Q1 2025 Mersana Therapeutics Inc Earnings Call and Business Update
Speaker Change: [music].
Good morning, and welcome to the Marsano Therapeutics first quarter 2025 conference call.
Currently all participants are in a listen only mode. There will be a question and answer session at the end of this call.
Speaker Change: I would now like to turn the call over to Mr. Jason Fredette Senior Vice President Investor Relations and corporate Communications. Please proceed sir.
Speaker Change: Thank you operator, and good morning, everyone. Before we begin. Please note that this call will contain forward looking statements within the meaning of federal Securities laws. These statements may include but are not limited to those related to the potential clinical benefits of our product candidates and platforms, our clinical trial progress and design addressable market.
Speaker Change: <unk> anticipated clinical milestones and data presentations and cash runway.
Speaker Change: Each of these forward looking statements are subject to risks and uncertainties that could cause actual results to differ materially from those projected in such statements. These risks and uncertainties are discussed in our annual report on Form 10-K filed with the Securities and Exchange Commission on March 3rd 2025, and in subsequent SEC filings our filings are available.
Speaker Change: S D C dot Gov and on our web site in Marseille, and the dotcom, except as required by law, we assume no obligation to update forward looking statements publicly even if new information becomes available in the future.
Speaker Change: On today's call, we have more Sun as Chief Executive Officer, Dr. Marty Huber, and our Chief operating Officer, and Chief Financial Officer, Brian The Shatner with that let me turn the call over to Marty to begin the discussion.
Marty: Thank you, Jason and good morning, everyone let's.
Marty: Let's begin by touching on last week's announcement of Marsano strategic restructuring and re prioritization part.
Marty: This plan includes several cost savings initiatives among them are the reduction of about 55% of our workforce across functions. The elimination of our internal pipeline development efforts a reduction of other research activities and the narrowing of our clinical development work with Emily to focus on breast cancer.
Marty: We will continue supporting phase one dose escalation work for <unk> 2056, and our ongoing collaborations.
Marty: Our main objective however was to extend our cash runway into mid 2026 to give us the opportunity to generate important objective response rate and durability data for Emily from both of our ongoing phase one dose expansion cohorts.
Speaker Change: Many of our colleagues learned last week that they will be departing marsano today.
Speaker Change: And others will be leaving in the near term.
Speaker Change: I would like to take a moment to thank them for all they have contributed to our programs and our patient centric culture.
Marty: Now, let's move onto a very timely topic.
Speaker Change: Early this morning at the ESMO breast cancer 2025 Congress in Munich, Dr. Erika Hamilton, who heads our breast cancer research at the Sarah Cannon Research Institute presented updated clinical data for Emily our Dulles F&B seven H for ATC.
Speaker Change: The presentation, primarily focused on preliminary time to event data from patients with triple negative breast cancer or T. N B C, who enrolled in our dose escalation and backfill cohorts safe.
Speaker Change: Safety and Tolerability data in this population remained consistent with those previously reported with no new safety signals.
Speaker Change: Now before getting into the clinical activity data it may be helpful to share a little context upfront.
Speaker Change: First it's worth noting that research has shown these seven H for expression is a negative prognostic factor in various cancers, including in T. N B C.
Speaker Change: In other words clinical outcomes in patients with higher B seven H for expression are generally worse than those for patients with lower expression.
Speaker Change: Additionally, it is helpful to know what performance is for today's standard of care in late line T. M. P C, namely single agent chemotherapy.
Speaker Change: He referenced for this is a scent <unk> registrational trial in relapsed or refractory T. M D C.
Speaker Change: Is that trial patients receiving chemotherapy achieved an objective response rate or O R. R of only 5%.
Speaker Change: The median progression free survival or PFS was about seven weeks and median overall survival or O. S was about seven months those data were from patients who were naive to total 186.
Speaker Change: Ultimately, we believe that this is the type of time to event data that a new agent would need to beat and a potential randomized pivotal trial in post Toper, one T N B C for full approval.
Speaker Change: And given these low bars, we believe such a randomized trial would not take much longer than a single arm trial.
Speaker Change: With that let's briefly recap the clinical activity data presented this morning.
Speaker Change: The presentation focused on our valuable patients with T. N B C, who received intermediate doses of Emily ranging from about 38 milligrams per meter squared up to about 67 milligrams per meter squared.
Speaker Change: Importantly, more than 80% of these T N B C patients had received a prior topel one ADC.
Speaker Change: Among those patients would be seven H for low tumors, who received four or fewer prior lines of treatment. The O. R. R was zero percent the.
Speaker Change: The median PFS was $6 four weeks and the median OS was five seven months.
Speaker Change: But among those patients with what we have initially characterized as these seven each for high tumors, who received four fewer prior lines of therapy. The O. R. R was 29%. The median PFS was 16 weeks and the median OS has not yet been reached as of the data cutoff of March eight.
Speaker Change: As a reminder, our current dose expansion cohorts are only enrolling T N B C patients who received four fewer prior lines of therapy, including at least one prior took a wait and see.
Speaker Change: While some patients would be seven H for low tumor expression are being enrolled our primary focus is on the beef seven H for high G. N B C population.
Speaker Change: And so while the sample size from dose escalation tobacco with small today's presentation shed further light on why we continue to believe Italy could represent a meaningful improvement over today's standard of care for patients with post hope a one P. M D C.
Speaker Change: The ESMO breast presentation also contain an update on clinical activity observed across all tumor types in dose escalation and backfill cohorts as of that data cutoff of March eight eight of 26 evaluable patients would be seven H for high tumor expression, who received intermediate doses of Emily achieved a can.
Speaker Change: Firmed response for an O R or a 31%.
Speaker Change: This is an increase from the 23% O R or that was reported based upon our December 'twenty 'twenty four data cutoff. Further details are contained in the ESMO breast presentation, which can be accessed on publications sections of our website Amazon Dot com.
Speaker Change: We will be sharing some additional clinical data from dose escalation and backfill cohorts across all tumor types based on that March a data cutoff in an oral presentation at <unk> and a couple of weeks.
Speaker Change: So where do we stand with our expansion work with Emily.
Speaker Change: We're making great progress again and expansion we are focusing on patients with T. N. B C who have received one to four prior lines of therapy, including at least one prior telco one ADC.
Speaker Change: Enrollment in our initial expansion cohort that is receiving 67.4 milligrams per meter square dose of Emily every four weeks has advanced rapidly in 2025.
Speaker Change: As a reminder, we amended our clinical trial protocol in the first quarter of this year with the goal of mitigating proteinuria related dose delays, we had seen at higher doses of Emily.
Speaker Change: These proteinuria management guidelines have now been adopted at our clinical sites.
Speaker Change: I'm also happy to share that we recently initiated and have progressed patient enrollment in our second T. N V C extension cohort.
Speaker Change: These patients are receiving a starting dose of 44.5 milligrams per meter squared of Emily on days, one and eight of the first four week cycle.
Speaker Change: Followed by 80 milligrams per meter squared every four weeks.
Speaker Change: We chose this regimen for a few reasons.
Speaker Change: First all four of the Evaluable <unk> seven H four I patients who received a 44.5 milligrams per meter squared day, one day eight dose every four weeks of dose escalation of backfill cohorts achieved tumor reductions of at least 30%.
Speaker Change: Second we believe our recent protocol amendment will enable us to maintain dose intensity and tolerability for our 80 milligram per meter squared Q4 dose.
Speaker Change: And third our PK work showed that exposures for the stretcher regimen are distinct versus our 67 milligram per meter squared every four week dose, which we believe may be helpful. In the spirit of project Optimists.
Speaker Change: As we continue advancing our work and expansion. We are also witnessing a series of developments that could significantly expand the post hope of one patient pool.
Speaker Change: Up until now in the breast cancer space totaled 186 have only been approved for relapsed and refractory patients, but in recent months there have been multiple positive phase III readouts for <unk> in the frontline setting.
Speaker Change: Focusing specifically on the T N B C. As we've noted before global T. M. B C revenues for <unk> and 'twenty twenty-five are projected to exceed $1 billion.
Speaker Change: Just a few weeks ago positive top line results were shared from a center for a clinical trial for the combination of today, albeit keytruda in frontline T. M D C.
Speaker Change: This readout may enabled <unk> to become the new standard of care for first line PD Lone positive T N B C and.
Speaker Change: And with results from the Phase III <unk> three trial in PDL, one negative patients also expected in the weeks ahead, we believe the post hope of <unk> T N B C patient population could expand substantially.
Speaker Change: In summary, we remain excited about <unk> prospects, we're making great progress with expansion of enrollment and we are looking forward to sharing initial clinical data from expansion in the second half of this year.
Brian: With that let's turn the call over to Brian for our financial review.
Brian: Thank you Marty beginning with our balance sheet. We ended the first quarter of 2025 with a $102.3 million in cash and cash equivalents due in part to the restructuring and re prioritization plan, we announced last week, we expect that our capital resources will enable us to support our current operating plan commitments into mid 2026. Please note that our cash runway guidance.
Brian: Does not assume any future milestone payments that we may earn from our current collaborations or proceeds that we may realize from future collaborations net cash used in operating activities for the first quarter of 2025 was $29 $3 million.
Brian: Turning to our income statement collaboration revenue for the first quarter of 2025 was $2 $8 million compared to $9 $2 million for the same period in 2020 for the year over year change was primarily related to reduced revenue recognized under our collaboration and license agreement with J&J and Mark Kaye J a.
Research and development expenses for the first quarter of 2025 or $18 $3 million compared to $18 7 million for the same period in 2024 for the most recent quarter approximately $1.4 million of this spending was related to noncash stock based compensation the year over year change was primarily related to a lower head count and really.
Brian: Employee compensation costs, partially offset by an increase in costs related to an elite clinical development activities.
General and administrative expenses for the first quarter of 2025 declined to $8 $9 million compared to $11 $6 million. During the same period in 2020 for approximately $1 3 million and noncash stock based compensation expenses were included in G&A for the most recent quarter the year over year decline was primarily related to a reduction in <unk>.
And professional services fees as well as the company's lower head count and related employee compensation costs.
Brian: And finally meson as net loss for the first quarter of 2025 was $24 $1 million compared to a net loss of $19 3 million for the same period in 2024 that concludes our business update operator would you. Please open the call to questions from the audience.
Speaker Change: Thank you we will now begin the question and answer session.
Speaker Change: To ask a question you May Press Star then one on your Touchtone phone.
Speaker Change: If youre using a speakerphone please pick up your handset before pressing the keys.
Speaker Change: If at any time your question has been addressed.
Speaker Change: And you would like to withdraw your question. Please press Star then two and at this time, we'll pause momentarily to assemble our roster.
Speaker Change: And the first question will come from Kara Bancroft with TD Cowen. Please go ahead.
Kara Bancroft: Hi, good morning, and thanks for taking the question. So I was hoping you could expand a little bit more even quantitatively.
Kara Bancroft: On the high dose, especially regarding safety in the updated protocol I know you mentioned that the PK profiles, where we're pretty distinct I'd love to hear more about that and if an update here will be included in the ask a update it all thanks so much.
Kara Bancroft: Thanks sure well just the last one first this is part of the second dose level. The 45 is part of expansion and just to be clear. The data. We are sharing it ASKO is based on escalation of backfill OLED there is not going to be expansion data at <unk>.
Kara Bancroft: So these data would not be included in that presentation.
Kara Bancroft: With regards to the rationale I think.
Kara Bancroft: I'm going to work backwards to the PK one of the things you want to look for when you study a second dose is make sure that from a exposure point of view, it's a discrete dose level and its not.
Kara Bancroft: Overlapping in other words it would be.
Kara Bancroft: Needs to be a meaningfully higher dose because if you think about the project Optimus project. If you have two doses that are 80% of the patients are overlapping exposure, it's really not a second dose. So we were looking for a dose that is meaningfully higher than 67 in Q4. So the dose we're putting forward at $44 five day, one day followed by.
Kara Bancroft: <unk> is a meaningfully higher exposure that you achieve was 67.
Kara Bancroft: And then the final part of why we believe it's doable is when we evaluated our data one of the observations. We found is the 44.5 day. One day eight was the most effective dose inmate ensuring a tumor reduction at week six so it.
Kara Bancroft: Clearly had.
Kara Bancroft: I said four out of four patients who were <unk> seven H for high with measurable tumor baseline who got that dose.
Kara Bancroft: We fixed the problem, we had with 44.5.
Kara Bancroft: Was the.
Kara Bancroft: Urea also resulted in patients interrupting treatment. So now we believe with the proteinuria and mitigation efforts in place that we will be able to maintain it.
Speaker Change: Now the question Dennis will why did you go from a day one day eight today and an 80, well and 80 is also a meaningfully higher exposure, but fundamentally you do run into a problem of trying to do a day, one day eight and maintaining that every cycle just gets to be challenging.
Speaker Change: Whereas 80 every four weeks gives you an exposure in the ballpark of 45 day, one day eight.
Speaker Change: But it's much.
Speaker Change: When we talk to our investigators.
Speaker Change: There was a lot of negative feedback about trying to maintain a day one day eight schedule on an ongoing basis, but we do think it's worth it trying to get it in for that for or getting it into that first cycle because that really is our best shot at efficacy.
Okay, great. Thank you so much.
The next question will come from Charles Xu with lifestyle capital. Please go ahead.
Charles Xu: Hey, good morning, everyone. Thanks for taking the questions. Congrats on the progress and nice to see some of these response rates are ticking upwards a bit.
Charles Xu: I have a question regarding maybe some of the deal.
Charles Xu: Three and four studies are they're having already read out or about to readout how might these assuming there assuming that the results are successful.
Charles Xu: <unk> standard of care and impact if at all your clinical development plans in the post <unk> setting and really what I'm getting at here is would you expect any sort of like <unk>.
Charles Xu: Different patient based on characteristics or outcomes based on whether or not they get this new standard of care versus getting the prior slush current standard of care. Thank you.
Charles Xu: Charles maybe I'll tell you I'll take that one as.
Charles Xu: As you know our exposure cohort is exclusively looking at host Towboat, one T N B C and so I think.
Charles Xu: While we certainly have activity we've shown this in the January data disclosure.
Charles Xu: The non.
Charles Xu: Non towboat pretreated patients in the U S and Western Europe. The penetration of these trouble delivering 86 has been very very rapid.
Marty: Each of the recurrent setting as Marty noted in his remarks.
Marty: I think what this provides the opportunity for us.
Earlier earlier those agents are used to more and more patients fall into this post towboat one category.
Marty: And we know that are uniquely we retain activity in that space and we've been deliberately study that space because it's one of the highest unmet needs.
Marty: In breast cancer, what do you do once you induce resistance phenotype in outpatient post total one it's a serious question for many of the physicians we've been uniquely in this space for <unk> 74.
Marty: Recruiting those types of patients to ask that hard question.
Marty: And so we view this as a very positive development for patients and for the size of the opportunity that we're pursuing.
Marty: Got it great. Thank you.
Speaker Change: The next question will come from Michael Schmidt with Guggenheim. Please go ahead.
Michael Schmidt: Hey, good morning, Thanks for taking my questions.
Speaker Change: Yeah me too.
Speaker Change: A couple of follow ups, you know again nice to see these additional two responses in the at the intermediate dose could you just comment on what types of patients those were where those two T NBC patients that perhaps some of the other histology.
Speaker Change: And then.
Speaker Change: Yeah, just curious if.
Speaker Change: You could just provide some qualitative.
Speaker Change: I'll just comment on the impact of some of the protocol amendment amendments that you've implemented to manage some of the protein proteinuria.
Speaker Change: And prophylaxis.
Speaker Change: Is that sort of you know.
Speaker Change: What was your experience with that so far in house that indeed.
Speaker Change: Besides it then perhaps lowering proteinuria or.
Speaker Change: Some of these treatment haulage and then and then lastly could you just give us a sense of enrollment at 67 milligram cohort and how that's been progressing and how substantial it is update in the second half later this year will be thanks, so much.
Speaker Change: I'm Gonna start work backwards. So on the on the 67 enrollment we're not giving further guidance I think what we suffice it to say we've seen sufficient enrollment that we felt comfortable issuing a new guidance are we kind of since we kind of run out of guidance for the year, because you'd actually achieved all the stuff we've ever done.
Speaker Change: So we decided that when we looked at our enrollment we have enough patients that we felt confident we would have a dataset.
Speaker Change: One of the questions. We might do is make sure we'd have a dataset that had enough durability because that's as you all recall from our initial data set that was one of the questions. So I think as far as we're not giving actual sample sizes, yet, but I think the fact that we've switch.
Speaker Change: Switched from 67, two the second dose should indicate you know we're doing we're doing fine on enrollment and I think for any of you who happened to get up at two am and listened to Erik because of call and in our people on the ground in Munich have been telling us the investigator enthusiasm has been hot and we're seeing that in the Enron.
Speaker Change: So I think I think this this niche opposed toco now we clearly become if you could if you have this trial available for your patients you are putting your patients on it. So this is so that's why I think we're comfortable putting out the new guidance for second half.
Speaker Change: With regards to the proteinuria.
Speaker Change: Once again, we're not giving any data yet and I think probably a couple of things that are important to understand about that is.
The mitigation that we're doing we do not anticipate them ever taking proteinuria to zero. So so we want to be very clear our expectation is you're still going to see an AE proteinuria in these patients with this is about is is managing the other consequences.
Speaker Change: Avoiding the development of serum HIFU L. P. D var changes in creatinine and I think we're at the point now we're confident enough in our mitigation efforts.
Speaker Change: That we are comfortable opening the expansion at the new dosing regimen.
Speaker Change: Will.
Speaker Change: I mean at some when we shared the data on the dose in the second half then we can get into more details of exactly what that looks like.
Speaker Change: And the first question was the 31% or our own tumor types.
Speaker Change: Those both were ACC ones.
Speaker Change: But as far as the the more details of that are we at our upcoming <unk> presentation, whereas ESMO kind of covered the tee. It focused on TWC, Eric is going to focus on the other tumor types, including the 31% at the <unk> presentation.
Speaker Change: And a few more things that we can disclose on that basis.
Speaker Change: Alright, thank you.
Speaker Change: Again, if you have a question. Please press Star then one our next question will come from Jonathan Chang with Leerink Partners. Please go ahead.
Jonathan Chang: Hey, guys. Good morning, Thanks for taking my questions.
Jonathan Chang: First question are there additional dosing regimens that could be further evaluated beyond dose and be an expansion or have you settled on these two dose cohorts.
Jonathan Chang: And second question can you help set expectations on the upcoming <unk> presentation.
Jonathan Chang: Could we learn at ESCO relative to the disclosure today. Thank you.
Jonathan Chang: First of all with regards to the doses. These are the two doses that we are taking to expansion, we do not anticipate any others, obviously, we always.
Jonathan Chang: We're data driven if we learn something new from the data with the go forward plan is that it would be either of these two doses.
Jonathan Chang: And in fact, that's one of the reasons, we kind of.
Jonathan Chang: Scheduled on this kind of loading and switch to 80 Q4, because we believe doing the loading for one cycle and then switching to 80 Q4 is a viable dose and schedule to take forward assuming the data supports it.
Jonathan Chang: But we do not.
Jonathan Chang: We've obviously looked at other doses and schedules as part of our backfill, but at this point in time, we don't have any plans to take any of those forward.
Jonathan Chang: And with regards to the <unk> presentation, I think really probably.
Jonathan Chang: Knowing that companies have gotten in trouble for violating embargo we don't.
Jonathan Chang: This is our first oral presentation at the company and the last thing I would hate to do is be the guy who lost it because I blew an embargo.
Jonathan Chang: But I don't think I think we can be very clear on just set expectations. This is the backfill and escalation data there is not going to be expansion data in Africa.
Speaker Change: Understood. Thanks for taking my questions.
Speaker Change: The next question will come from Colleen Cousy with Baird. Please go ahead.
Colleen Cousy: Hi, good morning, Congrats on all the progress and thanks for taking our questions.
Speaker Change: Marty I think you mentioned.
Speaker Change: Something about a randomized phase three taking that much longer than a single arm. So could you just provide a little bit more color on what you're thinking on a potential pivotal study and that would help please.
Speaker Change: I mean, a lot of people asked those questions of is your response rate going to be high enough for an accelerated approval and I think.
Speaker Change: One of the things we're looking at we think that's actually kind of Bob.
Speaker Change: Irrelevant question.
Speaker Change: Because fundamentally if you could do a randomized trial.
In a similar timeframe as a non randomized trial, that's always the better way to go and there's I'll give you three reasons to that.
Speaker Change: One is from a regulatory point of view and now you have to think beyond the U S.
Speaker Change: On a global basis, they randomized trial, you can file anywhere.
Speaker Change: A lot of companies have discovered you do these accelerated approval strategies with a single arm trial and then you can't go anywhere else and then you're kind of stuck waiting for a randomized trial.
Speaker Change: The second place you still end up having to do the randomized confirmatory trial.
Speaker Change: Is that randomized confirmatory trial is not well underway are near complete you can get in trouble if not getting an approval because you haven't progressed or confirmatory trial and that's the point, where the agency has gotten very very sticky they really really want to know that the definition of well underway. Its getting they basically want to know your trial is going to read out before they approve you.
Speaker Change: And then the other area where it comes in.
Speaker Change: And this is one of the things we were very pleased with sharing at ESMO is things like if you look at diseases like T. M D C.
Speaker Change: <unk>, especially where patients are progressing in six weeks and dying in six months or less is.
Speaker Change: What's important for <unk>.
Speaker Change: Physicians is to understand not only the the response rate but.
Speaker Change: Stable disease, as well and T. NBC post hobo, a patient who doesn't progress at 18 weeks is deriving a meaningful benefit from the treatment because we know the natural history of that patient as they progress in six weeks.
Speaker Change: And then finally, you can actually in a randomized trial in T. N V C. By the time you finish enrollment.
Speaker Change: Probably already have a depth in points for PFS. So you can basically complete your enrollment and almost turn around and look at your PFS endpoint. The next day and then your survival endpoint is literally coming in within months of that so we think there's an opportunity with a randomized trial to avoid.
Speaker Change: The confirmatory trial and get Oh, EFS data, even if it's a secondary endpoint rapidly and then once you have that dataset, we think that makes it you know.
Speaker Change: All of this churn you're seeing at the F. D. A about are they going to accept randomized trials or do they want could placebo controlled with all that nonsense. Just goes away. If you run a randomized trial because youre walking in with what everybody would agree is the gold standard of trials.
Speaker Change: Got it that's super helpful.
Speaker Change: And just to be clear, we have not had any formal regulatory advice on this.
Speaker Change: But on that point I think I would be shocked at the FDA wouldn't accept a randomized trial with PFS and OS as your in place got.
Speaker Change: Got it Okay Super helpful. And then kink in that in that context can you just talk about the the cutoff for B seven H for expression and how much additional work needs to be done before you feel like you can totally confirm that.
Speaker Change: We're doing that work and expansion.
Speaker Change: There there were.
Speaker Change: Would you switched to a pre commercial assay there were a few tweaks in the assay between escalation of backfill and expansion. So in expansion. It is possible that the TPS score comes out to be a slightly different place, but I think what's important to understand is even if the TPS scores shifts a little.
Speaker Change: <unk>.
Speaker Change: We still fully anticipate that 40% to 50% of patients are going to be positive. So the actual score may change a little bit, but we would be surprised if the percent of patients who are positive dramatically changed in that that's probably an important point as you think about the competitive landscape because people have different specifications around.
Speaker Change: Research assays the specification doesn't matter so much sustaining conditions sustaining time the temperature what youre looking for in <unk> hundred 74 is about 40% to 50% of the population and so regardless of what have someone describes the conditions of their assay, they're likely identifying the same patients.
Speaker Change: Got it that's great. Thanks for taking our question.
Speaker Change: The next question will come from Andy <unk> with William Blair. Please go ahead.
Andy: Thanks for taking my questions.
Speaker Change: Two quick ones from US one is.
Speaker Change: It's about the coastal the dynamics I think at the conference Dr. Terry Delaney presented almost 200 patients worth of data.
Speaker Change: Showing similar PFS for the intermediate or after an intermediary chemo for total ADP we challenge.
Speaker Change: And so that I.
Speaker Change: I guess two.
Speaker Change: So from my perspective.
Speaker Change: As I said the phenotype is more longer term I'm curious about your take on that data.
Speaker Change: And then secondarily in the January update for that.
Speaker Change: Triple negative cohort there were.
Speaker Change: Three patients with treatment ongoing I'm, just curious about the status of phase III patients for the March update thank you.
Speaker Change: With regards to your first question I mean, I'm not immune I mean I.
Speaker Change: I stayed behind because of the restructuring and the earnings so I cannot I want to be careful commenting on my presentation, which I did not see.
Speaker Change: So I mean.
Speaker Change: I'll have to go back and look at that we did have people on the ground at the well.
Speaker Change: We'll find out from them.
Speaker Change: With regards to the.
Speaker Change: Details of the ongoing status I think I would defer that as I've said to the <unk>, we will be giving an update the March update for all patients at the <unk> presentation, and I really don't want to front run that.
Speaker Change: The next question will come from a speaker going awarding with truest. Please go ahead.
Speaker Change: Hi, This is cleanup I forgot thanks for taking my question I had a follow up on the P 74 expression what question that patients have.
Speaker Change: H Y expression data 70.
Speaker Change: Your previous presentation, you had 40 out of 130 patients.
So should we see him around roughly 30% of the population.
Speaker Change: So I think we for T N B C.
Speaker Change: We're comfortable that that number will be somewhere between 40% to 50% of the population.
Speaker Change: Okay.
Speaker Change:
Speaker Change: And then also regarding the proteinuria medication that strategy or that the ace inhibitor prophylaxis is that in the heat it only once a patient exhibit signs of question area or.
Speaker Change: Pacific Great cash flow.
Speaker Change: Is it the new amendment that has now been adopted at most of the sites.
Speaker Change: You are encouraged to start that prophylactic Lee.
Speaker Change: Fire I mean, basically at the initiation of treatment unless the patient has a contra indication for the ace or arb.
Speaker Change: Okay. Thank you so much.
Speaker Change: Again, if you have a question. Please press Star then one our next question will come from Jeep.
Luca Gene: Luca gene with B T. I G. Please go ahead.
Luca Gene: Hey, good morning, and thanks for taking the question maybe two quick questions from me with the 67.4 and 44.5 make doses now moving forward and expansion what would you ultimately wants to see from a target product profile perspective to justify moving $44 five over the other dose.
Luca Gene: And enter pivotal studies and just in terms of the expansion update later this year or will it be strictly in T. N B C patients or could we also expect to see say ovarian or endometrial patients.
Luca Gene: For that update.
Luca Gene: With regards to your first question I mean.
Luca Gene: With 60, if the efficacy for the higher dose is not meaningfully better and 67 Q4 67 in Q4 is the dose we would take forward because it's just it is.
Luca Gene: Progeria is much less of an issue there.
Luca Gene: And its just a fairly straightforward and easy regimen to do.
Luca Gene: The the intent of the.
Luca Gene: The higher dose intensity upfront is getting patients into response faster, which is important and a very aggressive disease like CNBC, especially these late like Paris, Tokyo patients.
Luca Gene: What.
Luca Gene: With regards to the your other question was.
Luca Gene: I'm sorry.
Luca Gene: Thank you I was wondering just in terms of the externalization and actually this is I'm glad you asked that because this is one of the areas I think we probably did.
Luca Gene: The impact of restructuring when people are saying what did we stop doing.
Luca Gene: As part of this one of the things that we are not doing is we originally had planned to be starting multiple extensions across multiple tumor types.
Luca Gene: And so one of the reasons, we can get by with a smaller organization is it's going to be a very breast cancer focused expansion program. So the ovarian and endometrial data that we have already and backfill and escalation.
Luca Gene: We'll be at the <unk> presentation, but there will not be in 2025, new expansion data beyond breast cancer.
Luca Gene: And that is just an unfortunate consequence.
Luca Gene: You know.
Luca Gene: Extended cash runway.
Luca Gene: But we still want to look at those two indications. It's just we had to prioritize at this point in time.
Luca Gene: Thank you.
Speaker Change: This concludes our question and answer session I would like to turn the conference back over to Dr. Marty Huber for any closing remarks. Please go ahead Sir.
Speaker Change: Thank you operator, and thanks, everyone for dialing in we will look forward to seeing many of you in Chicago I'd ask on a couple of weeks that concludes our call. Thank you.
Speaker Change: The conference has now concluded. Thank you for attending today's presentation you may now disconnect.
Speaker Change: Okay.
Speaker Change: [music].