalation was encouraging, at least, that there is anti-tumor activity. We're seeing a good therapeutic index, and now we've gone to dose optimization and dose expansion. We're doing that in sarcoma. We've already started dosing patients in pancreatic, and the next step will be moving into lung cancer. For sarcoma, this is in all comers with pancreatic and non-small cell lung cancer.

It's also using a biomarker approach. We expect to share data from this, particularly in sarcoma and in pancreatic cancer, by the end of this year. Potentially have some initial lung data, but that's certainly by the first half of next year, we'll have robust data across all of these different tumor types. Then, if you look at our research platform, we've really expanded. So we started off, the platform of this company started off largely with PBD-based payloads, but we've expanded to several other payloads, linkers, conjugation technologies to really expand, and also antibody platforms, to expand the whole toolbox across the company that we're working with. The most advanced payload that we're going after is a novel exatecan-based approach. I think everyone's aware with DXD, which has had, you know, very strong data in a number of compounds, particularly in HER2.

DXD is a derivative of exatecan because exatecan is highly hydrophobic. It's tough to work with, and so you need a very novel hydrophilic linker to be able to stabilize the payload and be able to work well. So we've developed one internally, a novel hydrophilic linker that we're attaching exatecan to. What we're seeing when we do head-to-head studies preclinically between exatecan and DXD is better potency, better bystander effect, and with a better safety profile, where we don't have, for example, some of the liability, like interstitial lung disease. We've now tested 3 of our 4 molecules in monkeys, and we haven't seen that, where that was seen with DXD, even preclinically. So we think there's a real advantage. We see efficacy with single doses at the low mgs per kg dosing level, and we've been able to safely dose up to 40 mgs per kg.

So the therapeutic index is roughly 15. So it's a very, very large therapeutic index for us to work with as we move forward our different programs. 4 targets that we're going after, NaPi2b, Claudin-6, these are both already completed the Development Candidate stage, are now in IND-enabling stages. From DC to IND typically takes about 18 months, and PSMA and ASCT2, which are now nearing the Development Candidate stage. Now, in terms of our capital allocation approach, we're focusing most of our capital on the heme part of the portfolio. We know Zynlonta with all the expansion opportunities has the opportunity to get our company towards profitability for the heme part of our business. And so we're allocating a lot of capital to the expansion opportunities we have with LOTIS-5, with LOTIS-7, and the indolent lymphomas.

Together, we think this represents an opportunity of over $500 million. But even if you look at our current cost base, where we burn about $50 million a quarter, $200 million a year, getting to revenues of $250 million would get this company towards profitability. So with all the opportunities that we have, we think with our cash runway to mid-2026, we already start having an eye towards profitability at that stage. And that's why we're so focused on the heme side. We commercialize in the US, we have partners for ex-US, and then with our solid tumor side, while we're progressing things forward, the goal is to partner many of these assets. So to take these forward...

You know, either preclinically or through phase one to generate some data, at least for certain assets, and then be able to partner, given the number of solid tumor trials and number of indications. And then over time, we may expand our presence in solid tumor. So we have a clear case towards building towards profitability with our heme side of the business, while we're playing out a number of different earlier bets in solid tumor, that we have the opportunity to partner and also get more non-dilutive capital as we play out different solid tumor bets. Overall, if you look at our different achievements so far this year, as well as the upcoming catalysts, we completed the dose escalation, as I mentioned with LOTIS-7. All doses cleared with no DLTs, and now we're already in the expansion stage.

We had encouraging early data that was shared over the last six months for both follicular and marginal zone from the IITs in those studies. For AXL, we completed the dose escalation, and now our dose optimization and expansion. The research platform, we unveiled that really at the beginning of this year, and then had a research day to go through the details of our research platform and the four lead candidates. And then we completed a financing in the past month to extend our cash runway into mid-2026, which allows us to read all these other catalysts by mid-2025. So this year, we will have commercial brand profitability, meaning the sales we generate will offset the total commercial and medical affairs cost and infrastructure of the company, so that all of our uses of capital are for essentially R&D.

LOTIS-7, as I mentioned, we've already started the expansion in part two with the Glofitamab combination. We plan to enroll 40 patients by the end of this year. We'll have a subset of that data available by the end of this year and the full data set in the first half of next year. LOTIS-5 will complete enrollment by the end of this year. For both of the IITs, as the data matures, up to the 100 patients with follicular and the 50 patients in marginal zone, there will be presentations at upcoming medical congresses this year and next year to share more data on larger numbers of patients, as well as more durability. Our ADCT-602 compound, our anti-CD22, we'll be sharing data. We just did a dose escalation, and we'll be sharing more data from that compound by the end of this year.

For AXL, we've initiated not only the dose expansion and optimization in sarcoma and pancreatic, of which we'll have data by the end of this year, initial data. We'll have more robust data on those, as well as long data in the first half of next year. And then with our research platform, we continue to advance things through the DC stage and IND enabling stage, as we will progress one forward on our own into the clinic, and also continuing a number of different active partner discussions that we're having right now. And then finally, we'll execute across all these in a way where we're using our capital, as I said, primarily for R&D, while we also try to access non-dilutive capital to pursue a broader set of solid tumor targets. So with that, I thank you all very much for attending.

Powered by