Zai Lab Limited American Depositary SharesZLAB
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Zai Lab Limited American Depositary Shares Investor update

Review the key takeaways and the transcript of this earnings call.

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Transcript

Preview the first fifteen paragraphs, organized by speaker.

Operator

Good day, and thank you for standing by. Welcome to the Zai Lab 2026 ESMO Investor Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 1 1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1 and 1 again. Please be advised that today's conference is being recorded. I will now like to hand the conference over to our speaker today, Rafael Amado.

Rafael AmadoPresident and Head of Global Research and Development

Please go ahead. Hello, everyone, and thank you for joining us for the presentation of the results from our phase I study evaluating zoci, our DLL3-targeted ADC, in combination with atezolizumab, with or without carboplatin in small cell lung cancer.

Rafael AmadoPresident and Head of Global Research and Development

The results we're sharing today strengthen our confidence in zoci's potential and supports our global development strategy in frontline. Please refer to our forward-looking statements on slide 2. Here on slide 3 is our agenda. I'm very pleased to have Dr. Pedro Rocha join me today. He's a medical oncologist and clinical researcher specializing in thoracic malignancies, including small cell lung cancer at Vall d'Hebron University Hospital in Barcelona. I will start with brief comments on our global portfolio and the characteristics of zoci. Dr. Rocha will then take us through the highlights from ESMO, and we will end with a question and answer session.

Rafael AmadoPresident and Head of Global Research and Development

Please see slide 4 for Dr. Rocha's disclosure information. Before heading into the data, here's a snapshot of our global pipeline in oncology and immunology. Our lead oncology asset is zoci, and we're entering a pivotal period in zoci's development with three registrational trials expected to be underway by the end of the year, namely the ongoing second-line trial in small cell lung cancer in DLLEVATE, second-line extra-pulmonary NEC, and first-line small cell lung cancer. Our focus is on strong clinical execution and generating the data needed to realize zoci's full potential. In immunology, our long-acting IL-13, IL-31 receptor alpha bispecific, called ZL-1503, is approaching its first clinical data readout next month. We believe this combination of dual pathway inhibition and potentially extended dosing intervals could offer meaningful differentiation in atopic dermatitis and potential other inflammatory diseases. Turning to zoci. Zoci is a DLL3-targeted antibody drug conjugate with high picomolar binding affinity, a potent topoisomerase I inhibitor payload, and a drug-to-antibody ratio of 8.

Rafael AmadoPresident and Head of Global Research and Development

The linker is cleavable, which means that the payload can be released not only inside the tumor cell, but also in the surrounding tumor microenvironment, resulting in a strong bystander effect. This design allows zoci to have potent tumor killing while maintaining a favorable safety profile, and we're seeing this translate into meaningful clinical activity. We recognize that small cell lung cancer is an increasingly competitive field. But when you look at the totality of the data, we believe zoci has important clinical properties that make it an ADC of choice in this disease.

Rafael AmadoPresident and Head of Global Research and Development

As a monotherapy in second-line plus small cell lung cancer, zoci has demonstrated high response rates with good durability as well as robust intracranial activity, including in patients with untreated brain metastases. ADCs have a narrow therapeutic window, and that is why it is important to emphasize zoci's safety. We believe it has the potential for best-in-class tolerability, even among ADCs in this space, and therefore allows monotherapy and combination development approaches. This is particularly important as we move into the frontline setting, where the future of treatment will be built on new combination regimens. Tolerability will be a critical determinant of which ADC can become the backbone of choice, whether with IO or other agents, including T-cell engagers.

Rafael AmadoPresident and Head of Global Research and Development

We are already working with our partners Boehringer Ingelheim and Amgen to realize the potential of these combinations as the standard of care in small cell lung cancer continues to evolve, thereby developing zoci as a key product that will further differentiate it from others in the class. With that, I will hand it over to Dr. Rocha for the clinical data.

Pedro RochaMedical Oncologist and Clinical Researcher

Thank you, Rafael. Now I will be presenting results from the phase I study evaluating zoci in combination with atezo plus or minus carboplatin, what we call it doublet or triplet cohort. On this slide, we can see our study design, which includes dose escalation and backfill and expansion cohorts for the doublet combination, zoci plus atezo. As you can see also here, we will focus on what we have in the red squares on the backfill expansion for the doublet, and we also present some results on the triplet. On the next slide, we can see the baseline characteristics for the population included. About three-quarters at stage 4 disease at initial diagnosis. Most were ECOG 1, and this perhaps reflect that usually these patients are symptomatic and need treatment that can reduce the tumor burden.

Pedro RochaMedical Oncologist and Clinical Researcher

Also, highly important will be the presence of brain metastasis, that as a reminder, this study includes the patients with untreated brain metastasis. The doublet population was predominantly Asian, while the triplet was more balanced. This was related perhaps with the initial study that includes a lot of patients from Asia. It is true that if we take into account the study and also the efficacy on second-and-plus lines from zoci, we have not observed a difference in efficacy or safety between Asian and non-Asian patients. Also here, highlighting that for the first 15 patients treated with 1.6 mg/kg doublet, the median follow-up was 10 months. At the 1.2 mg/kg dose level, the median follow-up was 12.6 months. With that context, the next slide, we can see the waterfall plot for the doublet first-line combination.

Pedro RochaMedical Oncologist and Clinical Researcher

As you can see here, these three slides show the efficacy from zoci plus atezolizumab first line. Overall, the confirmed objective response rate was 81.4%, and nearly all patients had a response of stable disease. In particular, among the 33 patients treated with zoci at 1.6 mg/kg in combination with atezo, 27 patients achieved a confirmed response, an objective response rate of 81.80%. Taking account the standard of care, chemo plus immunotherapy, this compares favorably with, for the standard of care, we can think about a 60%-68% of response rate. On the next slide, we can also see a spider plot where we are seeing those responses occur early. This is also something that is clinically relevant. Of 35 responders, 34 achieved their response at the first post-baseline tumor assessment. So what we are seeing is a very rapid onset of response with this combination.

Pedro RochaMedical Oncologist and Clinical Researcher

Importantly, as you can see with some arrows, those responses are still ongoing. If we put it, again, in context of the standard of care that we have currently, usually the patients with small cell lung cancer, the disease progress quickly within the first 5 months. So this is something that is very positive from this combination. For the 10 patients treated with 1.2 mg/kg, the duration of response was 8.3 months. For the first 15 patients at 1.6 mg/kg with a minimum of 10 months of follow-up, the median duration of response was not reached. So this is very encouraging results. The progression-free survival for 33 patients at 1.6 mg/kg cohort, the 6 months progression-free survival was 81.9%, which is a very promising result.

Pedro RochaMedical Oncologist and Clinical Researcher

For the first 15 patients with longer follow-up, median progression-free survival has not yet been reached, and two-thirds of those patients have not progressed as of cutoff. The 18 additional patients in the expansion cohort demonstrated an encouraging early progression-free survival consistent with the initial 15 patients. For reference, the 6 months progression-free survival with chemo immunotherapy in the IMpower133 was around 30%. Clearly, these results could change how we think about the first-line small cell lung cancer treatment. On the next slide, we also evaluate the zoci as a triplet in combination with atezo plus carboplatin. Despite the small sample size, we can see a very notable anti-tumor activity with a confirmed objective response rate of 92.3%. As you can see, important tumor reduction with patients achieving almost a complete response.

Pedro RochaMedical Oncologist and Clinical Researcher

This is, again, as in the doublet, this tumor reduction is quite important in our patients that most of the times are very symptomatic at diagnosis. Again, if you look at the durability of this tumor reduction with a triplet, we can also see this is observed within the first tumor assessment, so very rapid, deep, again, with a sustained tumor reduction with a triplet. On the next slide, also important is the safety as a doublet, as a first-line therapy. So the favorable tolerability we have observed with zoci monotherapy previously in patients with second-and-plus lines has continued to be encouraging in this first-line doublet. There are no dose-limiting toxicities observed during dose escalation. At 1.6 mg/kg in 33 patients, only 9.1% of patients experienced Grade 3 or higher adverse events attributed to zoci.

Pedro RochaMedical Oncologist and Clinical Researcher

We only observed one case of Grade 1 ILD. This is relevant in the context of other ADCs in the field in small cell lung cancer that we are seeing higher rates of ILD. There were no zoci-related treatment discontinuations or treatment-related deaths reported in this cohort. This is something that deserves to be highlighted compared with other drugs currently being explored in small cell. Although it is also true that these data are still maturing, I believe that the zoci safety profile will be consistent with what we have seen in zoci monotherapy, where we have a longer follow-up. As the conclusions in the doublet part, it seems that adding atezolizumab does not seem to change the safety profile of zoci. On the next slide, we have the safety of the triplet as first-line therapy.

Pedro RochaMedical Oncologist and Clinical Researcher

In comparison, while the triplet demonstrated a higher anti-tumor activity, as we have seen before, it also resulted in a substantially more toxicity than the doublet. Serious drug-related adverse events and Grade 3 or 4 toxicities were more common with the triplet than with the doublet. We acknowledge that the addition of carboplatin is bringing more toxicity to our patients. We also saw more frequent treatment interruptions, primarily in the context of increased hematological toxicity. This is something that we expect with carboplatin, what we think in normal, current clinical practice. The next slide, I guess, with this tornado plot, clearly shows the difference between the adverse events on the safety profile from the doublet and the triplet. As you can see, the most common treatment-related events with the doublet were anemia, nausea, and leukopenia. Although, mainly Grade 1/2. With addition of carboplatin, we saw greater hematological toxicity, particularly neutropenia and thrombocytopenia, which is, as I was saying before, consistent with what we would expect from adding a platinum-based chemotherapy and is very similar to what we are seeing in clinical practice.

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