Zai Lab Limited ($ZLAB)
Earnings Call Transcript · April 20, 2026
Highlights from the call
In the first quarter of 2026, Zai Lab Limited reported significant advancements in its clinical pipeline, particularly for Zoci (zocilurtatug pelitecan) in treating small cell lung cancer (SCLC) and extrapulmonary neuroendocrine carcinomas (EP-NEC). The company highlighted a 54% overall intracranial response rate for Zoci, exceeding standard care benchmarks of 20-30%. Management maintained guidance on ongoing Phase III trials, anticipating interim results by mid-2027, which could lead to accelerated approval in 2028. Revenue and earnings details were not disclosed, but the focus on Zoci's promising data could drive stock performance in the near term.
Main topics
- Intracranial Activity of Zoci: Zoci demonstrated a 54% overall intracranial response rate in patients with extensive stage SCLC, with a notable 62% response rate at the 1.6 mg/kg dosage. Dr. Paz-Ares stated, "the early data are really encouraging" compared to standard care, which has response rates of 20-30%.
- Ongoing Clinical Trials: Zai Lab is advancing Zoci through multiple lines of therapy, with a Phase III study expected to complete enrollment in the first half of 2027. Dr. Amado mentioned, "we are executing against a comprehensive global development plan".
- Collaboration with Amgen and Boehringer Ingelheim: Zai Lab announced collaborations to explore combination therapies with Zoci, aiming to enhance treatment efficacy in SCLC and EP-NEC. This strategy is expected to deepen and extend responses with minimal overlapping toxicities.
- Safety Profile of Zoci: Zoci maintained a favorable safety profile, with most adverse events being low grade. Dr. Thummalapalli noted, "the safety profile is consistent with what we observed in small cell lung cancer".
- Market Potential for Zoci: Zoci is positioned as a potential backbone therapy for both SCLC and EP-NEC, addressing significant unmet needs in these aggressive cancers. Management emphasized the drug's potential to become a new standard of care.
Key metrics mentioned
- Overall Intracranial Response Rate: 54% (vs standard care of 20-30%, indicating strong efficacy)
- Response Rate at 1.6 mg/kg Dose: 62% (high response rate for patients treated at this dosage)
- Enrollment Completion for Phase III Study: 1H 2027 (expected timeline for completing patient enrollment)
- Projected Accelerated Approval: 2028 (if interim results are favorable)
- Overall Response Rate in EP-NEC: 38% (with a disease control rate of approximately 56%)
- Safety Profile: Grade 3 or 4 events in 15% (consistent with previous observations in SCLC)
Zai Lab's advancements with Zoci present a compelling investment thesis, particularly given the strong intracranial response rates and ongoing collaborations. Investors should monitor upcoming trial results and the potential for accelerated approval, while being aware of competitive pressures and the need for robust Phase III data.
Earnings Call Speaker Segments
Operator
OperatorHello, ladies and gentlemen. Thank you for standing by, and welcome to Zai Lab's 2026 AACR Investor Call. [Operator Instructions] As a reminder, today's call is being recorded. It is now my pleasure to turn the floor over to Dr. Rafael Amado, Zai Lab's President and Head of Global Research and Development. Please go ahead, sir.
Rafael Amado
ExecutivesHi, everyone. Thank you so much for joining us today. I am Rafael Amado, Zai Lab's President and Head of Global R&D. Before we begin, we will be making forward-looking statements today, and I ask you to review Slide 2 for further details. Moving to Slide 3. I'm joined today by 2 outstanding clinical investigators. Dr. Luis Paz-Ares is a leader in lung cancer. He's Chair of the Medical Oncology Department at the Hospital Universitario 12 de Octubre and Head of the Lung Cancer Unit at National Oncology Research Center in Madrid. Dr. Rohit Thummalapalli is an assistant attending physician and gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center. He specializes in GI and neuroendocrine cancers. And on the next slide, the disclosure information for both doctors. Moving to Slide 5. Here's our agenda. Dr. Paz-Ares will present first-time intracranial data with Zoci in small cell lung cancer, followed by Dr. Thummalapalli in neuroendocrine carcinomas. Both posters will be presented tomorrow at AACR. I will conclude with an overview of Zoci's clinical development plan and additional AACR highlights followed by Q&A. And with that, I will pass the call to Dr. Paz-Ares.
Luis Paz-Ares
AttendeesHello. This is Luis Paz-Ares. I'm a medical oncologist at the 12th of October Hospital in Madrid. And over the next few minutes, I'm going to report to you on the intracranial activity of zocilurtatug pelitecan in extensive stage small cell lung cancer with metastasis. -- stage small cell lung cancer is a high-grade, very aggressive carcinoma characterized by early metastatic spread and a very aggressive clinical behavior and therefore, group prognosis. One of the characteristics is the propensity to develop brain metastases, which are actually impacting in survival, but also in quality of life. Some 20% of the patients really present brain metastases at initial diagnosis. And over the time of the disease, the natural history of disease, some 70% of the patients do develop brain metastases. And as I said, that is really a very relevant clinical condition. And so far, the treatments are not the most effective therapy for that particular issue. At present, when a patient having symptomatic brain metastasis, we typically deliver radiotherapy, stereotactic or whole brain radiation. And the problem is that often you have to stop systemic therapy while you're giving the brain metastasis irradiation to put the patient at risk of rapid extracranial progression. For asymptomatic patients, often, we administer brain radiation as well and the risks be as well to develop into the future some cognitive deterioration. Overall, the survival impact is very clear for those patients. The real-world data suggest that typically median OS for those patients is in the range of 8 months being particularly bad for patients that really present brain metastases treated with whole brain radiation. The rationale to use the SS ADC into the brain is because it allows a target delivery of the payload on those tumor cells that are expressing DLL3, which is most of the cells. The payload is actually producing direct cytotoxic killing. And the good thing is that each ADC you have a good number of payload molecules of the TOPO1 inhibitor is actually having a of 8 and it's having a strong metastatic effect that really enhance the activity in the brain tissues. In the next few minutes, I'm going to provide you the data that are being presented at the AACR meeting this year. Pretty sure that you are aware of the background, what is Pelutcan, which is an ADC directed to DLL3 with a very efficient payload, a 1 inhibitor with a of 8. It has a very relevant bystandard killing mediated by the payload, as I mentioned, as the drug is typically released and accumulated into the tumor micro environment, thanks to the platform, the T platform that is being used to produce this ADC. The data from this study on brain metastases are coming from the dose escalation and expansion Phase I study 1310 using the ADC as monotherapy or in combination with atezo or atezo plus carboplatin in small cell lung cancer with the data cutoff of February 2026 and a median follow-up of some 8 months. The intracanular activity has been actually assessed with an independent radiology committee using the mRANO brain metastasis. And with this criteria, you may measure up to 5 brain lesions and they should have been studied using the contrast enhancing. And importantly, the diameter should be at least in the longest 10 millimeters and at least 5 in the perpend diameter. Included patients in these trials were patients with extensive stage small cell lung cancer with asymptomatic brain metastasis and archival biopsy was collected to retrospective DLL3 testing, good PS and importantly, prior DLL3 directed therapy was allowed. You see here on Part 1 and Part 2, what was the dosing use and from 0.8 milligrams per kg to 2.8 milligrams per kg in the Part A1 and the second -- the Part 2, the patients were randomized to receive 1.2 or 1.6 milligrams per kg. As you see here, some 136 patients were included on this study and importantly, brain metastases were seen in some 49%, 36%. And out of those, about 1/3, 13.2% overall didn't receive prior irradiation. So that means 2/3 received prior radiation and 1/3 didn't before entering the study. As you see, 2/3 of the patients had received 1 prior line of therapy and 1/3 had received 2 or more lines of systemic treatment and more than 90% received PD-L1 therapy and about some 10% of the patients received theLR3 T-cell engagers. The overall response rate that we have seen was 34%, 22 out of 41 patients responded and responses were particularly high on those patients treated at 1.6 milligram per kg that were 62% responses, 50% were assessed responses in cases treated with 1.2 milligrams per kg. Importantly, responses were seen in 50% of the patients treated with prior radiotherapy and in 60% of those that didn't receive radiotherapy before entering the study. Out of the 22 responders, 21 responses were already seen at the time of the first tumor assessment. That means some 6 weeks. The other issue is important is that 14 responders, that means 2/3 of the responses are still ongoing with a median time of 9 months. You see here 2 illustrative case. The first case on the top is a 60-year-old female treated with carboplatin, etoposide, durva plus tarlatamab that develop brain metastasis as you see here during the induction treatment in the first line. Patients received without prior radiation L1310 at 1.6 per kg -- and as you see here at the time of the initial evaluation, the patient was on complete response and still complete response 6 months later. The second case was another female, 65 years old that progressed while on initial therapy with carb-etoposide, developing multiple brain metastases. Importantly, the patient didn't receive before entering into the ADC study radiotherapy. And as you see here, a clear response was already seen at the time of the week 6 that was evolving over time to a scar remaining at week 24. Safety-wise, the drug was reasonably well tolerated. And the typical side effect we have seen related to the drug were typically seen consistent with the top 1 inhibition mechanisms of the drug. You see here some about 1/3 of the patients at all dose levels had some Grade 3 or 4 treatment-emergent side effect, but you restrict to those related to the treatment, you see that the doses that 1.1. only about 16% or 2% of the patients really had treatment-emergent adverse events related to the drug. Typical side effects, particularly as you see here are mainly myinosuppression. Others include, of course, nausea, fatigue, stthenia, typically on day 1 or 2. So as a conclusion, let me tell you, the drugs, CL-1310 have demonstrated a quite relevant high intracranial response rate in patients with extensive stage small cell lung cancer with brain metastases at baseline. As you remember, the overall response rate was in the range of 54%, including complete responses in 17% of the cases responses were observed in patients without prior radiation, 60%, but also on those with prior radiation, 50%. And the higher response rate was observed at the 1.6 milligram per kg dose level. At this dose, the treatment was pretty well tolerated. Remember, side effects, grade 3 or more were in the range of 15%, and we didn't identify new signals of safety, including no hemorrhages at the interferial level. So this study is still ongoing, enrolling now patients that had received DLL3 targeted therapy before study entry. And in addition, there is an ongoing Phase III study, the ELEVATE study in second plus lines of extensive stage small cell lung cancer, where patients that had prior to platinum-based chemo with or without tarlatamab are to be randomized to SOI versus the invest -- investigated choice of therapy, topoteclucin. So this is very much what I have to say today. So thank you very much for your attention.
Rohit Thummalapalli
AttendeesSo thank you, Dr. Paz. I'm here -- I'm excited to be here to present the updated data for ZL-1310 or zoci in extrapulmonary neuroendocrine carcinomas and other DL3xressing tumors. So extra pulmonary NECs are highly aggressive malignancies with very poor outcomes. 5-year survival in patients with metastatic disease is less than 15% and median overall survival in these patients is only 5 to 8 months. Extra pulmonary NECs share key biological features of small cell lung cancer, including frequent expression of DLL3. However, treatment options remain very limited, particularly after progression on platinum-based chemotherapy. So while initial responses following frontline etoposide and platinum-based chemotherapy can be observed, durability is limited compared to small cell lung cancer. And most notably, in the second-line setting, there is no established standard of care. Physicians can use different single-agent or combination chemotherapies with response rates of around 20%, but short median progression-free survival. In addition, different from small cell lung cancer, there is no established role for DLL3 targeted T cell engagers in extrapulmonary necks and no established role for new checkpoint inhibitors. And so hence, there really is an urgent medical need for more treatment options for these rare and aggressive cancers. So this is a global Phase Ib Phase II study of ZOCI in patients with extrapulmonary necks and other DLL3 expressing solid tumors who have progressed on or after platinum-based chemotherapy. The study included 2 cohorts, one in gastroenteropancreatic or GEP-NECs and the other in other extrapulmonary necks, including largealurocarcinoma of the lung, genititalurinary or gynecologic NECs, Merkel cell carcinoma and other DLL3 expressing solid tumors. For extrapulmonary neck patients, DLL3 expression was evaluated retrospectively by immunohistochemistry, but was not required for eligibility. Initial cohorts of 10 patients were enrolled with expansion triggered by observed responses and the Phase II part is a single-arm study, which is currently enrolling. The study enrolled evenly in the U.S. and China. As you can see, the majority of patients had advanced stage disease at enrollment. These tumors are highly proliferative as reflected by the majority of patients having high p67 levels. At baseline, nearly all patients had received prior platinum-based chemotherapy. About 1/4 of patients had prior immunotherapy, of course, although the role for checkpoint inhibitors in extrapulmonary neck is still debated. Five patients received prior irinotecan. These were all in Cohort 1, consistent with the common practice of using FOLFIRI or FOLFIRINOX in GI neuroendocrine cancers in the second line. So overall, we feel the study population represents a typical extra population extpoary neck population that we see in clinic. In terms of efficacy, we saw encouraging antitumor activity with Si. Among response evaluable patients, the overall response rate to date is 38% with a disease control rate of approximately 56%. We feel these responses are clinically meaningful in these aggressive tumor types with few treatment options after platinum-based chemotherapy. Tumor reductions were observed across multiple extrapulmonary neck subtypes. The response rate in Cohort 1 enrolling gastroenterpancreatic or GEP-NEC was 33% and in Cohort 2, which enrolled extrapulmonary NECs other than GEP primaries, the response rate was 44%. As shown in the waterfall plot, we saw substantial target tumor shrinkage in patients both in Cohort 1 and Cohort 2, although we did absorb more patients in Cohort 1 with primary progression. When we break down the data in more detail, we see responses were observed across a spectrum of extrapulmonary NECs. Interestingly, in the 5 patients who received prior irinotecan, which is another TOPO1 inhibitor, no patients showed a response. All these 5 patients had gastroenteropancreatic NECs or GEP-NECs, whereas a patient with neck of the cervix who received prior topotecan, which is another TOP1 inhibitor, did achieve a partial response with zoci. More data is being generated to understand factors that impact response to zoci. We are also seeing early signs of durability with multiple cases of durable responses across different origins of neck. These data are still immature, but taken together, these data suggest clinically meaningful efficacy with zoci. Similar to what we saw in small cell lung cancer, we have not yet observed a clear relationship between DLL3 expression and response. Importantly, responses have been observed in DLL3 negative patients, and we have seen activity across a broad range of DL3 expression levels. While preliminary, this data does not support excluding patients from zoci treatment in the case of negative DLPin expression. Taking a look at safety and tolerability. Overall, zoci demonstrated good safety and tolerability in extrapulmonary neck, consistent with the safety profile of small cell lung cancer. Most events were low grade. The most common events were hematologic and gastrointestinal, including anemia, leukopenia and nausea. There was only one case of Grade 2 ILD among these 46 patients treated to date. We have limited data so far, but the ILD rate in patient extrapulmonary neck seems to be lower than the small cell lung cancer, and this may be related to difference in tumor burden in the lung and lower frequency of prior radiation of the chest. So in summary, we believe ZL-1310 orzoi is well tolerated compared to other treatment options in extrapulmonary NEC. To bring this to life, I'll walk through a representative patient case. This is a 52-year-old patient with small cell neuron carcinoma of unknown origin. He exhibited primary progression on first-line platinum-based chemotherapy and then initiated ZL-1310 and achieved a partial response within 6 weeks. We saw a large tumor reduction at week 6 with one of the target lesions nearly disappearing. The tumor shrinkage deepened nearly 75% by week 18, and the patient is still benefiting at time of data cutoff with a very encouraging durability of response of more than 6 months. In summary, zoci is demonstrating clinically meaningful activity in a very difficult to treat population. We're seeing responses across multiple extrapulmonary neck tumor types and primary origins. And while cross-trial comparisons must be interpreted with caution, these response rates to date appear favorable relative to historical chemotherapy outcomes. The safety profile is consistent with what we observed in small cell lung cancer, and the study is ongoing with expansion to Phase II and continued follow-up in the Phase Ib ongoing to better characterize efficacy. And with that, I'll turn it back to Rafael.
Rafael Amado
ExecutivesThank you, Dr. Thummalapalli. This next slide outlines our broad and comprehensive development strategy for zoci across both small cell lung cancer and extrapulmonary neuroendocrine carcinomas. Starting with small cell lung cancer, we are advancing across multiple lines of therapy. In the second-line and third-line setting, -- our global Phase III DLLEVATE study is ongoing. We expect to complete enrollment in the first half of 2027, followed by an interim analysis positioning zoci monotherapy for potential accelerated approval in 2028. At the same time, we are expanding into first line. Here, we have multiple ongoing combination strategies. First, we're evaluating zoci in combination with a PD-L1 inhibitor plus or minus chemotherapy. We expect to present combination data, including first-line data in a conference later this year and expect to initiate a pivotal trial by end of the year with the selective combination. Additionally, we also recently announced a collaboration with Amgen as well as Boehringer Ingelheim, which I will discuss in an upcoming slide. Turning to EP-NEC. We are advancing zoci monotherapy in the second-line setting where there is significant unmet need. The ongoing study is generating registration-enabling data. In parallel, we're exploring combination strategies, including orixtamib through our collaboration with Boehringer Ingelheim to further expand the opportunity in this population. Overall, this strategy reflects our goal to position zoci as a backbone therapy across both small cell lung cancer and EP-NEC, spanning monotherapy and combination approaches and across multiple lines of therapy. I wanted to briefly touch on the recently announced collaboration with Amgen and BI to pursue combination strategies in small cell lung cancer and neuroendocrine carcinomas. The rationale is grounded in complementary mechanisms. Zoci delivers rapid cytotoxic tumor debulking, while T cell engagers activate immune-mediated killing to drive durability. Together, this approach has the potential to both deepen and extend responses. Importantly, these agents are expected to have minimal overlapping toxicities. Combined with zoci's favorable safety profile and compelling systemic and intracranial activity, we believe it is well positioned as a backbone for combination therapy. We've initiated a global Phase Ib study with Amgen evaluating zoci in combination with tarlatamab. The study includes dose exploration and dose expansion in both taratamab-naive and tarlatamabexosed patients. We plan to also evaluate a triplet in the first-line setting. We also plan to initiate a global Phase Ib/II study with PI evaluating zoci in combination with evrextamib in neuroendocrine carcinomas as well as a triplet combination with atezolizumab in first-line small cell lung cancer and depending on emerging data in first-line EP-NEC as well. Amgen and BI will sponsor and lead their respective global studies. Overall, we see OCI emerging as a differentiated DLL3 ADC with the potential to become a new standard of care across small cell lung cancer and extrapulmonary neuroendocrine carcinomas as monotherapy in previously treated population and as a backbone in the frontline combinations. With that, let me turn to the broader pipeline we're advancing at AACR. L1222 is our IL-12 PD-1 immunocytokine. It is designed to overcome the key limitations of current immune checkpoint blockade, which has had limited activity in cold tumors and systemic IL-12, which could result in significant toxicity. It combines PD-1 targeting for tumor localization, a silence Fc for half-life extension and a potency reduced IL-12 to improve tolerability. This enables localized activation of IL-12 signaling in the tumor microenvironment, reprogramming the TME and activating T cells to drive durable antitumor immunity. We see clear antitumor activity. ZL-1222 inhibits tumor growth in the ICV resistant model, ENT6 with good tolerability and shows dose-dependent efficacy that tracks closely with exposure in CT26 model. Together, this data show that ZL-1222 can drive meaningful antitumor responses in a biologically predictive profile. Our pilot toxicology study in nonhuman primates showed tolerability up to 10 milligrams per kilogram. We are currently conducting a dose range finding study and are preparing GLP toxicology study to establish its safety profile. We're now advancing towards IND-enabling studies in 2026. Turning now to ZL-6201, our LRRC15 targeting ADC. L-6201 combines a humanized anti-LRR-C15 antibody with a protease cleavable linker and a cantoason-based TOPO1 payload. Mechanistically, this enables efficient internalization and payload release in targeted cells, leading to DNA damage and tumor cell death. Importantly, LRR-C15 is broadly expressed across sarcomas and in cancer-associated fibroblasts within the stroma of many epithelial solid tumors with limited expression in normal tissues, making it a highly attractive ADC target. Collectively, these findings highlight the potential for ZL-6201 to address significant unmet need across both mesentchymel and epithelial malignancies. Looking at the efficacy data, ZLCC-201 demonstrated dose-dependent tumor growth inhibition across multiple LRR-C15positive sarcoma patient-derived xenograft models. We also observed robust antitumor activity in non-sarcoma CDx models where LRR-C15 is expressed on cancer-associated fibroblasts rather than in tumor cells. In these models, CABs facilitate the release of C24 payload to deplete nevering antigen negative tumor cells, demonstrating potent efficacy driven by a strong bystander effect. Together, these data support the dual mechanism of action involving both direct tumor cell killing and stromal targeting. Based on this profile, a global Phase I study is now underway with enrollment acceleration planned in 2026. And with this, I will end the highlights from AACR. Now please join me, Dr. Paz-Ares and Dr. Thummalapalli for questions and answers.
Operator
Operator[Operator Instructions] We will now take our first question from the line of Jonathan Chang from Leerink Partners.
Jonathan Chang
AnalystsDr. Ares, how should we be thinking about the intracranial activity of ZOCI relative to standard of care and development stage treatment options in small cell lung cancer? And how should we be thinking about the impact of this intracranial activity on overall survival?
Luis Paz-Ares
AttendeesWell, I mean, of course, those are -- I mean, today it is still early days because we haven't got, let's say, very robust data in terms of Phase III trials. The only thing I can tell you is that the response rate we have seen, you remember, 54% overall intracranial response rate being 62% on those patients that actually were treated at a 1.6 milligrams dose. I think this is quite impressive in this setting as compared to standard of care drugs, which are more on the 20% to 30%. So that is at least encouraging data thinking into the future about the possibility of impacting survival. At the same time, you're able to really get responses in the brain very likely, I would assume that you have good possibilities of getting better or improvement in quality of life. I mean having brain metastases, particularly symptomatic brain metastases are really impacting very much on what you're able to do and your quality of life. So I would say the early data are really encouraging, but still, of course, it's going to be needed randomized Phase III trial. I'm pretty sure the trial we just described in the pretreated setting is going to give us a more robust data, but early data are very encouraging.
Operator
OperatorWe will now take our next question from [ Michael Yee ] from UBS.
Unknown Analyst
AnalystsWe had 2 questions. One was just thinking about the enthusiasm about this data in intracranial tumors and how that would drive a robust response in the Phase III frontline small cell study, where obviously, it's much better to treat earlier. So could you talk a little bit about what type of results you would expect to then see in the first-line study and how that would compare versus, say, tarlatamab, which has a first-line label? And the second question then is, I guess, you're going to combine the 2. So how would that be envisioned if the 2 of them are combined?
Luis Paz-Ares
AttendeesOkay. So related to the first question, I could say, I mean, typically, n about 20% of the patients are having brain metastasis. But it's not only important to treat those 20% of the patients, but also to prevent brain metastasis to happen in the future. That is a very frequent sight of disease progression. So having a drug which is very effective into the brain likely is going to prevent brain metastasis to happen or at least delay that progression to happen. Of course, I mean, tarlatamab is an amazing therapy with a clear impact on survival and other endpoints -- the idea here would be to be able to combine those drugs. I think this is -- my anticipation would be that there are a couple of trials in the first-line setting, induction and maintenance. I would assume in the near future, the result of those trials are going to be positive and tarlatamab is likely to be part of the standard of care. So the way I envision this ADC against DLL3 in the first-line setting will be in combination with tarlatamab. And hopefully, that could have at least there are good rationale to really have a synergistic effect between both of them. And I think, I mean, it's been commented by Rafael that combination data are going to be produced. And I suppose frontline will be a qui strategy into the future.
Operator
OperatorWe will now take next question from the line of Anupam Rama from JPMorgan.
Anupam Rama
AnalystsCongrats on the update. One for the company. So in the Phase III DLLEVATE study in second-line plus small cell lung cancer, can you walk us through the rationale to stratify based on having brain mets or not? Isn't the activity that you're seeing today here at AACR ultimately, within brain mets, that's going to be key for PFS, right, in the overall population as derisking?
Rafael Amado
ExecutivesYes, that's a very good question. Thanks for asking. generally, these studies are stratified by brain metastasis because they pertain a poor prognosis as was remarked upon at the beginning by Dr. Paz-Ares. The difference in second line survival may be between 5 months to 9 months for those that don't and those that do have brain metastases. So stratification ensures that the number of patients with brain metastases is equal in both arms. Now the point that you're making, I think, is that if brain metastasis patients do appear to do equally well as those that don't when they're treated with zoci, why stratify. -- well, in the control arm that will not be the case, and we wouldn't want to be an evenness in the control arm whereby what preponderance of patients with or without brain metastasis occurs and then the comparison wouldn't be apples-to-apples comparison. So I think in spite of the good data that you've heard today because it's a randomized trial against chemotherapy, the stratification is necessary.
Operator
OperatorDo you have any follow-up question Anup? Our next question comes from the line of Yigal Nochomovitz from Citigroup.
Yigal Nochomovitz
AnalystsOkay. I thought I heard my name. So one for Dr. Paz-Ares, one for Dr. Thummalapalli and one for Rafael. So Dr. Paz-Ares, I'm wondering with the 10 patients that had responses intracranial, could you describe whether they also responded systemically? What was the concordance? As I recall with tarlatamab in their intracranial data, I believe the concordance was quite high.
Luis Paz-Ares
AttendeesOkay. So again, here, the concordance is pretty high. I mean those data have been already reported I think in prior trials and the response rate is over 50% as well. So the important thing would be what -- because there are a number of drugs that induce a reasonable response rate systemically, but they fail to produce the same type of activity in the brain. And the reason for this presentation here at AACR is specifically to highlight that the responses you're seeing in the brain are similar. So there is no problem to access into the brain and to induce responses here. That is very much the reason.
Yigal Nochomovitz
AnalystsOkay. And for Dr. Thummalapalli, I'm just curious, do you have any theories as to why you're not seeing a differential response with respect to DLL3 expression?
Rohit Thummalapalli
AttendeesYes, it's a great question. I mean I think we've limited data so far. I think there could be a number of reasons. In extrapulmonary NECs, DLL3 expression is not as universal as it is or at least as prevalent in small cell lung cancer. There also could be some heterogeneity. There also could be other factors that are DLL3 independent that could be associated. Of course, the drug also kind of invokes a bystander effect as well. And so you may not necessarily need kind of high level homogeneous DL3 expression, you could potentially respond to the drug even with lower levels. So I think a lot of different possible reasons. But I think the data will bear out with time.
Yigal Nochomovitz
AnalystsOkay. And for Rafael, quickly, you have the interim coming up next year, as you mentioned. What more can you tell us today about that interim? The sorts of questions we want to know would be the percent of PFS maturity, what you can say about the bar, meaning the critical hazard ratio. How much can you tell us today about what would be necessary for that study to report a positive interim next year?
Rafael Amado
ExecutivesYes. The critical endpoint for conditional approval or accelerated approval is response. It's not PFS. And FDA will be looking at duration of response and the analysis will be done when patients have been able to -- had an opportunity to be followed for at least 6 months after the first scan. And the agency will be looking at the durability of that response as well. So it won't be based on PFS or survival, but rather on differential response rate and the durability of that response. And in terms of the type of difference that needs to be seen, this is not something that we've commented in the past. And I think it will be probably something that FDA will deem clinically relevant. And I can tell you that we are tracking very well for that endpoint. We plan to have it -- to have approval by the end of the next quarter and shortly after, we will be able to do the analysis. So fingers crossed and stay tuned.
Operator
OperatorWe will now take our next question from Lee Watsek from Cantor.
Unknown Analyst
AnalystsThis is [indiscernible] on for Lee. Question about the next update. So it seems like the next update is going to be in the second half of '26, and that's going to be the combination of chemo and PD-L1. Can you guys set the expectation there? What kind of data we should expect to see?
Rafael Amado
ExecutivesI think you're asking about the frontline data with chemotherapy and PD-1. We treated a number of patients with both PD-1 in second line as well as in first line and then in first line with carboplatin as well. All that data is maturing. The majority of patients are with PD-1. I can tell you that the toxicity does not seem to be overlapping and where we've been able to advance the doses as expected. We obviously are observing data that is very encouraging to us, but we need more time to see what the durability of that data is going to be. Our hope is that with good data sparing chemotherapy, we would be able to treat longer than with chemotherapy alone. The majority of patients with chemotherapy alone tend to stop after about 4 cycles or so. And given the tolerability that you've seen with Oi and the one that we're seeing with zoci plus PD-1 that the treatment to progression or toxicity will be longer with zoci. So that -- I think that is the underpinning of that Phase III study. We're in discussions with regulators at the moment as to the actual details of the design. But as I said in the prior remarks, we plan to present the data in the second half of this year, sometime in one of the meetings in the fall.
Operator
OperatorWe will now take our next question from Linhai of Goldman Sachs.
Linhai Zhao
AnalystsThis is. Very exciting results. Congrats. I have 2 questions. The first question is, how do you think about the potential confounding effect from the prolonged intracranial efficacy from the previous radiotherapy? What is the time gap between the last radiotherapy to the first dose of zoci? That's the first question. And second question, I would appreciate some clarification as I see in the Page 9 of the deck, it was showing that zoci was able to penetrate the blood-brain barrier and enter within the brain tissue that was somehow the reason that it can generate the high intracranial efficacy. Just want to clarify if it is my understanding correct?
Rafael Amado
ExecutivesSo. Yes. I was just going to say that the protocol require at least a 7-day washout for radiotherapy. But Dr. Paz-Ares, please go on.
Luis Paz-Ares
AttendeesYes. So I mean, for sure, a washout were required. So the only thing I can say with this limited data is that among those patients that didn't receive radiotherapy before, the response rate was 60%, 9 out of 15 patients, and it was very similar, I would say, 50% response rate in patients that have been treated with prior radiotherapy, 13 out of 26. Then the number of patients are too small to really dissect on the time elapsing since last radiotherapy, always knowing, as Rafael mentioned, that anyway, it's going to be at least 2 weeks from last radiotherapy dose. So you need to have a controlled image before starting baseline post radiotherapy. So that means the effect you're observing is not due to the radiotherapy, but it's due to the drug. But anyway, I mean, that is the maximum we can say about those data, I have to say.
Operator
OperatorFollow-up question...
Linhai Zhao
AnalystsYes. Just on the second question is the ability of zoci to enter the -- to penetrate the blood-brain barrier.
Luis Paz-Ares
AttendeesSo I mean, the -- let's say, the idea here being that the way the drug is working, I mean, is brain metastasis, of course, because small cell lung cancer express quite uniformly L3 in the surface of the cell and that facilitates the entry into the tumor and into the microenvironment, the drug is actually delivered with a high number of molecules of the payload per cell. Of course, we know that when brain metastases are there, there is a disruption of the brain barrier. And actually, the fact that we have observed such a high response rate somehow validate that concept, I would say. I don't know, Rafael, if you like to add on something based on the preclinical data?
Rafael Amado
ExecutivesNo, nothing else. I think the disruption of the blood-brain barrier is an excellent point. And also, this is a very aid antibody with very, very low nanomolar affinity. So binding to DLL3 is with very high affinity. So perhaps that is one differentiating factor that makes it possible to have such high activity.
Operator
OperatorShowing no further questions. Thank you all very much for your questions. I'd now like to turn the conference back to Dr. Rafael Amado for his closing comments.
Rafael Amado
ExecutivesThank you so much, Dr. Thummalapalli and Dr. Paz-Ares. We believe that the data presented today reinforces the potential of zoci as a differentiating agent in DLL3pitive tumors and supports our strategy to advance it into multiple lines of therapies and in combination settings for both small cell lung cancer as well as neuroendocrine carcinoma. So we are executing against a comprehensive global development plan, as I outlined, including the current ongoing Phase III study, and we look forward to sharing additional data with you as the program progresses. We appreciate your time and interest today, and we look forward to keeping you updated. Thank you so much. Have a great day. And operator, you may now disconnect.
Operator
OperatorThank you for your participation in today's conference. This does conclude the program. You may disconnect your lines.
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