Q2 2026 Syndax Pharmaceuticals Inc Earnings Call

August 4, 2026

Speaker #1: Good day, everyone, and welcome to the Syndic's second quarter 2026 earnings conference call. Today's call is being recorded. If you'd like to ask a question, follow the company's prepared remarks.

Operator 2: Good day, everyone, and welcome to the Syndax Q2 2026 Earnings Conference Call. Today's call is being recorded. If you'd like to ask a question following the company's prepared remarks, please press star five during the call. At this time, I would like to turn the call over to Sharon Klahre, Head of Investor Relations at Syndax Pharmaceuticals.

Operator: Good day, everyone, and welcome to the Syndax Q2 2026 Earnings Conference Call. Today's call is being recorded. If you'd like to ask a question following the company's prepared remarks, please press star five during the call. At this time, I would like to turn the call over to Sharon Klahre, Head of Investor Relations at Syndax Pharmaceuticals.

Speaker #1: Please press star 5 during the call. At this time, I would like to turn the call over to Sharon Clary, Head of Investor Relations at Syndax Pharmaceuticals.

Speaker #2: Great. Thank you, operator. Welcome, and thank you all for joining us today for a review of Syndax's second quarter 2026 financial and operating results.

Sharon Klahre: Great. Thank you, operator. Welcome, and thank you all for joining us today for a review of Syndax's Q2 2026 financial and operating results. I'm Sharon Klahre, and with me this afternoon to provide an update on the company's progress and discuss financial results are Michael A. Metzger, Chief Executive Officer, Steven Closter, Chief Commercial Officer, Dr. Nicholas Botwood, Head of R&D and Chief Medical Officer, and Keith Goldan, Chief Financial Officer. This call is accompanied by a slide deck that has been posted on the investor page of the company's website. You can now turn to our forward-looking statements on slide two. Before we begin, I'd like to remind you that any statements made during this call that are not historical are considered to be forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.

Speaker #2: I'm Sharon Clary, and with me this afternoon to provide an update on the company's progress and discuss financial results. I'm Michael Metzger, Chief Executive Officer.

Speaker #2: Keith Closter, Chief Commercial Officer. Dr. Nick Botwood, Head of R&D, and Chief Medical Officer. And Keith Goldan, Chief Financial Officer. This call is accompanied by a slide deck that has been posted on the investor page of the company's website.

Speaker #2: You can now turn to our forward-looking statements on slide 2. Before we begin, I'd like to remind you that any statements made during this call that are not historical are considered to be forward-looking statements.

Speaker #2: Within the meaning of the Private Securities Litigation Reform Act of 1995, actual results may differ materially from those indicated by these statements as a result of various important factors.

Sharon Klahre: Actual results may differ materially from those indicated by these statements as a result of various important factors, including those discussed in the Risk Factors section in the company's most recent quarterly report on Form 10-Q, as well as other reports filed with the SEC. Any forward-looking statements made represent our views as of today, 4 August 2026, only. A replay of this call will be available on the company's website, www.syndax.com, following its completion. With that, I am pleased to turn the call over to Michael Metzger, Chief Executive Officer of Syndax.

Speaker #2: Including those discussed in the risk factor section in the company's most recent quarterly report on Form 10-Q. As well as other reports filed with the SEC.

Speaker #2: Any forward-looking statements made represent our views as of today, August 4, 2026, only. A replay of this call will be available on the company's website, www.syndax.com, following its completion.

Speaker #2: And with that, I'm pleased to turn the call over to Michael Metzger, Chief Executive Officer of Syndax.

Speaker #3: Thank you, Sharon. Good afternoon, everyone, and thank you for joining us. Starting Syndax team delivered another quarter of solid commercial results and progress across our growing pipeline of programs, targeting areas of high unmet need and substantial commercial opportunity.

Michael A. Metzger: Thank you, Sharon. Good afternoon, everyone, and thank you for joining us. Starting with slide three. The Syndax team delivered another quarter of solid commercial results and progress across our growing pipeline of programs targeting areas of high unmet need and substantial commercial opportunity. The business fundamentals are strong. Sales of Revuforj and Niktimvo grew to a combined total of $115 million in Q2. Both medicines are now annualizing at well over $200 million each, and we have just started to unlock their multibillion-dollar potential. Revuforj continue to grow by double digits, with net revenue totaling $55 million in Q2, up 91% year over year and 12% quarter over quarter.

Speaker #3: The business fundamentals are strong. Sales of Revue Forge and Noctimbo grew to a combined total of with slide 3. $115 million, in the second The quarter.

Speaker #3: Both medicines are now annualizing at well over $200 million each, and we have just started to unlock their multi-billion dollar potential. Revue Forge continued to grow by double digits, with net revenue totaling $55 million in the second quarter up 91% year over year and 12% quarter over quarter.

Speaker #3: These results highlight our continued leadership in Mendon Inhibition, robust demand in both MPM-1 and KMT-2A, and the positive impact of an increasing average treatment duration driven by multiple factors, including a growing number of patients on therapy for an extended period after receiving a stem cell transplant.

Michael A. Metzger: These results highlight our continued leadership in menin inhibition, robust demand in both NPM1 and KMT2A, and the positive impact of an increasing average treatment duration driven by multiple factors, including a growing number of patients on therapy for an extended period after receiving a stem cell transplant. As the number of patients on therapy post-transplant continues to stack, this recurring base will be an important driver of long-term compounding growth. Encouragingly, the average duration of treatment is also increasing among patients who are not proceeding to a transplant. As Steve will describe shortly, the positive impact of an extending average treatment duration, which was partially offset this quarter by fluctuation in the number of new patients initiating therapy, one of several drivers of our business. Today, we are even more confident in the forward trajectory and substantial commercial opportunity with Revuforj.

Speaker #3: As the number of patients on therapy post-transplant continues to stack, this reoccurring base will be an important driver of long-term compounding growth. Encouragingly, the average duration of treatment is also increasing among patients who are not proceeding to a transplant.

Speaker #3: As Steve will describe shortly, the positive impact of an extended average treatment duration was partially offset this quarter by fluctuations in the number of new patients initiating therapy, one of several drivers of our business.

Michael A. Metzger: As Steve will describe shortly, the positive impact of an extending average treatment duration, which was partially offset this quarter by fluctuation in the number of new patients initiating therapy, one of several drivers of our business. Today, we are even more confident in the forward trajectory and substantial commercial opportunity with Revuforj.

Speaker #3: Today, we are even more confident in the forward trajectory and substantial commercial opportunity with Revue Forge. Our conviction is underpinned by the multiple drivers for continued growth, including a best-in-class profile valued by physicians and increasing average duration of therapy, a broad and expanding prescriber base, and ample opportunity in MPM-1, KMT-2A, and other Mendon-dependent acute leukemias.

Michael A. Metzger: Our conviction is underpinned by the multiple drivers for continued growth, including a best-in-class profile valued by physicians, an increasing average duration of therapy, a broad and expanding prescriber base, and ample opportunity in NPM1, KMT2A, and other menin-dependent acute leukemias. We are well-positioned to extend our leadership in menin inhibition into the future and continue driving innovation for patients. Building on a long history of landmark firsts, we are positioned to be first to frontline AML, driven by strong global site initiation and patient enrollment in our pivotal trials. With future anticipated indications in frontline AML, we expect that Revuforj could reach in excess of $2 billion in peak annual net revenue in the US alone. We have another data-rich period ahead for revumenib.

Speaker #3: We are well positioned to extend our leadership in menin inhibition into the future and continue driving innovation for patients. Building on a long history of landmark firsts, we are positioned to be first to frontline AML, driven by strong global site initiation and patient enrollment in our pivotal trials.

Speaker #3: With future anticipated indications in frontline AML, we expect that Revue Forge could reach in excess of $2 billion in peak annual net revenue in the U.S.

Speaker #3: alone. We have another data-rich period ahead for Revue Mendon. In the second half of the year, we will report additional practice-informing evidence from multiple trials at major medical meetings, expanding on the prominent presence we had at ASCO and EHA in June.

Michael A. Metzger: In H2 of the year, we will report additional practice-informing evidence from multiple trials at major medical meetings, expanding on the prominent presence we had at ASCO and EHA in June. We also expect to publish data in relapse/refractory NUP98-rearranged acute leukemia in Q4. These results could inform clinical practice and guidelines in a patient population similarly sized to KMT2A. Patients with NUP98 urgently need new treatment options, including therapies that may reduce the risk of relapse after transplant, as is the case with KMT2A. Physician feedback indicates that NUP98 rearrangements are more common than once thought, occurring in perhaps 5% or more of AML cases, translating into potentially one to 2,000 pediatric and adult patients with NUP98 annually.

Speaker #3: We also expect to publish data in relapse refractory, NOOC 98, rearranged acute leukemia in the fourth quarter. These results could inform clinical practice and guidelines in a patient-population similarly sized to KMT-2A.

Speaker #3: Patients with NOOC 98 urgently need new treatment options, including therapies that may reduce the risk of relapse after transplant, as is the case with KMT-2A.

Speaker #3: Physician feedback indicates that NOOC 98 rearrangements are more common than once thought, occurring in perhaps 5% or more of AML cases, translating into potentially 1 to 2,000 pediatric and adult patients with NOOC 98 annually.

Speaker #3: As the first and only company to report clinical data showing activity with a Mendon inhibitor in this subtype, we have a unique opportunity to pursue a guideline listing that could meaningfully expand the patient population treated with Revue Mendon.

Michael A. Metzger: As the first and only company to report clinical data showing activity with a menin inhibitor in this subtype, we have a unique opportunity to pursue a guideline listing that could meaningfully expand the patient population treated with revumenib. Switching gears to Niktimvo and chronic GVHD. Niktimvo net revenue grew to $60 million in Q2, up 67% year over year. This performance reflects robust demand in Niktimvo's unique ability to address inflammation and fibrosis. Niktimvo is positioned for further growth, with strong adoption in the fourth line and increasing uptake in the third line, driven by a broad base of prescribers who are enthusiastic about the results they've seen in their patients. We also have multiple expansion opportunities and important upcoming catalysts for axatilimab with phase II data in IPF and frontline chronic GVHD expected in Q4, poised to unlock new multibillion-dollar opportunities.

Speaker #3: Switching gears to Noctimbo. And chronic GVHD. Noctimbo net revenue grew to $60 million in the second quarter, up 67% year over year. This performance reflects robust demand in Noctimbo's unique ability to address inflammation and fibrosis.

Speaker #3: Noctimbo is positioned for further growth with strong adoption in the fourth line and increasing uptake in the third line, driven by a broad base of prescribers who are enthusiastic about the results they've seen in their patients.

Speaker #3: We also have multiple expansion opportunities and important upcoming catalysts for Axitilumab, with phase two data in IPF and frontline chronic GVHD expected in the fourth quarter, poised to unlock new multi-billion dollar opportunities.

Speaker #3: Turning to our pipeline assets, at our R&D event last month we unveiled two innovative assets we are advancing into the clinic, leveraging our world-class R&D capabilities and experience taking revumenib and axatilimab from IND to FDA approval in about five years.

Michael A. Metzger: Turning to our pipeline assets. At our R&D event last month, we unveiled two innovative assets we are advancing into the clinic, leveraging our world-class R&D capabilities and experience taking revumenib and axatilimab from IND to FDA approval in about 5 years. SNDX-4321 is a novel mutant-selective CNS-penetrant allosteric EGFR inhibitor for non-small cell lung cancer that offers a new approach to addressing patient populations with high unmet medical needs, such as those with L858R mutations and CNS metastases. SNDX-62122 is a next-generation menin inhibitor we are developing for myelofibrosis or MF, building on our extensive experience pioneering menin inhibition in hematology. It is the first molecule from our internally developed and wholly owned library of next-generation menin inhibitors, which we intend to advance into promising new areas.

Speaker #3: SNDX-4321 is a novel, mutant-selective, CNS-penetrant allosteric EGFR inhibitor for non-small cell lung cancer that offers a new approach to addressing patient populations with high unmet medical needs, such as those with L858R mutations and CNS metastases.

Speaker #3: SNDX-62122 is a next-generation menin inhibitor we are developing for myelofibrosis, or MF, building on our extensive experience pioneering menin inhibition in hematology. It is the first molecule from our internally developed and wholly owned library of next-generation menin inhibitors, which we intend to advance into promising new areas.

Speaker #3: We are entering into another exciting chapter for the company as we build Revue Forge and Noctimbo into major commercial franchises and leverage our proven R&D engine to bring new treatment options to even more patients.

Michael A. Metzger: We are entering into another exciting chapter for the company as we build Revuforj and Niktimvo into major commercial franchises and leverage our proven R&D engine to bring new treatment options to even more patients. We are fully funded to execute on our commercial and R&D priorities and continue to advance towards profitability with growing revenue from the first two medicines from our pipeline.

Speaker #3: We are fully funded to execute on our commercial and R&D priorities, and continue to advance towards profitability with growing revenue from the first two medicines in our pipeline.

Speaker #3: I will now turn the call over to Steve to discuss our commercial results in more detail. Steve.

Michael A. Metzger: I'll now turn the call over to Steve to discuss our commercial results in more detail. Steve?

Speaker #2: Thank you, Michael. Starting with Revumenib on slide four. We delivered our sixth consecutive quarter of double-digit Revumenib net revenue and prescription growth, and continue to track well above launch benchmarks set by other mutation-directed AML therapies.

Steve Closter: Thank you, Michael. Starting with Revuforj on Slide four. We delivered our sixth consecutive quarter of double-digit Revuforj net revenue and prescription growth and continue to track well above launch benchmarks set by other mutation-directed AML therapies. Net revenue totaled $55 million, up 12% from the prior quarter. Total prescriptions were approximately 1,500, up 15% from the prior quarter. These results reflect robust demand and an increasing average duration of therapy, one of several important drivers of our business. We have dominant share of the overall menin business today, having treated over 1,600 patients commercially since launch, including 250 new patients added in Q2.

Speaker #2: Net revenue totaled $55 million, up 12% from the prior quarter. Total prescriptions were approximately 1,500, up 15% from the prior quarter. These results reflect robust demand and an increasing average duration of therapy, which is one of several important drivers of our business.

Speaker #2: We have dominant share of the overall Mendon business today, having treated over 1,600 patients commercially since launch, including 250 new patients added in the second quarter.

Speaker #2: We saw some fluctuation in new patient starts in Q2 relative to prior quarters, reflecting typical variation quarter to quarter in the number of available patients with a rare disease, and market dynamics when physicians have more than one drug and class they can consider using depending on the patient's mutational profile.

Steve Closter: We saw some fluctuation in new patient starts in Q2 relative to prior quarters, reflecting typical variation quarter to quarter in the number of available patients with a rare disease and market dynamics when physicians have more than one drug in class they can consider using, depending on the patient's mutational profile. To ensure we leave no appropriate patient behind, we have optimized our established customer footprint and targeting, expanded our ability to leverage lab data to engage physicians when they have a suitable patient in their care, and increased our promotional efforts and educational activities. We remain confident we will continue to lead this market with the strongest efficacy profile in an efficacy-driven market and multiple drivers supporting long-term growth. Our business in KMT2A and NPM1 is strong, and it is growing.

Speaker #2: To ensure we leave no appropriate patient behind, we have optimized our established customer footprint and targeting, expanded our ability to leverage lab data to engage physicians when they have a suitable patient in their care, and increased our promotional efforts and educational activities.

Speaker #2: We remain confident we will continue to lead this market with the strongest advocacy profile in an advocacy-driven market, and multiple drivers supporting long-term growth.

Speaker #2: Our business in KMT2A and MPM1 is strong and continues to grow. Revumenib is the standard of care for relapsed/refractory KMT2A-rearranged acute leukemia, and it remains the only targeted therapy for this aggressive cancer with no other effective treatment options.

Steve Closter: Revuforj is the standard of care for relapsed/refractory KMT2A translocated acute leukemia and remains the only targeted therapy for an aggressive cancer with no other effective treatment options. We continue to expand into our second indication with NPM1, accounting for at least 40% of new patients in Q2 and more than 30% of the $55 million in net revenue. All indicators suggest Revuforj will continue to be the menin inhibitor of choice for all menin-dependent acute leukemias. Physicians value having one efficacious and well-tolerated drug they can use across multiple acute leukemia subtypes in both adults as well as children. They appreciate that the efficacy they see with Revuforj in the real world is consistent with, or in fact even better than, the clinical trial results.

Speaker #2: We continue to expand into our second indication with MPM1, accounting for at least 40% of new patients in the second quarter, and more than 30% of the $55 million in net revenue.

Speaker #2: All indicators suggest Revue Forge will continue to be the Mendon inhibitor of choice for all Mendon-dependent acute leukemias. Physicians value having one efficacious and well-tolerated drug they can use across multiple acute leukemia subtypes, in both adults as well as children.

Speaker #2: They appreciate that the efficacy they see with Revue Forge in the real world is consistent with, or in fact even better, than the clinical trial results.

Speaker #2: They value individualized dosing, not having to worry about reduced efficacy, when their patients are taking commonly prescribed gastric acid-reducing agents like PPIs and H2 blockers, and the lack of any clinically meaningful pruritus and adverse event that can be impactful for patients and very difficult for clinicians to manage.

Steve Closter: They value individualized dosing, not having to worry about reduced efficacy when their patients are taking commonly prescribed gastric acid-reducing agents like PPIs and H2 blockers, and the lack of any clinically meaningful pruritus and adverse event that can be impactful for patients and very difficult for clinicians to manage. This combination of efficacy, tolerability, and dosing flexibility is why Revuforj is and will remain the drug of choice for physicians. Turning to Slide five. There are two fundamental drivers of our business, new patients and average treatment duration, and both are building. The unique breadth of our indication provides us with the opportunity to target approximately 2,000 patients diagnosed annually with relapsed/refractory KMT2A translocated acute leukemia, plus 4,500 with relapsed/refractory NPM1 mutated AML.

Speaker #2: This combination of efficacy, tolerability, and dosing flexibility is why Revue Forge is, and will remain, the drug of choice for physicians. Turning to slide five.

Speaker #2: There are two fundamental drivers of our business: new patients and average treatment duration, and both are building. The unique breadth of our indication provides us with the opportunity to target approximately 2,000 patients diagnosed annually with relapsed refractory KMT2A-translocated acute leukemia, plus 4,500 with relapsed refractory MPM1-mutated AML.

Speaker #2: And we've made excellent progress reaching this population, with more than 1,600 patients treated with commercial drug since launching in KMT-2A in the fourth quarter of 2024, and MPM1 in the fourth quarter of last year.

Steve Closter: We've made excellent progress reaching this population, with more than 1,600 patients treated with commercial drug since launching in KMT2A in Q4 2024 and NPM1 in Q4 of last year. Importantly, there's still plenty of room to reach more patients each quarter. For instance, of the annual 4,500 relapsed/refractory NPM1 patients, we estimate that less than 15% have received a menin inhibitor, highlighting the substantial opportunity for further growth. Compared to KMT2A, where we saw a steep uptake curve due to the lack of other approved or impactful therapies, we expect our NPM1 business will build over time due to other options that physicians may consider for this population, depending on their co-mutations or other factors.

Speaker #2: Importantly, there's still plenty of room to reach more patients each quarter. For instance, of the annual 4,500 relapsed refractory MPM1 patients, we estimate that less than 15% have received the Mendon inhibitor, highlighting the substantial opportunity for further growth.

Speaker #2: Compared to KMT-2A, where we saw a steep uptake curve due to the lack of other approved or impactful therapies, we expect our MPM1 business will build over time due to other options that physicians may consider for this population, depending on their co-mutations or other factors.

Speaker #2: The second fundamental driver is average treatment duration, which has increased due to evolving clinical practice and a product profile that is conducive to patients staying on therapy for extended periods of time.

Steve Closter: The second fundamental driver is average treatment duration, which is increasing due to evolving clinical practice and a product profile that is conducive to patients staying on therapy for extended periods of time. Physicians are reaching for Revuforj early in the relapsed/refractory treatment paradigm and are often choosing to use it in combination with other therapies, with the goal of driving responses and extending the duration of effect. Claims data show 75% use in the second and third line and approximately 40% use in combination. Encouragingly, a significant proportion of patients are proceeding to stem cell transplant after receiving Revuforj, which is the goal in the relapsed/refractory setting for both KMT2A and NPM1 patients who are fit enough to receive a transplant. We continue to observe approximately 50% of KMT2A patients proceeding to transplant.

Speaker #2: Physicians are reaching for Revue Forge early in the relapse refractory treatment paradigm, and are often choosing to use it in combination with other therapies with the goal of driving responses and extending the duration of effect.

Speaker #2: Claims data show 75% of use in the second and third line, and approximately 40% of use in combination. Encouragingly, a significant proportion of patients are proceeding to stem cell transplant after receiving Revue Forge which is the goal in the relapse refractory setting for both KMT-2A and MPM1 patients who are fit enough to receive a transplant.

Speaker #2: We continue to observe approximately 50% of KMT-2A patients proceeding to transplant. About 50% of those patients have resumed therapy thus far, after pausing for three to six months, up from an estimated 45% last quarter.

Steve Closter: About 50% of those patients have resumed therapy thus far after pausing for 3 to 6 months, up from an estimated 45% last quarter. We expect this percentage will continue to increase as our colleagues in Medical Affairs report additional evidence from the post-transplant setting in collaboration with leading treatment centers, building on the encouraging data MD Anderson presented at ASCO and EHA this past June. Over time, we expect that up to 70% to 80% of transplant patients will ultimately return to therapy for 1 to 2 years based on feedback from physicians and clinical trial and real-world experience. These evolving treatment patterns are increasing the average treatment duration, especially the growing number of patients on therapy post-transplant. This group is already averaging at least 9 months of therapy, with this duration expected to steadily increase as we continue to follow patients over time.

Speaker #2: We expect this percentage will continue to increase as our colleagues in medical affairs report additional evidence from the post-transplant setting in collaboration with leading treatment centers, building on the encouraging data MD Anderson presented at ASCO and AHA this past June.

Speaker #2: Over time, we expect that up to 70% to 80% of transplant patients will ultimately return to therapy for one to two years, based on feedback from physicians and clinical trial and real-world experience.

Speaker #2: These evolving treatment patterns are increasing the average treatment patients on therapy post-transplant. This group is already averaging at least nine months of therapy, with this duration expected to steadily increase as we continue to follow patients over time.

Steve Closter: These evolving treatment patterns are increasing the average treatment duration, especially the growing number of patients on therapy post-transplant. This group is already averaging at least 9 months of therapy, with this duration expected to steadily increase as we continue to follow patients over time.

Speaker #2: Among patients who do not receive a transplant, over half are still staying on therapy for a significant period, with an average treatment duration that is already over seven months and increasing.

Steve Closter: Among patients who do not receive a transplant, over half are still staying on therapy for a significant period, with an average treatment duration that is already over seven months and building. With a significant addressable patient population and an increasing average treatment duration, we are confident in our ability to build a sustainable business with our first two indications for Revuforj. Moving to slide six. We have a solid commercial foundation in place to support the success of Revuforj, including a highly accomplished team with deep and strong customer relationships. Our already robust prescriber base has continued to expand quarter over quarter, including our activation of Tier 1 and Tier 2 accounts, the highest volume centers in the US who treat two-thirds of our target population. Nearly 90% of these accounts have ordered, up from 70% prior to the approval of Revuforj in NPM1.

Speaker #2: With a significant addressable patient population and an increasing average treatment duration, we are confident in our ability to build a sustainable business with our first two indications for revumenib and axatilimab.

Speaker #2: Moving to slide six. We have a solid commercial foundation in place to support the success of Revue Forge including a highly accomplished team, with deep and strong customer relationships.

Speaker #2: Our already robust prescriber base has continued to expand, quarter over quarter, including our activation of tier one and tier two accounts—the highest volume centers in the U.S.—which treat two-thirds of our target population.

Speaker #2: Nearly 90% of these accounts have ordered up from 70% prior to the approval of Revue Forge in MPM1. Overall, more than 500 and 80 accounts have ordered Revue Forge up 11% from the prior quarter, reflecting growing adoption from centers of all sizes including community practices.

Steve Closter: Overall, more than 580 accounts have ordered Revuforj, up 11% from the prior quarter, reflecting growing adoption from centers of all sizes, including community practices. Our growing prescriber base reflects physicians' enthusiasm for Revuforj and positions us to drive further penetration for both indications. We have excellent payer coverage, and physicians can access the menin inhibitor they prefer. As of the end of Q2, Revuforj's formulary coverage was 98% for all covered lives for both indications, a coverage position that leads the class. In addition to having nearly 100% formulary coverage, Revuforj has preferential coverage on plans representing 17% of all covered lives versus less than 2% of lives for the other menin inhibitor. Turning to Niktimvo on slide seven. Niktimvo net revenue totaled $60 million in the second quarter, up 67% year over year and 9% quarter over quarter.

Speaker #2: Physicians' enthusiasm for Revumenib and physicians' use continue to drive further penetration for both indications. We have excellent payer coverage, and physicians can access the menin inhibitor they prefer.

Speaker #2: As of the end of Q2, Revue Forge's formulary coverage was 98% of all covered lives for both indications, a coverage addition to having nearly 100%. Our growing prescriber base reflects formulary coverage. Revue Forge has preferential coverage on plans representing 17% of all covered lives, versus less than 2% of lives for the other Mendon inhibitor.

Speaker #2: Turning to NCTIMVO on slide seven. NCTIMVO net revenue totaled $60 million in the second quarter, up 67% year over year, and 9% quarter over quarter.

Speaker #2: This result reflects strong and consistent new patient starts and solid persistency. More than 300 new patients were added, and about 5,750 infusions were administered in the second quarter.

Steve Closter: This result reflects strong and consistent new patient starts and solid persistency. More than 300 new patients were added and about 5,750 infusions were administered in the second quarter. Niktimvo is annualizing at $240 million and continues to track with the launch of Rezurock, a drug that reached $500 million in annual US net sales within the first four years of launch in the same indication. Moving to slide eight. The fundamentals of our Niktimvo business are strong, with multiple drivers for continued growth. The first is continued adoption in the fourth line and steadily increasing uptake in the third line as clinicians gain experience with Niktimvo. Within one and a half years of launch, Niktimvo has captured approximately one-third of the third-line-plus chronic GVHD market. As the patient mix shifts more towards patients with less advanced disease, we expect this will extend the average treatment duration.

Speaker #2: NCTIMVO was annualizing at $240 million, and continues to track with the launch of Rezeroc, a drug that reached $500 million in annual US net sales, within the first four years of launch in the same indication.

Speaker #2: Moving to slide eight. The fundamentals of our NCTIMVO business are strong, with multiple drivers for continued growth. The first is continued adoption in the fourth line and steadily increasing uptake in the third line, as clinicians gain experience with NCTIMVO.

Speaker #2: Within one and a half years of launch, NCTIMVO has captured approximately one-third of the third-line plus chronic GVHD market, as the patient mix shifts more towards patients with less advanced disease.

Speaker #2: We expect this will extend the average treatment duration. This is a chronic disease, with the potential for patients to stay on therapy for long periods.

Steve Closter: This is a chronic disease with the potential for patients to stay on therapy for long periods. We've observed solid persistency in a commercial setting, with 60% to 70% of patients staying on Niktimvo for at least 12 months. Our clinical trial experience suggests the duration of therapy could be measured in years for a meaningful proportion of patients. Our Niktimvo business benefits from a broad and productive prescriber base and commercial synergies for both Syndax and Incyte. Nearly every bone marrow transplant center in the US has prescribed Niktimvo and become a repeat customer. Physicians continue to report impressive activity in multiple organs, with particularly notable responses in the lungs and skin, some of the most difficult to treat organs. All these drivers position us to expand our impact in third-line-plus chronic GVHD, a $2 billion US market opportunity.

Speaker #2: We've observed solid persistency in the commercial setting, with 60% to 70% of patients staying on NCTIMVO for at least 12 months. Our clinical trial experience suggests the duration of therapy could be measured in years for a meaningful proportion of patients.

Speaker #2: Our NCTIMVO business benefits from a broad and productive prescriber base, and commercial synergies for both Syndax and Insight. Nearly every bone marrow transplant center in the US has prescribed NCTIMVO and become a repeat customer.

Speaker #2: Physicians continue to report impressive activity in multiple organs, with particularly notable responses in the lungs and skin, some of the most difficult to treat organs.

Speaker #2: All these drivers position us to expand our impact in third line plus chronic GBHD at $2 billion US market opportunity. Looking ahead, the ongoing trials and frontline chronic GBHD and IPF could unlock additional multi-billion dollar opportunities.

Steve Closter: Looking ahead, the ongoing trials in frontline chronic GVHD and IPF could unlock additional multibillion-dollar opportunities. With that, I will hand the call over to Nick to talk about our development programs.

Speaker #2: With that, I'll hand the call over to Nick to talk about our development programs.

Speaker #3: Thank you, Steve. Turning to slide nine, I'd like to highlight the progress we've made advancing our scientific leadership in Mendon inhibition with a strong presence at e-medical meetings, and two landmark publications.

Nick Botwood: Thank you, Steve. Turning to slide nine, I would like to highlight the progress we have made advancing our scientific leadership in menin inhibition with a strong presence in medical meetings and two landmark publications. At ASCO, we had 4 revumenib abstracts, including an oral presentation of post-transplant maintenance data from a cohort of heavily pretreated patients with KMT2A, NPM1, or NUP98 alterations who resumed revumenib post-transplant. This analysis showed a 2-year overall survival rate of 90%, which is nearly double the historical rate observed prior to the introduction of revumenib. Moving on to EHA, we had 12 revumenib abstracts highlighting the clinical activity with revumenib in multiple acute leukemia subtypes and settings, including in combination with standard of care therapies in the frontline and relapsed/refractory setting.

Speaker #3: At ASCO, we had four Revumenib abstracts, including an oral presentation of post-transplant maintenance data from a cohort of heavily pre-treated patients with KMT2A, MLL, or NUTM1 alterations, who resumed Revumenib post-transplant.

Speaker #3: This analysis showed a two-year overall survival rate of 90%, which is nearly double the historical rate observed prior to the introduction of Revue Mendon.

Speaker #3: Moving on to EHA, we had 12 Revue Mendon abstracts highlighting the clinical activity with Revue Mendon in multiple acute leukemia subtypes and settings, including in combination with standard of care therapies in the frontline and relapse refractory setting.

Speaker #3: In June, data from the relapse refractory cohort in the phase one, two SAVE trial were published in the Journal of Clinical Oncology. The results observed with the all-oral combination of Revue Mendon venatoclax and dicyclopine cetasuridine in a heavily pre-treated population of patients with MPM1 KMT2A or NUT98 AML are impressive.

Nick Botwood: In June, data from the relapsed/refractory cohort in the phase I/II SAVE trial were published in the *Journal of Clinical Oncology*. The results observed with the all-oral combination of revumenib, venetoclax, and decitabine/cedazuridine in a heavily pretreated population of patients with NPM1/KMT2A or NUP98 AML are impressive. 88% achieved an overall response. 80% of evaluable CRc responders achieved MRD negativity, and 45% of patients proceeded to transplant, with 63% resuming revumenib post-transplant. These results are similar to outcomes observed in real-world cohorts treated with revumenib-based combinations, underscoring the potential to reproduce these results in clinical practice. In July, we and our collaborators published the results of groundbreaking preclinical studies with revumenib, which showed menin is a novel dependency in proliferative megakaryocytes, major drivers of myelofibrosis. These data provide the basis for our innovative clinical development program in myelofibrosis.

Speaker #3: 88% achieved an overall response. 80% of the valuable CRC responders achieved MRD negativity, and 45% of patients proceeded to transplant with 63% resuming Revue Mendon post-transplant.

Speaker #3: These results are similar to outcomes observed in real-world cohorts treated with Revue Mendon-based combinations, underscoring the potential to reproduce these results in clinical practice.

Speaker #3: In July, we and our collaborators published the results of groundbreaking preclinical studies with Revue Mendon, which showed Mendon is a novel dependency in a prolific megacarocytes major drivers of myelofibrosis.

Nick Botwood: In July, we and our collaborators published the results of groundbreaking preclinical studies with revumenib, which showed menin is a novel dependency in proliferative megakaryocytes, major drivers of myelofibrosis. These data provide the basis for our innovative clinical development program in myelofibrosis.

Speaker #3: These data provide the basis for our innovative clinical development program in myelofibrosis. Looking ahead to the second half of the year, we will deepen our scientific leadership with new Revue Mendon data from across the acute leukemia treatment continuum.

Nick Botwood: Looking ahead to H2 of the year, we will deepen our scientific leadership with new revumenib data from across the acute leukemia treatment continuum, including from the maintenance and real-world setting. We also look forward to presenting more mature frontline data in Q4, with updates expected from SAVE and Beat AML trials of revumenib with low-intensity chemotherapy, and from the 708 trial with intensive chemotherapy. We expect these data will be impactful for the clinical community and provide strong support for our ongoing pivotal frontline combination trials. We also expect to publish data in relapsed/refractory NUP98-rearranged acute leukemia in Q4, followed by submission of this important publication to the clinical guidelines for consideration.

Speaker #3: Including from the maintenance and real-world setting. We also look forward to presenting more mature frontline data in the fourth quarter, with updates expected from SAVE and BEAT AML trials of Revue Mendon with low-intensity chemotherapy, and from the 708 trial with intensive chemotherapy.

Speaker #3: We expect these data will be impactful for the clinical community and provide strong support for our ongoing pivotal frontline combination trials. We also expect to publish data in relapse refractory NUT98 rearranged acute leukemia in the fourth quarter.

Speaker #3: This will be followed by submission of this important publication to the clinical guidelines committee for consideration. Patients with NUT98 rearrangements have poor outcomes, and there is an urgent need for new treatment options, with many parallels to the unmet needs in KMT2A prior to the introduction of Revumenib.

Nick Botwood: Patients with NUP98 rearrangements have poor outcomes, and there is an urgent need for new treatment options, with many parallels to the unmet needs in KMT2A prior to the introduction of revumenib. Physicians are positive about the potential for revumenib to provide a new treatment option for this disease subtype based on the data reported. At EHA, we presented data from 25 heavily pretreated relapsed/refractory NUP98 patients showing a 28% overall response rate, with 43% of responders proceeding to a transplant and all resuming revumenib post-transplant. Turning to our pipeline on slide 10, I'd like to highlight just a few key points. First, we are rapidly advancing an integrated evidence generation plan designed to establish revumenib as the menin inhibitor of choice across the acute leukemia treatment continuum. Importantly, we maintain good momentum to be the first to deliver pivotal frontline data for a menin inhibitor.

Speaker #3: Physicians are positive about the potential for Revue Mendon to provide a new treatment option for this disease subtype, based on the data reported. At EHA, we presented data from 25 heavily pre-treated relapse refractory NUT98 patients showing a 28% overall response rate, with 43% of responders proceeding to a transplant, and all resuming Revue Mendon post-transplant.

Speaker #3: Turning to our pipeline on slide 10, I'd like to highlight just a few key points. First, we are rapidly advancing an integrated evidence generation plan designed to establish Revue Mendon as the Mendon inhibitor of choice across the acute leukemia treatment continuum.

Nick Botwood: Turning to our pipeline on slide 10, I'd like to highlight just a few key points. First, we are rapidly advancing an integrated evidence generation plan designed to establish revumenib as the menin inhibitor of choice across the acute leukemia treatment continuum. Importantly, we maintain good momentum to be the first to deliver pivotal frontline data for a menin inhibitor.

Speaker #3: Importantly, we maintain good momentum to be the first to deliver pivotal frontline data for the menin inhibitor. Global site activations and patient enrollment are well established in our pivotal trials, informed by an extensive body of clinical evidence, allowing for optimization of endpoint assumptions and other aspects of the study design.

Nick Botwood: Global site activations and patient enrollment is well established in our pivotal trials, informed by an extensive body of clinical evidence, allowing for optimization of endpoint assumptions and other aspects of the study design. Second, we are nearing two important axatilimab readouts. We are on track to report top-line data from the phase II MAXPIRe IPF trial in Q4. Positive data would open a transformative opportunity for axatilimab and provide a strong biological rationale for its mechanism in several other diseases where the pathology is underpinned by fibrosis and inflammation. We also anticipate top-line results from the phase II trial of axatilimab in combination with ruxolitinib in frontline chronic GVHD in Q4. Positive outcomes with the novel combination could begin to unlock the potential for a steroid-sparing regimen in newly diagnosed chronic GVHD.

Speaker #3: Second, we are nearing two important axatilimab readouts. We are on track to report top-line data from the Phase 2 MAXPIRE IPF trial in the fourth quarter.

Speaker #3: Positive data would open a transformative opportunity for axitilumab and provide a strong biological rationale for its mechanism in several other diseases, whether pathology is underpinned by fibrosis and inflammation.

Speaker #3: We also anticipate top-line results from the phase two trial of axitilumab in combination with ruxolitinib in frontline chronic GVHD in the fourth quarter. Positive outcomes with the novel combination could begin to unlock the potential for a steroid sparing regimen in newly diagnosed chronic GVHD.

Speaker #3: Third, as highlighted at our recent R&D event, we announced two new pipeline assets, SNDX-4321 and SNDX-62122. In line with our focused R&D strategy, these are targeted molecules, both with first- and best-in-class potential, supported by compelling preclinical data, mechanistic insights, and the advocacy of leading researchers and clinicians.

Nick Botwood: Third, as highlighted at our recent R&D event, we announced two new pipeline assets, SNDX-4321 and SNDX-62122. In line with our focused R&D strategy, these are targeted molecules both with first and best-in-class potential, supported by compelling preclinical data, mechanistic insights, and advocacy of leading researchers and clinicians. With both revumenib and axatilimab, we have demonstrated our ability to efficiently generate clinical data that validates new therapeutic targets, leading to new approvals, a strength we will leverage again as we advance the next chapter of our R&D strategy. Turning to slide 11. 4321 is a novel mutant-selective CNS-penetrant allosteric EGFR inhibitor. We're developing it for non-small cell lung cancer patients with high unmet needs, such as those with the L858R mutations, CNS metastases, and atypical activating mutations or resistance to current therapies.

Speaker #3: With both Revue Mendon and axitilumab, we have demonstrated our ability to efficiently generate clinical data that validates new therapeutic targets leading to new approvals, a strength we will leverage again as we advance the next chapter of our R&D strategy.

Speaker #3: Turning to slide 11, 4321 is a novel mutant selective CNS penetrant allosteric EGFR inhibitor. We're developing it for non-small cell lung cancer patients with high unmet needs, such as those with the L858R mutation, CNS metastases, and atypical activating mutations or resistance to current therapies.

Speaker #3: In contrast, ATP site-directed third and fourth generation EGFR inhibitors 4321 binds at a pocket adjacent to the ATP site that is only accessible in the presence of L858R and certain other EGFR mutations.

Nick Botwood: In contrast to ATP site-directed third- and fourth-generation EGFR inhibitors, 4321 binds at a pocket adjacent to the ATP site, which is only accessible in the presence of L858R and certain other EGFR mutations. The allosteric approach allows for high selectivity and a double-lock approach to inactivating the receptor. 4321 and ATP site-directed therapies combine EGFR at the same time at different sites on the receptor, potentially enhancing efficacy and delaying resistance. We expect to submit an IND for 4321 by the end of 2026, with an assessment of monotherapy activity expected in early 2028. 62122 is our next-generation menin inhibitor in development for myelofibrosis that could offer a novel and potentially disease-modifying approach. It is the first candidate from our library of internally developed and wholly owned next-generation menin inhibitors that we plan to advance into new areas.

Speaker #3: The allosteric approach allows for high selectivity, and a double-lock approach to inactivating the receptor. 4321 and ATP site-directed therapies combine to target EGFR at the same time, at different sites on the receptor, potentially enhancing efficacy and delaying resistance.

Speaker #3: We expect to submit an IND for 4321 by the end of 2026, when an assessment of monotherapy activity expected in early 2028. 62122 is our next generation Mendon inhibitor in development for myelofibrosis, that could offer a novel and potentially disease-modifying approach.

Speaker #3: It is the first candidate for my library of internally developed and wholly owned next-generation Mendon inhibitors that we plan to advance into new areas.

Speaker #3: We expect to submit an IND and initiate phase one trial of 62122 in 2027. This program will be informed by a proof of principle trial of Revue Mendon in myelofibrosis that will be conducted in partnership with world-leading experts in myelofibrosis.

Nick Botwood: We expect to submit an IND and initiate phase I trial of SNDX-62122 in 2027. This program will be informed by a proof-of-principle trial of revumenib in myelofibrosis that will be conducted in partnership with world-leading experts in myelofibrosis. We expect this trial to initiate in Q4, with initial data anticipated in H2 of next year. In summary, we've made enormous progress advancing our late-stage trials and expanding our pipeline of differentiated assets. We are nearing several important data readouts and have multiple opportunities to transform the standard of care for some of the most difficult-to-treat diseases. With that, I'll turn the call to Keith to discuss our financials.

Speaker #3: We expect this trial to initiate in the fourth quarter with initial data anticipated in the second half of next year. In summary, we've made enormous progress advancing our late-stage trials and expanding our pipeline of differentiated assets.

Speaker #3: We are nearing several important data readouts and have multiple opportunities to transform the standard of care for some of the most difficult to treat diseases.

Speaker #3: With that, I'll turn the call over to Keith to discuss our financials.

Speaker #1: Thank you, Nick. Pardon me. Earlier this afternoon, we reported detailed second quarter 2026 financial results, and I'll highlight a few key points on slide 12.

Keith Goldan: Thank you, Nick. Pardon me. Earlier this afternoon, we reported detailed Q2 2026 financial results, and I'll highlight a few key points on slide 12. Total revenue for Q2 2026 was $72.8 million, up 92% over the same period last year. This consisted of $54.7 million of Revuforj net revenue and $18.1 million in Niktimvo collaboration revenue, which equated to 30% of the Niktimvo net revenue reported by our partner Incyte in the quarter.

Speaker #1: Total revenue for the second quarter of 2026 was $72.8 million, up 92% over the same period last year. This consisted of $54.7 million of Revue Forge net revenue and $18.1 million in Noctimvo collaboration revenue, which equated to 30% of the Noctimvo net revenue reported by our partner, Insight, in the quarter.

Speaker #1: We expect Noctimvo margin contribution defined as a collaboration revenue recorded by Syndax as a percentage of Noctimvo net sales to continue to be in the 25% to 30% range in the near term, and increase longer term as sales grow.

Keith Goldan: We expect Niktimvo margin contribution, defined as a collaboration revenue recorded by Syndax as a percentage of Niktimvo net sales, to continue to be in the 25% to 30% range in the near term and increase longer term as sales grow. We expect revenue from both Revuforj and Niktimvo to continue growing and advancing the company towards profitability. Our guidance for R&D plus SG&A expenses in 2026 remains approximately $400 million, excluding the impact of $50 million in estimated non-cash stock compensation expense. We ended Q2 with $575 million in cash equivalents and investments. This includes $244 million in net proceeds from the issuance in June of $250 million of 2.25% convertible notes. That deal provided the lowest cost of capital that Syndax has ever accessed and positions us well to build shareholder value over the long term.

Speaker #1: We expect revenue from both Revue Forge and Noctimvo to continue growing and advancing the company towards profitability. Our guidance for R&D plus SG&A expenses in 2026 remains approximately $400 million, excluding the impact of $50 million in estimated non-cash stock compensation expense.

Speaker #1: We ended the second quarter with $575 million in cash, equivalents, and investments. This includes $244 million in net proceeds from the issuance in June of $250 million of 2.25% convertible notes.

Speaker #1: That deal provided the lowest cost of capital that Syndax has ever accessed and positions us well to build shareholder value over the long term.

Speaker #1: We're fully funded to execute our commercial and R&D priorities including our late-stage trials of Revue Mendon and axitilumab and the development of our pipeline assets.

Keith Goldan: We're fully funded to execute our commercial and R&D priorities, including our late-stage trials of revumenib and axicabtagene autoleucel, and the development of our pipeline assets. With relatively modest investments and proof of principle trials of SNDX-4321 and SNDX-62122, we believe we can quickly generate early clinical data that creates significant value for the company and its shareholders. With that, I'll hand the call to Michael for closing remarks.

Speaker #1: With relatively modest investments and proof of principle trials, of SNDX4321 and 62122, we believe we can quickly generate early clinical data that creates significant value for the company and its shareholders.

Speaker #1: With that, I'll hand the call over to Michael for closing remarks.

Speaker #2: Thank you, Keith. Syndax is well positioned for long-term growth and success. With multiple blockbuster opportunities and upcoming milestones as highlighted on slides 13 and 14, we have a best-in-class Mendon inhibitor that is positioned to be the first to frontline AML and deliver peak annual net revenue in excess of $2 billion in the US alone.

Michael A. Metzger: Thank you, Keith. Syndax is well-positioned for long-term growth and success, with multiple blockbuster opportunities and upcoming milestones as highlighted on slides 13 and 14. We have a best-in-class menin inhibitor that is positioned to be the first to frontline AML and deliver peak annual net revenue in excess of $2 billion in the US alone. We are nearing data readouts in Q4 that could unlock multi-billion dollar upside for Niktimvo in IPF and frontline chronic GVHD. We have a proven track record of successfully developing and commercializing novel medicines and are bringing forward two new pipeline assets with best-in-class and blockbuster potential in EGFR mutated lung cancer and myelofibrosis. With $575 million on the balance sheet and growing revenue from two products, we are funded through profitability and have the capital to realize our pipeline opportunities and drive significant long-term value.

Speaker #2: We are nearing data readouts in the fourth quarter that could unlock multi-billion-dollar upside for Noctimvo in IPF and frontline chronic GVHD. We have a proven track record of successfully developing and commercializing novel medicines, and are bringing forward two new pipeline assets with best-in-class and blockbuster potential in EGFR-mutated lung cancer and myelofibrosis.

Speaker #2: With $575 million on the balance sheet and growing revenue from two products, we are funded through profitability and have the capital to realize our pipeline opportunities and drive significant long-term value.

Michael A. Metzger: With $575 million on the balance sheet and growing revenue from two products, we are funded through profitability and have the capital to realize our pipeline opportunities and drive significant long-term value. I will close by thanking our dedicated employees and the many patients, clinicians, and scientists who support our work and inspire us to pioneer bold, new approaches to some of the most devastating diseases. With that, I would like to open the call for questions. Operator?

Speaker #2: I will close by thanking our dedicated employees and the many patients, clinicians, and scientists who support our work and inspire us to pioneer bold, new approaches to some of the most devastating diseases.

Michael A. Metzger: I will close by thanking our dedicated employees and the many patients, clinicians, and scientists who support our work and inspire us to pioneer bold, new approaches to some of the most devastating diseases. With that, I would like to open the call for questions. Operator?

Speaker #2: And with that, I would like to open the call for questions. Operator?

Speaker #3: At this time, I would like to remind everyone that in order to ask a question, please press 'Star' then the number '5' on your telephone keypad.

Operator 2: At this time, I would like to remind everyone in order to ask a question, press star then the number five on your telephone keypad. If you would like to withdraw your question, press star and the number five once again. We will pause for just a moment to compile the Q&A roster. The first question is from Anupam Rama with JPMorgan. Your line is now open.

Operator: At this time, I would like to remind everyone in order to ask a question, press star then the number five on your telephone keypad. If you would like to withdraw your question, press star and the number five once again. We will pause for just a moment to compile the Q&A roster. The first question is from Anupam Rama with JPMorgan. Your line is now open.

Speaker #3: If you'd like to withdraw your question, press Start and then the number five once again. We'll pause for just a moment to compile the Q&A roster.

Speaker #3: And the first question is from Anupam Rama with JP Morgan. Your line is now open.

Speaker #4: Hey guys, this is Joyce Owen for Anupam. Thanks for taking our question. Could you discuss the physician feedback you received at ASCO and EHA on the Revumenib FORGE data that you guys presented there?

[Analyst] (J.P. Morgan): Hey, guys. This is Joyce on for Anupam. Thanks for taking our question. Could you discuss the physician feedback you received at ASCO and EHA on the Revuforj data that you guys presented there, especially the post-transplant maintenance data? How soon could those data have positive pull-through to the launch in terms of what you are seeing with the proportion of patients going on maintenance therapy? Thank you.

Joyce Zhou: Hey, guys. This is Joyce on for Anupam. Thanks for taking our question. Could you discuss the physician feedback you received at ASCO and EHA on the Revuforj data that you guys presented there, especially the post-transplant maintenance data? How soon could those data have positive pull-through to the launch in terms of what you are seeing with the proportion of patients going on maintenance therapy? Thank you.

Speaker #4: Especially the post-transplant maintenance data, and how soon could those data have positive pull-through to the launch, in terms of what you're seeing with the proportion of patients going on maintenance therapy?

Speaker #4: Thank you.

Speaker #2: Joyce, thanks so much for the question. So, I'll direct the first question to Nick. Thank you for the question. I think the data was very well received.

Steve Closter: Joyce, thanks so much for the question. I'll direct the first question to Nick.

Michael A. Metzger: Joyce, thanks so much for the question. I'll direct the first question to Nick.

Nick Botwood: Thank you for the question. I think the data was very well received. I think it's a remarkable outcome when you look at the proportion of patients alive at two years, 90%. It's obviously not randomized, but MD Anderson did a very nice job comparing it to the current standard of care, which is considerably less than that. I think they're very encouraged by that. We have significant research efforts ongoing to further elucidate the benefits of giving revumenib in the post-transplant setting. It's really important, I think, to optimize the dose. We're learning a lot about that, and we have a dedicated phase I study ongoing to optimize dose, and we hope to report on that later this year.

Speaker #2: I think it's a remarkable outcome when you look at the proportion of patients alive at two years, 90%. It's obviously not randomized, but MD Anderson did a very nice job comparing it to the current standard of care, which is considerably less than that.

Speaker #2: So, I think they're very encouraged by that. We have significant research efforts ongoing to further elucidate the benefits of giving revumenib in the post-transplant setting.

Speaker #2: It's really important, I think, to optimize the dose. We're learning a lot about that, and we have a dedicated phase one study ongoing to optimize dose, and we hope to report on that later this year.

Speaker #2: We also actually have the first prospectively randomized study called the MAINTAINED study that was recently announced on CT.gov in collaboration with Dana-Farber and other collaborators, which will hopefully further elucidate the benefits of maintenance. That will be extremely helpful, and it's an important study to do.

Nick Botwood: We also actually have the first prospectively randomized study called the MAINTAIN study that was recently announced on ct.gov in collaboration with Dana-Farber and other collaborators, which will hopefully further elucidate the benefits of maintenance, which will be extremely helpful, and it's an important study to do. Generally, however, we are seeing the uptake of maintenance very much in clinical practice, and that will be evidenced by the real-world series we've already reported upon, where you see high rates of both transplant and then patients going back onto therapy after transplant. We'll be updating on those further in the year with more data, which I think support and perhaps even exceeds what we've seen to date.

Speaker #2: Generally, however, we are seeing the uptake of maintenance very much in clinical practice, and that will be evidenced by the real-world series we've already reported upon, where you see high rates of both transplant and then patients going back onto therapy after transplant.

Speaker #2: And we'll be updating on those further in the year with more data, which I think support and perhaps even exceed what we've seen to date.

Speaker #3: Our next question is from Brad Canino with Guggenheim. Brad, you may unmute yourself and ask your question.

Operator 2: Our next question is from Brad Canino with Guggenheim. Brad, you may unmute yourself and ask your question.

Operator: Our next question is from Brad Canino with Guggenheim. Brad, you may unmute yourself and ask your question.

Keith Goldan: Hey. Afternoon. Thanks for the questions. Maybe two for me. One, just any quantification you can provide on the duration of treatment increasing, either numerical or some estimation of a relative increase the DoT saw? I'm just trying to judge the magnitude of increase. Two, have you seen any indication of an inflection in the maintenance rate? Sounds like it was 50% is what you're up to for this past Q2. Any inflection in July after showing the maintenance data at ASCO and EHA as you've been going out and talking with physicians? Thank you.

Brad Canino: Hey. Afternoon. Thanks for the questions. Maybe two for me. One, just any quantification you can provide on the duration of treatment increasing, either numerical or some estimation of a relative increase the DoT saw? I'm just trying to judge the magnitude of increase. Two, have you seen any indication of an inflection in the maintenance rate? Sounds like it was 50% is what you're up to for this past Q2. Any inflection in July after showing the maintenance data at ASCO and EHA as you've been going out and talking with physicians? Thank you.

Speaker #5: Hey, afternoon. Thanks for the questions. Maybe two for me. One, just any quantification you can provide on the duration of treatment increasing, either numerical or some estimation of a relative increase of the DOT you saw?

Speaker #5: I'm just trying to judge the magnitude of increase. And then two, have you seen any indication of an inflection in the maintenance rate? Sounds like it was 50% is what you're up to for this past two Q.

Speaker #5: But any inflection in July after showing the maintenance data at ASCO and EHA as you've been going out and talking with physicians? Thank you.

Speaker #2: Brad, thanks so much for the question. So first of all, in terms of the duration, of treatment, we're very much encouraged by what we're seeing.

Steve Closter: Brad, thanks so much for the question. First of all, in terms of the duration of treatment, we're very much encouraged by what we're seeing. I think for patients who are actually going on to maintenance, we know that cohort of patients is out beyond 9 months, that's an increase from what we've seen previously, and we feel quite encouraged by that. You might have picked up in my remarks, what's also encouraging are patients who don't go to transplant, who remain on therapy for an extended period of time, are well beyond 7 months at this point and building. That's new news and very encouraging for what we think will continue to build the recurring revenue within the franchise. Thank you. In terms of inflection in maintenance rates in July, that was a pretty specific question.

Michael A. Metzger: Brad, thanks so much for the question. First of all, in terms of the duration of treatment, we're very much encouraged by what we're seeing. I think for patients who are actually going on to maintenance, we know that cohort of patients is out beyond 9 months, that's an increase from what we've seen previously, and we feel quite encouraged by that. You might have picked up in my remarks, what's also encouraging are patients who don't go to transplant, who remain on therapy for an extended period of time, are well beyond 7 months at this point and building. That's new news and very encouraging for what we think will continue to build the recurring revenue within the franchise. Thank you. In terms of inflection in maintenance rates in July, that was a pretty specific question.

Speaker #2: I think that for patients who are actually going on to maintenance, we know that cohort of patients is out beyond nine months, and so that's an increase from what we've seen previously, and we feel quite encouraged by that.

Speaker #2: And what's also—you might have picked this up in my remarks—what's also encouraging are our patients who don't go to transplant, who remain on therapy for an extended period of time. They are well beyond seven months at this point, and building.

Speaker #2: So that is that's sort of new news, and very encouraging for what we think will continue to build the recurring revenue within the franchise.

Speaker #2: Thank you. And then in terms of inflection in maintenance rate in July, that was a pretty specific question. I'll just say that we are seeing continued buildup in maintenance.

Steve Closter: I'll just say that we are seeing continued build-up in maintenance. I don't think we've quantified it quite for July, we feel very encouraged by what we've seen coming out of the last quarter and into this quarter. We believe that will continue to build. We've talked about reaching 70% to 80% of patients getting on maintenance. We believe that assumption will hold as we build beyond the 50% that we saw this quarter. When exactly that will get to the 70% and 80% will take a little bit of time, we do feel quite encouraged by the momentum we're seeing coming out of last quarter.

Michael A. Metzger: I'll just say that we are seeing continued build-up in maintenance. I don't think we've quantified it quite for July, we feel very encouraged by what we've seen coming out of the last quarter and into this quarter. We believe that will continue to build. We've talked about reaching 70% to 80% of patients getting on maintenance. We believe that assumption will hold as we build beyond the 50% that we saw this quarter. When exactly that will get to the 70% and 80% will take a little bit of time, we do feel quite encouraged by the momentum we're seeing coming out of last quarter.

Speaker #2: I don't think we've quantified it quite for July, but we feel very encouraged by what we've seen coming out of last quarter and into this quarter.

Speaker #2: And so we believe that will continue to build. We've talked about reaching 70 to 80% of patients, getting on maintenance. We believe that assumption will hold as we build beyond the 50% that we saw this quarter.

Speaker #2: When exactly that we'll get to the 70, 80 percentile, it'll take a little bit 80, 70, 80%. We'll take a little bit of time, but we do feel quite encouraged by the momentum we're seeing coming out of the last quarter.

Speaker #3: The next question is from Faisi Khurshid with Jefferies. Your line is now open.

Operator 2: The next question is from Faisal Khurshid with Jefferies. Your line is now open.

Operator: The next question is from Faisal Khurshid with Jefferies. Your line is now open.

Speaker #6: Hey, guys. How are you doing? This is Faisi from Jefferies. I just wanted to ask this looks like the first quarter that you actually took a step down in New Starts.

Fasi Khurshid: Hey, guys. How are you doing? This is Fasi from Jefferies. I just wanted to ask, this looks like the first quarter that you actually took a step down in new starts. Can you give any more specificity on the reasons for this? Also, in terms of modeling this going forward, what are the forward trends that we should expect on new starts, each in KMT2A and NPM1? Thank you.

Faisal Khurshid: Hey, guys. How are you doing? This is Fasi from Jefferies. I just wanted to ask, this looks like the first quarter that you actually took a step down in new starts. Can you give any more specificity on the reasons for this? Also, in terms of modeling this going forward, what are the forward trends that we should expect on new starts, each in KMT2A and NPM1? Thank you.

Speaker #6: Can you give any more specificity on the reasons for this? And also, in terms of modeling this going forward, what are the forward trends that we should expect on New Starts each in KMT2A and NPM1?

Speaker #6: Thank you.

Speaker #2: Thanks so much for the question. So maybe I'll turn it over to Steve to make some comments on New Starts for this quarter.

Steve Closter: Thanks so much for the question. Maybe I'll turn it over to Steve to make some comments on new starts for this quarter.

Michael A. Metzger: Thanks so much for the question. Maybe I'll turn it over to Steve to make some comments on new starts for this quarter.

Speaker #5: Yeah. Thanks for the question. Appreciate you pitching that to me, Michael. Overall, I mean, good performance. I mean, it's a six consecutive quarter of double-digit revenue and demand growth.

Steve Closter: Yeah. Thanks for the question. I appreciate you pitching it to me, Michael. Overall, good performance. It's a sixth consecutive quarter of double-digit revenue and demand growth. I think interestingly, we grew 15% on TRX demand, and that was in the face of what you notice is a falling number of patient starts from Q1 into Q2. The reasons for that, there are just multiple drivers to the business. A lot of our prepared comments around the KMT2A business, how it's advancing, it's heading exactly in the direction that we predicted it would. Higher transplant rates, higher restart rates relative to the clinical trials, which is really driving the DOT. I'd say for NPM1, it's still early days, but we know that the business is growing. It's growing nicely. Our revenue and our patients on drug from Q1 into Q2 advanced as well.

Speaker #5: And I think interestingly, we grew 15% on TRX demand, and that was in the face of what you notice is a falling number of patients starts from Q1 into Q2.

Speaker #5: And the reasons for that are that there are just multiple drivers to the business. A lot of our prepared comments are around the KMT2A business, how it's advancing, and it's heading exactly in the direction that we predicted it would.

Speaker #5: Higher transplant rates, higher restart rates, relative to the clinical trials, which is really driving the DOT. And I'd say for NPM1, it's still early days, but we know this, the business is growing.

Speaker #5: It's growing nicely. Our revenue and our patients on drug from Q1 to Q2 advanced as well. So new patients starts are simply just a part of the growth story, but not the only part.

Steve Closter: New patient starts are simply just a part of the growth story, but not the only part. Couple things I hit out in the prepared comments, I'll maybe add a different flavor to it as well. This is normal. You're going to see, at least in the larger targeted AML therapy class, new starts do jump around. There's typical variability. We see it month to month. You're going to see it quarter to quarter. We've been largely immune to that. Rev has existed in this space, and we've either had the same number of new starts or grown them quarter after quarter. This is a fundamental aspect of the market that is typically there. Other things that we've mentioned, physicians have more than one drug class to consider. There is a big focus on the NPM1 patient.

Speaker #5: A couple of things I hit out in the prepared comments. I'll maybe add a different flavor to it as well. But this is normal.

Speaker #5: You're going to see at least in the larger target AML therapy class, New Starts do jump around. There's typical variability. We see it month to month.

Speaker #5: You're going to see it quarter to quarter. We've been largely immune to that, right? Rev has existed in this space, and we've either had the same number of New Starts or grown them quarter after quarter.

Speaker #5: But this is a fundamental aspect of the market that is typically there. It's other things that we've mentioned. Physicians have more than one drug class to consider, right?

Speaker #5: And there is a big focus on the NPM1 patient. Based on that, patients' mutational profile, physicians are going to make a choice. I think there's still figuring out how to where to menace fit.

Steve Closter: Based on that patient's mutational profile, physicians are going to make a choice. I think they're still figuring out where dovitinib is fit. Is it before a FLT3, is it during a FLT3, or perhaps after? That will play its way out, but ultimately, patients will relapse, and Rev will play a role. The last piece are just clinical trials. When you sign up to be in this business, oncology, hematology, you're advancing drugs through the clinic, and you're also commercializing them. We've done that successfully since the launch of Rev, so this isn't something that's entirely new. There are new trials that pop up from time to time. As they get established, patient flow will ultimately work its way through, and opportunities for commercial patients are going to stabilize. Many of these are placebo-controlled trials.

Speaker #5: So is it before, a flip three? Is it during a flip three or perhaps after? So that will play its way out, but ultimately, patients will relapse and rev will play a role.

Speaker #5: And the last piece are just clinical trials. So when you sign up to be in this business, oncology, hematology, you're advancing drugs through the clinic, and you're also commercializing them.

Speaker #5: And we've done that successfully since the launch of Rev. So this isn't something that's entirely new, but there are new trials that pop up from time to time.

Speaker #5: As they get established, patient flow will ultimately work its way through, and opportunities for commercial patients are going to stabilize. Many of these are placebo-controlled trials.

Speaker #5: So we expect to still treat many of these patients either when they relapse—not all patients are, obviously, eligible—for clinical trials. And we made a conscious decision about a year ago to go to a much broader audience.

Steve Closter: We expect to still treat many of these patients either when they relapse. Not all patients are obviously eligible for clinical trials. We made a conscious decision about a year ago to go to a much broader audience. As we updated in this call, we're approaching 600 accounts that have prescribed. Many of those are medium-sized to smaller accounts, less impacted by clinical trials, and we find meaningful patient build there as well. These factors can cause some lumpiness and fluctuation quarter to quarter, but we are able to flex and change our business as needed. We're confident in the forward. I think one of the questions was what is the trend moving forward? We look at this quarter as an anomaly. We feel confident about finding patients and getting back to levels that we've seen historically.

Speaker #5: So, as we updated in this call, we're approaching 600 accounts that have prescribed. Many of those are medium-sized to smaller accounts, less impacted by clinical trials, and we find meaningful patient build there as well.

Speaker #5: So these factors can cause some lumpiness and fluctuation quarter to quarter. But we were able to flex and change our business as needed. So we're confident in the forward.

Speaker #5: So I think one of the questions was, what is the trend moving forward? We look at this quarter as an anomaly. We feel confident about finding patients and getting back to levels that we've seen historically.

Speaker #6: Got it. And Steve, if you don't mind, just a quick follow-up. So am I to take your comments to mean that New Starts on commercial drug in relapsed AML as a whole were down quarter over quarter?

Fasi Khurshid: Got it. Steve, if you don't mind, just a quick follow-up. Am I to take your comments to mean that new starts on commercial drug in relapsed AML as a whole were down quarter over quarter? If so, are you able to quantify that at all?

Faisal Khurshid: Got it. Steve, if you don't mind, just a quick follow-up. Am I to take your comments to mean that new starts on commercial drug in relapsed AML as a whole were down quarter over quarter? If so, are you able to quantify that at all?

Speaker #6: And if so, are you able to quantify that at all?

Speaker #2: Probably don't have the full data set to look across all of AML. We're limited in what we can see in our drug. But perhaps that is the case.

Steve Closter: Probably don't have the full data set to look across all of AML. We're limited in what we can see on our drug. Perhaps that is the case. I would bet that it is. Again, it'll jump around from quarter to quarter.

Speaker #2: I would bet that it is. And it'll, again, it'll jump around from quarter to quarter.

Speaker #6: Great. Thank you.

Fasi Khurshid: Great. Thank you.

Faisal Khurshid: Great. Thank you.

Speaker #3: The next question is from Phil Nadir with TD Cowen. Your line is now open.

Operator 2: The next question is from Fiona Adu with TD Cowen. Your line is now open.

Operator: The next question is from Fiona Adu with TD Cowen. Your line is now open.

Speaker #5: Good afternoon. Congrats on the progress, and thanks for taking our questions. A few commercial questions from us. So first, in NPM1, I apologize if I missed this.

[Analyst] (TD Cowen): Good afternoon. Congrats on the progress, and thanks for taking our questions. Few commercial questions from us. First, in NPM1, I apologize if I missed this, did you say what you estimate your share of NPM new patient starts was this quarter and how that compared to last quarter? That's first. Second, I think you said 15% of NPM1 patients have been on revumenib. That's after approximately three quarters of your launch. Is that a trend that we should continue into the future? In another three quarters, should we expect maybe 30% of NPM1 patients will be on revumenib? Or is there any reason to think that would either accelerate or decelerate? Finally, on maintenance, can you tell us where maintenance is being used today in terms of what centers and where's the growth going to come from?

Phil Nadeau: Good afternoon. Congrats on the progress, and thanks for taking our questions. Few commercial questions from us. First, in NPM1, I apologize if I missed this, did you say what you estimate your share of NPM new patient starts was this quarter and how that compared to last quarter? That's first. Second, I think you said 15% of NPM1 patients have been on revumenib. That's after approximately three quarters of your launch. Is that a trend that we should continue into the future? In another three quarters, should we expect maybe 30% of NPM1 patients will be on revumenib? Or is there any reason to think that would either accelerate or decelerate? Finally, on maintenance, can you tell us where maintenance is being used today in terms of what centers and where's the growth going to come from?

Speaker #5: Did you say what you estimate your share of NPM new patients starts was this quarter and how that compared to last quarter? That's first.

Speaker #5: Then second, I think you said 15% of NPM1 patients have been on and been in. That's after approximately three quarters of your launch. Is that a trend that we should continue into the future?

Speaker #5: So in another three quarters, should we expect maybe 30% of NPM1 patients will be having on and been in, or is there any reason to think that would either accelerate or decelerate?

Speaker #5: Then finally, on maintenance, can you tell where maintenance tell us where maintenance is being used today in terms of what centers and where is the growth going to come from?

Speaker #5: What new centers could come online over the next several quarters to drive increased use of maintenance across the market? Thank you.

[Analyst] (TD Cowen): What new centers could come online over the next several quarters to drive increased use of maintenance across the market? Thank you.

Phil Nadeau: What new centers could come online over the next several quarters to drive increased use of maintenance across the market? Thank you.

Speaker #2: Great. Phil, thanks for the question. So, first question, I took as, what's our NPM1 share? And I think, as we stated in our prepared remarks, we're about two-thirds of the business right now.

Steve Closter: Great, Phil. Thanks for the question. First question I took as what's our NPM1 share, I think as we stated in our prepared remarks, we're about two-thirds of the business right now. If you think about where we were last quarter, it was roughly about the same, two-thirds or more of the overall business. We expect that to continue to build over time. We do have a dominant position. I would also say in terms of relapse refractory business, we're probably, assuming our competitor gets close to their numbers, we're probably 85% plus of relapse refractory. We are quite dominant in the space and expect to continue to build that.

Michael A. Metzger: Great, Phil. Thanks for the question. First question I took as what's our NPM1 share, I think as we stated in our prepared remarks, we're about two-thirds of the business right now. If you think about where we were last quarter, it was roughly about the same, two-thirds or more of the overall business. We expect that to continue to build over time. We do have a dominant position. I would also say in terms of relapse refractory business, we're probably, assuming our competitor gets close to their numbers, we're probably 85% plus of relapse refractory. We are quite dominant in the space and expect to continue to build that.

Speaker #2: I mean, if you think about where we were last quarter, it was roughly about the same, two-thirds or more, of the overall business. And so we expect that to continue to build over time.

Speaker #2: But we do have a dominant position. I would also say in terms of relapse refractory business, we're probably assuming our competitor gets close to their numbers.

Speaker #2: We're probably 85-plus percent of relapse refractory. So we are quite dominant in the space and expect to continue to build that. We did make the comment about 15% of the patients is your second question, 15% of the NPM1 patients have seen a med inhibitor, and that's not only our drug, but our understanding of what how our competitor contributes as well.

Michael A. Metzger: We did make the comment about 15% of the patients, this is your second question, 15% of the NPM1 patients have seen a menin inhibitor, and that's not only our drug, but our understanding of how our competitor contributes as well. That's 15% total. We do expect that to expand meaningfully and from quarter to quarter, we expect that to grow, accelerate. In a year from now, we'll be at 30%. Well, we would hope that it would be even greater than that, and it's supported by all the data that we're generating. Nick mentioned the presence at our congresses and what we've provided in terms of monotherapy and combinations, and that has shown Revuforj to be a very useful drug in a number of ways.

Speaker #2: So that's 15% total. We do expect that to expand meaningfully, and from quarter to quarter, we expect that to grow and accelerate. In a year from now, we'll be at 30%.

Speaker #2: Well, we would hope it hope that it would be even greater than that. And it's supported by all the data that we're generating. Nick mentioned the presence at our congresses and what we've provided in terms of monotherapy and combinations.

Speaker #2: And that has shown Reviforge to be a very useful drug in a number of ways. So, we expect that we'll be treating NPM1 patients and continuing to penetrate that market very meaningfully.

Steve Closter: We expect that we'll be treating NPM1 patients and continuing to penetrate that market very meaningfully, hopefully well beyond 30% in a year. Maintenance, maybe I'll turn to Nick on this one. Maintenance, where is it being done? What are those centers? We won't list them all. Academic centers for sure, maybe Nick can make a comment there. Where is the growth going to come from in terms of maintenance? Nick?

Michael A. Metzger: We expect that we'll be treating NPM1 patients and continuing to penetrate that market very meaningfully, hopefully well beyond 30% in a year. Maintenance, maybe I'll turn to Nick on this one. Maintenance, where is it being done? What are those centers? We won't list them all. Academic centers for sure, maybe Nick can make a comment there. Where is the growth going to come from in terms of maintenance? Nick?

Speaker #2: Hopefully well beyond 30% in a year. And then maintenance, maybe I'll turn to Nick on this one. Maintenance, where is it being done? What are those centers?

Speaker #2: I mean, we won't list them all. Academic centers for sure, but maybe Nick can make a comment there. And where is the growth going to come from in terms of maintenance, Nick?

Speaker #4: Well, I think the growth will come from a number of drivers. Number one is patients getting treated earlier on. They're getting treated increasingly in combination.

Nick Botwood: Well, I think the growth will come from a number of drivers. Number 1 is patients getting treated earlier on. They're getting treated increasingly in combination. That's just driving response rates higher. We know that if a patient gets to response, they're eligible for transplant. Having had a transplant, the likelihood of them going on to post-transplant maintenance, as we gather more data and present more data there, I think physicians are feeling more confident. They understand how to manage the dose better. These patients after transplant are particularly prone to cytopenias generally, you really do need to manage the dose, that's something we'll be presenting updated data on later this year, I think they're getting confidence to do that. Really just the real-world experience from academic centers. We've seen extremely high rates. They're feeling more confident doing it.

Speaker #4: That's just driving response rates higher. We know that if a patient gets to response, they're eligible for transplant. Having had a transplant, the likelihood of them going on to post-transplant maintenance is— we gather more data and present more data there.

Speaker #4: I think physicians are feeling more confident. They understand how to manage the dose better. These patients after transplant are particularly prone to cytopenias generally.

Speaker #4: So you really do need to manage the dose. And that's something we'll be presenting updated data on later this year. And I think they're getting confidence to do that.

Speaker #4: And really just the real-world experience from academic centers. We've seen extremely high rates. They're feeling more confident doing it. Their intent is to treat out to one to two years.

Nick Botwood: Their intent is to treat out to 1 to 2 years. Most of our clinical trials include therapy out to 2 years. Given the high rates of relapse after transplant without any active therapy, they really want to just do their best for the patients and think that REVLIMID gives them the best chance of a durable remission, and so we're seeing uptake increase. From a research perspective, it's our efforts to further confirm that benefit, who's most likely to benefit, and how we can make sure that the drug is well-tolerated. I think we're very encouraged by what we're seeing in the uptake, and we'll be presenting more data on that again later this year with a big focus on this whole post-transplant maintenance area.

Speaker #4: Most of our clinical trials include therapy out to two years. And given the high rates of relapse after transplant without any active therapy, they really want to just do their best for the patients and think that Revimen gives them the best chance of a durable remission.

Speaker #4: And so we're seeing uptake increase. From a research perspective, it's our efforts to further confirm that benefit, who's most likely to benefit, and how we can make sure that the drug is well tolerated.

Speaker #4: But I think we're very encouraged by what we're seeing and the uptake, and we'll be presenting more data on that again later this year, with a big focus on this whole post-transplant maintenance area.

Speaker #5: That's very helpful. Thank you.

[Analyst] (TD Cowen): That's very helpful. Thank you.

Phil Nadeau: That's very helpful. Thank you.

Speaker #2: Thanks, Phil.

Steve Closter: Thanks, Phil.

Speaker #3: The next question is from Steven Woolley with STIFO. Your line is now open.

Operator 2: The next question is from Stephen Willey with Stifel. Your line is now open.

Operator: The next question is from Stephen Willey with Stifel. Your line is now open.

Speaker #5: Yeah. Good afternoon. Thanks for taking the questions and congrats on the progress. So I guess, Nick Timbo, sequential growth is kind of flattened out here over the past couple of quarters.

Stephen Willey: Good afternoon. Thanks for taking the questions, and congrats on the progress. I guess Niktimvo's sequential growth has kind of flattened out here over the past couple of quarters. Just curious how you're thinking about the near-term growth opportunity for this franchise prior to potential label expansion. Was also just wondering if you can confirm whether the definition of event-free survival, which is being used in the phase II frontline trial that reads out later this year, plus ruxolitinib, is the same as the phase III frontline trial that's looking at Niktimvo combination with steroids. Thanks.

Speaker #5: So just curious, how you're thinking about the near-term growth opportunity for this franchise prior to potential label expansion? And then was also just wondering if you can confirm whether the definition of event-free survival which is being used in the phase two frontline trial that reads out later this year plus ROCs is the same as the phase three frontline trial that's looking at Nick Timbo combination with steroids.

Speaker #5: Thanks.

Speaker #2: Got it. Steven, thanks for the question. Maybe I'll take the first with maybe a comment on the second from Nick. So Nick Timbo, look, I don't agree with the characterization that it's flat.

Michael A. Metzger: Stephen, thanks for the question. Maybe I'll take the first with maybe a comment on the second from Nick. Niktimvo, look, I don't agree with the characterization that it's flat, first of all. Niktimvo is not flat. It's growing, and we see it tracking very nicely to what Rezurock has done. We expect it to continue to grow meaningfully. What I'm talking about is third and fourth line. We've penetrated well into the fourth line. Third line, we have about a third of the third line population at this point, which is very meaningful about a year post-launch. I think we will continue to build that and be meaningful in third and fourth line. You should expect continued growth there. Of course, we have expansion opportunity with the new data coming at the end of the year with combination with ruxolitinib.

Speaker #2: First of all, Nick Timbo is not flat. It's growing. And we see it tracking very nicely to what Reserock has done. And so we expect it to continue to grow meaningfully.

Speaker #2: And what I'm talking about is third and fourth line. So we've penetrated well into the fourth line, third line. We have about a third of the third line population at this point, which is very meaningful about a year post-launch.

Speaker #2: So I think we will continue to build that and be meaningful in third and fourth line. So you should expect continued growth there. And then, of course, we have expansion opportunity with the new data coming at the end of the year with combination with Ruxolitinib.

Speaker #2: And so we feel like that's an obvious expansion opportunity as we're on our way to the front line. And we'll also have the steroid combination in early 2028.

Michael A. Metzger: We feel like that's a obvious expansion opportunity as we're on our way to the front line. We'll also have steroid combination in early 2028. A lot of data to come. I think physicians are eager to see the combinations and how our drug combines with Jakafi. In the meantime, we'll have considerable growth, we believe, over the near term with third and fourth line. Maybe I'll turn it to Nick on definition for event-free survival.

Speaker #2: So a lot of data to come. I think physicians are eager to see the combinations and how our drug combines with Jakafi and in the meantime, we'll have considerable growth, we believe, over the near term with third and fourth line.

Speaker #2: And then maybe I'll turn to Nick on definition for event-free survival.

Speaker #3: Steve, the event-free survival endpoint is in the,

Nick Botwood: Steve, the event-free survival endpoint is in the frontline steroid combination phase III, that does have an event-free survival primary endpoint. For the phase II three-arm study, we're actually going to look at overall response rate at 6 months. As you recall, this is steroids versus rux versus a combination of axatilimab and rux. We expect a benchmark from that based on a publication in 2022 to be about 40% response rate for steroids alone at 6 months. We're looking for a meaningful improvement over that. I think for the combination, it could be considerably higher than that. It's not formally a comparative study. It's randomized 1-to-1-to-1, about 120 patients. You'll recall.

Speaker #4: for the front line, steroid combination phase three. So that does have an end-free survival primary endpoint for the phase two, three on study. We're actually going to look at overall response rate at six months.

Speaker #4: So as you recall, this is steroids versus RUCs versus a combination of AXA and RUCs. We expect the benchmark from that based on a publication in 2022 to be about 40% response rate for steroids alone at six months.

Speaker #4: We're looking for a meaningful improvement over that. I think for the combination, it could be considerably higher than that. It's not a formally a comparative study.

Speaker #4: It's randomized one to one to one, about 120 patients. You recall. So yeah, we'll look at overall response rate. But I think also the duration of response will be very important to look at in that study to see whether the combination and RUCs alone can offer a meaningful alternative to steroids.

Nick Botwood: Yeah, we'll look at overall response rate, but I think also the duration of response will be very important to look at in that study to see whether the combination and rux alone can offer a meaningful alternative to steroids. That's what we will report on and looking forward to seeing that readout, because I think it could be very informative and potentially practice and guideline informing readout if either or both of those combinations beat steroids alone.

Speaker #4: So that's what we will report on. And looking forward to seeing that readout. Because I think it could be a very informative and potentially practice and guideline-informing readout if either or both of those combinations beat steroids alone.

Speaker #5: All right. Thanks for taking the questions.

Stephen Willey: All right. Thanks for taking the questions.

Speaker #2: Thanks, Steven.

Michael A. Metzger: Thanks, Steven.

Speaker #3: The next question is from Edser Darut with Barclays. Your line is now open.

Operator 2: The next question is from Etzer Darout with Barclays. Your line is now open.

Operator: The next question is from Etzer Darout with Barclays. Your line is now open.

Speaker #5: Great, thanks for taking the question. Quick one from me—just wondering, for the proof-of-principle trial of Revumenib in myelofibrosis, what is the primary analysis?

Etzer Darout: Great. Thanks for taking the question. A quick one for me. Just wondering, for the proof of principle trial of revumenib in myelofibrosis, what is the primary analysis? What will that entail, and what endpoints will you be evaluating there, just as a potential, obviously, read-through to the next-gen menin inhibitor. Thank you.

Speaker #5: What will that entail? And what endpoints will you be evaluating there just to as a potential, obviously, read through to the next gen med and inhibitor?

Speaker #5: Thank you.

Speaker #2: Great, Edser. Thanks for the question. Maybe I'll turn to Nick on the proof-of-concept trial.

Michael A. Metzger: Great, Etzer. Thanks for your question. Maybe I'll turn to Nick on the proof of concept trial.

Speaker #4: Yeah, this is a study we're doing with the NPM research consortium with John Mascarinis in collaborators. It's not under our sponsorship. It was recently posted on clinicaltrials.gov.

Nick Botwood: Yeah. This is a study we're doing with the MPN Research Consortium with John Mascarenhas and collaborators. It's not under our sponsorship. It was recently posted on ClinicalTrials.gov. It's quite a full posting if you want to look at some of the details of the study there, but I'll just summarize it for you. Cohort 1, which is primarily the safety assessment, will look at just those limiting toxicities. That's going to be relatively few patients treated, around six. In Cohort 2, where we will look for the combination of rev in combination with Jakafi, we'll be looking at standard response criteria. We'll be using the ELN response criteria, looking at anemia, spleen response, and symptom benefit. We'll be looking at SVR less than 35%.

Speaker #4: It's quite a full posting if you want to look at some of the details of the study there. But I'll just summarize it for you.

Speaker #4: Cohort one, which is primarily the safety assessment, will look at just dose-limiting toxicities. That's going to be relatively few patients treated, around six. In cohort two, where we will look for the combination of Rev in combination with Jakafi, we'll be looking at standard response criteria.

Speaker #4: So we'll be using the ELN response criteria, looking at anemia, spleen response, and symptom benefit. We'll be looking at SVR less than 35%. So in patients that have a suboptimal response on Jakafi alone, and a stable on Jakafi for 12 weeks, we'll add in Revumenib.

Nick Botwood: In patients that have a suboptimal response on Jakafi alone and are stable on Jakafi for 12 weeks, we'll add in revumenib. We will be looking for using standard ELN response criteria to generate proof of principle data, which will be incredibly informative to our development program and really catalyze, I think, when we go into phase I in 2027 with our next-gen menin inhibitor in myelofibrosis.

Speaker #4: And then we will be looking for using standard ELN response criteria. To generate proof of principle data, which will be incredibly informative to our development program and really catalyze, I think, when we go into phase one in 2027 with our next gen med and inhibitor in monofibrosis.

Speaker #5: Great. Thank you.

Etzer Darout: Great. Thank you.

Speaker #2: Thanks, Edser.

Michael A. Metzger: Thanks, Etzer.

Speaker #3: Our next question is from Igo Nochimovitz with Citigroup. Your line is now open.

Operator 2: Our next question is from Igor Motumovic with Citi. Your line is now open.

Operator: Our next question is from Igor Motumovic with Citi. Your line is now open.

Speaker #6: Hi, this is Duan Kim on for you as well. Thanks for taking our questions. I was wondering, I was wondering with regards to your expanded use of lab data, I believe that you had mentioned, to engage physicians when they have a suitable patient.

Jiwon Kim: Hi, this is Jiwon Kim on for Igor. Thanks for taking our questions. I was wondering with regards to your expanded use of lab data, I believe that you had mentioned, to engage physicians when they have a suitable patient. I was wondering, but to what extent can that help smooth new start variability, particularly in NPM1, where the population is larger, but co-mutations can help influence the treatment choice? Also with regards to the MAXPIRe trial, just wondering, so patients can be on pirfenidone, then a bit or no background anti-fibrotic. If the study is positive, how should we think about the extent to which the background therapy could help define axatilimab's role, whether it's add-on or potentially if a patient's not getting much benefit from current treatments? Thanks.

Joohwan Kim: Hi, this is Jiwon Kim on for Igor. Thanks for taking our questions. I was wondering with regards to your expanded use of lab data, I believe that you had mentioned, to engage physicians when they have a suitable patient. I was wondering, but to what extent can that help smooth new start variability, particularly in NPM1, where the population is larger, but co-mutations can help influence the treatment choice? Also with regards to the MAXPIRe trial, just wondering, so patients can be on pirfenidone, then a bit or no background anti-fibrotic. If the study is positive, how should we think about the extent to which the background therapy could help define axatilimab's role, whether it's add-on or potentially if a patient's not getting much benefit from current treatments? Thanks.

Speaker #6: I was wondering, to what extent can that help smooth new start variability, particularly in NPM1, where the population is larger, but co-mutations can help influence the treatment choice?

Speaker #6: And then, also with regards to the MAXPIRE trial, just wondering, since patients can be on pirfenidone, then or no background anti-fibrotic—if the study is positive, how should we think about the extent to which the background therapy could help define acetylamide's role?

Speaker #6: Whether it's add-on or potentially for patients not getting much benefit. From current treatments. Thanks.

Speaker #4: Great. Thanks for the question. So first, with the use of lab data, maybe Steve, you want to make some comments on how we identify patients?

Michael A. Metzger: Great. Thanks for the question. First, with the use of lab data, maybe Steven, you want to make some comments on how we identify patients?

Speaker #2: Yeah, sure. So we do use lab data as pointed out in the question and enables us to find diagnosed patients. We buy lab data.

Steve Closter: Yeah, sure. We do use lab data, as pointed out in the question. It enables us to find diagnosed patients. We buy lab data. We can identify patients that may be suitable. It's obviously de-identified. We can target accounts that we know patients exist. It's largely worked since launch. I think that really speaks to why we've been so successful, particularly at the K228 launch. We've modified our approach over time. We've been able to bring in new lab data sets. We've been able to apply some applied artificial intelligence and machine learning principles. It still holds. I think specifically the question was, can you use that to smooth out new starts? The market's the market. Patients are going to come in at often a random pace. Over a year, you kind of know what it is, but month to month, it's going to be different.

Speaker #2: We can identify patients that may be suitable. It's obviously de-identified. We can target accounts that we know patients exist. It's a largely work since launch.

Speaker #2: I think that really speaks to why we've been so successful, particularly at the KN22A launch. We've modified our approach over time. We've been able to bring in new lab data sets.

Speaker #2: We've been able to apply some applied artificial intelligence and machine learning principles. So it still holds, I think, specifically the question was, can you use that to smooth out new starts?

Speaker #2: The market's the market. Patients are going to come in at an often a random pace. So over a year, you kind of know what it is, but month to month, it's going to be different.

Speaker #2: We will find every possible patient that we can. Right? And we've shown we've been able to do that, and we're going to get better simply over time.

Steve Closter: We will find every possible patient that we can. Right? We've shown we've been able to do that, and we're going to get better simply over time. That's something we remain committed to.

Speaker #2: So that's something we remain committed to.

Speaker #4: Maybe Nick, do you want to talk about MAXPIRE and the background therapy impact? It has three strata. So we stratified by nintedanib, pirfenidone, and then no anti-fibrotic, as you would expect. Consistent with previous studies that looked at IPF, by far the majority of the patients were on a background anti-fibrotic.

Michael A. Metzger: Maybe Nick, do you want to talk about MAXPIRe or the background therapy impact?

Nick Botwood: MAXPIRe has three strata. We stratified by nintedanib, pirfenidone, and no anti-fibrotic. As you would expect, consistent with previous studies that looked in IPF, by far the majority of the patients were on a background anti-fibrotic. We will obviously look at subtypes in those strata to ensure there isn't an imbalance between the arms. The study is really not powered. Recall, it's two-to-one randomized. It's not powered to detect differences between the different types of anti-fibrotic. That's something we will look at. In terms of phase III planning, we will plan to include axatilimab on a background of standard of care anti-fibrotics, and potentially other standards of care.

Speaker #4: We will obviously look at subtypes in those strata to ensure there isn't an imbalance between the arms. The study is really not powered. Recall, it's two to one randomized.

Speaker #4: It's not powered to detect differences. Between the different types of anti-fibrotic, it's something we will look at. In terms of phase three planning, we would plan to include acetylamide on a background of standard of care, anti-fibrotics.

Speaker #4: And potentially other standards of care. One of the attractive things, I think, about the mechanism of action of acetylamide is that it really does treat what we think is the underpinning pathology.

Nick Botwood: One of the attractive things I think about the mechanism of action of axatilimab is that it really does treat what we think is the underpinning pathology by targeting specifically these monocyte-derived macrophages, so inflammatory and fibrotic components of the disease. We really think that that could be a very important differentiator and particularly suitable for combination with current standards of care.

Speaker #4: By targeting specifically these monocyte-drive, macrophages, inflammatory and fibrotic components of the disease. And we really think that that could be a very important differentiator and particularly suitable for combination with current standards of care.

Speaker #5: Got it. Thank you.

Jiwon Kim: Got it. Thank you.

Joohwan Kim: Got it. Thank you.

Speaker #2: Thank you.

Michael A. Metzger: Thank you

Speaker #3: Our next question is from David Dye with UBS. Your line is now open.

Operator 2: Our next question is from David Dai with UBS. Your line is now open.

Operator: Our next question is from David Dai with UBS. Your line is now open.

Speaker #6: Great. Thanks for taking my questions. So just thinking about the RevuFORGE, your patient starts and CAMT2A penetration, last quarter you mentioned that you were 50% penetrated into the CAMT2A market.

David Dai: Great. Thanks for taking my questions. Just thinking about the Revuforj, new patient starts, and KMT2A penetration. Last quarter, you mentioned that you were 50% penetrating to the KMT2A market. How did the number look like this quarter? How do you envision the peak penetration will look like, and how long do you think that's going to take? The same question will apply to NPM1. What percentage of NPM1 market have you penetrated so far, and what would the peak penetration look like?

Speaker #6: How did the numbers look this quarter? And how do you envision the peak penetration will look? And how long do you think that's going to take?

Speaker #6: Because the same question will apply to NPM1. What percentage of the NPM1 market have you penetrated so far, and what would peak penetration look like?

Speaker #2: David, thanks for the question. So maybe I'll address CAMT2A first. So first of all, we own the CAMT2A market. So this is a part of a business that where we are firmly established as standard of care.

Michael A. Metzger: David, thanks for the question. Maybe I'll address KMT2A first. First of all, we own the KMT2A market. This is a part of a business where we are firmly established as standard of care. NPM1 is building. We firmly acknowledge that we have best in class profile for both broadest set of opportunities there. For KMT2A, we have said that we were about 50% penetrated, and that continues to build. Peak penetration is likely to get to roughly 80% or maybe even more. We've seen examples in the market of companies launching products into targeted areas where they have dominant position, and they get to those levels. KMT2A should reach a very deep penetration over the reasonably near term. NPM1, I would say, is a slower build, mainly because of some of the things that Steve said.

Speaker #2: NPM1 is building we firmly acknowledge that we have best-in-class profile for both broadest set of opportunities there. For CAMT2A, we have said that we were about 50% penetrated.

Speaker #2: And that continues to build. And so peak penetration is likely to get to roughly 80% or maybe even more we've seen examples in the market of companies launching products into targeted areas where they have dominant position and they get to those levels.

Speaker #2: So CAMT2A should reach a very deep penetration over the reasonably near term. NPM1, I would say, is a slower build. Mainly because of some of the things that Steve said, it is a bigger patient population, for sure.

Michael A. Metzger: It is a bigger patient population for sure. More patients are able to be treated. More patients are being treated, they just happen to be on other therapies. Our job is to introduce Revuforj to those patients as monotherapy and perhaps combination as physicians want to use the product, and we'll continue to penetrate there. Again, I think Revuforj can have a very high penetration. We already own, as of today, about two-thirds or more of the business in NPM1, and that should continue to build. Our penetration will get to a high percentage over time. Maybe not quite as high as KMT2A, but we do think that we'll have a dominant position in both with best offering as we've talked about. I think there are different kinetics of build between KMT2A and NPM1 as described, but high penetration is the name of the game here.

Speaker #2: More patients are able to be treated. More patients are being treated. They just happen to be on other therapies. And so our job is to introduce RevuFORGE to those patients.

Speaker #2: It's monotherapy and perhaps combination as physicians want to use the product. And we'll continue to penetrate there again. I think a RevuFORGE can have a very high penetration we already own as today about two-thirds or more of the business.

Speaker #2: In NPM1, that should continue to build. But our penetration will get to a high percentage over time maybe not quite as high as CAMT2A, but we do think that we'll have a dominant position in both with best offering as we've talked about.

Speaker #2: So I think there are different kinetics of build between CAMT2 and NPM1 as described, but high penetration is the name of the game here.

Speaker #6: Got it. That's helpful. And then just a question on inventory stocking. What did the inventory stock look like this quarter? Any dynamics there?

David Dai: Got it. That's helpful. Then just a question on inventory stocking. What did the inventory stock look like this quarter? Any dynamics there?

Speaker #2: I'll give this one to Keith. Inventory.

Michael A. Metzger: I'll give this one to Keith. Inventory.

Speaker #1: Yeah, thanks, David. The guidance that we've been pretty consistent with, very consistent with since launch, still holds. And again, not just for Syndax, but really for any rare disease, targeted oncology product, we're about two to three weeks it's been remarkably consistent since we've launched the product.

Keith Goldan: Yeah. Thanks, David. The guidance that we've been pretty consistent with, very consistent with since launch, still holds. Again, not just for Syndax, but really for any rare disease-targeted oncology product. We're about two to three weeks. It's been remarkably consistent since we've launched the product. We'll let you know if there's any changes, but you can assume that we have about two to three weeks of Revuforj in the channel.

Speaker #1: So we'll let you know if there's any changes. But you can assume that we have about two to three weeks of RevuFORGE in the channel.

Speaker #6: I thank you so much.

David Dai: Thank you so much.

Speaker #2: Thanks, David.

Michael A. Metzger: Thanks, David.

Operator 2: Sure. Our next question comes from Selene Saeed with Mizuho. Your line is now open.

Operator: Sure. Our next question comes from Selene Saeed with Mizuho. Your line is now open.

Speaker #3: Our next question comes from Celine Sayeed with Mizuho. Your line is now open.

Speaker #6: Great. question. Just one from us on the $2 billion revenue expected in the US alone. Mike or Keith, could you maybe I think this is the first time we're formally seeing it in a slide written like that.

Selene Saeed: Great. Congrats on the progress, guys. Thanks for the question. Just one from us on the $2 billion revenue expected in the US alone. Mike or Keith, I think this is the first time we're formally seeing it in a slide written like that, and I noticed also that I think this is the first time that the bar chart for the TAM has been taken out of the deck. Just wondering if you guys are starting to think here that the $5 billion TAM is a conservative number, you're sort of reworking your numbers internally, or what your assumptions were exactly going into $2 billion, how much first-line is in there versus second-line, et cetera. Then just one clarification. I think you guys mentioned, I think it was Mike, 85% of relapse is what you guys are getting. I presume that's also inclusive of KMT2A rearrange.

Salim Syed: Great. Congrats on the progress, guys. Thanks for the question. Just one from us on the $2 billion revenue expected in the US alone. Mike or Keith, I think this is the first time we're formally seeing it in a slide written like that, and I noticed also that I think this is the first time that the bar chart for the TAM has been taken out of the deck. Just wondering if you guys are starting to think here that the $5 billion TAM is a conservative number, you're sort of reworking your numbers internally, or what your assumptions were exactly going into $2 billion, how much first-line is in there versus second-line, et cetera. Then just one clarification. I think you guys mentioned, I think it was Mike, 85% of relapse is what you guys are getting. I presume that's also inclusive of KMT2A rearrange.

Speaker #6: And I noticed also that I think this is the first time that the bar chart for the TAM has been taken out of the deck.

Speaker #6: Just wondering if you guys are starting to think here that the $5 billion TAM is a conservative number you're sort of reworking your numbers internally.

Speaker #6: Or what your assumptions were exactly going into the $2 billion. How much first line is in there versus second line, etc.? And then just one clarification.

Speaker #6: I think you guys mentioned I think it was Mike. 85% of relapse is what you guys are getting. I presume that's also inclusive of CAMT2A rearrange.

Speaker #6: But what percentage of NPM1 starts are you guys seeing? I think Cora, on their side, they've said 40% is their share, which would imply you guys are at 60%.

Selene Saeed: What percentage of NPM1 starts are you guys seeing? I think Kura, on their side, they've said 40% is their share, which would imply you guys are at 60. Is that ballpark-ish correct in line? Thank you.

Salim Syed: What percentage of NPM1 starts are you guys seeing? I think Kura, on their side, they've said 40% is their share, which would imply you guys are at 60. Is that ballpark-ish correct in line? Thank you.

Speaker #6: Is that ballpark-ish correct, in line? Thank you.

Speaker #2: Yeah, Celine, lots of parts of your question. So let me see if I can tackle them. So first of all, just because I see it on the page here, 85% of what I had mentioned, 85% of the relapse refractory business is CAMT2A and NPM1 combined.

Michael A. Metzger: Selene. Lots of parts of your question. Let me see if I can tackle them. First off, just because I see it on the page here, 85% of what I had mentioned, 85% of the relapse refractory business is KMT2A and NPM1 combined. That's our calculation. If you look at the numbers for the quarter relative to our competitor, we're at least 85% of the business. That's one. When we talk about the estimate of $2 billion plus in revenue peak potential when we include the frontline, you're right, that is the first time we're talking about this in this way, and I think it's important. Why now? We're more confident than ever, and this is clear to us that this is a very large market opportunity.

Speaker #2: So that's our calculation. If you look at the numbers for the quarter relative to our competitor, we're at least 85% of the business. So that's one.

Speaker #2: When we talk about the estimate of $2 billion-plus in revenue, peak potential, when we include the front line, you're right, that is the first time we're talking about this in this way.

Speaker #2: And I think it's important. And why now? We're more confident than ever. And this is clear to us that this is a very large market opportunity.

Speaker #2: When you look at the data that we've published over the last quarter or two, all things point to growing relapse I would say overall survival, days of therapy, the response rates are higher than we've seen previously.

Michael A. Metzger: When you look at the data that we've published over the last quarter or two, all things point to growing relapse, I would say, overall survival, days of therapy. The response rates are higher than we've seen previously. The data is all very positive and gives us confidence that we will once we get to the frontline, have a very supportable market position and dominant position in frontline. We will be the first to get there. With the profile that we have today, we feel quite confident that we will have very meaningful share, a dominant share of frontline. Thinking of probably the most important driver here is days of therapy or time on therapy. What we've said today is that we see that elongating.

Speaker #2: So the data is all very positive and gives us confidence that once we get to the front line, we'll have a very supportable market position and a dominant position in front line.

Speaker #2: We will be the first to get there. And with the profile that we have today, we feel quite confident that we will have very meaningful share, dominant share of front line.

Speaker #2: But thinking of probably the most important driver here is days of therapy or time on therapy. And what we've said today is that we see that elongating.

Speaker #2: We're quite encouraged by that, which gives us a lot of confidence, because it's a very important indicator—a very important component of the calculation for the market: how long patients stay on therapy.

Michael A. Metzger: We're quite encouraged by that, which gives us a lot of confidence because it's a very important indicator or a very important component of the calculation for the market, how long patients stay on therapy. So far, even relapsed refractory patients, we're seeing this exceed our expectations. We are quite confident, again, that we can reach that level of sales. When you talk about the breakdown between frontline and relapse refractory, as we've said in our bar chart, nothing's really changed in terms of our evaluation of the overall total addressable market. $5 billion does assume the $2 billion is part of that. We've always kind of been clear about it, that $5 billion is the overall market when you assume that you get to frontline. $2 billion is really our assessment of the relapsed refractory opportunity.

Speaker #2: And so far, we're even relapse refractory patients, we're seeing this exceed our expectations. So we are quite confident, again, that we can reach that level of sales.

Speaker #2: And when you talk about the breakdown between front line and relapse refractory, as we've said in our bar chart, nothing's really changed in terms of our evaluation of the overall total addressable market.

Speaker #2: $5 billion does assume the $2 billion is part of that. So we've always kind of been clear about it, that $5 billion is the overall market when you assume that you get to front line $2 billion is really our assessment of the relapse refractory opportunity.

Speaker #6: Okay. Thanks so much.

Selene Saeed: Okay, thanks so much.

Salim Syed: Okay, thanks so much.

Speaker #2: You're welcome. Thank you.

Michael A. Metzger: You're welcome. Thank you.

Speaker #3: The next question is from Andres Maldonado with HC Winrate. Your line is now open.

Operator 2: The next question is from Andres Maldonado with H.C. Wainwright. Your line is now open.

Operator: The next question is from Andres Maldonado with H.C. Wainwright. Your line is now open.

Speaker #7: Hi, guys. Thanks for taking the questions and congrats on the progress. First question is a question on slide 5. You talk about 40% of RevuFORGE use is in combination.

Andres Maldonado: Hi, guys. Thanks for taking the questions and congrats on the progress. First question is a question on slide five. You talk about 40% of Revuforj uses in combination. Curious if, are physicians mainly adding Revuforj to a failing venetoclax-based regimen, or are they beginning a new combination at relapse? How should we be thinking of the potential of those variants and approaches, their potential to produce different treatment durations or transplant rates? Is the first question, then I have a follow-up.

Speaker #7: So, curious if our physicians are mainly adding RevuFORGE to a failing venetoclax-based regimen, or are they beginning a new combination at relapse? And how should we be thinking of the potential—kind of those variants and approaches—their potential to produce different treatment durations or transplant rates is the first question. I have a follow-up.

Speaker #2: Right. Andres, thank you for the question. So maybe I'll turn it to Nick to talk a little bit about the combination regimens.

Michael A. Metzger: Great. Andres, thank you for the question. Maybe I'll turn it to Nick to talk a little bit about combination regimens.

Speaker #5: Yeah. What we're observing in the real world is multiple combinations. I think you're right that VEN is a common desire, right? The VEN or VENA is a combination.

Nick Botwood: Yeah. What we're observing in the real world is multiple combinations. I think you're right that ven is a common desire, either ven or ven is a combination. Sometimes patients have been exposed to prior ven. There's some interesting data that revumenib may actually synergize with BCL-2 and may even be an opportunity to re-challenge. That's one of the more common combinations, but we do also see other combinations in use. We have, for example, ongoing studies, which I think is important with FLT3 inhibitors. It's not something we hear that it's a high priority amongst the physician community, but we do want to generate data to confirm both tolerability and efficacy with a FLT3 inhibitor. Potentially other single agent therapies as well. Certainly ven is one of the more common ones.

Speaker #5: Sometimes patients have been exposed to prior VEN. I mean, there's some interesting data that RevuMeniv may actually synergize with BCL2 and may even be an opportunity to rechallenge.

Speaker #5: So that's one of the more common combinations. But we do also see other combinations in use. We have, for example, ongoing studies, which I think is important with FLIP3 inhibitors.

Speaker #5: It's not something we hear is a high priority among the physician community, but we do want to generate data to confirm both tolerability and efficacy with a FLIP3 inhibitor.

Speaker #5: And then potentially other single-agent therapies as well. But certainly VEN is one of the more common ones. And what we have observed in our real-world data today is that it does drive response rates up significantly from what you observe with RevuMeniv alone.

Nick Botwood: What we have observed in our real-world data today is that it does drive response rates up significantly from what you observe with revumenib alone. If a patient's able to tolerate it and they want to treat, we're obviously not promoting in that indication, it's not within our label to treat in combination. We do see, in some cases, 50% up to 80% of patients actually treated in combination because we know it drives a 60% to 80% response rate, which gives the patient a much better chance for durable response than potentially a transplant.

Speaker #5: And so if a patient's able to tolerate it and they want to treat, we're obviously not promoting in that indication. It's not within our label to treat in combination.

Speaker #5: But we do see, in some cases, 50% up to 80% of patients actually treated in combination because we know it drives a 60% to 80% response rate, which gives the patient a much better chance for a durable response from potentially a transplant.

Speaker #7: Great.

Andres Maldonado: Great. A quick one.

Speaker #2: Andres, do you have a follow-up question?

Michael A. Metzger: Andres, you have a follow-up question?

Speaker #7: Sure. A quick one on Max Pyre. I think you guys have highlighted in the past kind of some of the expectations of the scenarios, whether you expect the FCC charts to separate earlier or maybe potentially later.

Andres Maldonado: Sure. A quick one on MAXPIRe. I think you guys have highlighted in the past some of the expectations of the scenarios, whether you expect the FVC curves to separate earlier or maybe potentially later. In the simulation that in the scenarios that the curve maybe gives a modest 26-week FVC result with a longer, later slope or biomarker effect, how should we interpret that influence on the potential market there?

Speaker #7: But in the simulation that in the scenario that the curve maybe gives a modest 26-week FVC result with a longer later slope or biomarker effect, how should we interpret that influence on the potential market there?

Speaker #2: Yeah. Nice question, Andres. Maybe I'll turn it to Nick.

Michael A. Metzger: Yeah, nice question, Andres. Maybe I'll turn to Nick.

Speaker #5: Yeah. We're pretty confident saying that 26-week endpoint, it's been a very good predictor in other studies of IPF. I mean, we model that out to 52 weeks because that's the endpoint we would use in a pivotal phase three and is the FDA's preferred endpoint.

Nick Botwood: Yeah, we're pretty confident. I have to say in that 26-week endpoint, it's been a very good predictor in other studies of IPF. We model that out to 52 weeks because that's the endpoint we would use in a pivotal phase III and is the FDA's preferred endpoint. For a proof of concept study like MAXPIRe, 26 weeks is pretty robust. Some other studies have used 12. We're not anticipating any delayed separation of those curves. We saw in our experience in GVHD, very early onset. Certainly symptoms were responding within a month, and we were observing responses within the first month or two. We are expecting by week 26, the evidence of activity will be very much in evidence. That's what we'll be using. We'll be using the model. We're using a mixed linear regression model out to 52 weeks.

Speaker #5: But for a proof of concept study like Max Pyre, 26 weeks is pretty robust. Some other studies have used 12. We're not anticipating any delayed separation of those curves.

Speaker #5: We saw in our experience in GVHD that the very early-onset symptoms were certainly responding within a month, and we were observing responses within the first month or two.

Speaker #5: So we are expecting by week 26, the evidence of activity will be very much in evidence. And that's what we'll be using. We'll be using the model we're using, a mixed linear regression model, out to 52 weeks.

Speaker #5: That's what we will be using if it's positive. To inform and power the phase three study. And obviously, the phase three study size, and dimensions will be influenced by what we observe in the phase two.

Nick Botwood: That's what we will be using if it's positive to inform and power the phase III study. Obviously the phase III study size and dimensions will be influenced by what we observe in the phase II. We're feeling very confident, I have to say, in everything we've observed to date that would suggest that study will read out well. Obviously, it remains a double-blind, placebo, ongoing study. We don't know what the study will show, but given all of the preclinical and clinical data we've generated and the mechanism of action, we're feeling quite positive, and we're looking forward to that study reading out in the Q4. We think it'll be a very robust proof of concept given its design.

Speaker #5: But we're feeling very confident, I have to say, and everything we've observed today that we know that would suggest that study will read out well.

Speaker #5: Obviously, that's a it remains a double-blind placebo ongoing study. We don't know what the study will show. But given all of the preclinical and clinical data we've generated and the mechanism of action we're feeling quite positive, and we're looking forward to that study reading out in the fourth quarter.

Speaker #5: And we think it'll be a very robust proof of concept, given its design.

Speaker #7: Thank you very much.

Andres Maldonado: Thank you very much.

Speaker #2: Thank you.

Michael A. Metzger: Thank you.

Speaker #3: The next question is from Jason Zemansky with Bank of America. Your line is now open.

Operator 2: The next question is from Jason Zemansky with Bank of America. Your line is now open.

Operator: The next question is from Jason Zemansky with Bank of America. Your line is now open.

Speaker #8: Hi, this is Jackie on for Jason. Thanks so much for taking my question. So, you previously characterized the decline in new RevuFORGE starts as an anomaly.

[Analyst] (Bank of America): Hi, this is Jackie on for Jason. Thanks so much for taking our question. You previously characterized the decline in new Revuforj starts as an anomaly, but can you quantify how starts change sequentially within NPM1 and KMT2A? Clarify whether the decline primarily reflected clinical trial enrollment, competition, or underlying patient availability. Also, could you maybe tell us whether July starts have returned to prior quarter levels? Thank you.

Speaker #8: But can you quantify how starts change sequentially within the MPM1M and KMT2R? Clarify whether the decline primarily reflected clinical trial enrollment, competition, or underlying patient availability.

Speaker #8: And also, could you maybe tell us whether July starts have returned to prior quarter levels? Thank you.

Speaker #2: Jackie, thanks for your question. So first, maybe I'll turn it to Steve to talk a little bit about what the decline in new patient starts reflected.

Michael A. Metzger: Jackie, thanks for your question. First, maybe I'll turn it to Steve to talk a little bit about what the decline in new patient starts, what it reflected. That's it.

Speaker #2: That's it.

Steve Closter: Yeah. I think we talked about the potential reasons why it's difficult to piece out each one and determine the contribution factor from each. I'd say it was an overall drop in all new patient starts. I think there was an earlier question on AML in general. We didn't see a differing change in NPM1 relative to KMT2A. We do believe it's a temporary effect, and we're going to return back to where we were previously. I think there was a good question also.

Speaker #4: Yeah. I think we've talked about the potential reasons why it's difficult to pierce out each piece out each one and determine the contribution factor from each.

Speaker #4: And I'd say it was an overall drop in all new patient starts. I think there was an earlier question on AML in general. So we didn't see a different change in MPM1 relative to KMT2A.

Speaker #4: So, we do believe it's a temporary effect, and we're going to return back to where we were previously. I think there was the question also just.

Michael A. Metzger: About July, yeah.

Speaker #4: We're not going to comment on July, at least not a quarter forward. But we feel good. We feel confident in the business plan and in everything that we have going on against the brands, as shared on this call.

Steve Closter: We're not going to comment on July, at least in the quarter forward. We feel good. We feel confident in the business plan and in everything that we have going against the brands as shared on this call.

Speaker #2: Yeah, absolutely. I think we expect to return to growth, as Steve mentioned. And look, in terms of the dynamics for MPM1 and some of these others, I mean, I think these are different things that impact from quarter to quarter.

Michael A. Metzger: Yeah, absolutely. I think we expect to return to growth as Steve mentioned. Look, in terms of the dynamics for NPM1 and some of these other I think there are different things that impact from quarter to quarter, but I think we feel confident we have a plan to make sure that we get back to that positive growth there.

Speaker #2: But I think we feel confident we have a plan to make sure that we get back to that. Positive growth there. Thank you.

Speaker #8: Great. Thank you so much.

[Analyst] (Bank of America): Great.

Michael A. Metzger: Thank you.

[Analyst] (Bank of America): Thank you so much.

Speaker #3: The final question today is from Mayank Motami with B. Raleigh Securities. Your line is now open.

Operator 2: The final question today is from Mayank Mathrani with B. Riley Securities. Your line is now open.

Operator: The final question today is from Mayank Mathrani with B. Riley Securities. Your line is now open.

Speaker #6: Yes. Good afternoon. Thanks for squeezing me in. Appreciate it. I'm going to keep it very tight. Did you say the NPM1 relapse segment, how is your duration of therapy tracking?

Mayank Mathrani: Yes, good afternoon. Thanks for squeezing me in. Appreciate it. I will keep it very tight. Did you say the NPM1 relapse segment, how is the duration of therapy tracking, sorry if I missed that, relative to what you had in the trials, given the context of earlier line use in co-mutation patients? Was also curious if there's a year-end exit rate you expect to have in terms of how the split between NPM1 and KMT2A patients you expect to have at the end of the year?

Mayank Mamtani: Yes, good afternoon. Thanks for squeezing me in. Appreciate it. I will keep it very tight. Did you say the NPM1 relapse segment, how is the duration of therapy tracking, sorry if I missed that, relative to what you had in the trials, given the context of earlier line use in co-mutation patients? Was also curious if there's a year-end exit rate you expect to have in terms of how the split between NPM1 and KMT2A patients you expect to have at the end of the year?

Speaker #6: Sorry if I missed that relative to what you had in the trials given the context of earlier line use and co-mutation patients. And also curious if there's an year-end exit rate you expect to have in terms of how the split between NPM1 and KMT2A patients you expect to have at the end of the year.

Speaker #2: No. Thanks for the question. So I don't think we gave a specific number for MPM1 tracking, but I'd just say the duration most of these patients don't go to transplant, as we commented that very encouraging that the duration for patients who haven't gone to transplant is averaging well over seven months.

Michael A. Metzger: No, thanks for the question. I don't think we gave a specific number for NPM1 tracking, but I'd just say that duration, most of these patients don't go to transplant. As we commented, that very encouraging that the duration for patients who haven't gone to transplant is averaging well over seven months at this point early on. A lot of those patients, of course, are NPM1, or I'd say the disproportionate amount of NPM1 patients don't go to transplant. I think that's a potential indicator of how things are going. We're quite encouraged by the overall, and without breaking it out, that's perhaps an indicator. In terms of the number of NPM1 patients at the end of the year, I don't think we've said or guided to that. All I'd say is that we do have a dominant position in the market.

Speaker #2: At this point, early on, and a lot of those patients, of course, are MPM1 or say they're disproportionate amount of MPM1 patients don't go to transplant.

Speaker #2: So, I think that's a potential indicator of how things are going. We're quite encouraged by the overall result, and without breaking it out, that's perhaps an indicator.

Speaker #2: And then in terms of the number of MPM1 patients at the end of the year, I don't think we've said or guided to that.

Speaker #2: All I'd say is that we do have a dominant position in the market. We expect that to build over time. We'll continue to use all of our resources to identify patients and build that business.

Michael A. Metzger: We expect that to build over time. We'll continue to use all of our resources to identify patients and build that business, and we feel encouraged by what we see, both as monotherapy and in combination. That's been what the themes have been at our medical congresses. We're quite in a good position to continue to build and feel good about the forward.

Speaker #2: And we feel encouraged by what we see both as monotherapy and in combination and that's been what the themes have been at our medical congresses.

Speaker #2: So we're quite a good position to continue to build and feel good about the forward.

Speaker #6: Understood. And maybe just lastly, we are coming off a busy conference season, but you obviously have your biggest conference at the end of the year.

Mayank Mathrani: Understood. Maybe just lastly, we are coming off a busy conference season, but you obviously have your biggest conference at the end of the year. If you could just quickly comment on what to expect there, including from the three frontline setting trials you have ongoing, and if there's any enrollment update we can expect to have on EVOLVE-2, DEW, or REVEAL-ND would be good to know. Thanks for taking my questions.

Mayank Mamtani: Understood. Maybe just lastly, we are coming off a busy conference season, but you obviously have your biggest conference at the end of the year. If you could just quickly comment on what to expect there, including from the three frontline setting trials you have ongoing, and if there's any enrollment update we can expect to have on EVOLVE-2, DEW, or REVEAL-ND would be good to know. Thanks for taking my questions.

Speaker #6: If you could just quickly comment on what to expect there including from the three frontline setting trials you have ongoing and if there's any enrollment update we can expect to have on evolve to our reveal and the would be good to know.

Speaker #6: Thanks for taking our questions.

Speaker #2: Yeah. Thanks for the follow-up. So end of the year, Nick, you have very data-rich end of year looking forward to the second half of the year.

Michael A. Metzger: thanks for the follow-up. End of the year, Nick.

Nick Botwood: Yeah, very data rich end of year. Looking forward to the second half of the year. We hope to carry the momentum which I outlined briefly what we saw at ASCO and EHA. The teams have been working very hard. We're going to see multiple data sets. I would expect to see updates to all of our frontline studies. There's several, two studies in combination with ven and HMA combinations, and then obviously our combination study with intense chemotherapy as well. That'll be very informative to our ongoing pivotal phase IIIs, which remains a focus for us. Expect to also see, as we've talked a lot about, further data on the maintenance after transplant, informing practice there, combination, and of course, real world evidence. That will be very important.

Speaker #2: I mean, we hope to carry the momentum. I outlined briefly what we saw at ASCO and EHA. The teams have been working very hard.

Speaker #2: We're going to see multiple data sets. I would expect to see updates to all of our frontline studies. There are several studies in combination with Ben and HMA combinations, and then obviously our combination study with intensive chemotherapy as well.

Speaker #2: That will be very informative to our ongoing pivotal phase threes, which remains a focus for us. But expect to also see, as we've talked a lot about, further data on the maintenance after transplant, informing practice there, combination, and of course, real-world evidence.

Speaker #2: That will be very important. I think it'll be also important that I know there'll be a lot of interest in looking at how some of the time-to-event things are coming from our frontline studies like event-free survival and particularly overall survival.

Steve Closter: I think it'll be also important that I know there'll be a lot of interest in looking at how some of the time to event things are coming from our frontline studies, like event-free survival and particularly overall survival, and I think we should have sufficient maturity to update on those as well. As I say, very data rich period coming up in the second half of the year we're looking forward to.

Nick Botwood: I think it'll be also important that I know there'll be a lot of interest in looking at how some of the time to event things are coming from our frontline studies, like event-free survival and particularly overall survival, and I think we should have sufficient maturity to update on those as well. As I say, very data rich period coming up in the second half of the year we're looking forward to.

Speaker #2: And I think we should have sufficient maturity to update on those as well. So as I say, very data-rich period coming up in the second half of the year.

Speaker #2: We're looking forward to.

Speaker #6: Thanks so much. No problem with it.

Mayank Mathrani: Thanks so much. Look forward to it.

Mayank Mamtani: Thanks so much. Look forward to it.

Speaker #2: Thank you.

Michael A. Metzger: Thank you.

Speaker #3: This concludes our question-and-answer session. I will now turn the floor over to Michael Metzger for any additional comments or closing remarks.

Operator 2: This concludes our question and answer session. I will now turn the floor over to Michael Metzger for any additional comments or closing remarks.

Operator: This concludes our question and answer session. I will now turn the floor over to Michael Metzger for any additional comments or closing remarks.

Speaker #2: Thank you all. We really appreciate everyone tuning in today to discuss our recent progress and the exciting milestones we have ahead. We look forward to seeing many of you at the upcoming investor conferences in the third quarter.

Michael A. Metzger: Thank you all. We really appreciate everyone tuning in today to discuss our recent progress and the exciting milestones that we have ahead. We look forward to seeing many of you at the upcoming investor conferences in Q3. Have a great evening, everyone.

Q2 2026 Syndax Pharmaceuticals Inc Earnings Call

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