Mark Goldsmith
Analyst · Cowen
Thanks, David. Good afternoon, everyone. Thank you all for joining us today. I'll start with a few top line comments. We've made great progress in the first quarter. We continue to advance what we believe is the deepest portfolio of RAS targeted therapeutics in the field, led by our RAS on inhibitors in development with significant opportunity for patient impact. excessive RASon-signaling drives some 30% of all human cancers. Today, I am very pleased to let you know that we have submitted the IND for RMC-6236, our RAS multi-ON-inhibitor and expect to dose the first patient in mid-2022. Preparation of the IND for RMC-6291, our KRAS G12C inhibitor is also on track with our original guidance, and we expect to dose the first patient in the second half of 2022. These 2 Raton inhibitors approaching the clinic and an exciting pipeline behind them represent a wave of Raton inhibitor drug candidates that could address the majority of RAS-addicted cancers that lack effective targeted drugs. Concurrently, we continue clinical evaluation of the class-leading RAS companion inhibitors RMC-4630 and RMC-5552 that are intended as combination agents with direct RAS inhibitors, including our own Raton inhibitors to maximize patient benefit. Regarding our development-stage compounds, we are transitioning our communication schedule. Going forward, we plan to focus milestones for development-stage programs on clinical initiation rather than IND submissions. Investors should look to our postings on clinicaltrials.gov for indications that an IND is open and that clinical investigation sites are being activated to enable study initiation. We also plan to communicate after we've begun dosing patients in each program. Slide 5. Revolution Medicines has a deep science-driven pipeline of targeted therapies for RAS-addicted cancers. We have 4 Raton drug candidates that are supported by robust and growing data sets that have large clinical opportunities with the potential to serve patients with a wide range of RAS-addicted cancers. Further, we expect that our pipeline will continue to grow with highly distinctive new assets deriving from our RAS cancer innovation engine, which should expand our reach to other key oncogenic mutations on RAS proteins. Although RAS-addicted cancers are induced primarily by mutations that cause RAS on proteins to behave as cancer drivers. Often, these cancers are also supported and maintained by other cellular proteins we call RAS cooperating targets and pathways. We believe it is important scientifically to match our treatment strategies to this biological cooperativity by developing RAS companion inhibitors to suppress the cooperating proteins while deploying Raton inhibitors to suppress the primary RAS drivers. Lastly, I note that in many instances, we expect drugs of these 2 types may be combined to deliver the greatest clinical benefit. In the next few minutes, I'll highlight examples of 3 specific themes that are important to our strategy. First, Raton inhibitors demonstrate compelling monotherapy antitumor activity in diverse preclinical models of genetically defined RAS cancers. Second, Raton inhibitors can be combined with RASK companion inhibitors to improve antitumor activity in preclinical models that are less sensitive to monotherapy. And third, Raton inhibitors as monotherapies reverse the immunosuppressive tumor microenvironment in RAS-driven cancer models and can unlock profound antitumor immunity when combined with immune system modulators such as PD-1 checkpoint inhibitors. Now, I'll turn to specific comments about our portfolio progress. The first theme is Raton inhibitors as highly active monotherapy agents preclinically. We have produced a large collection of tri-complex inhibitors targeting diverse oncogenic RAS variants through highly differentiated chemical and pharmacologic profiles. Slide 9; as a first example, RMC-6236 is a potent oral Raton selective inhibitor with broad potential across cancers driven by a variety of RAS mutations. To date, it has been shown to be active in 3 histotypes including pancreatic, colorectal and non-small cell lung cancer models and across mutations, including KRAS G12D, KRAS G12V and KRAS-G12R, cancer drivers for which patients whose tumors bear these mutations black targeted therapy options. Slide 12; we are on the path to clinical data now that the IND has been submitted. We expect to announce dosing of the first patient in a monotherapy dose escalation study in mid-2022. And in 2023, we plan to provide evidence of first-in-class single-agent activity for ARMC6236. I also note that RMC-6236 may also be deployed as a RAS companion inhibitor in combination with mutant selective Raston inhibitors, something I will say a bit more about later. Slide 14; as another example, RMC-6291 is a potent oral selective covalent inhibitor of KRAS G12C on with a differentiated preclinical profile designed to serve patients with cancers driven by the KRAS G12C mutation, including lung, colorectal and pancreatic cancers. 6291 has demonstrated best-in-class potential for treating KRAS G12C-driven lung cancers, non-small cell lung cancers based on superior outcomes in a mouse clinical trial with KRAS G12C lung cancer models. Slide 17; our IND preparation is on track for submission in the first half of 2022, and we anticipate RMC-6291 will be our second RAN inhibitor program to enter the clinic this year and expect to disclose preliminary evidence of superior activity over the first-generation KRAS G12C inhibitors in 2023. Slide 19; as a third example, ARMC9805 is an oral selective covalent inhibitor of KRAS G12D on, the primary tumor driver for more than 50,000 new patients annually in the United States, predominantly patients with colorectal pancreatic or non-small cell lung cancer. RMC9805 exhibits a highly differentiated profile, and we believe it is one of our most technically sophisticated Raton inhibitors to date. It uniquely engages the KRAS G12D cancer variant covalently through the oncogenic aspartic acid residue by taking advantage of a proprietary chemical warhead, a bespoke linker and our tri-complex binding modality. These design elements deliver a highly distinctive preclinical profile that includes oral bioavailability and selective and irreversible inhibition of this important cancer target. When administered orally to mice and grafted with the KRAS G12D tumor, ARMC9805 achieves favorable plasma exposures, dramatically suppresses DS6 mRNA, a molecular biomarker of RAS pathway signaling for over 24 hours due to its irreversible inactivation of the target. Slide 20; we believe ARMC9805 is the first ever drug candidate described that can covalently modify in aspartic acid residue in a targeted protein. -- drives deep and durable antitumor responses and pancreatic and colorectal cancer models in vivo upon oral dosing and it is well tolerated. Slide 22; as a fourth example, RMC8839 is an oral selective covalent inhibitor of KRAS G13C on. We believe it is the first compound to directly inhibit KRAS G13C, a target primarily for lung and select colorectal cancer patients who are currently not served by a targeted RAS inhibitor. Slide 24; lastly, in our pipeline expansion programs, we continue leveraging our RAS innovation engine to identify additional orally bioavailable tri-complex Raton inhibitors to target RAS variants driving RAS-addicted cancers that are unserved by current targeted drugs. As illustrated on this slide, our tri-complex inhibitors bind to RAS on proteins at a site that provides the opportunity for direct chemical interaction with amino acids at each of the 3 well-recognized mutational hotspots affecting residues G12 G13 or Q61. This binding geometry is leveraged in each of our programs to design compounds that are selective in engaging mutant domino assets of these positions that are responsible for most RAS-addicted cancers. Today, I'll share compelling initial data about RM-043, a representative mutant selective noncovalent inhibitor of KRAS Q61H -- on that was shown for the first time at the recent AACR Annual Meeting. RM-043 chose nanomolar activity in cells driven by the KRAS Q61H variant is selective for KRAS Q61H over wild-type RAS and drives deep progressions in a KRAS Q61H xenograft model of lung cancer. To our knowledge, this is the first ever example of a targeted RAF inhibitor directed to an oncogenic RAS variant at the CU-61 mutation hotspot. This compound not only represents proof of principle for selective targeting of codon 61 by tri-complex inhibitors, but also demonstrates that this modality can be leveraged to develop highly mutant selective inhibitors even when covalent bonding is not possible. Slide 26; the second theme and parallel approach that I'll talk about today is that our RAS companion inhibitors in development may be combined with Raton inhibitors to improve antitumor activity in preclinical models that are less sensitive to monotherapy. These RAS companion inhibitors are targeted drugs that suppress cooperating targets and pathways known to work in coordination with Rast cancer drivers to sustain raced cancers and in some instances, confer drug resistance. We believe that combining best-in-class Raton inhibitors with best-in-class RAS companion inhibitors offers the greatest chance of pathway suppression and durability of response to deliver the best clinical outcomes. Ultimately, the optimal RAS on and companion inhibitor strategy will likely be disease specific. I will highlight here 2 clinical stage assets that support combination treatment approaches. Slide 28; first, RMC-4630 is a potent oral small molecule that is designed to selectively inhibit the activity of SHP2 and upstream cellular protein that plays a central role in modulating self-survival and growth by facilitating RAS pathway signaling. Amgen continues its initial evaluation of dosing RMC-4630 in combination with sotorasib in second-line treatment of various KRAS G12C tumors in the U.S. CodeBreaK 101 study and recently announced that has submitted initial data from this study to a medical congress for late summer. Revolution Medicine's clinical study called RMC-463003 is progressing and continues to enroll. This is a global Phase II study of RMC-4630 in combination with sotorasib in patients with advanced non-small cell lung cancer with a KRAS G12C mutation who have failed prior standard therapy and who have not been previously treated with a Razon inhibitor with a RAS inhibitor. We are on track to enroll the study fully this year and have sufficient data by the end of the year to share some of the high-level findings. Slide 29; I Second, RMC-6236, the exciting RAS multi ON inhibitor I described earlier, is notable within our broad Raton inhibitor portfolio because it, in particular, has the potential to be deployed as a RAS companion inhibitor as well as a primary cancer driver targeted agents. In some clinical context, patients may gain maximal clinical benefit from the broad activity of this RAS-multi-AN inhibitor in combination with the deep and sustained target coverage provided by a mutant selective Raton inhibitor, such as RMC-6291. Slide 30; at the AACR meeting, we reported that RMC-6236 in combination with RMC-6291, demonstrated enhanced antitumor activity in KRASG12C non-small cell lung cancer and colorectal cancer models. -- that are relatively resistant to single-agent treatments. An example shown on this slide, CRC 022 is one such KRAS G12C colorectal cancer model, in which either the G12C on inhibitor RMC-6291 or the RAS multi inhibitor RMC-6236 as a single agent slow tumor growth but fails to induce tumor regressions. In contrast, combining these 2 agents convert the impact into significant tumor regression. Slide 32; lastly, RMC-5552 continues to advance. This drug candidate is a potent, first-in-class bisteric-MTorq 1 selective inhibitor. -- designed to suppress phosphorylation and inactivation of 4 EBP 1 for cancers with hyperactive mTORC1 signaling, including certain RAS-addicted cancers. We aim to combine RMC-5552 with RAS inhibitors in patients with cancers, harboring RAS and mTOR pathway co-mutations. We are making progress in our ongoing Phase I/Ib clinical trial, evaluating RMC-5552 as a monotherapy and are now focused on dose optimization in preparation for accommodations with Razon inhibitors. Slide 11; I -- our third theme is unlocking the antitumor immune response by targeting RAS cancer drivers within tumors. We have seen examples, multiple examples in which Raston inhibitors as monotherapies reverse the immune-suppressive tumor microenvironment in RAS-driven cancer models and can unlock profound antitumor immunity when combined with immune system modulators such as PD-1 checkpoint inhibitors. In particular, both RMC-6236 and RMC-6291 alone can favorably transform the immune microenvironment in RAS tumors and are highly additive with a checkpoint inhibitor. RMC-6236 favorably transforms the tumor immune microenvironment by moduling both the adaptive and innate immune cells infiltrating these RAS-addicted tumors. -- and these changes significantly increased the sensitivity of such tumors to immune checkpoint inhibitors. Hence, the combination of RMC-6236 with a checkpoint inhibitor, cases profound, durable and even complete antitumor responses in some preclinical models in mice with intact immune systems. Slide 16; RMC-6291 is able to modulate the immune microenvironment via tumor intrinsic effects that prime cancer cells for antitumor immunity in the presence of a checkpoint inhibitor. Here, we show this combination is also able to drive complete responses in an immunogenic model of KRASG12C cancer. In summary, these prepared comments have provided an update on our portfolio across 3 core themes that are important to our strategy. First, RAS inhibitors demonstrate compelling monotherapy antitumor activity in diverse preclinical models of genetically defined rest cancers. Second, RAS1 inhibitors can be combined with RAS companion inhibitors to improve antitumor activity in preclinical models that are less sensitive to monotherapy. And third, Raton inhibitors as monotherapies reverse the immunosuppressive tumor microenvironment in RAS-driven cancer models and can unlock profound antitumor immunity when combined with immune system modulators such as PD-1 checkpoint inhibitors. These concepts in conjunction with preclinical data sets behind each of the development stage assets in our R&D portfolio, underline our belief that we may be able to serve significant unmet clinical needs for patients with a wide range of RAS-addicted cancers. I'll now turn to Jack Anders, our Senior Vice President of Finance, to report on our financial condition. Jack?