Summit Therapeutics Inc. (SMMT) Earnings Call Transcript & Summary

Good afternoon, and welcome to Summit Therapeutics Q2 2026 Earnings Call. [Operator Instructions] We do not expect any technical difficulties today. However, in the event that we lose the webcast connection and are unable to provide any updates, please wait up to 10 minutes for resolution. Please refer to the company's website for updates. Please note that today's call is being recorded. [Operator Instructions] At this time, I would like to turn the call over to Dave Gancarz, Summit Therapeutics Chief Business and Strategy Officer. You may proceed.

Good afternoon, and thank you for joining us. On today's call, we will provide an update on our second quarter 2026 financial results and operational progress. This afternoon's press release is available on our website, www.smmttx.com. Our Form 10-Q was also filed today and is available on our website and via the SEC's website. Today's call is being simultaneously webcast, and an archived replay will also be made available later today on our website. Joining me on the call today is Bob Duggan, our Chairman of the Board and Co-Chief Executive Officer; Dr. Maky Zanganeh, our President and Co-Chief Executive Officer; Manmeet Soni, our Chief Operating Officer and Chief Financial Officer; and Dr. Allen Yang, Chief of R&D Strategy. I'm Dave Gancarz, the Chief Business and Strategy Officer here at Summit. Before we get started with the rest of the call, I would like to note that some statements made by our management team and some responses to questions that we make today may be considered forward-looking statements based on our current expectations. Summit cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Please refer to our SEC filings for information, including the Form 10-Q issued today about these risks and uncertainties. Summit undertakes no obligation to update these forward-looking statements, except as required by law. One item of note, this presentation is being webcast with slides, so we'll be referring to the slides being displayed in the web link. I'd encourage you to use the webcast link to see the slides being presented this afternoon that will accompany our comments. Following comments from our team, we will take questions. And with that, I'll hand it over to Bob.

Thank you, Dave. Good afternoon, everyone. Thank you for joining us today. I'm very proud of the highly focused, mission-driven patient-first team at Summit and the growing physician support around ivonescimab, our PD-1/VEGF bispecific and lead investigational asset. In addition, we continue to appreciate big pharma's high interest in ivonescimab as the backbone of combination therapy in many different solid tumor settings as we look to successfully combine ivonescimab with their innovative new targets. Our team continues to grow in number and ability as we expand our clinical development plan and prepare for commercialization in anticipation of a decision from the FDA on our BLA towards the end of this year. Before we start with key updates from the past couple of months, I'd like to take a moment to remind those of you who have been with us from the beginning and introduce to those of you who may be new to the story of what ivonescimab has accomplished to date. You can see this on Slide 3. Ivonescimab has read out 4 Phase III clinical studies to date, all 4 with positive data. This has led to 2 approvals in China so far, with 1 currently under review in addition to the pending BLA with the U.S. FDA. A total of 15 Phase III trials are currently ongoing or have read out in multiple tumor types. Between Summit and our partners at Akeso, 52 clinical trials have been initiated evaluating ivonescimab in a variety of solid tumors. When including investigator-initiated and collaborative studies, a total of 171 clinical trials are now listed on clinicaltrials.gov. The enthusiasm demonstrated by investigators around the world to generate data and seek positive signals for patients facing high unmet medical need really speaks to the opportunity and ever-present optimism surrounding ivonescimab. Together with Akeso, over 4,000 patients in either Summit-sponsored or Akeso-sponsored clinical trials across the world have been dosed with ivonescimab. Commercially, in China, over 70,000 patients have been administered ivonescimab. On Slide 4, we see a snapshot of the current ivonescimab development plans across Summit and Akeso, as well as a Phase III clinical trial sponsored by a prominent European cooperative group, GORTEC. Our collective pipelines cover not only multiple settings in lung and colorectal cancers, but also head and neck, breast, biliary, pancreatic, gynecological, gastric and hepatocellular cancer, including non-metastatic settings. Summit's announced Phase III studies focus on non-small cell lung cancer and colorectal cancer, and these studies represent only a subset of ivonescimab's potential future indications, as you can see here. Through our wonderful partnership with Akeso, data generated in our studies, as well as data generated through investigator-sponsored trials, we continuously consider evolving ivonescimab to drive more informed as well as faster decisions, all of which support efficient and timely expansion of our global ivonescimab development plan. I'll now turn it over to Maky to discuss some of the recent developments. Maky?

Thank you, Bob. Yesterday, we announced an updated OS analysis conducted for our global Phase III HARMONi trial. The HARMONi study evaluated ivonescimab plus chemo against chemo alone as a treatment for EGFR-mutated non-small cell lung cancer after TKI therapy, a patient population of significant unmet need with few available treatment options. In this most recent analysis with the data cutoff in June 2026, Western patients increased their time on study, reaching a median follow-up of over 23 months. Asian patients remained locked with a median follow-up time of 33 months. A hazard ratio of 0.76 was observed in both the total population as well as the regional Western data. The hazard ratio for Western patients has improved with more follow-up time. With longer follow-up, results of Western patients are now consistent in terms of the magnitude of OS benefit with those patients enrolled in Asia who had a longer follow-up at the time of the primary OS analysis. Ivonescimab continued to demonstrate an acceptable and manageable safety profile that was consistent with previous Phase III results of ivonescimab plus chemo. No additional safety signals were observed in this current HARMONi data cut compared to the previous data cuts. As a reminder, this setting is one in which multiple PD-1 inhibitors have failed previously to show a benefit in either PFS or OS. Prior Phase III studies were conducted in this setting individually with pembro or nivo, each in combination with chemo and were not successful. In addition, there are currently no approved agents in this setting, which have demonstrated an overall survival benefit compared to chemo alone. The encouraging results from this long-term overall survival analysis continue to support the ability to translate the therapeutic profile of ivonescimab across the globe, including the efficacy potential of ivonescimab in Western patients from North America and Europe. This data shows a consistent favorable OS trend across geographies, as Western patients were followed for additional time on study. With meaningful follow-up time in both regions, the magnitude of the OS benefit is consistent between patients enrolled in China and enrolled in Western countries, including the United States in the HARMONi study. We intend to provide exciting additional details from this new long-term analysis at a future medical meeting. We have also made these results available to the FDA. As previously disclosed, the FDA noted that a statistically significant overall survival benefit is necessary to support marketing authorization in this setting. Considering the safety and efficacy profile of the current FDA-approved options for patients in this setting, none of which have demonstrated a statistically significant OS benefit, as well as the continuing positive regionally consistent data of this Phase III multiregional study and discussions with key opinion leaders and physicians who have administered ivonescimab to patients, we believe that ivonescimab is a potential treatment option with favorable benefit-risk profile. Turning specifically to Summit's global ivonescimab pipeline, which is noted on Slide 7, we have 4 Phase III trials completed or ongoing. HARMONi, which we just covered, HARMONi-3, HARMONi-7 and HARMONi-GI3. HARMONi-3 is evaluating ivonescimab plus chemo against pembro plus chemo in frontline metastatic non-small cell lung cancer in both patients with squamous and non-squamous histologies, each of which will be analyzed separately. These patient populations represent a significant unmet medical need with the nearly 100,000 patients in the United States alone, as this trial covers frontline non-small cell lung cancer patients without genomic alterations. In line with prior guidance, we have completed enrollment in both the squamous and non-squamous cohorts. We expect to reach the number of events needed to conduct the PFS analysis for the squamous cohort in the second half of this year, which would also come with a corresponding early interim look at overall survival. We would expect to reach the number of events for the first look at OS that is independent of the PFS analysis in the first half of 2027. For the non-squamous cohort, we expect to reach the number of events needed to conduct a progression-free survival analysis in the first half of 2027. HARMONi-7 is evaluating ivonescimab monotherapy against pembro, monotherapy as frontline treatment for patients with non-small cell lung cancer that has high PD-L1 expression levels. Enrollment continues to be strong, and we look forward to providing additional updates on this trial in the near future. HARMONi-GI3 evaluates ivonescimab plus chemo compared to beva plus chemo as frontline therapy in patients with unresectable colorectal cancer. Our decision to initiate this study was driven by encouraging Phase II data published at ESMO 2024 and supported by global Phase II data presented in Q2 of this year at ASCO 2026. We look forward to providing further updates as this global Phase III colorectal cancer trial progresses. In addition to our sponsored studies, the Phase III study, ILLUMINE, is currently enrolling in a head and neck cancer through a European cooperative group, GORTEC. This is another multiregional Phase III study that tests ivonescimab with and without an anti-CD47 agent head-to-head against pembro in an additional tumor setting from our historical work. The trial is enrolling in Europe, is intended to start in China later this year, and we will evaluate opening sites in the United States based on continued progress. Additionally, we have over 65 ISTs that we intend to support in various stages of development. Of this, 24 are currently enrolling and more publications are being featured at each major medical conference, often in prominent session at ASCO, ESMO and World Conference on Lung Cancer. Through this combined research, ivonescimab has now been featured in over 50 publications, presentations and posters. Now I would like to take a minute to focus on some of the clinical trial collaboration in which we have entered to evaluate ivonescimab with novel combinations. Clinical development of ivonescimab in additional tumor settings also continues to progress as planned via our collaborations with RevMed, GSK and now with Arcus. With respect to novel-novel combinations, our collaboration with Revolution Medicines began enrolling in the first quarter of this year. This collaboration evaluates ivonescimab in combination with 3 novel RAS inhibitors across multiple solid tumor settings, including pancreatic, colorectal and non-small cell lung cancers. We are enthusiastic about the opportunity of ivonescimab with multiple existing RAS inhibitors and what the combination has the potential to do for patients facing difficult-to-treat cancers. Our GSK collaboration evaluating ivonescimab in multiple solid tumor settings in combination with their B7-H3 ADC, is expected to enroll its first patient later this quarter. This is another example of promising targets seeking to significantly advance outcomes in settings such as multiple types of lung cancer and colorectal cancer, where both ivonescimab and B7-H3 ADCs have shown promise. We are also pleased to announce yesterday that we have established a collaboration with Arcus Biosciences to evaluate ivonescimab in combination with Arcus HIF-2 alpha inhibitor, casdatifan, in first-line metastatic clear cell renal cell carcinoma, the most common form of kidney cancer. This combination presents a compelling opportunity for a potentially well-tolerated TKI sparing option to prolong survival in this setting. We expect initial data from this collaboration to be generated by mid next year. Collectively, these trials enhance and inform our own clinical development activities as we learn more about new settings where neither we nor Akeso have yet had the opportunity to explore. Additionally, the continued enthusiastic interest in ISTs is a testament for the optimist. We have heard from many investigators as they consider the potential opportunity that ivonescimab presents across multiple tumor types and in multiple novel-novel combination regimens. Now let's take a closer look at the clinical trial -- clinical data we have seen from ivonescimab today, focusing on U.S. results. Of the 4 Phase III studies that have read out to date, all 4 studies had positive, statistically significant, clinically meaningful progression-free survival results. In each of these studies, ivonescimab has achieved overall survival hazard ratios less than the generally accepted clinical meaningfulness threshold of 0.80. We discussed the updated data from the global HARMONi study earlier. We look forward to presenting additional details such as Kaplan-Meier curves, medians and other important components of the analysis at an upcoming medical conference. While not achieving statistically significant at the primary OS analysis, the nominal p-value implies significance of the OS benefit for the global study, and this is further supported by the updated OS data announced yesterday. The HARMONi-A study in China in a similar setting to HARMONi, produced consistent results and demonstrated a statistically significant benefit in OS. HARMONi-2, conducted in China, which was the first time a Phase III clinical trial has shown a statistically significant improvement in progression-free survival directly replaced a PD-1 inhibitor in a head-to-head setting, reported an overall survival hazard ratio of 0.78 at just 39% data maturity. This study evaluate ivonescimab monotherapy against pembro monotherapy as frontline treatment for patients with non-small cell lung cancer, whose tumors have positive PD-L1 expression, a similar patient population to Summit global Phase III HARMONi-7 study, which focuses on tumors with high PD-L1 expression. Finally, the HARMONi-6 study conducted in China achieved an overall survival hazard ratio of 0.68 as announced at the plenary session of ASCO 2026. The magnitude of benefit measured by the hazard ratio for OS was consistent with the benefit for PFS, both with hazard ratios in the 0.6. Again, this study compared ivonescimab with chemo against an anti-PD-1 plus chemo as frontline treatment for patients with non-small cell lung cancer or squamous histology. This is the first time a Phase III clinical trial in any tumor type, not just in non-small cell lung cancer, has shown a statistically significant improvement in overall survival compared to a PD-1 inhibitor in combination with chemo in a head-to-head setting. 4 Phase III studies have been conducted in 3 different non-small cell lung cancer settings, all producing clinically meaningful overall survival hazard ratios under 0.80. 2 of the 4 studies were conducted head-to-head against a PD-1 inhibitor with or without chemotherapy, and 2 were conducted in settings where PD-1 inhibitors are not approved because they failed in the past Phase III clinical studies. These results speak to the opportunity to replace current immunotherapy options with ivo, the potential next generation of cancer therapy. As we have said before, we feel the data speaks for themselves and support immense potential for ivonescimab to help patients with lung cancer, and we believe in additional tumor settings as well as more data is generated and accumulates across Summit and Akeso trials, ISTs and collaborations. Turning to Slide 9, and looking to the existing next steps for ivonescimab, our global Phase III HARMONi-3 all-comers trial evaluating ivonescimab with chemo in frontline non-small cell lung cancer has completed enrollment in both the squamous and non-squamous cohorts. We expect to reach the number of events for the primary PFS analysis for the squamous cohort in the second half of this year, which would come with a corresponding interim look at overall survival. Importantly, we expect to have another interim look at OS in first half of 2027, which will have additional follow-up time, something we continue to note as an important factor in showing the value of ivonescimab in these clinical studies. For the non-squamous cohort, we expect to reach the number of events for the PFS analysis in the first half of 2027. Turning to our BLA filing based on our Phase III HARMONi study seeking approval for ivonescimab plus chemo in the EGFR-mutated non-small cell lung cancer setting post-TKI therapy, the submission is currently under review with the U.S. FDA. The agency has provided a target PDUFA date of November 14 of this year. We continue to grow our commercial capabilities as we prepare in anticipation of ivonescimab's potential first U.S. approval and potential launch later this year. We will continue to provide further details on additional new global studies throughout the year, as they are ready to share. To date, we have initiated global Phase III studies in non-small cell lung cancer, colorectal cancer, through our partnership with GORTEC's head and neck squamous cell carcinoma. We look forward to continuing to grow our global pipeline, explore ivonescimab's potential to help additional patients in new tumor types and settings in the near future. On today's call, we have covered ivonescimab recent accomplishments in the clinic. But as a reminder, this is only the beginning of a vast potential market opportunity for ivonescimab across solid tumors. We have discussed this previously, but with each successful data set, it becomes closer to reality. Ivonescimab has the potential to be a platform blockbuster drug. Ivonescimab is well positioned to make a significant impact across the solid tumor treatment landscape between checkpoint inhibitors and anti-VEGF therapies. The estimated total addressable market is in excess of $100 billion globally. Looking only at the checkpoint inhibitor market for non-small cell lung cancer in which our first set of registrational Phase III studies are conducted, market estimates for immunotherapy itself are expected to exceed $20 billion per year by 2028. On Slide 10, we identified the more than 50 solid tumor settings where anti-PD-1, anti-VEGF therapies are approved, established PD-1 and PD-L1 indications in green and anti-VEGF indication in purple. The settings highlighted in yellow represent the indications we are currently running global Phase III trials for ivonescimab, lung and colorectal cancers. Clearly, there are several additional opportunities for ivonescimab beyond today PD-1 or VEGF landscape, including novel settings such as EGFR-mutant lung cancer. We intend to provide details regarding additional studies, including Phase III studies in the near term. Ivonescimab's differentiated profile as we saw with HARMONi-6 achieving a statistically significant, highly clinically meaningful progression-free survival and overall survival benefit, alongside the updated global HARMONi data support its platform potential across multiple indications, many of which could be blockbuster opportunities on their own. We have only just begun to see the potential of ivonescimab to help patients with solid tumors. These are exciting times at Summit, and we encourage you to follow our journey closely as we continue to expand the ivonescimab clinical development plan in a new tumor settings. Now I will turn the call over to Manmeet to provide a financial update. Manmeet?

Thank you, Maky, and good afternoon, everyone. On the financials front, let me start with our cash position. We ended the second quarter of 2026 with a strong cash position of approximately $690.7 million as compared to $598.7 million at the end of first quarter of 2026. This increase of $92 million in cash position for the quarter is primarily due to the $231 million cash raised from our ATM facility, offset by the cash used in our operating activities of approximately $140 million for the second quarter of 2026. Consistent with our financing strategy in the past, earlier today, we also filed a prospectus supplement for a new ATM facility up to $380 million to provide us with additional flexibility for financing, both with respect to mechanism and timing. And finally, to remind everyone, currently, we have no debt on our balance sheet. Turning to operating expenses. I will provide details on both GAAP and non-GAAP numbers. You can refer to our press release issued earlier today for a reconciliation of GAAP to non-GAAP financial measures. As a reminder, non-GAAP expenses exclude stock-based compensation expense. Total GAAP operating expenses for the second quarter of 2026 were $220.5 million compared to $195.2 million for the first quarter of 2026. The increase in GAAP operating expense was primarily due to an increase in our R&D expenses related to clinical trial expenses for HARMONi-GI3, HARMONi-3 and HARMONi-7. Overall, our non-GAAP operating expenses during the second quarter of 2026 were $151.8 million compared to $122.4 million for the first quarter of 2026. This increase in non-GAAP operating expenses was primarily related to an increase in R&D expenses, as previously mentioned. And with that, I will turn the call back over to Dave. Dave?

Thank you, Manmeet. We will now see if there are any questions. Operator, if you could please open the line for those questions.

[Operator Instructions] Your first question is from Yigal Nochomovitz with Citigroup.

So very interesting recent updated overall survival cut from the second-line EGFR study. I'm wondering if you could speak to the translatability of that conclusion in terms of equivalence on OS across geographies when thinking about some of the other larger markets, specifically, of course, frontline non-small cell lung cancer. Could you talk about how you think those OS results could translate to those other settings, please?

Sure. Thanks, Yigal, and appreciate the question. This is Dave. So I mean, I think in terms of takeaways and learnings, right, maturity and follow-up time is critical, in particular, for ivonescimab as a next-generation immunotherapy. And so as we think about the translatability, what we saw is with meaningful follow-up time, there was consistent magnitude of benefit of overall survival. And that's particularly important when we think about the difference between what we saw at the primary analysis in HARMONi versus what we saw published yesterday. But then when we take that to the other frontline studies, we have an opportunity now to show a magnitude of benefit that is clinically meaningful in those studies as well with the appropriate follow-up time specifically for overall survival. And so if you recall, HARMONi-6 had an overall survival median follow-up -- or median follow-up time rather, of 21 months in its overall survival analysis. And then the recent data that we published yesterday for HARMONi, the Western patients now have 23 months approximately of median follow-up time. And so as we look at what that means overall, it's important globally to have consistent follow-up time that's meaningful across both. So not necessarily equal to each other, but meaningful for all regions. And so we expect the ability to translate clinically meaningful results in China to clinically meaningful results across the globe with meaningful follow-up time.

Okay. And just one quick follow-up, if I may, on HARMONi-3. So can you provide any more granularity on the timing within the second half of this year for the final PFS? And then with the early interim OS look, is this going to be like a qualitative comment? Or are you going to be able to perhaps give a very early hazard ratio? If you could speak to that, please?

Yes, absolutely. And so I think with respect to timing, as we enter the second half of '26, we have a little bit of a clearer view on event rates and are providing more precise language with respect to expectations here for disclosures. So in general, event rates have slowed down a little bit. And so we still expect to reach the number of events needed for the PFS analysis in the second half of this year. But that timing is not next month, and it is going to be likely towards the middle to back end of 2026. And that's why we're a little bit more precise within the press release itself. With respect to the actual disclosure itself, I don't know that we have a specific disclosure plan set. But I think what we would expect is a directional trend from that data. But again, not necessarily a determined disclosure plan. But what we do expect is an ability to meaningfully take away the opportunity of what overall survival will show in this study. Again, recall the fact that with 22, 23 months of overall survival or follow-up time in an overall survival analysis, we've shown meaningful data in HARMONi-6 in China and then the global HARMONi data, the Western patients with meaningful follow-up time showed that benefit. And so the follow-up time will be important there to get a full clear picture. But we do expect to see an overall survival trend that is meaningful to us when we look at it later on.

The next question comes from the line of Tyler Van Buren with TD Cowen.

This is Nick on for Tyler. With the HARMONi-3 survival analysis, the interim survival analysis in the first half of next year, will we get an overall survival hazard ratio potentially at this point? And if so, what will be the median follow-up as we think about what the bar should be and how it could progress over time, just like we saw with the Western population in the HARMONi trial?

Yes. That's a fair question, Nick, and I appreciate it. I think with respect to the overall survival, the additional overall survival interim analysis looked at in the first half of 2027, that gets closer to the median follow-up times that we saw with the HARMONi-6 OS analysis as well as the Western patients that we disclosed yesterday. And so I think that piece, in particular, when we look at the first half 2027. That's really the first analysis that is independent of any preplanned PFS analysis. And so that's why it was important we felt to call that out specifically in Maky's prepared remarks as well as our press release, that additional OS analysis is that first not -- analysis that's not directly linked to a PFS analysis. But from a follow-up time perspective, we would expect that to be in the first half of 2027, the median follow-up to be consistent with what we saw for HARMONi-6 as well as for the HARMONi Western data that we talked about yesterday.

Your next question is from the line of Salveen Richter with Goldman Sachs.

Just following up on the last question. But as you -- just given the split of the study into separate squamous and non-squamous cohorts and that enrollment was overall back-end loaded. How do we think about the level of follow-up in the context of the interim OS readout if statistical significance is not seen at the interim in your view, what level of OS benefit would support or trend here would support a statistically significant final OS result?

Yes. Thanks, Salveen, for the question. I think -- so want to just clarify a couple of points. So when we look at -- so we'll hit the number of events or we expect to hit the number of events for PFS analysis sometime in the second half of this year. That will be accompanied by a supporting OS analysis, and that would be an interim. And then in the first half of 2027, that would also be an interim OS analysis. So the final OS, as would be consistent with frontline studies, would be a ways out. But what I would expect that we see when we look at the analysis in the second half of this year would be one that supports the curve splitting for survival. So a beginning look at overall survival that we would expect if we look and we compare when the curves split for HARMONi-6, that's a good indication in terms of what we would be looking to see. But that will be early, and that's really supportive of PFS as we look at many trials when they run a primary PFS analysis have a supporting OS look. When we look in the first half of 2027, that now has median follow-up time, consistent with what we saw, again, in the HARMONi analysis that we -- for Western patients that we talked about yesterday. And so when we look at HARMONi-3 squamous in the first half of 2027, that's really a powered look at OS from an interim analysis perspective. So we're not going to give specific thresholds per se because I think that it's a totality of what the curve looks like, number of events, maturity, so on and so forth. But that Q1 or first half rather, 2027 look, that really would be that independent of PFS, that powered interim look at OS.

The next question is from the line of Brad Canino with Guggenheim.

Question from me is around the regional enrollment in H3. I'm wondering if that was done in parallel or if that was staggered because I'm thinking about this from the perspective of making sure the subgroups at an early interim OS analysis aren't skewed by, say, the North American patients coming in later than the China patients and not having time to see the effect like actually happened in the HARMONi study.

Thanks for the question, Brad. I think -- so we've talked a little bit about the fact that the enrollment started together, generally speaking. But obviously, enrollment in China is more rapid than it is in Western countries. So there's certainly a little bit of data that you see that involves Chinese enrollment a little bit faster, which is typical of what you would see in many studies. I think when we look at the timing of the events, part of what we take away from the learnings from HARMONi and whatnot is to make sure we have sufficient events that have taken place across the globe. And so it's not sequential timing to the extent that HARMONi is by any stretch. But of course, it becomes important to have sufficient events across the study with respect to those events. And so that's contemplated within our approach plan. And I'll let Allen add some comments as well.

Yes. I'm going to add, Brad, to this. This is Allen. Brad, question and just commenting on some of the previous questions. I just want to remind everyone that HARMONi-3 was our global study. So it was started globally at the same time. There are some differences. Certain regions open very quickly and enroll very quickly. Other areas, there's more administrative burden like Europe to get the ethics committee review to open. So in the squamous study population, that is more prevalent in China. So you'll see more aggressive enrollment. However, I think people are asking about the non-squamous cohorts. And remember, we added that cohort after the study was ongoing. So the sites were mostly open across the globe. And in addition, that disease is more prevalent in the West. It's probably 2/3 of non-small cell lung cancer outside of China, whereas in China, it's the other way around with the squamous. And so therefore, enrollment was actually very brisk in the West. And so we don't expect to see those differences.

Our next question is from the line of Mohit Bansal with Wells Fargo.

This is Will Zhang on for Mohit Bansal. So just kind of following up on HARMONi-3. I know you guys previously expanded the enrollment for the trial to include both squam and non-squam, but also the totality -- the total size of the trial to push up some of these like PFS and OS analysis timelines. Just want to understand how are you guys thinking about, one, kind of the risk of a high proportion of these PFS and OS events coming from early progressors or early OS event patients? And then two, just how you're thinking about what the median follow-up time will look like at the first half interim OS for squam.

Yes. So the last question, I think, is probably the easier of the 2 in the sense of when we get to the first half of 2027, we would expect median follow-up time, generally speaking, in the low 20s months, right? And so as I was saying before, consistent generally with what we saw in the HARMONi-6 OS analysis as well as what we saw in terms of the Western follow-up for patients in the HARMONi study. And so with respect to the first question on not being dominated by early progressors, part of that also includes the larger sample size takes that effect away. And so with a smaller sample size, you run more variability. And so you could be more dominated with unexpected answers, if you will, with respect to if you have a few more patients who progress early or pass away early, with a smaller sample size, you have a little bit more variability in what you see there. With a larger sample size, with what we see in squamous, unfortunately, those patients pass on a little bit earlier. So that's -- that doesn't require quite as large of a sample size. But for the squamous and non-squamous, we have what we believe is a sufficient sample size in order to be able to avoid any of that statistical noise and variability that you can see.

Yes. And I would just add, unlike the KEYNOTE-024, 042 studies, which were monotherapy IO, this includes chemotherapy, so it should prevent early progression. The chemo will control the disease early in both cohorts and allow the IO to take effect.

Your next question is from the line of David Dai with UBS.

So for the updated HARMONi data that you presented yesterday, could you help us understand the maturity of the updated OS data set relative to September 2025 analysis? And whether the incremental follow-up meaningfully increased the number of OS events observed? We just want to get a sense of whether the investors really focus on the incremental improvement from -- for HR from 0.78 to 0.76 or the fact the OS benefit remains stable despite a substantially longer Western follow-up.

Yes. So David, I think part of the -- so the main takeaway from the analysis yesterday, right, is that with meaningful follow-up in both regions, Asian and Western, you have a similar magnitude of benefit, right? And I think as everybody is well aware, the HARMONi study was effectively enrolled first in China, a pause, and then enrolled in the West. And that was based on the timing of when we did the transaction to in-license ivonescimab with our partners at Akeso, right? So that's a little bit driven based on the circumstances of timing of the transaction and what was already enrolled at the time. When we look at the study as a whole, EGFR mutation-positive lung cancer is something -- is a disease that is more prevalent in Asian patients. And so we would expect a higher proportion of patients to be enrolled in Asia as is typical and has been run with the osimertinib studies, some of the amivantamab studies, so on and so forth. And so it's -- because of that, it's about 60% Asian and about 40% Western. And again, typical split with respect to that for EGFR mutation-positive. So when we look at the global survival analysis overall, we saw pretty consistent results with the HARMONi-A study that was China-only in the HARMONi study, which was important because there was no clear detriment that was being seen from Western patients with very early follow-up time at the beginning. But as that follow-up time matured, what we saw is the Western patients really kind of merged in and saw the same magnitude of benefit with the Asian patients. So we saw across the whole study, we saw a consistent magnitude of benefit irrespective of when we looked at the data. And so we saw the 0.79, 0.78 in the follow-up shortly thereafter the primary and then the 0.76 that was announced yesterday. So we're seeing that consistent magnitude of benefit and what we see is when the Western subgroup has additional maturity and those patients progress along the Kaplan-Meier curve, if you will, they have the same magnitude of benefit. So I think our real takeaway is the importance of follow-up time, the importance of the maturity of the data and then ultimately, the consistency by which we saw the Western patients perform when they had meaningful time on study, and I think that was important.