Cardiff Oncology, Inc. (CRDF) Earnings Call Transcript & Summary
December 10, 2024
Earnings Call Speaker Segments
Operator
operatorWelcome to the Cardiff Oncology Clinical and Business Update Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to turn the conference call over to Kiki Patel of Gilmartin Group. Please go ahead.
Kiki Patel
attendeeThank you, operator. Joining us on the call today from Cardiff Oncology, are Chief Executive Officer, Mark Erlander; Chief Medical Officer, Dr. Fairooz Kabbinavar; and Chief Financial Officer, Jamie Levine. During this conference call, management will make forward-looking statements, including, without limitation, statements related to guidance, results and the timing of data readouts for onvansertib clinical trials. These forward-looking statements are based on the company's current expectations and inherently involve significant risks and uncertainties. Our actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these risks and uncertainties. Factors that could cause results to be different from these statements include factors the company describes in the section titled Risk Factors in its annual report on Form 10-K filed with the SEC for the year ended December 31, 2023. Cardiff Oncology undertakes no duty or obligation to update any forward-looking statements as a result of new information, future events or changes in its expectations. With that, I turn the call over to Chief Executive Officer, Mark Erlander. Mark?
Mark Erlander
executiveWell, thank you, Kiki, and good morning, everyone, and welcome to the CRDF-004 initial data release call. In the fall of 2022, we announced we have discovered an exciting finding from our Phase 1b/2 trial in second-line KRAS-mutated mCRC. Patients who did not previously receive beblituvumab or BEV, exhibited a significantly higher response rate than expected when treated with our drug candidate onvansertib in combination with the standard of care. This finding sparked a deep dive into preclinical translational research where we uncovered a novel mechanism of action for PLK1 inhibition. This effort going from the bedside back to the lab bench revealed that onvansertib has the greatest potential for success, both clinically and commercially in first-line RAS-mutated mCRC, where all patients are BEV-naive. We were convinced that we should pivot to a first-line clinical development path. And in addition to our views, we had external sources of validation as well when we shared our comprehensive data package with the FDA and with Pfizer through their seat on our Scientific Advisory Board. Both provided their support for a first-line program. In fact, Pfizer Ignite is providing the clinical execution of the trial. Furthermore, the significance of this discovery is demonstrated by the recent acceptance of our findings for publication in ASCO's flagship journal, the Journal of Clinical Oncology, or JCO and the United States Patent and Trade Office has recently issued to us a patent, which extends to 2043 that is a method of use with claims that cover treatment with onvansertib in first-line KRAS-mutated mCRC patients. We announced our first-line program in August of 2023. Today, we can share an initial encouraging first-line clinical data set. In addition, we can also share that as a result of these new CRDF-004 clinical data, we've completed a financing of $40 million from new mutual fund and biotechnology dedicated investors along with support from existing investors. You can find the data supporting our move to the first-line setting in our corporate presentation on our website. As you can see in Slide 4, today, we will cover 3 critical topics for establishing the scale of the opportunity we see for Cardiff Oncology going forward. We'll start with our new clinical data from the CRDF-004 trial. Our Chief Medical Officer, Dr. Fairooz Kabbinavar; will present the initial data from the trial, which evaluates onvansertib combined with the standard of care in the first-line treatment of RAS-mutated mCRC. Next, I'll discuss with significant market potential for onvansertib in this setting and why we believe it represents such an attractive focus for our efforts. Finally, I will conclude with some comments about the broader potential for onvansertib beyond mCRC. Today's announcement shows that our preclinical findings can identify new clinical areas where treatment can be improved with the addition of onvansertib to the standard of care regimen, and we want to share some of these other indications that our preclinical data suggests that we should explore. Before turning to the data, I'd like to remind you that our drug candidate onvansertib on Slide 5. Onvansertib is a serine [ screening ] kinase inhibitor targeting the enzyme polo-like kinase 1 or PLK1, a well-established oncology target. Onvansertib is a highly specific inhibitor of only PLK1 and is administered orally and has a short half-life of 24 hours. We believe this unique pharmacological profile avoids the toxicity seen in previous PLK inhibitors, with data from over 380 patients treated in multiple trials Onvansertib has been well tolerated, paving the way for its potential use in combination with standard of care therapies. Now our Chief Medical Officer, Dr. Fairooz Kabbinavar, will walk through the initial results from the CRDF-004 clinical trial. Fairooz?
Fairooz Kabbinavar
executiveThank you, Mark. Good morning. It's a pleasure to share initial data on the first-line CRDF-004 trial we you today. On Slide 7, you can see the design of the CRDF-004 trial, our ongoing randomized Phase II study, evaluating onvansertib combined with current standard of care regimens for FOLFIRI plus bevacizumab or FOLFOX plus bevacizumab in first-line RAS-mutated mCRC patients. The trial will enroll 90 patients with first-line mCRC with unresectable disease and with the KRAS or NRAS mutation. None of the patients in the trial have had prior exposure to bevacizumab. Patients will be randomized to 1 of the 6 arms in the trial. The primary endpoint is objective response rate and the secondary endpoints and duration of response and progression-free survival. Importantly, all of the reported trial data is based on a blinded independent central review of the patient's tumor scan, which I will refer to as [ Victor ]. This is the highest quality and stringent approach to evaluating patient response to treatment because it ensures there is no bias in the interpretation of the scans. The dosing schedule for the trial is the same as in our previous MCRC trials, where all patients received an infusion of the standard of care every 2 weeks, and patients in the experimental arm received onvansertib orally once daily for 5 days following each infusion. A baseline measurement of the patient's tumors is established at the start of the trial and the change in tumor size is determined by subsequent scans taken every 8 weeks until the patient leaves the trial. For clarity, we refer to scans as 2, 4, 6 months rather than the number of weeks. On Slide 8, we lay out the objectives of the trial. The first objective is to demonstrate the efficacy in the first-line setting when adding onvansertib for the standard of care. The second objective of the trial is to confirm the dose of onvansertib either 20 milligrams or 30 milligrams daily, consistent with the requirements of the FDA's project Optimus. Evaluating these 2 specific dose levels of onvansertib was agreed with the FDA at a Type C meeting in June 2023. Importantly, confirming our dose will be based on a numerical evaluation of the safety and efficacy data for the dosing arms and does not require a statistically significant difference between the 20-milligram and the 30-milligram onvansertib arms. The third objective of this trial is to demonstrate the safety of onvansertib when combined with the standard of care FOLFIRI bev or FOLFOX bev. On Slide 9, we show the breakdown of the 30 evaluable patients for whom we are reporting initial efficacy and safety data today. As you can see at the far right, we have 9 patients in the control arm, 10 patients with a 20-milligram onvansertib arms and 11 patients in the 30-milligram onvansertib arms. For a patient to be evaluable, they must have had a scan of the tumor, 2 months after starting treatment on cycle 1, day 1, so we can report the change in tumor size as determined by [indiscernible] during this period. The table on the right shows you the length of time on trial for all the patients. For example, the 2-month column indicates the number of patients that had only a 2-month scan. The 4-month column indicates the number of patients that had a 2 and a 4-month scans. In the 6 months, or greater column indicated a number of patients that have had a 2, 4 and 6 month or greater scans. Around half the partial responses we have observed on a trial have occurred at the 2 months scan and half as the 4 months scan. Given that we are providing an initial look at the data from an ongoing trial, it is important to have similar duration of the trial for the patients in each arms for the arms to be comparable. Looking at the table, we believe that this 30-patient cohort is well balanced across the control 20-milligrams and 30-milligrams with respect to patient time on trial. Given the clarity of this efficacy signal we are observing, we felt compelled to share this initial data from the CRDF-004 trial with the investors. I'll make one last comment regarding enrollment. I'm pleased to say that as of today, we have enrolled approximately 2/3 of the 90 patients expected in the trial. We have also seen an increase in the monthly rate of enrollment, which is expected as the trial size become accustomed to spinning patients for the trial. Based on our current rate of enrollment, we expect to complete enrollment of the trial in early 2025. On Slide 10, you can see the first of the 3 waterfall plots showing each evaluable patients' best response as of November 26. Bars rising above the midline represent tumor growth, bar falling below the midline represent tumor reduction. The yellow bars are for patients who have stable disease as defined by the RECIST 1.1 and the green bars are for patients who have demonstrated a partial response to treatment, meaning the tumor volume was shrunk by more than 30%. On the left-hand side, you see the best response for 9 patients in the 2 control arms and on the right are the 21 patients in the 4 experiment arms. You can see that there are 3 partial responses among the 9 control arm patients, giving us a 33% response rate and 12 partial responses among the 21 experimental arm patients giving us a 57% response rate. This is a highly encouraging start. And you can also see that some of the patients with a partial response have a dot over their bar. This indicates that the response confirmed by the patients next scan 2 months later. You can see that many of the partial responses on this plot are not confirmed. And this is because we are awaiting the follow-up confirmatory scan. There are no partial response patients to date who have failed to confirm their responses on the follow-up scan in any of the arms. On Slide 9 -- sorry, on Slide 11, we take the same 30 patients and combine the arms to compare the 2 chemotherapy regimens. Our preclinical models suggest onvansertib should be equally effective when paired with FOLFIRI bev and FOLFOX bev. Looking at the data for both chemotherapy backbones, there's approximately an absolute 25% improvement in response rates in the experimental arms compared to the control arms. If this remains the case, it would allow us to use both standard of care regimens in our registrational trial and maximize the addressable market for onvansertib in the first-line setting. On third waterfall plot on Slide 12 addresses our question regarding the efficacy of 20-milligram dose versus 30-milligram dose of onvansertib. On the left are the 9 control arm patients. In the middle are the 10 patients who received 20 milligrams of onvansertib in combination with either FOLFIRI BEV or FOLFOX BEV. And on the right are the 11 patients in the 30-milligram onvansertib cohort. The results are striking. It is encouraging to see that 64% response rate with 30-milligram dose is almost doubled with 33% response rate in the control arm. And in addition, the 30-milligram arm is demonstrating much deeper tumor responses, as you can see on the right side of the slide. Of the 15 patients in any trial arm with partial response, the 5 deepest tumor regressions are seen in the patients receiving the 30-milligram dose of onvansertib. At this stage of the trial, the signals we are seeing in the 30-milligram dose is very impressive. The waterfall plots show each patients single best response for all the scans they've had on the trial. But on Slide 13, we see a spider plot showing how each patient's tumor has changed over time. Once again, we are looking at the same cohorts of patients, including the control arms, the 20-milligram onvansertib arms or the 30-milligram onvansertib arms. You can see on the right side that for the 11 patients at the 30-milligram dose, we started that 2-month scan every subsequent scan for every patient shows a decrease in tumor size. This trend based on dose is exciting. And consistent with this observation is the pharmacokinetic data we are capturing for all our patients on our trial. At this point, we have PK data for 21 patients receiving onvansertib. And for these patients, we are seeing almost a doubling of the onvansertib exposure in our 30-milligram dose patients versus the 20-milligram dose patients. Slide 14, shows the swimmer plot, showing each patients response over time. Here, you will see that 26 of the 30 patients remain on trial. I'll briefly address the 4 patients that have left the trial as of this data cut, 2 patients left the trial for surgery with curative intent once they were rendered resectable after being treated with chemo bev and onvansertib. And 2 patients continued from the trial for non-onvansertib related adverse events. All other patients continue on the trial. To conclude the discussion of the efficacy results of the trial as of this November 26 data cut, slide 15 shows a summary of the response rate data. Each blue box contains the results from 1 of the 6 arms of the trials. And you can see how we have designed this trial to allow for various combinations that can address the trial objectives I mentioned earlier. Regarding historical controls, no trial to date has ever prospectively examined objective response rate in first-line RAS-mutated mCRC patients. The data that are available suggests an approximate 38% to 44% response rate for RAS-mutated mCRC patients based on post-hoc subgroup analysis. In conclusion, we believe our 30-milligram dose is prospectively showing great promise against the control arms on our trial, and we will continue to track all patients on the trial and assess the data against our trial objectives. Slide 16 shows the demographic and baseline patient characteristics, while the patients are randomized to each trial arms, we still we still assess the baseline characteristics for any skewing that could impact the results. At this point, we don't see any sign that this has occurred in the study. Slide 17 shows the safety data for the trial. They do not appear to be any unmanageable or unexpected toxicities when onvansertib is combined with standard of care. The grade 3 and 4 toxicities are also limited in number. Slide 18 shows our clinical development plan for onvansertib and mCRC as we agreed at our FDA meeting in June 2023. The details of our clinical development plan and the associated timelines are heavily impacted by the strength of the signal generated by the CRDF-004 trial. The gating item for moving into a registrational trial is to confirm the dose of onvansertib to be used in the registrational trial. The strength of the signal will allow us to optimize the powering of registrational trial and a number of patients we must enroll so we can seek accelerated approval as quickly as possible. In addition, we are exploring the possibility of amending the CRDF-004 protocol to convert the trial to a registrational trial rather than initiating a new CRDF-005 trial. To be clear, we could not include the current CRDF-004 trial patients in the registration trial patient population, but converting CRDF-004 into a registrational trial could shorten certain start-up -- trial startup and logistics activities. We look forward to updating our registration plans once we have mature data from the CRDF-004 trial. I will stop here and will return to Mark to talk about the commercial opportunity we have with onvansertib. Mark?
Mark Erlander
executiveThank you, Fairooz and as I said at the start of the call, we are very encouraged by the data that Fairooz just reviewed, including the overall signal of efficacy, the consistency of the data between the chemotherapy arms, the higher ORR and deepening responses at the 30 mg dose of onvansertib and finally, the safety profile of onvansertib. If these trends and the data continue, we believe we can make a significant impact on the treatment of this terrible disease. I'd now like to focus on the opportunity for the stakeholders of Cardiff Oncology. This starts with the patients, their families and the medical community affected by metastatic colorectal cancer as well as our investors who have supported our development efforts. On Slide 20, you can see the scope of the opportunity for onvansertib. Almost 50,000 patients are diagnosed with RAS-mutated mCRC every year in the United States, and it is the fourth most common type of cancer diagnosed and the second deadliest after lung cancer. And our goal is to bring a better therapeutic option to each of them. And the fact that Onvansertib is not targeting a single oncogenic driver of mutation like KRAS G12C, but appears effective across all RAS mutations further expands the impact we can have. A second driving -- factor driving this significant opportunity for onvansertib is apparent on Slide 21. The innovations in cancer therapies over the past 20 years have not been successful in the first-line RAS-mutated mCRC setting. Standard of care in the first-line and second-line setting remains chemotherapy and bev. So there is an urgent need for the development of new effective therapies. Finally, on Slide 22, we returned to a critical element of Onvansertib's therapeutic profile, and we believe will accelerate its commercial adoption from the small cell lung cancer IT -- sorry, over 380 patients have been dosed with Onvansertib over multiple clinical trials and the therapy has been well tolerated. I described earlier that Onvansertib's oral dosing, short half-life and specificity for targeting only PLK1 contribute to its safety profile, and this profile allows it to be added to the current standard of care chemo backbones. And this is a critical factor that we believe will facilitate its commercial adoption. We routinely hear from the investigators on our mCRC trials that's simply adding an oral medication to current standard of care makes it easy to add to a patient's treatment regimen. Together, these 3 factors the large patient population, the significant unmet need and the ease of adoption create a significant opportunity for our company. I'll now conclude today's call with a comment on the broader opportunity for Onvansertib outside of RAS-mutated mCRC. On Slide 24, you can see the current development pipeline for Onvansertib. In addition to the mCRC program, we have promising clinical data from a pancreatic investigator-initiated trial as well as promising monotherapy data from a small cell lung cancer investigator-initiated trial. We have not yet released data from a triple-negative breast cancer IIT but are working with the investigator to do so. The breadth of opportunities for Onvansertib expands even further. And you can see in the Scientific Presentations section of our website, several recent posters highlighting supportive preclinical data in hormone receptor positive breast cancer, RAS wild-type mCRC and ovarian cancer. And later this week, we will present 2 new posters at the San Antonio Breast Cancer Symposium. We believe there are significant additional opportunities for adding Onvansertib to standard of care regimens given its tolerability profile, and we will update investors as we develop new clinical programs to evaluate these promising preclinical findings. In conclusion, on Slide 25, I'd like to emphasize that to evaluate the strength of the first-line data we have released today. It should be viewed together with the evidence of our previous second-line clinical findings and our understanding of the novel mechanism of action we discovered in our second line program. We are very excited by all the nuances of this initial and positive look at first-line data. The results so far are consistent with our expectations for this program with a higher response rate and a clear trend towards deeper tumor regression for patients receiving the 30 mg dose of Onvansertib. And these benefits are coming with a tolerability profile that is consistent with standard of care alone. And finally, we are pleased to announce that based on the strength of the first-line data, we raised $40 million this morning in an oversubscribed registered direct offering. This gave us the opportunity to add biotech-focused institutional investors to our shareholder base. We believe this financing serves as further validation of our CRDF-004 data and further details are contained in today's press release. Looking ahead, we plan to provide an update on our first-line program in the first half of 2025 to see how the promising data we are sharing today matures over time. With that, I will now open the call up for questions. Operator?
Operator
operator[Operator Instructions] Our first question comes from the line of Mark Frahm with TD Cowen.
Marc Frahm
analystCongrats on the response data today. Just -- can you maybe speak to how many patients may be already on trial, but you obviously haven't made it to that first scan yet just and then along that kind of any guidance you can kind of provide on how many patients you think might be in that first half update next year?
Mark Erlander
executiveYes. Yes. Thanks, Marc, for your question. As we stated at the call here, today, you're getting the data of all the patients that have had at least 1 post-baseline scan from our data cut. We do have approximately 2/3 of the patients enrolled in the trial of the 90 total. As far as releasing further data, our plan is to give another update. But at this point, we're just saying in the first half of 2025.
Marc Frahm
analystOkay. It sounds like a fair number of patients -- of new patients will be in that update. And then maybe I know it wasn't ruled treatment related to Onvansertib, but can you just clarify on the couple of patients you discontinued? Just what was driving the decision unfortunately to discontinue due to AEs.
Mark Erlander
executiveYes. Thank you. Yes, there were -- as we mentioned, 4 patients and 2 of them went off for curative intent surgery because their tumors now became resectable. And then there were 2 patients that we mentioned, which came off with diverse effects. They were one of the patients, it was neuropathy. So that's really tied to a [ felplatinum-based ] or FOLFOX, and the other one did have multiple strokes, and this was attributed -- well-known attributed to Avastin or bev. So that's really today the total of patients that have gone off the trial.
Marc Frahm
analystOkay. That's very helpful. And then maybe just one last one that's more forward-looking. You mentioned during the remarks, the possibility of maybe trying to alter this trial to form the pivotal trial and kind of satisfy that requirement rather than a new one. Just -- is this data that you have today enough to go start having that conversation with the FDA? How much more -- if not, how much more do you think you need? And when might that discussion happen to kind of figure out what that next step is.
Mark Erlander
executiveYes. Thank you, Marcus. Yes, we're in a very exciting part of this. As you know, we are in the CRDF-004, one of the primary objectives of this trial is to confirm a dose to go to the registrational trial. And that's really the gating -- is gating that is the data for that to support that. We will go to the FDA as soon as possible to be able to make that argument. We hope that, that require -- does not require the entire 90 patients. We're really looking to see if we can go with much less number of patients given the clarity of the signal that we're seeing already today with 30 patients. So we're very aggressive on this and very excited and positive about it. And so I think the other decision really to do a part 2 on the CRDF-004 to move it into a -- with an amendment to the registration. As Fairooz mentioned earlier on the call, we are obviously not using the patients and CRDF-004 for that. However, it really does allow us to save significant time from a logistical point of view to move that registrational trial even faster than what we have originally planned.
Operator
operatorOur next question comes from the line of Joe Catanzaro with Piper Sandler.
Joseph Catanzaro
analystThanks for the update. And yes, let me add my congrats on the great early data here. So response rate delta looks really, really encouraging. Obviously, it seems a little too early to start getting a sense of PFS. But I'm guessing my question is, if you go historically and look at first-line experience with chemo, Bev and other regimens, what is your sense of this response rate delta potentially translating to PFS and maybe even OS benefits? And I have a follow-up.
Mark Erlander
executiveOkay. Well, thanks, Joe. Yes. Well, at this point in time, as you know, a couple of things. Number one, in previous trials, current standard of care, the chemo plus BEV. The median PFS is a range between 9 to 10 months in first line. Now I'll just say that, as you know, in second -- our second line trial, our median PFS was 15 months. So we have -- we've already demonstrated in the second-line setting, a much longer PFS than what has been observed in previous trials in first line. So we remain very bullish about this. But like you said, this will take some time for that to mature to see how that plays out. But given our past history, in second line, we remain very bullish about PFS rates in this trial.
Joseph Catanzaro
analystOkay. And my follow-up, I guess, is on safety. I'm wondering if you could just speak a little bit to whether you're seeing any dose reductions at the 30 mg dose to what extent, if any, and whether you're seeing any growth factor support utilization in that arm?
Mark Erlander
executiveThanks, Joe. Yes, we have had a couple of patients with dose reductions in the 30 mg. There have been no growth factor usage at this point. I have to say also that we've had dose reductions in the control arm as well. So we -- I think this is kind of normal what happens. So there's nothing there to have any kind of safety flag.
Operator
operatorOur next question comes from the line of Andy Hsieh with William Blair.
Tsan-Yu Hsieh
analystCongratulations on the data. It's been a longtime coming, so really happy for you and the entire Cardiff team. I have 3 questions, if you don't mind. So one is about the kind of the spider plot. If you look at the 30-milligram arm, it seems like all the slope based on the last scan is negative. So I'm just curious if you can comment on the deepening of response over time, especially for those who are so borderline relative to the cutoff for partial response. And second question, this is probably for Fairooz. Looking at the baseline patient characteristics, a lot of patients have baseline liver metastases the 30 milligrams over 90% versus 70%. I'm just curious if that's kind of a normal within the context of a first-line CRC patient population or you're enrolling potentially a more difficult-to-treat population? And then lastly, the third question has to do with the surgical resection. We also saw that with the Phase 1b study. How common is that for patients in the metastatic setting to be improved to resectable and can you comment on [indiscernible]
Mark Erlander
executive1 Okay. Well, thank you. Thank you, Joe. I really appreciate it. I mean, I'm sorry, Andy. I'm sorry about that, Andy. Thank you for your questions. And yes, I mean, I'm glad you noticed that, but the spider plots. We're very excited about that because, in particular, in the 30 mg, as you mentioned, they are really -- the slope is it's going down for all patients. And I think that one thing that we did mention Andy, about this on the call, Fairooz mentioned it was that we've gotten some preliminary data PK data. And when you look at the PK data of the 30 mg versus 20 mg patients and you look at things such as the AUC, the overtime area under the curve for Onvansertib, we're seeing about a doubling of 2x of the 30 mg versus the 20 mg and so this really is exciting because we are seeing that, of course, also is tracks very nicely with the increase in response rate and more deep responses that we're observing so far in this trial. And your second question, Andy, was really about the baseline liver medicine. And Fairooz maybe make a comment about that, and then also maybe also comment about the -- how common is it to have surgery for curative intent.
Fairooz Kabbinavar
executiveThank you, Mark, and thank you, Andy, for the questions. So your second question was regarding the baseline liver metastases. As you all know, colon cancer for the first stop for metastatic site usually happens to be the liver and lymph nodes in the belly. Those are the 2 places. And beyond that, lung mets and other things that are uncommonly seen, not rarely, but uncommonly seen. So liver mets are very common in colorectal cancer patients. The -- we are seeing responses at 20 and 30 milligrams in patients deliver metastases. That doesn't appear to be -- at least based on our Phase 1b/2 study that did appear to be a feature that would predict against efficacy of onvansertib in patients who had liver metastases disease. Patients with liver mets as well as no liver mets both responded, multiple mets, single mets, they also responded. So the having patients with liver metastases is fairly common for patients with colorectal cancer. Now that brings us to the second -- the last question that you had about this surgery. Surgery in patients with metastatic disease over the last few years has now become -- becoming a part of how we manage these patients. Initially, the patients were all unresectable. That was one of the criteria for patients to be entered on the study. That means surgery was not an option. Subsequently, these patients were majority of the disease, metastatic foci resolved in response to chemotherapy onvansertib and they were left with minimal residual disease or making them potentially resectable. And resecting these patients to give them a chance to the cure is one of the parts of the continuum of care for patients with metastatic colorectal cancer. So about 25% to 30% of patients, if you look -- again, if you look through a real-world incident, they will undergo -- eventually be rendered oligometastatic and will be taken to curative surgery with curative intent.
Operator
operatorOur next question comes from the line of Robert Burns with H.C. Wainwright.
Robert Burns
analystCongrats on the data. Just one for me, if I may. So could you provide some clarity as to the data update that we're going to get in the first half and whether we can expect initial PFS data?
Mark Erlander
executiveThank you, Robert, for your question. At this point, as you know, as I was mentioned a little earlier, the PFS for standard of care is 9 to 10 months, and we've already seen 15 months for PFS in second line. So I think we'll have to watch how the data matures as far as how much of an update will be PFS in this next update.
Robert Burns
analystOne more, if I may. So given the strength of the data that we've seen at the 30-milligram dose, what sort of sample size would you want to see with assuming that to maintain that delta before you move on to creating a more accelerated trial?
Mark Erlander
executiveRight. I mean I think we're still evaluating that as we go. But all I can say at this point is that, Robert, is that we're going to move aggressively to the FDA because that really, to your point, that's the gating factor is really getting the thumbs up from the FDA of the dose, which, as we sit here today, we would be proposing the 30 mg dose.
Operator
operatorAnd I'm currently showing no further questions at this time. I'd like to hand the call back over to Mark Erlander, for closing remarks.
Mark Erlander
executiveWell, thank you, operator, and this concludes our conference call. Thank you all again, everyone, for joining us this morning.
Fairooz Kabbinavar
executiveThank you all.
Operator
operatorLadies and gentlemen, this concludes today's conference call. Thank you for your participation. You may now disconnect.
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