Sean A. McCarthy
Management
Yeah, I think - this was covered in some level of detail by Dr. Tolaney at our Investor event on April 7. And I would say just high level to recap her remarks, you've obviously got two quite different diseases here with hormone receptor positive and triple-negative. In the hormone receptor positive setting, ORR tends to be less of a driver unless of an objective given the natural history of these patients over extended periods of time. It's really more about the duration of response as evidenced in our Phase 1 data actually where we showed a promising clinical benefit rate, about 16 and 24 weeks. So Dr. Tolaney said in this setting, an ORR, you're looking for greater than 10% and you're looking for something in the range of three to four months of PFS. Obviously, we'll be looking to do even better than that, but that would be, in her words and those of our other steering committee members, clinically significant in the hormone receptor positive setting. Triple-negative, different, much more aggressive disease, of course. These patients, they progress much more rapidly. So here, ORR is going to be more important and of course, likely in the post-sacituzumab setting. We saw in the ASCEND study for sacituzumab govitecan, an ORR of 35%, PFS five to six months, overall survival 12 months. So, really a terrific outcome for patients and that is what is underpinning the approval in the second- and third-line settings. In the post-sacituzumab setting, I think what we heard from Dr. Tolaney was an ORR of 20% or above will be clinically meaningful with the relatively short duration of PFS, two to three months, would be meaningful for these patients. I would underscore my comments earlier on that if you look at in the ASCEND study, the chemo arm, these patients had overall response rate of 5%. So there is going to be significant unmet need remaining in this patient population where the disease can progress very, very rapidly. So those are some of the benchmarks that we're thinking about. For the combination, just to round out and talk a little bit about Arm C, which is the combination with our PD-L1 Probody pacmilimab, the K2 study here, which has been reported previously by Roche, atezo plus T-DM1 was able to show a significant shift in the ORR monotherapy from about 30% into the 50s with PFS of greater than eight months. So of course, we will be looking for the combination here to do more than the monotherapy, and we've shown previously we've reported pretty robust monotherapy activity for pacmilimab in triple-negative as well. So we know both of these agents, CX-2009, praluzatamab and pacmilimab, both have single agent activity. And obviously, we're excited to see what this combination can do in this patient setting as well. So I hope that helps.