Good morning, everybody, and thank you for joining us at the 44th Annual Canaccord Genuity Growth Conference here in sunny Boston today. I'm John Newman, one of the biotech analysts here at the firm. We're very excited to have Merus with us today, and CEO Bill Lundberg. Bill? Thank you. Thank you, John. Thank you to the entire Canaccord team for the continued support that you guys have provided. It's been a great partnership. It continues to be a great partnership. This is our disclaimer slide. I think this is the remote that advances slides. Merus is an oncology-focused company. We have four clinical stage assets of our own and multiple others with our partners and collaborators. If we advance the slides. ... Got it. And the top of the list is petosemtamab, which is a bispecific antibody combining an EGFR binding arm with an LGR5 binding arm, and I'll talk in detail about this asset. It is a drug that has compelling clinical research data in both frontline and second, third line head and neck cancer, which I'll talk about in some detail. It is advancing into Phase 3 registration trials. We've started dosing in the first of two planned registration trials, and for the second trial, we plan on dosing by the end of the year. It is also enrolling in a metastatic colorectal cancer trial, so we're expanding the potential opportunities for this medicine. We've made significant progress across our pipeline, both with zenocutuzumab, which is a HER2 and HER3 bispecific antibody, which is under review at the FDA for potential approval. That BLA has been accepted under priority review for these NRG1 fusion cancers. In addition, we have a drug, MCLA-129, that has demonstrated strong clinical activity in a variety of settings in lung cancer, and we're quite excited about that opportunity as well. We also have multiple collaboration programs developed with our Multiclonics or bispecific and trispecific antibody platforms that are advancing into the clinic. This is a unique technology platform, and if we have time at the end, I'll speak about some of the very important advantages that this, platform provides. In addition, we have a strong cash position with $846 million as of the last quarter close, which we believe will take us into 2028, and importantly, through top-line readouts for our registration trials and beyond. We've set forth in 2024 some very ambitious goals for ourselves, and I'm pleased to say we are well on track to achieve these goals. For petosemtamab, our goals were to initiate Phase 3 registration trials, both in the first-line setting and in the second, third-line setting, and we've initiated the first of these two, and we're on track to start the second by the end of the year. We've provided clinical data on the safety and tolerability of our drug, petosemtamab, together with pembrolizumab in the first-line setting in head and neck cancer. I'll discuss those data. We've also guided a clinical update on the drug alone monotherapy in the second-line setting, which we've guided we will provide late 2024, and we're on track for that. And we've also guided we would initiate, excuse me, a cohort of petosemtamab with standard chemotherapy in second-line colorectal cancer. With zenocutuzumab, we had guided we would file a BLA, which we have achieved for this drug in NRG1 fusion cancers, as shown here. And with MCLA-129, we've initiated cohorts in combination with chemotherapy in the second-line setting in lung cancer. Our clinical pipeline is shown on the next slide. Petosemtamab is up at the top, with the opportunities, and the other assets are listed below. And importantly, many of our programs and our early research programs are with our collaborators and partners in strategic relationships. This has been a key element to the Merus strategy to finance the business for a number of years and to lead to the opportunity for product rights, for the potential for programs. For example, with our Gilead trispecific antibody collaboration, this is a potential development and commercialization, milestone-driven program with tiered royalties as well on two Triclonics programs, and the ability for us to opt in to co-development of a third program. In this deal, we received $56 million upfront from Gilead, and in addition, they invested $25 million in Merus shares at a premium. Importantly, these types of deals also provide substantial validation for our program technologies. So petosemtamab is a drug that you've all heard about. It is a bispecific between EGFR and LGR5, and it's designed to potently block dysregulated signaling in these cancers and shrink these cancers down. It targets both EGFR and LGR5, a cancer stem cell antigen, and the antibody itself has modifications to enhance antibody-dependent cellular cytotoxicity, or ADCC. It's received Fast Track designation and Breakthrough Therapy designation, as shown here, and we've shown meaningful clinical activity that I'll review on the next two slides. In addition, we have a cohort in second-line colorectal cancer in combination with standard chemotherapy enrolling. So we're excited about the potential for this drug in the large opportunity of head and neck cancer and also potentially beyond.... The mechanism of action is shown on the following slide. We believe that petosemtamab acts by three important ways. One is to block EGFR binding from its ligand, EGF, just like cetuximab or other cetuximab-like antibodies. The second is through an LGR5-dependent mechanism. It completely degrades and eliminates the EGFR receptor, and that's shown in the colorful pictures on right. In an organoid model, when you put on petosemtamab, the antibody itself, shown in red, gets internalized into the cell, and it drags with it the EGFR protein, which is bound on the other side of the antibody, and leads to the EGFR degradation. There's no green in the image on the left. As compared to cetuximab, an EGFR antibody on the cell, which largely sticks on the cell surface, and EGFR remains in this. We've shown this independently by an orthogonal method shown down below, which is a Western blot showing the amount of protein present in these cells, and you can see the disappearance of the band in the petosemtamab box reflects the disappearance of EGFR in this model system. Lastly, petosemtamab is fully ADCC-enhanced with the latest technology, and so it potently engages with the patient's immune cells and immune system to help drive the disappearance or shrinkage of cancer in patients. We showed our first clinical data of petosemtamab monotherapy in head and neck cancer last year at AACR, and that's recapitulated here, but I'd refer you to the full presentation, which is available on our website. In that presentation at AACR last year, petosemtamab monotherapy led to a very compelling confirmed overall response rate of 37%. That's shown in the waterfall plot on the left, and the duration of treatment and response is shown in the swimmer plot on the right. This compares quite favorably to what these patients could otherwise receive. The approved regimens or commonly used regimens are typically cetuximab monotherapy with a response rate of 15%-19%, and single agent chemotherapy with a response rate at that level or even lower. So our 30%-37% number here is substantially favorable compared to those. In terms of time to response and duration of therapy, there's a very rapid onset of response, and Dr. Cohen, in his presentation at AACR, commented not only on the rapidity and dramatic nature of these responses, but on the quality of them, that for some patients, he saw healing of the fistulas that sometimes occur upon treatment of head and neck cancer. So not only quantitatively, but qualitatively, this appears to be a different drug than just cetuximab alone. In addition, what we've seen in these data are a median duration of response of 6 months and median progression-free survival of 5.3 months. Again, compared to the standard therapies patients are currently receiving in this setting, where the PFS is around 2.3 months or less, this compares quite favorably. So on the safety side, this was well-tolerated. Even the EGFR type toxicities were even maybe numerically a little bit more mild than what one might see with cetuximab. Importantly, we did see infusion-related reactions in up to 75% of patients, and I'd refer you to the presentation on those data. We've continued to work hard to improve those. We followed this with a presentation at ASCO this year on the combination of our drug, petosemtamab, with pembro in the frontline setting in head and neck cancer. And here, by way of comparison, the frontline setting standard therapy of pembro alone has a 19% response rate, and what we showed at ASCO was a 67% response rate. Now, this includes both confirmed and three patients whose responses had not yet been confirmed at the time of presentation, but were subsequently confirmed after data cutoff. So we include them all, and we're clear about the confirmed response rate here and the important information about confirmation of the additional three. So confirmed response rate is the endpoint that is recognized by the FDA as a surrogate for approval, for accelerated approval. That's the important endpoint you wanna pay attention to. What you can see in the waterfall plot is the vast majority of patients had tumor shrinkage, this is over on the left, and the responses occurred robustly across different subsets. In patients with different levels of the PD-L1 target on their tumor, CPS 1-19 or 20 and greater, there were responses across both categories. In patients whose tumors were driven by the human papillomavirus, as indicated by the p16 marker, those, patients, there were 4 of them, and 3 had robust responses. So a small number, 4, but a reasonable, and encouraging response rate in this population as well. This is important because cetuximab and cetuximab-like drugs do not have activity in this patient population, and it really drives our thinking that this is a drug really for all patients with head and neck cancer in this setting. Time to response, duration of therapy is shown on the right. It's very early to say anything. 14 out of 16 responders remain in response and on treatment, but we're encouraged that the median duration or median progression-free survival in this population will be substantially greater than the median PFS seen for pembrolizumab alone, which is 3 months. So already it looks like, you know, we're trending very well to improve upon that. The safety again showed a favorable safety profile, no overlapping toxicities between these two medicines, and the infusion-related reactions, the IRRs, were only seen in 38% of patients in this study, and the vast majority were Grade 1 or Grade 2, and they were all manageable in this setting. So we're really quite encouraged that we're also making significant progress in being able to provide a drug that's well-tolerated for patients as well. Head and neck cancer has become an important area in oncology, largely because of the opportunity for new therapies, initially, like pembrolizumab, and now for the opportunity of petosemtamab alone. It's the sixth most common cancer, with almost a million new cases in 2020, and the incidence is rising for a variety of reasons. We believe that the pembrolizumab-based regimens are the standard of care, and we have believed that both of these pembrolizumab alone and pembrolizumab chemotherapy regimens, we have the opportunity to improve upon with the data I just showed you, which is significantly important for these patients with head and neck cancer. We view this as, based on the analysis shown here in the citations and the footnotes, as a potential market opportunity that could exceed $5 billion. So we think this is both medically important for patients and commercially important as an opportunity for petosemtamab. Importantly, also, head and neck cancer patients are typically patients with a fair amount of comorbid diseases, and so to have a chemo-free regimen that is well-tolerated, that is not associated with the toxicities of chemotherapy, is a very important aspect as well. So just to provide you a summary on petosemtamab, we believe this is a potential first and best-in-class bispecific, or the first and best-in-class antibody-based therapy in head and neck cancer. In terms of the progress of the program, we've shown meaningful clinical activity in both frontline in combination with pembro and second-line monotherapy activity in head and neck cancer. It has a well-tolerated and manageable safety profile, with significant improvement now in the infusion-related reactions. And we believe it's a potential new standard of care for patients with head and neck cancer. We have initiated the Phase 3 registration trial in the second-line setting in head and neck cancer, and importantly, we have completed our requirements for Project Optimus, which have taken us about a year and a half to complete, so that we have now aligned with the FDA on the dose of 1500 milligrams in both the frontline combination setting and the monotherapy setting. That is a significant achievement, for which I'm quite proud of the team in executing on that. We've guided that we will initiate, which for us means starting dosing, the Phase 3 registration trial in the frontline setting later this year. We do have a clinical cohort in colorectal cancer, ongoing as well. Turning now to zenocutuzumab, which is bispecific between HER2 and HER3. It's in clinical development for NRG1 fusion lung and pancreatic cancer. It's received breakthrough therapy designations for both of those indications, and it is under review. Biologics License Application for approval is under expedited review at the FDA. So we're excited about the progress we've been able to make here, and it continues to represent our company's ability to focus and execute on bringing innovative new medicines to patients. The NRG1 fusion aspect is important because NRG1 is the ligand for HER3, the receptor that's the target of zenocutuzumab, and it's in these genetically defined patients in which we've been able to identify great success to date. This has been granted orphan designation and Fast Track designation, as shown in, for the indications as shown in the slides, and, we continue to be excited about the progress we're making. In terms of clinical data, what's shown on this slide is the clinical data for zeno and NRG1 fusion, non-small cell lung cancer on the left and pancreatic cancer on the right. We can't put the entire presentations in a single slide here, so I'd refer you back to the full presentations of these programs that are available on our website. In non-small cell lung cancer, once a patient has progressed on initial therapies, the standard therapies of docetaxel alone or docetaxel give you a response rate of about 14%-21%. What we've seen in this population is a response rate of 37%, with the median duration of response of almost 15 months, which is substantial and clinically important. In pancreatic cancer, the NRG1 fusion pancreatic cancer shown here, patients with pancreatic cancer could otherwise get Onivyde plus 5-FU, with a 7% response rate. Our drug in this setting is providing a 42% response rate, with a median duration of nine months. Again, a really substantial improvement in what patients could otherwise receive. We're excited about the progress this is making. Important to note, the safety profile is very well tolerated. It's an antibody therapy. It's not a cytotoxic chemotherapy. MCLA-129 is the last program I wanna speak about, just briefly, which targets both EGFR and MET on cancer cells. It is a fully ADCC-enhanced molecule, and we've shown that it has substantial activity, and in vitro, even greater activity than amivantamab or Rybrevant, a drug that's approved, a bispecific EGFR/MET that's approved in a number of lung cancer settings. And what we've shown to date is clinical data in EGFR mutant lung cancer, showing that our antibody has significant clinical activity. Shown on this slide is the data presented at ASCO just most recently, in which our drug as monotherapy has significant activity in exon 14 MET non-small cell lung cancer. Again, these are patients with previously treated lung cancer, and you can see that our antibody leads to tumor shrinkage in the vast majority of patients. You can see that 53% achieved tumor shrinkage beyond 30%, the initial requirement for confirmed ORR. As of the data cutoff, eight of the fifteen patients had confirmed PRs. This includes patients whose confirmation occurred after data cutoff. The safety profile, again, is shown here. It was generally very well tolerated, and I refer you to the presentation itself for the full data set. This, too, is a very active molecule. These are the data shown on the next slide that I mentioned just briefly in passing in EGFR mutant lung cancer, both in the frontline setting, where every patient had tumor shrinkage, and in the second line setting, where patients progressed on Tagrisso, and we added our antibody on top, and more than a third of patients achieved true RECIST PRs in this setting as well. So just to summarize MCLA-129, we believe it's a very active molecule. Our challenge with this program is that we are a small company, and we have made the strategic decision to focus our resources and management time and attention on our lead asset, petosemtamab. We continue to develop MCLA-129, but we're also open to potentially partnering this drug to be able to make sure that it can have the full resourcing required to develop such an active molecule. I'd refer you to our website and our past presentations to understand a bit more about MCLA-145. I'm gonna talk a little bit about our platform on the next two slides and what makes Merus different than the many companies out there that are making bispecific or multispecific antibodies. And that is, in essence, we make our antibodies like monoclonal antibodies. Now, why should you care about that? We know how to make medicines out of monoclonal antibodies. We've been doing it for decades. We know how to discover them, develop them, undertake process development, manufacture them, take them through the wringer, and at the end, get a drug that's really meaningful for patients. And so we've adopted this philosophy, shown here, of the exact same strategy to discover and develop our Multiclonics antibodies, because we can. Because we make our multispecific antibodies or bispecifics, essentially like monoclonals. We can do true high-throughput screens to generate the common light chain antibodies that are the basis of our starting material. We can undertake robotics and these high-throughput screens and combinatorial work to look through large sets of bispecific antibodies and undertake unbiased screening to identify the best possible molecules for an indication. For example, for zenocutuzumab, our HER2/HER3 antibody, the one that we chose to move forward with in the clinic was only one or two out of more than 500 bispecifics tested. You wouldn't have been able to pick that up if you were simply combining part A with binder B. You would never have found that molecule. And for petosemtamab, our drug in head and neck cancer that is so interesting clinically, that too was a screen of over 500 bispecific antibodies, where we could use sophisticated biological assays to screen, including organoids and other model systems. And it really allows us tremendous power to let the biology select the best possible antibodies to bring forward in research and then ultimately bring forward in the clinic. That's shown on the right side, where there's a large screen of each vertical bar in this graphic in blue and red is essentially a different bispecific antibody, and we can screen across large space, whether it's a bispecific or a trispecific. Most recently, we've shown that our platform is fully compatible with standard ADC technologies. What's shown on the next slide is a graphic of what our bispecifics and trispecifics look like. The secret sauce here is really that they have common light chains. Antibodies are a heavy chain and a light chain, and having four different pieces makes it complicated. Turns out that if you make the light chain the same in all of these, that's what allows you, with a little bit more technology, to really be able to discover and develop these like monoclonal antibodies. And when you look across our clinical portfolio, this doesn't guarantee success in the clinic, but time and time and time again, the antibodies that we bring into the clinic, whether it's petosemtamab, with a 67% response rate, or zenocutuzumab, with a response rate of 42% in pancreatic cancer, where the standard of therapy is 7%, or even with MCLA-129, we're in the frontline setting, every patient's tumor shrank. Like, these are really active molecules, and we believe it's because they are grounded in this belief that we wanna minimize and mitigate risk and stand on well-established processes, approaches, and really let the biology drive the selection of our molecules, ultimately our clinical candidates, and hopefully, the medicines that we bring to the pharmacy shelf for our patients. So here now is our Merus overview. Petosemtamab had blockbuster potential in multiple oncology indications, as I've shared with you. We continue to execute very effectively as a company across our clinical pipeline. We believe it's all based on our foundational platform technology, which is not only validated by these very effective response rates and clinical efficacy that I've shown you today, but also our partnerships. And we have a robust balance sheet to take us well into the next several years. Thank you for your time and attention.
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