把昨天活动的字幕整理出来,让豆包翻译给大家看看,注意语音识别的字幕可能不准确,ai的翻译可能也有问题,仅供参考亚盛医药国际集团访谈文字稿(中英对照)1号讲话人00:04:00各位古根海姆会议的来宾,我是布拉格,非常荣幸能与亚盛医药的代表共同开启接下来的炉边座谈,有请我们的嘉宾登场。HereattheGuggenheimConferencemynameisBragg,I'mhappytobesharingthestageforthenextfiresidechatwithAscentagePharma.Let'swelcomeourguesthere.2号讲话人00:04:09感谢邀请。Thankyouforhavingme.1号讲话人00:04:10我们先从公司概况开始吧。能否为大家简要介绍一下亚盛医药目前的发展现状、核心业务方向、全球布局,以及公司战略的核心支柱是什么?Andmaybewecanjustkickoff.IfyoucangiveabriefoverviewofAscentagePharma—whereyouaretoday,corefocusofthecompany,whereyou'vegotthefootprintandwhatyouseeisreallythekeypillarsofthestrategyforthecompany.2号讲话人00:04:23好的,感谢提问。亚盛医药是一家在纳斯达克和香港联合交易所双重上市的公众公司,属于全球化企业,目前员工规模接近800人。Yeah,thankyouforthequestion.SoAscentagePharmaisapubliccompanyduallistedonboththeNasdaqandHongKongStockExchange,averyglobalcompanywithcloseto800employeesatthispoint.2号讲话人00:04:37我们已在中国进入商业化阶段,拥有两款用于血液肿瘤适应症的创新药产品,业务正处于快速增长期。公司管线中有7款已披露的化合物,包括刚才提到的两款上市产品,每一款都具备首创或同类最佳的潜力。We'reacommercialstageinChinawithtwonovelproductsforoncologyindicationsinhematology,andwe'rerapidlygrowing.Wehaveapipelineofsevendisclosedcompounds,includingthetwoproductsImentioned,eachofthemwithnovelandbest-in-classpotential.2号讲话人00:05:02这些产品基本覆盖了血液肿瘤领域的主要市场,同时我们也拥有自主的药物发现引擎。从员工分布来看,大部分员工位于中国,美国团队也有超100人。Spanningessentiallythemajormarketsinhematology,andwehaveaninternaldiscoveryengineaswell.Intermsofthebreakdownoftheemployeespread,predominantlyinChina,butwehaveoveronehundredintheUS.2号讲话人00:05:16中国主要负责药物发现、创新研发和临床试验执行,同时开展产品销售;美国主要聚焦临床试验执行,目前有4项美国注册性研究正在进行中。Chinaisfordiscovery,innovation,clinicaltrialexecutionandsales;intheUS,it'sclinicaltrialexecution,andwehavefourUSregistrationstudiesongoing.2号讲话人00:05:26美国将成为我们的全球市场枢纽,这也是公司商业化全球扩张的下一阶段核心布局。SotheUSisgoingtobeourglobalmarkethub,whichisthenextchapterofthecompanyintermsofitsglobalcommercialexpansion.1号讲话人00:05:45好的,感谢详细的公司介绍,你们的产品管线布局也相当丰富。能否再介绍一下已上市产品和后期管线的情况?Okay,sogreatoverviewofthecompany.You'vegotadecentlylargepipelineofproductsaswell,maybeintroducethemarketedproductsandthelate-stagepipeline.2号讲话人00:05:56当然可以。首先介绍已上市产品,第一款是第三代酪氨酸激酶抑制剂奥雷巴替尼,这是一款三代TKI药物,该领域近几个月备受关注。Yes,certainly.Sointermsofthemarketedproducts,wehavefirstlyathird-generationTyrosineKinaseInhibitor(TKI)calledOlverembatinib,whichisathird-generationTKI,inaspacethat'sgottenalotofattentioninrecentmonths.2号讲话人00:06:20伊马替尼于2001年由诺华推出后,极大地提高了患者的生存率,但耐药性问题使得临床仍需要更多TKI药物来满足患者需求,其中T315I守门人突变是主要耐药突变之一。ImatinibwasbroughtoutbyNovartisintwothousandandone,whichincreasedsurvivalsignificantly,butthere'sbeentheneedforadditionalTKIstobebroughttomarkettomeetpatientneedsduetoresistance.There'sthegatekeepermutationT315I.2号讲话人00:06:43在慢性髓性白血病患者群体中,该突变的发生率约为25%,部分人群中甚至达30%。Whichisabouttwentyfivepercent,sometimesthirtypercent,dependingontherepresentativepopulationofChronicMyeloidLeukemia(CML).2号讲话人00:06:53此外,第二代TKI药物还存在近期或远期的安全性问题,以及患者不耐受的情况。慢性髓性白血病是一个规模较大的药物研发领域,全球范围内对该疾病的药物需求持续存在。Andthentherearesafetyconcernsthatcanariseintheneartermorlaterterm,andintoleranceissuesthathavebeenthecasewiththesecond-generationTKIs.It'sbeenalargepharmacategory,andthereisaworldwideunmetmedicalneedforCML.2号讲话人00:07:20同时,我们的这款药物也针对急性淋巴细胞白血病,该疾病是儿童最常见的恶性肿瘤,包括实体瘤在内,且覆盖成人和老年患者群体。因此,TKI药物需要具备强效的作用,以应对急性淋巴细胞白血病。AndalsoforAcuteLymphoblasticLeukemia(ALL)–it'sthenumberonechildhoodcancer,includingsolidtumors,andalsospansadultandelderlypopulationaswell.SoTKIshavetobeespeciallypotenttoaddressALLaswell.2号讲话人00:07:36我们正在开展针对急性淋巴细胞白血病的美国注册性研究,同时该研究也纳入了全球注册性研究的范畴,这一点我们非常期待。第二款上市产品是在中国获批的B细胞淋巴瘤因子2抑制剂索乐匹尼布,它是继2016年艾伯维推出维奈克拉后,全球第二款获批的BCL-2抑制剂。We'rerunningaUSregistrationstudyandpartofaglobalregistrationstudyinALL,sowe'reexcitedaboutthat.AndthenalsowehaveaBCL-2inhibitorapprovedinChinacalledSolabatinib.It'sthesecondBCL-2inhibitortogetapprovedeversinceVenetoclaxgotapprovedbyAbbVieintwentysixteen.2号讲话人00:08:06这款药物从研发到上市历时9年,目前市场上有一款针对骨髓增生异常综合征的BCL-2抑制剂竞品。而我们这款化合物的特点是采用每日剂量递增的给药方式,而非周剂量给药。It'sbeenanine-yearjourneygettingthattothemarket.There'sacompetitorouttherethathasaBCL-2inhibitorapprovedforMyelodysplasticSyndromes(MDS).Essentially,thecharacteristicsofourcompoundareadailydoserun-upasopposedtoweekly.2号讲话人00:08:34此外,我们的化合物未出现药物相互作用问题,而这一问题在与其他药物联用中至关重要,尤其是与布鲁顿酪氨酸激酶抑制剂的联用。接下来谈谈BTK靶点,我们在今年1月初宣布了BTK蛋白降解剂的美国临床试验申请获批,随后上周也宣布了该药物获得中国国家药品监督管理局药品审评中心的临床试验批准。Andwealsohavenotexperienceddrug-druginteraction(DDI)issueswithourcompound,whichisaconcernasitrelatestotheimportanceofcombiningwithotheragents,includingnamelyBTKinhibitors.I'lljumptoBTK–wehaveaBTKproteindegraderthatwejustannouncedinearlyJanuaryaUSINDclearance,wesubsequentlylastweekannouncedChinaCDEclearance.2号讲话人00:09:04这款BTK蛋白降解剂拥有令人振奋的临床前研究数据,我们认为其与竞品相比具备显著的差异化优势,后续我们会详细介绍。这也让我们能够将其与自研的BCL-2抑制剂进行联合用药研究。WehaveanexcitingpreclinicalpackageofthisBTKproteindegrader,webelieveit'squitedifferentiatingversusourcompetitors,whichwe'lltalkaboutmoreovertime.AndthatyieldsacombinationapproachwithaBCL-2inhibitorwhichwehave,obviously,inhouse.2号讲话人00:09:25我们是全球唯一一家同时拥有第三代TKI和BCL-2抑制剂的公司,且两款药物均具备同类最佳的潜力。回到管线的问题,我们还有三款针对实体瘤的多激酶抑制剂,目前正在开展相关研究。Wefeellikewearetheonlycompanythathasathird-generationTKIandaBCL-2inhibitor,bothofwhichwebelievehavestrongbest-in-classpotential.Andtoansweryourquestionabouttherestofourpipeline,wehavethreemulti-kinaseinhibitorsdirectedtowardssolidtumorsthatwe'recarryingoutstudieson.2号讲话人00:09:48正如我之前所说,我们拥有自主的药物发现引擎,目前也在推进一款PRC2复合物抑制剂的研发,暂命名为APG5918,该药物针对血液疾病适应症,包括镰状细胞病、β地中海贫血,同时也布局肿瘤领域。AndasImentioned,wehaveadiscoveryengine,sowealsoarebringingforwardaPRC2complexinhibitor,whichwecallAPG5918fornow,directedtowardsbothhematologicindicationsincludingSickleCellDisease(SCD),BetaThalassemia,andoncology.2号讲话人00:10:18近期已有部分企业采用同类研发思路针对镰状细胞病和前列腺癌开展研究,并取得了令人振奋的结果,辉瑞也有一款同复合物的EZH2抑制剂。目前该领域的研发参与者数量极少。Youknowrecentlysomecompanieshavegoneaftersicklecellandprostatecancerusingthesametypeofapproachandhaveyieldedexcitingresults,butPfizerhasanEZH2inhibitor,partofthesamecomplex.Sothere'sreallyquiteaminimalnumberofplayersinthiscategoryaswell.2号讲话人00:10:33这就是我们的商业化战略:推进全球临床试验执行、开展药物联合用药研究,并持续将更多创新化合物纳入研发管线。Sothisiskindofourspinontheapproachintermsofcommercialization:globalclinicalexecution,fusion(combination)andbringingaboutadditionalnovelcompoundstoforwardinthepipeline.1号讲话人00:10:42好的,我们先深入聊聊慢性髓性白血病相关的研发。你刚才提到了突变抑制效力和耐受性的提升,能否详细对比一下我们的药物与已上市产品及竞品在研临床阶段产品的差异化优势?Right,maybewe'lldrillintotheCMLfirstalittlebitmore.Imean,youmentionedthemutationpotency,theimprovedtolerability,maybegiveabitmoregranulardetailsaroundthatdifferentiationcomparedtothemarketedproductsandtheclinical-stageproductsthatcompetitorsaredeveloping.2号讲话人00:11:01当然。过去一年多来,慢性髓性白血病领域备受关注,包括我们在内的几家企业正致力于解决该领域未被满足的临床需求,有人认为这一研发方向具有颠覆性,毕竟正如我所说,这是一个规模庞大的药物领域。Yeah,certainly.Soit'sbeeninterestingtoseetheattentionontheCMLspace,especiallyinthelastyear,maybeslightlymorethanayear.There'sbeenacoupleofcompanies,IguessI'dputourselvesinthatcategory,thatareessentiallyaddressingtheunmetneed–somepeoplecanviewitasdisruptive,maybeinthesensethatit'sbeenalargepharmacategoryasImentioned.2号讲话人00:11:43患者面临的核心问题是对第二代TKI药物最终会产生不耐受和耐药性。武田的普纳替尼虽解决了第二代TKI的诸多问题,但遗憾的是存在毒性相关问题。大家可能也知道,我们与武田在中国就奥雷巴替尼达成了选择权协议。Theissuewiththepatientsiseventualintoleranceandresistancetosecond-generationTKIs.There'sadrug,Ponatinib,byTakeda,thataddressedalotoftheconcernsofsecond-generationTKIs,butunfortunatelyithasissuesasitrelatestotoxicity.WedohavearelationshipwithTakeda,asalotofpeopleprobablyknow,wheretheyhaveanoptionagreementex-ChinaasitrelatestoOlverembatinib.2号讲话人00:12:17我们认为这一合作本身就充分印证了我们研发思路的合理性,这也是武田的一项潜在产品线拓展战略。因此,我认为研发的核心应聚焦于药物的效力、药代动力学特征和长期疗效持久性。Webelievethatinitselfishighlyvalidatingofourapproach,andit'sapotentialfranchiseextensionstrategyforTakeda.SoIthinkonereallyneedstofocusonpotency,PK/PDandlong-termdurability.2号讲话人00:12:29我们的这款化合物于2021年在中国先获得有条件批准,后获批完全上市,并被纳入国家医保目录。相较于其他试图实现颠覆性突破的竞品,我们的药物已拥有多年的临床应用数据,这一点至关重要。Ourcompoundgotconditionalapprovalandeventuallyfullapproval,andwasincludedintheNRDLinChina,startingfromtwentytwenty-one.Sowehaveanumberofyearsofhistoryoverourcompetitorsthataretryingtobedisruptors.Ithinkthatreallymatters.2号讲话人00:12:53行业内常会关注临床试验的阶段性数据、某一时间点的安全性数据,并以此推断药物的整体表现,这一做法本身无可厚非,但必须结合行业整体格局,关注那些能展现出长期疗效持久性的研发成果。Peoplegetcaughtintheexcitementoflookingatdatacuts,lookingatthesafetyprofileatapointintime,andextrapolatefromthat–that'sfine,there'snothingwrongwiththat,however,onehastotakeintoconsiderationinthelandscapewhoaretheonesthatareshowingdurabilityovertime.2号讲话人00:13:18因为对于慢性髓性白血病的治疗,核心目标是提高患者的生存率。而作为一款已在中国获批的药物,我们的优势还在于,与国内核心专家建立了良好的合作网络,并顺利开展了上市后研究。Becausethat'swhatmatterswhendealingwithCML–thenameofthegameissurvival.Sowehavethebenefit,especiallybeingadrugthatisapprovedinChina,whereourKOLnetworkandrelationshipshavealsoeffectivelyconductedpost-marketingstudies.2号讲话人00:13:41目前我们已有相关研究数据发表在《自然-临床肿瘤学》等具有高度权威性的期刊上,包括4年、6年的长期随访研究,以及相关患者病例研究。Sowe'vedone,andthere'spublisheddatanowoutthereinveryhigh-reputablepublications–NatureClinicalOncology,etcetera–long-termstudiesoffouryears,sixyears,casestudiesofpatients.2号讲话人00:13:53部分患者在多款TKI药物治疗失败后,甚至会重新使用此前无效的药物,这是因为临床治疗选择有限。而使用我们的药物后,部分患者原本因耐药性导致的分子学缓解水平下降的情况得到改善,重新实现了主要分子学缓解。WhohavehadmultiplefailuresofTKIs,oftentheyevenrotatebacktoadrugthathasn'tworkedbefore–it'sbecausethere'slimitedoptions.AndthenyoucanseepatientsactuallyrevertbacktohavingMMRsafterthey'vehaddeclinesduetoresistance.2号讲话人00:14:19此外,一个重要的临床成果是,部分进展期慢性髓性白血病患者(加速期或急变期)的远期生存预后极差,而在使用我们的药物后,这些患者能够从加速期/急变期转回慢性期。Inaddition,andthisisimportantaswell,patientshaveconvertedfromadvancedCML–APorBP,acceleratedphaseorblastphase–wheretheoverallsurvivalprognosisbecomesmoreandmorepoor,backtoCP,chronicphase.2号讲话人00:14:44慢性期是慢性髓性白血病最主要的发病阶段,绝大多数患者初诊时均为慢性期,而让这类难治性患者实现疾病阶段的逆转,具有重要的临床意义。目前我们的竞品尚未达到这一临床效果。WhichisthemajorityoftheCMLcases–they'rediagnosedmostoftenasCP.Buttoactuallygetaverydifficult-to-treatpopulationtorevertback,that'squitemeaningful.Soourcompetitorsaren'tevenclosetothatpointyet.2号讲话人00:15:10同时,得益于公司同时拥有TKI和BCL-2抑制剂两款药物,我们在内部开展了联合用药研究,部分研究者也开展了相关研究,将我们的奥雷巴替尼与维奈克拉联用。Also,wehavethebenefitofhavingboththeTKIandtheBCL-2inhibitorinonecompany,sowe'veactuallydonestudiesin-house,andothershaveaswell(investigator-initiatedstudies),combiningourdrugwithVenetoclax.2号讲话人00:15:25当然,我们也可以将自研的两款药物进行联合使用,研究结果显示,患者能够实现深度微小残留病缓解,即达到微小残留病阴性的完全缓解,这一点至关重要,因为这类患者有资格接受造血干细胞移植,进而有望实现更长期的缓解。Whichwecandowithourcombinationofourproprietarycompounds,andhaveshownpatientscanachievedeepMRD,soMRD-negativeCR,andthisisimportantbecausethesepatientscanthenbeeligibleforHSCT,whichmeanstheycanthengoontolonger-termpotentialremission.2号讲话人00:16:03目前我们正围绕这款药物开展相关研究,而这也是衡量一款药物长期疗效持久性的关键指标。疗效决定销量,这也是该领域再次吸引投资者关注的原因,而我们在这一难治性疾病领域的研究成果,也印证了药物的临床价值。Sothesearethetypesofstudiesthatarebeingcarriedoutrightnowwithourdrug,andthisiswhatyouwanttoseeintermsofthelong-termdurabilityofthedrug.Efficacyequatestosales,that'swhyIthinkthishasalsobeenamarketthat'scaughttheattentionofinvestorsagain,andwe'veshownthistypeofeffectinwhatis,asImentioned,adifficult-to-treatdiseasewithunmetneed.1号讲话人00:16:17好的,接下来聊聊针对慢性髓性白血病的POLARIS-2研究。能否介绍一下该研究的设计思路、对照方案,以及为了让这款药物在全球市场具备竞争力,你们认为研究成功的核心关键点是什么?Allrightnow,maybeyoucanspeakalittlebitaboutthePOLARIS-2studyforCML–thedesignforthatstudy,whatyou'regoingupagainst,andwhatyouthinkthebarsforsuccessaretomakethatadrugthatiscompetitiveontheglobalstage.2号讲话人00:16:34好的。该研究的设计思路非常科学合理,旨在对比我们的药物与对照药的安全性和有效性特征。研究分为两个部分,A部分为对照试验,以博舒替尼和辉瑞的一款第二代TKI为对照药;Yeah,Ithinkthedesignisanicerationalapproachtoshowthesafetyandefficacyprofileofourdrugversuscomparators.There'stwopartstoit,oneisPartAhasacontrolarm,pittedagainstBosutinibandaPfizersecond-generationTKI.2号讲话人00:17:09B部分为单臂试验,入组患者均为T315I突变型。这是一项覆盖美国、欧洲等地区的全球多中心研究,我们今年正在推进患者入组工作,预计年内完成大部分入组,后续我们会公布研究完成的具体时间节点,目前研究进展顺利。Andthenthere'saPartBthat'sasinglearm,onlyT315Imutants.SothisstudyisaglobalstudyincludingtheUSandEMAregions.Weareadvancingenrollmentthisyear,welooktohavethemajorityofenrollmentactuallycompletethisyear,sowe'llgivemoreguidanceastowhenthetrialisgoingtobecompleted,butit'sprogressingwell.2号讲话人00:17:40基于研究设计,我们认为成功的概率较高,对照药为博舒替尼,研究终点设定为24周主要分子学缓解和更长期的90周主要分子学缓解。Iwouldsaythatoneofthethingsisthatwefeellikethere'sagoodprobabilityofsuccessgiventhetrialdesign,goingagainstBosutinib.Theendpointsare24-weekMMRandthenalonger-term,90-weekMMR.2号讲话人00:17:56这一设计旨在充分验证药物是否达到美国食品药品监督管理局和欧洲药品管理局认可的临床终点,同时也有望充分展现药物对T315I突变的抑制效力。Soit'sdesignedtotrulyshowtheFDA-provableendpointandEMA-provableendpoint,andalsowe'llemphasizethepotency,hopefullyinT315I.2号讲话人00:18:11结合我们在中国的临床应用经验和上市后研究数据,相关研究结果已发表在期刊上,包含4年、6年的随访数据,综合来看,我们认为这一研究设计能让我们取得理想的研究结果。Nottomention,giventheexperiencewehaveinChinaandwithpatientsinpost-marketingstudiesasIarticulated,there'spapersoutthere,publicationswithfour-year,six-yearfollow-up.Wefeellikethis,whenlookingatthetotality,thisdesignwillgetusagoodoutcome,hopefully.1号讲话人00:18:23好的。我们切换话题,聊聊BCL-2抑制剂。这款药物已在中国获批适应症,能否详细介绍一下,同时谈谈这款产品的全球布局愿景?Okay,well,let'sswitchalittlebitandtalkabouttheBCL-2inhibitor.YouhaveanapprovedindicationinChinaforthat,maybediscussthatindetail,butthenwheredoyouseethevisionforthisproductpotentiallyglobally?2号讲话人00:18:38好的。先补充一点,POLARIS-2研究中,博舒替尼组患者还可以交叉至我们的药物组,这一设计也推动了患者入组工作的开展。回到BCL-2抑制剂的问题,首先需要说明的是,该药物在中国获批的注册研究中,入组的是临床难度极高的患者人群。Yeah,soonethingIshouldmention,though,forthePOLARIS-2study,there'sactuallyacrossoveraswellbetweenBosutinibandourdrugaswellthathasactuallyhelpedtostimulateenrollmentalso.Yes.Sotoansweryourquestion,theonethingtonoteintermsofthepopulationthatwasapprovedintheregistrationstudyinChina–itwasaverydifficult-challengedpatientbackgroundpopulation.2号讲话人00:19:17该研究为关键的II期研究,凭借研究结果获得了上市批准。入组患者中,几乎半数为复杂核型,所有患者均接受过BTK抑制剂治疗,且大部分患者对BTK抑制剂存在真正的不耐受或耐药性。ItwasapivotalPhase2studythatyieldedapproval.Thesepatientshadcomplexkaryotype,almosthalfwereclassifiedascomplexkaryotype,onehundredpercentofthemhadBTKexposure,amajorityofthatgroupwereactuallytrulyintolerantorresistanttoBTKinhibitors.2号讲话人00:19:34在中国,对患者的临床特征界定要求非常严谨,监管机构需要企业秉持科学严谨的态度,因此可以明确的是,这些均为经多线治疗后耐药的难治性血液肿瘤患者。InChina,thecharacterizationhastobeprecise,noonewantstocutcorners–oneneedstobeveryintellectuallyhonestwiththeregulatorsthere.Soyoucankindoftakeitatitswordthattheseweretrulypre-treated,resistanthematologypatients.2号讲话人00:20:10基于这样的患者入组背景,我们最终获得的药品说明书适应症描述超出了市场预期,具体表述为“既往接受过至少一种系统性治疗(包括BTK抑制剂)的患者”,这一表述中未出现“耐药”或“不耐受”的限定词。Andwiththatbackground,actually,wedidgetapprovalwithalabelthatwasbetterthanthemarketanticipated–thespecificlanguagewas"patientswhohavereceivedatleastonepriorsystemictherapyincludingBTKinhibitors".Andessentiallythatlanguagedoesn'thavethewordresistantorintolerantinit.2号讲话人00:20:29这意味着医生可以将其作为1.5线治疗药物开具处方,而非仅作为二线治疗药物。我们在美国血液学会年会上公布的研究数据显示,该患者人群实现了较高的客观缓解率和总生存率。Soitallowsdoctorstoprescribeiteffectivelyasa1.5-linetherapy,notasecond-linetherapy.We'veactuallyshownatASH,takenforward,thispatientpopulationhavedemonstratedhighORRandoverallsurvival.2号讲话人00:20:49同样,我们也在中国开展了该药物的上市后研究,相关数据也将为全球研发提供支撑。此前行业内对中美临床数据的认可度存在一些争议,这一问题也给其他企业带来了困扰,目前大家的看法已趋于理性,更关注数据本身的价值,而非简单否定中国的临床数据。Again,wehavethebenefitofpost-marketinginChinathatwecancarryforwardhere,andwefeellikethat,withalotofthenoisethatwasgoingon–it'sstillnotfullyresolvedyetwithChinaversusUSdata,howmuchofthatisvalid,we'vebeenhearingthatforothercompanies–Ithinkwe'remorerationalaboutthatnowandjustkindoflookatthedatawhereitisandnotdiscountingsomuchwhat'sgoingoninChina.2号讲话人00:21:20如今中国的临床试验质量已达到极高水平,且相关研究结果也多次发表在高权威性的期刊上。当然,我们也在开展全球多中心研究,确保各地区患者的入组比例均衡。Thesearenowveryextremelywell-conductedtrialsinChina,andthesehavebeenforawhile,validatedbyverystrongreputablepublications,sowe'llhavethatdatatosupport,andobviouslywe'reconductingglobalstudiesaswellwiththeproperbalanceandrepresentationofpatientsfromeachpartoftheworld.1号讲话人00:21:37好的。你们的这款药物与维奈克拉在剂量递增方案等方面存在差异,能否谈谈中国的临床应用经验?同时,该药物也在全球研究者发起的临床试验中被使用,Yeah,andyouofferadifferentdosingschedulethanVenetoclaxaswellintermsoframpupandeverything.Youknowwhat'sbeentheexperiencelikeinChina?Butalso,thishasbeenusedinsomeglobalinvestigator-initiatedclinicaltrials.1号讲话人00:21:48全球研究者如何看待这种差异?这一差异的优势是什么?为什么你们的药物能实现这一独特的给药方式?HowdotheyseethatdifferentfromVenetoclaxandwhat'sthepositiveaspectofthatandhowisyourdrugexclusivelyabletodeliverthat?2号讲话人00:22:01好的,给药方式至关重要,尤其是在社区肿瘤医生的临床诊疗场景中。竞品的多周给药方案存在一定的不稳定性,而我们的药物采用明确的剂量递增方案。Yeah,sothedosingmatters,especiallyinacommunityoncologyphysiciansetting.There'sbeensomeinconsistencyfromcompetitionasitrelatestowhatisultimatelygoingtobethemulti-weekdosingschedulefortheirdrug.Forus,it'sclear–wehaveadoserun-up.2号讲话人00:22:31这一点对于慢性淋巴细胞白血病、小淋巴细胞淋巴瘤的用药安全性至关重要,对急性髓系白血病等适应症也同样重要,毕竟急性髓系白血病的死亡率极高。ThatisimportantforsafetywhenyouthinkaboutCLLandSLL,andthenotherindicationsaswell,suchasAML,whichisobviouslyhasahighmortalityrate.2号讲话人00:22:45此外,我们还布局了一个极具市场潜力的高风险领域——高危骨髓增生异常综合征,目前全球尚无其他企业针对该适应症开展III期注册性研究,这是一个数十亿美元规模的市场机会,我们正在开展针对该适应症的全球多中心研究。Andthenobviouslywe'regoingafteranareawhichisabigopportunityforus–high-riskMDS.There'snoothercompanythat'sdoingaPhase3registrationstudyinthisdiseasecategory,it'samulti-billionmarketopportunity,andweareconductingaglobalstudyinHR-MDS.2号讲话人00:23:24另一个关键优势是药物相互作用,BTK抑制剂或蛋白降解剂与BCL-2抑制剂的联用已是临床常态,而固定疗程治疗是当前的研发趋势,因此消除药物相互作用问题至关重要。Theotheraspectthat'simportantisdrug-druginteraction(DDI),becausethecombinationwiththeBTKinhibitororproteindegraderisdefinitelygoingtocomeintoplay–it'salreadyinplaywiththeinhibitor,butnowthebigpushisforfixed-durationtherapy.SoobviouslyyouwanttohaveeliminationofDDIissues.2号讲话人00:23:43而我们是全球唯一一家明确证实自研BCL-2抑制剂无药物相互作用问题的企业,这一点极具临床价值。尤其是随着BTK蛋白降解剂的研发受到越来越多的关注,这一优势会更加凸显。Butwe'retheonlyoneswho'vedefinitivelyshownthere'snoDDIissueswithourcompound,sothat'sgoingtobeinteresting,andespeciallyastheBTKproteindegraderbecomesmoreandmorehighprofile.2号讲话人00:23:56同时,在支持治疗中,抗真菌药等药物的使用也会涉及药物相互作用问题。此外,骨髓毒性也是临床关注的重点,而我们的药物在这方面的优势,也让我们能够顺利推进高危骨髓增生异常综合征的研发。Andthenyouknow,whenyouthinkaboutsupportivecareaswell,likeantifungals–that'swhereDDIalsocomesintoplay.Andthenofcourse,theotherareaisbonemarrowtoxicity.SothishasenabledustoreallypushforwardinHR-MDS.2号讲话人00:24:18维奈克拉数年前因骨髓毒性问题,在两项多发性骨髓瘤的III期研究中失败,去年美国血液学会年会上公布的细节也显示,其在高危骨髓增生异常综合征的研究中也存在骨髓毒性问题。VenetoclaxhasshownyearspriorinabilitytotreatmultiplemyelomaduetotwoPhase3studiesshowingbonemarrowtoxicity,andthensubsequentlyasmoredetailscameoutlastyearduringASH,inHR-MDSaswell.2号讲话人00:24:35据我们了解,另一款BCL-2抑制剂竞品的研发方向为多发性骨髓瘤,并未布局高危骨髓增生异常综合征,因此坦率地说,这一适应症的市场机会由我们主导。Andasfarasweknow,anothercompetitorwithaBCL-2inhibitorisnotgoingafterHR-MDS,they'regoingafterMM.Sothisisourstolose,tobefrankwithHR-MDS–greatopportunityforus.2号讲话人00:24:47只有同时具备上述所有优势,才能在该领域的研发中占据先机。Andthenyouknow,onecanonlygoafterthistypeofcategorywithallthosecharacteristicsintact.1号讲话人00:24:52好的。我们再聊聊骨髓增生异常综合征,你们开展了GLORE-4研究。维奈克拉针对该适应症的研究遗憾未能取得成功,Yeah,solet'stalkaboutMDSforabit.You'vegottheGLORE-4study,Venetoclaxdidhaveastudythatwasunfortunatelynotsuccessful.1号讲话人00:24:58同为BCL-2抑制剂,你们为何选择布局该适应症?差异化优势体现在哪里?该研究设计的核心关键点有哪些值得我们关注?Whatistherationaleforbringingyourdrugtheregivenit'sthesamemechanism,maybehowdoesthedifferentiationplayintothatandwhatarethekeyelementsofthattrialdesignthatweshouldbepayingattentionto?2号讲话人00:25:12这是一个很好的问题。你提到的维奈克拉针对高危骨髓增生异常综合征的研究为VERONA研究,其设计方案为维奈克拉联合阿扎胞苷对比阿扎胞苷单药。Yeah,it'sareallygoodquestion.SotheVeronastudyyou'rereferringtoisVenetoclaxinHR-MDS.ThedesignwasVenetoclaxplusAzacitidineversusAzacitidine.2号讲话人00:25:33早在研究结果正式公布前,行业内就已得知该研究失败的消息,而我们当时也在推进相同设计的研究,即GLORE-4研究,这也让我们倍感压力,同时也收到了很多疑问,大家都想知道VERONA研究失败的具体原因。It'sbeenknownforquiteawhile,leadinguptotheactualfulldisclosureoftheresults,thatthetrialfailed.Andwewereembarkingonthesamedesignaswell,butasyoumentionedtheGLORE-4study–itwasalittlebitlikewewereontheedgeofourseatsandweweregettingalotofquestionsaboutwhatexactlywentwronginthatVeronastudybecauseyou'redoingthesamedesign.2号讲话人00:25:59去年美国血液学会年会上,相关细节终于公布:该研究为双盲、随机、安慰剂对照研究,试验组在研究早期就出现了大量的药物停药情况,具体为阿扎胞苷的停药,因为研究者只能调整已知的用药方案。Wellthen,finallycameoutduringASHthatthedesignofthattrialwasadouble-blind,randomized,placebo-controlledstudy,andwhatoccurredwastherewasearlywithdrawalofdrugintheactivearm–earlyinthestudy,inthiscase,itwasAzacitidine,becauseyoucanonlypullbackontheknowndrug.2号讲话人00:26:38这一结果也印证了我们一直以来的观点:维奈克拉的毒性是导致研究失败的核心原因。该研究的风险比仅为0.98,并非差一点成功,而是完全未达到预期,两组患者的中位生存期均仅为2个月。但这也印证了我们的研发思路的合理性,目前我们正投入大量资源推进GLORE-4研究的患者入组工作。ButitessentiallyconfirmedourpositionallalongthatitwasthetoxicityofVenetoclax.Thehazardratiowaszeropointnineeight,soitwasn'tevenanearmiss.Andunfortunately,thesurvivalcurvesconverged–botharmshadamedianOSoftwomonths.Soithowevervalidatedourapproach,andwe'rereallydedicatingalotofourresourcestopushenrollment.2号讲话人00:27:03GLORE-4研究的另一大特点是设置了双重主要研究终点,除了长期研究终点总生存期外,还将完全缓解率设为主要研究终点,这一终点也有望成为药物获得加速批准的依据,具体还要看研究结果。TheotherthingaboutGLORE-4iswehaveadualprimaryendpoint–sothelongerendpointis,ofcourse,overallsurvival,butwealsohavecompleteresponserateasaprimaryendpoint,whichcouldbethebasisforacceleratedapproval,we'llseedependingontheresults.1号讲话人00:27:14好的,非常详细。最后,能否用一分钟左右的时间,谈谈公司整个产品管线在未来12-18个月内,有哪些核心催化剂和里程碑事件值得投资者重点关注?Okay,great.Maybeinthelastminuteorsoifyoucouldjusttalkaboutacrosstheportfolio,thenexttwelvetoeighteenmonths,whatarethetopcatalystsandmilestonesthatinvestorsshouldbefocusedonwitheverythingyou'vegotgoingon?2号讲话人00:27:26当然。首先是持续推进各项注册性研究,包括刚才提到的POLARIS-2、POLARIS-1研究,还有我们尚未详细介绍的GLORE研究(BTK抑制剂与BCL-2抑制剂的联合用药研究),以及GLORE-4研究。Yeah,exactly.Forsure,pushingforwardontheregistrationstudiesasImentioned–POLARIS-2,POLARIS-1,GLORE(wedidn'treallytalkaboutthat,butthat'sacombinationwithBTKinhibitors),andthenGLORE-4,we'repushingforwardonallofthese.2号讲话人00:27:46这些研究是我们实现美国商业化的核心支撑。其次,在早期研发管线方面,PRC2复合物EZH2抑制剂目前备受关注,我们将公布该药物的I期研究结果,同时也会公布BTK蛋白降解剂的更多研究数据。ThiswillbeourpushtowardscommercializationintheUS.Andthenalso,asitrelatestotheearly-stagepipeline,alotofattentionnowisbroughttowardsthePRC2complexEZH2inhibitor,sophaseoneresultsinthataswellastheBTKproteindegrader–givingmoredetailsattheupcomingconferences.2号讲话人00:28:12重点展示其与竞品相比的具体差异化优势。我们发现,对于这类创新药,即使是小样本量的早期临床数据,也能直观体现药物的临床价值,Thedifferentiation,specificdifferentiationofthatversusourcompetitors.Sowe'veseenforboththosecaseswhatcomparableearly,small–reallysmall–patientsetscanshow.2号讲话人00:28:28当然,要让市场建立信心,最终仍需要大样本量的研究来验证药物的安全性、有效性和长期疗效,但小样本量的早期数据已能对公司价值产生重要影响。Ultimatelyyouneedtohavetherightnumbertoshowsafety,efficacy,long-termtoinstillconfidence,butyoucanseehowevensmallnumberofpatientsetscanreallymovetheneedleintermsofvaluecreation.2号讲话人00:28:39因此,我们也在为这些早期管线投入充足的资源,以便向市场公布更多研究数据。目前公司的资金状况充足,发展也具备多种可能性。Sowe'redefinitelyallocatingtheappropriateresourcesforthoseaswelltogivethepublicmoredata.Sothat'sacrossourportfolio.Youknowwe'reessentiallywellcapitalizedatthispointandIthinkwehavegoodoptionality.1号讲话人00:29:00好的,非常感谢你的分享。Okay,great.We'llbewrappingup,thankyousomuchforsharingthestory.2号讲话人00:29:03谢谢。Thankyou.1号讲话人00:29:03感谢各位的聆听。Thankseveryoneforlisteningin.2号讲话人00:29:04谢谢你,布拉格。Thankyou,Bragg$亚盛医药-B(06855)$