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FORM
CURRENT REPORT
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Item 7.01 Regulation FD Disclosure.
On May 24, 2024, Verastem, Inc. (the “Company” or “Verastem”) issued a press release announcing the initiation of a rolling submission of a New Drug Application (“NDA”) to the U.S. Food and Drug Administration (“FDA”) for Accelerated Approval of the combination of avutometinib and defactinib for adult patients with recurrent KRAS mutant (“KRAS mt”) low-grade serious ovarian cancer (“LGSOC”);
A copy of the press release is furnished hereto as Exhibit 99.1 to this Current Report on Form 8-K.
On May 24, 2024, the Company also posted its corporate presentation on its website, a copy of which is furnished hereto as Exhibit 99.2 to this Current Report on Form 8-K.
Item 8.01 Other Events.
Recent Developments
RAMP-201 (ENGOTov60/GOG3052)
The Company recently announced that it has initiated the rolling submission of an NDA to the FDA seeking accelerated approval of the combination of avutometinib and defactinib for patients with recurrent KRAS mt LGSOC who received at least one prior systemic therapy. The rolling review process allows Verastem to submit completed sections of an application for review by the FDA before all sections become available. The initial sections of the application will include the nonclinical and quality sections. Based on discussions with the FDA, the primary efficacy analysis will be based on the RAMP 201 study with 12 months of follow up and that the proposed indication for final submission of the clinical module can be expanded in the event the Company provides data that would be considered a substantial improvement over available therapy in the KRAS wildtype (“KRAS wt”) population. Previously, the FDA granted Orphan Drug Designation for the combination in LGSOC and Breakthrough Therapy Designation for the combination for treatment of patients with LGSOC with recurrent disease after one or more prior lines of therapy, including platinum-based chemotherapy. The Company plans to request a priority review of the NDA. Currently, there are no FDA-approved treatments specifically for recurrent LGSOC.
In the RAMP 201 trial, 115 patients with recurrent LGSOC were treated with the combination of avutometinib and defactinib, of which 109 patients had measurable tumor masses at baseline and were eligible for formal efficacy evaluation as of the data cutoff (February 2024). As of the data cutoff, all patients had a minimum follow-up of five months since enrollment. Confirmed objective response rates by blinded independent central review for patients evaluable for efficacy were 27% in all patients, and 37% and 15% in KRAS mt (n=57) and KRAS wt (n=52) LGSOC, respectively. Of the 32 patients who remained on study treatment at the data cutoff, 14 achieved a best response rate of stable disease or unconfirmed partial response and therefore have the potential to achieve a formal objective response upon further treatment. 60% of evaluable patients (65/109) achieved either a complete response, partial response, or stable disease response for 6 months or longer (Clinical Benefit Rate ≥ 6 months). The safety results were consistent with previously reported safety data, and the discontinuation rate due to adverse events was 9% in the trial overall, as of the cutoff date.
The Company previously announced results from Part A of the RAMP 201 trial, which were presented at the American Society of Clinical Oncology Annual Meeting in 2023. For the patients in Part A, as of the February 2024 cutoff date, median duration of therapy for all patients was 11 months, and for patients with KRAS mt and KRAS wt LGOSC, median duration of treatment was 18 months and 8 months, respectively.
Based on internal revenue forecasts, including potential market penetration of the Company’s product candidates and the longer median duration of treatment observed in RAMP 201 Part A, the Company believes that KRAS mt represents over two-thirds of the revenue opportunity, compared with combined KRAS mt and KRAS wt, without any differential pricing. According to awareness trial usage survey results conducted by the Company, using a target product profile based on the avutometinib and defactinib combination, 70% of oncologists surveyed indicated they would plan to treat prevalent patients with the combination at the patients’ next recurrence, and 49% indicated that initial recurrence would be the ideal time to introduce the combination treatment in the patient journey. The Company plans to have a focused commercial launch targeting the top 400 healthcare providers and top 100 healthcare organizations which are estimated to cover nearly half of the LGSOC population with a target sales force of between 14-18 representatives.
Note Regarding Recent Developments
The potential market opportunity for The Company’s product candidates is difficult to estimate precisely. Management of the Company makes estimates, including those contained in this Current Report on Form 8-K, regarding the incidence and prevalence of target patient populations, the rate of recurrence and the median survival for particular diseases, including with respect to LGSOC, based on various third-party sources and internally generated analysis and use such estimates in making decisions regarding the Company’s drug development strategy determining indications on which to focus in preclinical or clinical trials.
Management’s estimates of the patient population, pricing and revenue opportunities for the Company’s product candidates, including KRAS mt and KRAS wt for patients with LGSOC, are based on a number of internal and third-party estimates that may be inaccurate or based on imprecise data. For example, if approved by the FDA, the market opportunity of the Company’s product candidates will depend on, among other things, acceptance by the medical community, patient access, drug pricing and reimbursement. The number of patients in the addressable market may turn out to be lower than expected, patients may not be otherwise amenable to treatment with the Company’s drugs, or new patients may become increasingly difficult to identify or gain access to, all of which may significantly harm the Company’s business, financial condition, results of operations, and prospects. Further, if any approval that the Company obtains is based on a narrower definition of patient populations than the Company had anticipated, the potential market for the Company’s product candidates will be smaller than management’s current estimates, which could have a materially adverse effect on the Company’s ability to achieve commercialization and generate revenues.
In addition, the FDA and other comparable regulatory authorities could require clearance or approval of an in vitro diagnostic or companion diagnostic device as a condition of approval for any product candidates that require from such tests, including the combination of avutometinib and defactinib. If the Company is unable to successfully validate, develop and obtain regulatory approval for companion diagnostic tests for the Company’s product candidates that require such tests, or experience significant delays in doing so, the Company may not realize the full commercial potential of these product candidates and the Company’s drug development strategy and operational results may be harmed.
The development programs for some of the Company’s product candidates contemplate working with developers or obtaining access to marketed companion diagnostic tests, which are assays or tests to identify an appropriate patient population. For example, in connection with the Company’s planned rolling NDA submission for the combination of avutometinib and defactinib for patients with recurrent KRAS mt LGSOC, the Company may be required to obtain FDA approval or clearance of a companion diagnostic. If safe and effective use of any of the Company’s product candidates the Company may develop depends on a companion diagnostic, the Company may not receive marketing approval, or marketing approval may be delayed, if the Company is unable to or is delayed in developing, identifying, or obtaining regulatory approval or clearance any such the companion diagnostic product for use with the Company’s product candidate. The process of obtaining or creating such companion diagnostics is time consuming and costly and the Company, and/or future collaborators, may encounter difficulties in developing and obtaining regulatory clearance or approval for the companion diagnostics.
Note Regarding Forward-Looking Statements
This Current Report on Form 8-K includes forward-looking statements about, among other things, the Company’s programs and product candidates, strategy, future plans and prospects, the potential clinical value of various of its clinical trials, including the RAMP 201 and RAMP 301 trials, the timing of commencing and completing trials, including topline data reports, interactions with regulators, the potential for and timing of commercialization of product candidates and potential for additional development programs involving the Company’s lead compound and the potential market opportunities of the Company’s drug candidates. The words "anticipate," "believe," "estimate," "expect," "intend," "may," "plan," "predict," "project," "target," "potential," "will," "would," "could," "should," "continue," "can," "promising" and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Each forward-looking statement is subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied in such statement.
Applicable risks and uncertainties include the risks and uncertainties, among other things, regarding: the success in the development and potential commercialization of our product candidates, including avutometinib in combination with other compounds, including defactinib, LUMAKRAS™ and others; the uncertainties inherent in research and development, such as negative or unexpected results of clinical trials, the occurrence or timing of applications for our product candidates that may be filed with regulatory authorities in any jurisdictions; whether and when regulatory authorities in any jurisdictions may approve any such applications that may be filed for our product candidates, and, if approved, whether our product candidates will be commercially successful in such jurisdictions; our ability to obtain, maintain and enforce patent and other intellectual property protection for our product candidates; the scope, timing, and outcome of any legal proceedings; decisions by regulatory authorities regarding trial design, labeling and other matters that could affect the timing, availability or commercial potential of our product candidates; whether preclinical testing of our product candidates and preliminary or interim data from clinical trials will be predictive of the results or success of ongoing or later clinical trials; that the timing, scope and rate of reimbursement for our product candidates is uncertain; the market opportunities of our drug candidates are based on internal and third-party estimates which may prove to be incorrect; that third-party payors (including government agencies) may not reimburse; that there may be competitive developments affecting our product candidates; that data may not be available when expected; that enrollment of clinical trials may take longer than expected, which may delay our development programs, including delays in submission or review by the FDA of our NDA submission in recurrent KRAS mutant LGSOC if enrollment in our confirmatory trial is not well underway at the time of submission, or that the FDA may require the Company to have completed enrollment or to enroll additional patients in the Company’s ongoing RAMP-301 confirmatory Phase 3 clinical trial prior to Verastem submitting or the FDA taking action on our NDA seeking accelerated approval; that our product candidates will cause adverse safety events and/or unexpected concerns may arise from additional data or analysis, or result in unmanageable safety profiles as compared to their levels of efficacy; that we may be unable to successfully validate, develop and obtain regulatory approval for companion diagnostic tests for our product candidates that require or would commercially benefit from such tests, or experience significant delays in doing so; that our product candidates may experience manufacturing or supply interruptions or failures; that any of our third-party contract research organizations, contract manufacturing organizations, clinical sites, or contractors, among others, who we rely on fail to fully perform; that we face substantial competition, which may result in others developing or commercializing products before or more successfully than we do which could result in reduced market share or market potential for our product candidates; that we will be unable to successfully initiate or complete the clinical development and eventual commercialization of our product candidates; that the development and commercialization of our product candidates will take longer or cost more than planned, including as a result of conducting additional studies; that we may not have sufficient cash to fund our contemplated operations; that we may not attract and retain high quality personnel; that we or Chugai Pharmaceutical Co., Ltd. will fail to fully perform under the avutometinib license agreement; that our target market for our product candidates might be smaller than we are presently estimating; that Secura Bio, Inc. will fail to fully perform under the asset purchase agreement with Secura Bio, Inc., including in relation to milestone payments; that we will not see a return on investment on the payments we have and may continue to make pursuant to the collaboration and option agreement with GenFleet Therapeutics (Shanghai), Inc. (“GenFleet”), or that GenFleet will fail to fully perform under the agreement; that we may be unable to obtain adequate financing in the future through product licensing, co-promotional arrangements, public or private equity, debt financing or otherwise; that we will not pursue or submit regulatory filings for our product candidates; and that our product candidates will not receive regulatory approval, become commercially successful products, or result in new treatment options being offered to patients.
Other risks and uncertainties include those identified under the heading “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, as filed with the Securities and Exchange Commission (the “SEC”) on March 14, 2024, and in any subsequent filings with the SEC, including in this Current Report on Form 8-K, which are available at www.sec.gov and www.verastem.com.
As a result of these and other factors, we may not achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. The forward-looking statements contained in this Current Report on Form 8-K reflect the Company’s views as of the date hereof, and the Company does not assume and specifically disclaims any obligation to update any forward-looking statements whether as a result of new information, future events or otherwise, except as required by law.
Item 9.01. Financial Statements and Exhibits
| Exhibit No. | Description | |
| 99.1 | Press Release, dated May 24, 2024 relating to Verastem’s Regulatory Update | |
| 99.2 | Corporate Presentation, dated May 24, 2024 | |
| 104 | Cover Page Interactive Data File (embedded within the Inline XBRL document) |
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
| VERASTEM, INC. | ||
| Dated: May 24, 2024 | By: | /s/ Daniel W. Paterson |
| Daniel W. Paterson | ||
| President and Chief Executive Officer | ||
Exhibit 99.1
Verastem Oncology Announces the Initiation of
a Rolling Submission of NDA to FDA Seeking
Accelerated Approval of Avutometinib and Defactinib Combination for the Treatment
of
Adult Patients with Recurrent KRAS Mutant Low-Grade Serous Ovarian Cancer
Plan to complete NDA submission with the mature RAMP 201 dataset, anticipated to include 12 months of follow-up, in the second half of 2024
Plan to present the mature dataset from RAMP 201 at a medical conference in the second half of 2024
Avutometinib and defactinib combination have continued to show robust and durable response rates in ongoing RAMP 201 trial in patients with recurrent low-grade serous ovarian cancer
Company to host investor conference call and webcast on Friday, May 24, 2024 at 8:00 am EDT to provide update on RAMP 201 and rolling NDA submission
BOSTON--(BUSINESS WIRE)--May 24, 2024--Verastem Oncology (Nasdaq: VSTM), a biopharmaceutical company committed to advancing new medicines for patients with cancer, today announced that it has initiated the rolling submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) seeking accelerated approval of the combination of avutometinib, a RAF/MEK clamp, and defactinib, a selective FAK inhibitor, for adult patients with recurrent KRAS mutant (KRAS mt) low-grade serous ovarian cancer (LGSOC), who received at least one prior systemic therapy. The rolling review process allows the Company to submit completed sections of an application for review by the FDA before all sections become available. The initial sections of the application will include the nonclinical and quality sections. In discussions with the FDA, Verastem reached agreement to submit a primary efficacy analysis based on the RAMP 201 study with 12 months of follow up. Based on discussions with the FDA, we understand that the proposed indication for final submission of the clinical module can be expanded in the event Verastem provides data that demonstrates a substantial improvement over available therapy in the KRAS wild-type (KRAS wt) population. FDA has accepted Verastem’s plan to submit the clinical module in the second half of 2024 to complete the NDA application. Previously, the FDA granted Breakthrough Therapy Designation (BTD) for the combination for treatment of patients with recurrent LGSOC, regardless of KRAS status, following one or more previous lines of therapy and Orphan Drug Designation (ODD) for the combination in certain LGSOC indications. The Company plans to request a priority review of the NDA. Currently, there are no FDA-approved treatments specifically for recurrent LGSOC.
"The initiation of our rolling NDA submission of the avutometinib and defactinib combination for accelerated approval, is an important step towards addressing the significant unmet needs that patients face living with KRAS mutant low-grade serous ovarian cancer,” said Dan Paterson, president and chief executive officer of Verastem Oncology. "The data from our ongoing RAMP 201 trial continues to support our belief that the avutometinib and defactinib combination has the potential to be a new standard of care in patients with recurrent low-grade serous ovarian cancer, if approved. In the second half of this year, we anticipate completing our NDA submission with the mature data from the RAMP 201 trial and discussing with the FDA a path forward for patients with KRAS wild-type disease. We also expect to present the mature dataset at a medical meeting in the second half of 2024."
RAMP 201 is a Phase 2 registration-directed study evaluating avutometinib and defactinib combination in patients with recurrent LGSOC. The enrollment in RAMP 201 is completed, with 115 patients being treated at the recommended Phase 2 dose (RP2D) of avutometinib 3.2 mg twice weekly and defactinib 200 mg twice daily for 3 out of every 4 weeks, and follow-up continues. Verastem expects to complete the NDA submission after obtaining mature safety and efficacy data from the RAMP 201 trial, including 12 months of follow-up, anticipated in the second half of 2024. Verastem also plans to further discuss the KRAS wt data with FDA to inform the potential path forward for approval for this patient population. The Company plans to present the mature dataset from RAMP 201 at a medical meeting in the second half of 2024. As of February 2024, the interim data continued to show robust overall response rates (ORR) and durable responses with low discontinuation rates due to adverse events (AEs) in patients from RAMP 201 Parts A, B, C, who had a minimum follow-up of five (5) months.
The FDA granted Breakthrough Therapy Designation of the investigational combination of avutometinib and defactinib for the treatment of all patients with recurrent LGSOC regardless of KRAS status after one or more prior lines of therapy, including platinum-based chemotherapy in May 2021. Avutometinib alone or in combination with defactinib was also granted Orphan Drug Designation by the FDA for the treatment of LGSOC in March 2024. The Company believes that this Orphan Drug Designation signifies that LGSOC is a rare ovarian cancer that is a distinct and different disease from other forms of ovarian cancer such as high-grade serous ovarian cancer (HGSOC). LGSOC is highly recurrent and fatal, with no FDA-approved treatment options, and the current standard of care treatments include hormonal therapy or chemotherapy, which have demonstrated an ORR between 6-13% with discontinuation due to AEs of 17-30%.
The Company is currently enrolling patients and activating sites for RAMP 301, an international confirmatory Phase 3 trial, evaluating the avutometinib and defactinib combination versus standard of care chemotherapy or hormonal therapy for the treatment of patients with KRAS mt and KRAS wt recurrent LGSOC.
Conference Call and Webcast Information
Verastem will hold an investor conference call and webcast on Friday, May 24 at 8:00 am EDT, to review the initiation of the NDA submission and limited, topline data from the RAMP 201 trial, with a minimum follow-up of five (5) months and the RAMP 205 data. The call will feature members of Verastem’s management team. To access the conference call, please dial (844) 763-8274 (local) or (412) 717-9224 (international) at least 10 minutes prior to the start time and ask to be joined into the Verastem Oncology conference call. A live audio webcast of the call, along with accompany slides, will be accessible here. The Company expects to file an 8-K pertaining to this update.
About RAMP 201
RAMP 201 (ENGOTov60/GOG3052) is an adaptive, two-part multicenter, parallel cohort, randomized, open-label trial to evaluate the efficacy and safety of avutometinib alone and in combination with defactinib in patients with recurrent low-grade serous ovarian cancer. The first part of the study (Part A) determined the selection of the go forward regimen, which was the combination of avutometinib and defactinib versus avutometinib alone, based on overall response rates. The expansion phases of the trial (Parts B and C) are evaluating the safety and efficacy of the go forward regimen of avutometinib 3.2 mg twice weekly and defactinib 200 mg twice daily. The Part D portion of the trial is evaluating a low dose of avutometinib in combination with defactinib to inform individualized dose reduction.
About RAMP 301
RAMP 301 (GOG-3097; ENGOT-ov81/NCRI) is an international collaboration between The GOG Foundation, Inc. (GOG) and the European Network of Gynaecological Oncological Trial groups (ENGOT) sponsored by Verastem Oncology. The trial is expected to enroll a total of 270 patients in the U.S., Canada, the United Kingdom, Europe, Australia and South Korea, who will be randomized to either the combination of avutometinib and defactinib or investigator’s choice chemotherapy (pegylated liposomal doxorubicin, paclitaxel, topotecan) or hormone therapy (letrozole, anastrozole). The primary endpoint is progression free survival (PFS) by Blinded Independent Central Review. Secondary endpoints include ORR, duration of response, disease control rate, safety and tolerability, patient reported outcomes, and overall survival.
About Low-Grade Serous Ovarian Cancer (LGSOC)
LGSOC is a rare ovarian cancer that is insidious, persistent and ultimately fatal. LGSOC is distinct and different from high-grade serous ovarian cancer (HGSOC) and requires different treatment. LGSOC is highly recurrent and less sensitive to chemotherapy compared to HGSOC. Approximately 6,000-8,000 women in the U.S. and 80,000 worldwide are living with this disease. LGSOC affects younger women with bimodal peaks of diagnosis at ages between 20-30 and 50-60 and has a median survival of approximately ten years. The majority of patients report negative impact of LGSOC on their mental and physical health, fertility, and long-term quality of life. The current standard of care for this disease includes hormone therapy and chemotherapy, but there are no treatments specifically approved by the U.S. Food and Drug Administration to treat LGSOC.
About the Avutometinib and Defactinib Combination
Avutometinib is a n investigational RAF/MEK clamp that is designed to induce inactive complexes of MEK with ARAF, BRAF and CRAF potentially creating a more complete and durable anti-tumor response through maximal RAS/MAPK pathway inhibition. Avutometinib is designed to block both MEK kinase activity and the ability of RAF to phosphorylate MEK. This differentiated proposed mechanism potentially allows avutometinib to block MEK signaling without the compensatory activation of MEK that appears to limit the efficacy of other MEK-only inhibitors. The U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation of the investigational combination of avutometinib and defactinib, a selective FAK inhibitor, for the treatment of all patients with recurrent low-grade serous ovarian cancer (LGSOC) regardless of KRAS status after one or more prior lines of therapy, including platinum-based chemotherapy. Avutometinib alone or in combination with defactinib was also granted Orphan Drug Designation by the FDA for the treatment of LGSOC.
Verastem Oncology is currently conducting clinical trials with avutometinib in RAS/MAPK driven tumors as part of its Raf And Mek Program or RAMP. RAMP 301 (NCT06072781) is an international Phase 3 confirmatory trial evaluating the combination of avutometinib and defactinib versus standard chemotherapy or hormonal therapy for the treatment of recurrent LGSOC. RAMP 201 (NCT04625270) is a Phase 2 registration-directed trial of avutometinib in combination with defactinib in patients with recurrent LGSOC and enrollment has been completed in each of the dose optimization and expansion phases and the low-dose evaluation.
Verastem Oncology has established clinical collaborations with Amgen and Mirati to evaluate LUMAKRAS™ (sotorasib) in combination with avutometinib and defactinib and KRAZATI™ (adagrasib) in combination with avutometinib in KRAS G12C mutant NSCLC as part of the RAMP 203 (NCT05074810) and RAMP 204 (NCT05375994) trials, respectively. The RAMP 205 (NCT05669482), a Phase 1b/2 clinical trial evaluating avutometinib and defactinib with gemcitabine/Nab-paclitaxel in patients with front-line metastatic pancreatic cancer, is supported by a PanCAN Therapeutic Accelerator Award.
About Verastem Oncology
Verastem Oncology (Nasdaq: VSTM) is a late-stage development biopharmaceutical company committed to the development and commercialization of new medicines to improve the lives of patients diagnosed with cancer. Our pipeline is focused on RAS/MAPK-driven cancers, specifically novel small molecule drugs that inhibit critical signaling pathways in cancer that promote cancer cell survival and tumor growth, including RAF/MEK inhibition and FAK inhibition. For more information, please visit www.verastem.com and follow us on LinkedIn.
Forward Looking Statements
This press release includes forward-looking statements about, among other things, Verastem Oncology’s programs and product candidates, strategy, future plans and prospects, including statements related to the expected timing of the planned rolling New Drug Application (NDA) submission for the avutometinib and defactinib combination in low-grade serous ovarian cancer, the potential clinical value of various of the Company’s clinical trials, including the RAMP 201, RAMP 205 and RAMP 301 trials, the timing of commencing and completing trials, including topline data reports, interactions with regulators, the potential for and timing of commercialization of product candidates and potential for additional development programs involving Verastem Oncology’s lead compound. The words "anticipate," "believe," "estimate," "expect," "intend," "may," "plan," "predict," "project," "target," "potential," "will," "would," "could," "should," "continue," “can,” “promising” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied in such statement.
Applicable risks and uncertainties include the risks and uncertainties, among other things, regarding: the success in the development and potential commercialization of our product candidates, including avutometinib in combination with other compounds, including defactinib, LUMAKRAS™ and others; the uncertainties inherent in research and development, such as negative or unexpected results of clinical trials, the occurrence or timing of applications for our product candidates that may be filed with regulatory authorities in any jurisdictions; whether and when regulatory authorities in any jurisdictions may approve any such applications that may be filed for our product candidates, and, if approved, whether our product candidates will be commercially successful in such jurisdictions; our ability to obtain, maintain and enforce patent and other intellectual property protection for our product candidates; the scope, timing, and outcome of any legal proceedings; decisions by regulatory authorities regarding trial design, labeling and other matters that could affect the timing, availability or commercial potential of our product candidates; whether preclinical testing of our product candidates and preliminary or interim data from clinical trials will be predictive of the results or success of ongoing or later clinical trials; that the timing, scope and rate of reimbursement for our product candidates is uncertain; the market opportunities of our drug candidates are based on internal and third-party estimates which may prove to be incorrect; that third-party payors (including government agencies) may not reimburse; that there may be competitive developments affecting our product candidates; that data may not be available when expected; that enrollment of clinical trials may take longer than expected, which may delay our development programs, including delays in submission or review by the FDA of our NDA submission in recurring KRAS mutant LGSOC if enrollment in our confirmatory trial is not well underway at the time of submission, or that the FDA may require the Company to have completed enrollment or to enroll additional patients in the Company’s ongoing RAMP-301 confirmatory Phase 3 clinical trial prior to Verastem submitting or the FDA taking action on our NDA seeking accelerated approval; that our product candidates will cause adverse safety events and/or unexpected concerns may arise from additional data or analysis, or result in unmanageable safety profiles as compared to their levels of efficacy; that we may be unable to successfully validate, develop and obtain regulatory approval for companion diagnostic tests for our product candidates that require or would commercially benefit from such tests, or experience significant delays in doing so; that our product candidates may experience manufacturing or supply interruptions or failures; that any of our third party contract research organizations, contract manufacturing organizations, clinical sites, or contractors, among others, who we rely on fail to fully perform; that we face substantial competition, which may result in others developing or commercializing products before or more successfully than we do which could result in reduced market share or market potential for our product candidates; that we will be unable to successfully initiate or complete the clinical development and eventual commercialization of our product candidates; that the development and commercialization of our product candidates will take longer or cost more than planned, including as a result of conducting additional studies; that we may not have sufficient cash to fund our contemplated operations; that we may not attract and retain high quality personnel; that we or Chugai Pharmaceutical Co., Ltd. will fail to fully perform under the avutometinib license agreement; that our target market for our product candidates might be smaller than we are presently estimating; that Secura Bio, Inc. will fail to fully perform under the asset purchase agreement with Secura Bio, Inc., including in relation to milestone payments; that we will not see a return on investment on the payments we have and may continue to make pursuant to the collaboration and option agreement with GenFleet Therapeutics (Shanghai), Inc. (GenFleet), or that GenFleet will fail to fully perform under the agreement; that we may be unable to obtain adequate financing in the future through product licensing, co-promotional arrangements, public or private equity, debt financing or otherwise; that we will not pursue or submit regulatory filings for our product candidates; and that our product candidates will not receive regulatory approval, become commercially successful products, or result in new treatment options being offered to patients.
As a result of these and other factors, we may not achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Other risks and uncertainties include those identified under the heading “Risk Factors” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 as filed with the Securities and Exchange Commission (SEC) on March 14, 2024 and in any subsequent filings with the SEC. The forward-looking statements contained in this press release reflect Verastem Oncology’s views as of the date hereof, and the Company does not assume and specifically disclaims any obligation to update any forward-looking statements whether as a result of new information, future events or otherwise, except as required by law.
For Investor and Media Inquiries:
Julissa Viana
Vice President, Corporate Communications and Investor Relations
investors@verastem.com or
media@verastem.com
Exhibit 99.2
Delivering Novel Therapies in RAS/MAPK Pathway Driven Cancers May 2024 Corporate Presentation
2 Disclaimers F orward - Looking This presentation includes forward - looking statements about, among other things, Verastem Oncology’s (the “Company”) programs an d product candidates, strategy, future plans and prospects, including statements related to the timing of the planned rolling New Drug Application (NDA) submission for the avutometinib and defactinib combination in low - grade serous ovarian cancer (LGSOC) the expected outcome and benefits of collaborations, including with GenFleet Therapeutics (Shanghai), Inc. (GenFleet), the potential clinical value of various of the Company’s clinical trials, including the RAMP 201, RAMP 205 and RA MP 301 trials, the timing of commencing and completing trials, including topline data reports, interactions with regulators, the potential for and timing of commercialization of product candidates and potential for additional development programs involvi ng the Company’s lead compound and the potential market opportunities of our drug candidates. The words "anticipate," "believe," "estimate," "expect," "intend," "may," "plan," "predict," "project," "target," "potential," "will," "would," "coul d," "should," "continue," “can,” “promising” and similar expressions are intended to identify forward - looking statements, although not all forward - looking statements contain these identifying words. Each forward - looking statement is subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied in such statement. Applicable risks and uncertainties include the risks and uncertainties, among other things, regarding: the success in the dev elo pment and potential commercialization of our product candidates, including avutometinib in combination with other compounds, including defactinib, LUMAKRAS г and others; the uncertainties inherent in research and development, such as negative or unexpected results of clinical trials , the occurrence or timing of applications for our product candidates that may be filed with regulatory authorities in any jurisdictions; whether and when regulatory authorities in any jurisdictions may approve any suc h a pplications that may be filed for our product candidates, and, if approved, whether our product candidates will be commercial ly successful in such jurisdictions; our ability to obtain, maintain and enforce patent and other intellectual property protecti on for our product candidates; the scope, timing, and outcome of any legal proceedings; decisions by regulatory authorities rega rdi ng trial design, labeling and other matters that could affect the timing, availability or commercial potential of our product ca ndi dates; whether preclinical testing of our product candidates and preliminary or interim data from clinical trials will be pre dic tive of the results or success of ongoing or later clinical trials; that the timing, scope and rate of reimbursement for our product can didates is uncertain; the market opportunities of our drug candidates are based on internal and third - party estimates which may prove to be incorrect; that third - party payors (including government agencies) may not reimburse; that there may be competitive developments affecting our product candidates; that data may not be available when expected; that enrollment of clinical trials may take longer than expected, which may delay our development programs, including delays in submission or review by t he FDA of our NDA submission in recurrent KRAS mutant LGSOC if enrollment in our confirmatory trial is not well underway at the time of submission; that our product candidates will cause adverse safety events and/or unexpected concerns may arise fro m additional data or analysis, or result in unmanageable safety profiles as compared to their levels of efficacy; that we may be unable to successfully validate, develop and obtain regulatory approval for companion diagnostic tests for our product candid ate s that require or would commercially benefit from such tests, or experience significant delays in doing so; that our product candidates may experience manufacturing or supply interruptions or failures; that any of our third - party contract research organ izations, contract manufacturing organizations, clinical sites, or contractors, among others, who we rely on fail to fully pe rfo rm; that we face substantial competition, which may result in others developing or commercializing products before or more succes sfu lly than we do which could result in reduced market share or market potential for our product candidates; that we will be unable to successfully initiate or complete the clinical development and eventual commercialization of our product candidates ; t hat the development and commercialization of our product candidates will take longer or cost more than planned, including as a result of conducting additional studies; that we may not have sufficient cash to fund our contemplated operations; that we ma y n ot attract and retain high quality personnel; that we or Chugai Pharmaceutical Co., Ltd. will fail to fully perform under the avutometinib license agreement; that our target market for our product candidates might be smaller than we are presently esti mat ing; that Secura Bio, Inc. will fail to fully perform under the asset purchase agreement with Secura Bio, Inc., including in relation to milestone payments; that we will not see a return on investment on the payments we have and may continue to make pur suant to the collaboration and option agreement with GenFleet or that GenFleet will fail to fully perform under the agreement; that we may be unable to obtain adequate financing in the future through product licensing, co - promotional arrangemen ts, public or private equity, debt financing or otherwise; that we will not pursue or submit regulatory filings for our produ ct candidates; and that our product candidates will not receive regulatory approval, become commercially successful products, or re sult in new treatment options being offered to patients. Other risks and uncertainties include those identified under the heading “Risk Factors” in the Company’s Annual Report on For m 1 0 - K for the year ended December 31, 2023, as filed with the Securities and Exchange Commission (SEC) on March 14, 2024, and in any subsequent filings with the SEC, which are available at www.sec.gov and www.verastem.com . The forward - looking statements in this presentation speak only as of the original date of this presentation, and we undertake no obligation to update or revise any of these statements whether as a result of new information, future events or otherwise, except as required by law. Use of Non - GAAP Financial Measures This presentation contains references to our non - GAAP operating expense, a financial measure that is not calculated in accordanc e with generally accepted accounting principles in the US (GAAP). This non - GAAP financial measure excludes certain amounts or expenses from the corresponding financial measures determined in accordance with GAAP. Management believes this no n - G AAP information is useful for investors, taken in conjunction with the Company’s GAAP financial statements, because it provides greater transparency and period - over - period comparability with respect to the Company’s operating performance and ca n enhance investors’ ability to identify operating trends in the Company’s business. Management uses this measure, among other factors, to assess and analyze operational results and trends and to make financial and operational decisions. Non - GAAP in formation is not prepared under a comprehensive set of accounting rules and should only be used to supplement an understanding of the Company’s operating results as reported under GAAP, not in isolation or as a substitute for, or superior to , financial information prepared and presented in accordance with GAAP. In addition, this non - GAAP financial measure is unlikely to be comparable with non - GAAP information provided by other companies. The determination of the amounts that are exclu ded from non - GAAP financial measures is a matter of management judgment and depends upon, among other factors, the nature of the underlying expense or income amounts. Reconciliations between this non - GAAP financial measure and the most com parable GAAP financial measure are included in the footnotes to the slides in this presentation on which such non - GAAP number appears. Third - Party Sources Certain information contained in this presentation, including industry and market data and other statistical information, rel ate s to or is based on studies, publications, surveys and other data obtained from third - party sources and the Company’s own internal estimates and research. While the Company believes these third - party sources to be reliable as of the date of this pres entation, it has not independently verified, and makes no representation as to the adequacy, fairness, accuracy or completene ss of, any information obtained from third - party sources. In addition, all of the market data included in this presentation involve s a number of assumptions and limitations, and there can be no guarantee as to the accuracy or reliability of such assumption s
3 Verastem Oncology Positioned to deliver on potential 2024 catalysts » Potential to be the first approved therapy in LGSOC • Topline data from RAMP 201 evaluating avutometinib, a RAF/MEK Clamp in combination with defactinib, a FAK inhibitor, have continued to demonstrate robust responses in patients with recurrent low - grade serous ovarian cancer (LGSOC) • Initiating rolling NDA for Accelerated Approval in recurrent KRAS mt LGSOC in Q2 2024; anticipated to be completed in H2 2024 • P hase 3 confirmatory study underway with site activations and patient enrollment ongoing in US, Australia, and UK and enrollment planned in Canada, Europe, and South Korea » Ongoing studies in additional indications including NSCLC • RAMP 205 study ongoing to evaluate additional dose/schedule combinations of avutometinib + defactinib + gemcitabine + Nab - paclitaxel in first - line metastatic pancreatic cancer » GenFleet collaboration furthers pipeline potential in RAS/MAPK driven cancers • GenFleet’s IND application for GFH375/VS - 7375, an oral KRAS G12D (ON/OFF) inhibitor , was filed in China and accepted for review • GenFleet expects to initiate Phase 1 trial for GFH375/VS - 7375 in China in H2 2024 • Ongoing discovery/lead optimization for second and third programs » Balance sheet supports ongoing programs and operations • Company ended Q1 2024 with $110.1M in cash and investments and $28.1M GAAP operating expenses ($26.6M non - GAAP operating expenses*) *Q1 2024 GAAP operating expenses of $28.06M less Q1 2024 stock - based compensation expense of $1.48M = $26.58M Q1 2024 non - GAAP o perating expenses ; • Expect to report updated interim data from RAMP 203 non - small cell lung cancer (NSCLC) trial evaluating avutometinib plus defactinib with Amgen’s KRAS G12C inhibitor, sotorasib, expected in H2 2024 • Expect to report initial interim data from RAMP 204 NSCLC trial evaluating avutometinib with Mirati Therapeutics (Bristol Myers Squibb (BMS)) KRAS G12C inhibitor, adagrasib , expected in H2 2024 » Encouraging initial interim data in first - line metastatic pancreatic cancer IND: investigational new drug; NDA: new drug application; RAS: Rat sarcoma; KRAS: Kirsten Rat Sarcoma virus; MAPK: Mitogen - Activated Protein Kinase; RAF: Rapidly Accelerated Fibrosarcoma; MEK: Mitogen - activated extracellular signal - regulated kinase
4 Clinical Program Designed to Address LGSOC and Beyond Trial/Regimen IND - Enabling/ Preclinical Phase 1 Phase 2 Phase 3 Anticipated Milestones Collaboration Avutometinib + Defactinib: Recurrent LGSOC RAMP 301 RAF/MEK Clamp + FAKi vs ICT RAMP 301 Ongoing Enrollment RAMP 201 RAF/MEK Clamp + FAKi RAMP 201 Mature Dataset Expected to be presented at a Medical Meeting in 2H 2024; Initiate Rolling NDA Submission in Recurrent KRAS mt LGSOC Seeking Accelerated Approval: Q2 2024 Avutometinib “ Defactinib + KRAS G12C Inhibitors: mKRAS G12C NSCLC RAMP 203 RAF/MEK Clamp ± FAKi + KRAS G12Ci (sotorasib) RAMP 203 Updated Interim Data: H2 2024 Amgen RAMP 204 RAF/MEK Clamp + KRAS G12Ci (adagrasib) RAMP 204 Initial Interim Data: H2 2024 Mirati (BMS) Avutometinib + Defactinib + Chemotherapy: 1L Metastatic Pancreatic Cancer RAMP 205 RAF/MEK Clamp + FAKi + gemcitabine, nab - paclitaxel RAMP 205 Initial Interim Safety & Efficacy Data at ASCO 2024 PanCAN GFH375/VS - 7375 KRAS G12D (ON/OFF) inhibitor IND filed in China and accepted for review; upon clearance expect to initiate Phase 1 in China in H2 2024 GenFleet ASCO: American Society of Clinical Oncologist; FAKi: focal adhesion kinase inhibitor; ICT: investigator choice of treatment
Avutometinib, RAF/MEK Clamp Program Overview
6 Avutometinib is a Differentiated Agent with the Potential to Serve as the Backbone for Combinations Across RAS Pathway - Driven Cancers • Differentiated investigational RAF/MEK clamp mechanism of action • Novel intermittent dosing schedule; convenient oral regimen • Orphan Drug Designation for avutometinib alone or in combination with defactinib in recurrent LGSOC • Breakthrough Therapy Designation for combination of avutometinib and defactinib for treatment of recurrent LGSOC after one or more prior lines of therapy including platinum - based chemotherapy • Received FDA Fast Track Designation for avutometinib in combination with Amgen’s G12C inhibitor sotorasib in KRAS G12C - mutated metastatic NSCLC • FDA Fast Track Designation granted for avutometinib plus defactinib in combination with sotorasib for the treatment of KRAS G12C - mutated metastatic NSCLC • FDA Fast Track Designation granted for avutometinib in combination with Mirati’s (BMS) G12C inhibitor adagrasib in KRAS G12C - mutated metastatic NSCLC • Potential best - in - class safety & tolerability profile relative to marketed MEK inhibitors, with potential for combinability with agents from multiple target classes • Promising signals of clinical activity in various RAS pathway - driven cancers, including in patients whose tumors previously progressed on other MEK inhibitors RAF - Rapidly accelerated fibrosarcoma, MEK - Mitogen - activated protein kinase kinase , RAS - Rat sarcoma virus MAPK - Mitogen - activated protein kinase KRAS - Kirsten rat sarcoma virus; NRAS - Neuroblastoma RAS viral oncogene homolog, BRAF - v - raf murine sarcoma viral oncogene homolog B1, NF1 - Neurofibromatosis type 1
7 Avutometinib is a Differentiated Small Molecule RAF/MEK Clamp Contrasting Mechanism of Action vs. MEK - Only Inhibitors Coma et al., AACR 2022; Ishii et al., Cancer Res , 2013; Lito et al., Cancer Cell , 2014 RTK Growth factors Avutometinib RAS RAF MEK ERK Tumor Growth Avutometinib conc. (µmol/L) Avutometinib conc. (µmol/L) % Inhibition % Inhibition DMSO Tram Avuto Avutometinib induces dominant negative RAF/MEK complexes Avutometinib inhibits both RAF and MEK activities The RAF/MEK clamp mechanism avoids the compensatory activation of pMEK enabling more complete pERK inhibition Collaboration with Deborah Morrison, NCI
8 Avutometinib Inhibits Cell Proliferation Across Multiple RAS/MAPK Pathway Alterations and Multiple Solid Tumor Histologies Verastem, unpublished data S W 1 4 6 3 M I A P A C A 2 H 3 5 8 H 1 3 7 3 S W 8 3 7 H 2 1 2 2 H 2 0 3 0 S W 1 5 7 3 H P A C A S P C 1 H P A F I I S N U - C 2 B L S 5 1 3 L S 1 8 0 S K L U 1 A 4 2 7 S N U - C 2 A H 4 4 1 S W 4 0 3 S K - C O - 1 S W 6 2 0 P A N C 0 3 2 7 H 2 2 9 1 S N G - M S W 4 8 0 H 2 4 4 4 C A P A N 2 C F P A C 1 P S N 1 K P 2 H U P - T 3 H 2 0 0 9 H 1 5 7 3 S W 1 1 1 6 A 5 4 9 L S 1 2 3 N C I - H 7 4 7 H C T 1 1 6 D L D - 1 T 8 4 H C T - 1 5 C a l u - 6 H T - 2 9 W M - 2 6 6 - 4 S W 1 4 1 7 A - 3 7 5 C 3 2 S K - M E L - 5 I G R - 1 C o l o - 2 0 5 A 2 0 5 8 H S 8 5 2 . T R K O N C I - H 2 4 0 5 N C I - H 2 0 8 7 R L 9 5 - 2 N C I - H 1 3 9 5 N C I - H 1 7 5 5 N C I - H 1 6 6 6 N C I - H 2 0 8 7 G A K S K - M E L - 2 H E C - 1 5 1 H 1 5 7 3 D L D - 1 H S 9 4 0 . T H 1 3 7 3 H M C B H C T 1 1 6 R K O S W 4 8 A N 3 C A R L 9 5 - 2 L S 5 1 3 5 6 3 7 0.01 0.1 1 10 Avutometinib IC50 (3D proliferation assay) A v u t o m e t i n i b I C 5 0 ( M ) KRAS G12V KRAS G12D BRAF V600EKRAS G12C Indication NSCLC Panc CRC Indication:MAPK pathway lateration: Melanoma NF1 mt NRAS mt KRAS G12R BRAF class 2 KRAS G12C KRAS G12D KRAS G12V Other KRAS mt BRAF mt NRAS mt ARAF mt RAF1 mt Endometrial Bladder NF1 mt KRAS G12S KRAS G13D KRAS Q61K KRAS G12A ERK2 mt Other mt BRAF class 3
9 Novel Combination of Investigational Avutometinib + Defactinib with Aim to Improve Patient Outcomes 1 Coma et al., AACR 2022; 2 Ishii et al., Cancer Res , 2013; 3 Lito et al., Cancer Cell , 2014; 4 Gershenson et al., Lancet 2022 (Study GOG 281); 5 Monk et al., J Clin Oncol 2020 (MILO Study); 6 Banerjee et al., ESMO Sept 2021 (Study FRAME); 7 Banerjee et al., ASCO June 2023 (Study RAMP 201); 8 Awad et al., EORTC - NCI – AACR Conference Oct 2023 (Study RAMP 203); 9 McNamara et al., Gynecol Oncol 2024; 10 Liu et al., AACR 2024; 11 Lubrano et al., AACR 2024; 12 Stanley et al., AACR 2024 ; 13 Fennell et al., J Clin Oncol 2019; 14 Wang - Gillam et al., Clin Cancer Res 2022 Avutometinib is an investigational ora l RAF/MEK clamp, that confers a vertical blockade of both RAF and MEK • This differentiated mechanism of action potentially avoids the compensatory reactivation of MEK by RAF enabling more complete pERK inhibition 1 - 3 • Potential best - in - class safety & tolerability profile relative to marketed MEK inhibitors and standard of care for LGSOC 4 - 7 • Promising signals of clinical activity in various RAS pathway - driven cancers, including in patients whose tumors previously progressed on other MEK inhibitors 6 - 8 Defactinib is an investigational selective oral inhibitor of FAK, a signal target, which has been show to mediate adaptive resistance to RAS/MAPK pathway inhibition • Parallel pathway inhibitor demonstrating synergy with avutometinib in multiple tumor models including LGSOC, pancreatic cancer and melanoma 9 - 12 • Monotherapy and combination with other agents such as PD - 1 inhibitors, and chemotherapy, defactinib demonstrated a manageable safety profile 13, 14 Outsmarting Multiple Resistance Mechanisms in the RAS/MAPK Pathway
10 Scientific Rationale for Avutometinib and FAK Inhibitor Combination KRAS mutant LGSOC PDX model RTK RAS RAF MEK ERK YAP Growth factors β α Y397 Integrin FAK Extracellular Matrix SRC RhoA Tumor Growth P AKT defactinib Feedback Reactivation 0 10 20 30 0 100 200 300 Tumor growth Days after first dose T u m o r v o l u m e ( m m 3 + / - S E M ) vehicle FAKi avutometinib avutometinib + FAKi KRAS wild - type LGSOC PDX model P r e d o s e P o s t a v u t o m e t i n i b P o s t a v u t o m e t i n i b + d e f a c t i n i b 0 50 100 150 pFAK H - S c o r e Banerji, BTOG Dublin, Jan 23, 2019; Banerji, AACR VM 1, April 27, 2020, CT143; Banerji, unpublished; Santin, unpublished avutometinib Anti - Tumor Efficacy in KRAS Mutant and KRAS Wild - Type LGSOC models
11 Optimized Dosing Schedule Defined: Favorable Tolerability Profile with Novel Intermittent Dosing Regimen Avutometinib monotherapy Daily at MTD N=6 28 - day cycle RP2D Avutometinib monotherapy 4mg twice weekly N=26 28 - day cycle RP2D (Avutometinib 3.2mg twice weekly + defactinib 200mg twice daily) N=38 21 days of 28 - day cycle Treatment Related Adverse Event Grade ≥3 Grade ≥3 Grade ≥3 Rash 3 (50%) 5 (19%) 2 (5%) CK elevation (Creatine phosphokinase) 1 (17%) 2 (8%) 2 (5%) 1 Chenard - Poirier, et al . ASCO 2017; References: Banerji, Q4 2020 report; Data on file; RP2D: recommended phase 2 dosing Summary of Adverse Events Grade ≥ 3 Occurring in ≥ 5% of patients
Low - Grade Serous Ovarian Cancer (LGSOC)
13 Greater than 80% of patients with LGSOC will experience a recurrence 1 Affects a younger patient population and can disproportionately impact health, fertility, and long - term quality of life 9,10 Current SOC treatments offer poor to moderate response rates (6 - 13%) 5,9,14 Median overall survival of ~10 years from time of diagnosis 5 No FDA - approved treatment specifically for LGSOC 11 LGSOC is a Rare Ovarian Cancer that is Insidious, Persistent, and Ultimately Fatal 1 - 4 >80% 20 - 30s ~10 YEARS 1. Babaier 2022/p1/para1/ln6,7; 2. Gadducci 2020/p4/para2/ln16,7; 3. Gershenson Lancet 2022/p545/col2/para2/ln6 - 9; 4. Gershenson 2015/p2681/Fig1; 5. Gershenson Gynecol Oncol 2022; 6. Manning - Geist Clin Cancer Res 2022; 7. El Naggar Gynecol Oncol 2022; 8. AACR GENIE v9.0 VSTM unpublished analysis (data on file); 9. Slomovitz Gynecol Oncol 2020; 10. Manning - Geist B et al. Clin Cancer Res 2022;28(20):4456 - 4465.;11. Banerjee SN). J Clin Oncol. 41. No 16_suppl (June 1, 2023) 5515 - 5515;12. Verastem DOF; 13. US Cancer Statistics. Accessed 2024. 14. Monk 2020/p3758/table2/footnot e - b KRAS mutant , 30% NRAS, BRAF, ARAF mutant , 20% Other RAS - associated gene mutations , 20% Non - RAS - associated , 30% 6 - 8 6 - 8 6 - 8 6 - 8 1k - 2k 12 incidence of LGSOC with a prevalence of 6k - 8k 13 in the US; 80,000 worldwide
14 Low - Grade and High - Grade Serous Ovarian Cancer Are Different Diseases LGSOC HGSOC Nuclear atypia Uniform round to oval with little variation +++ Marked variation Mitotic Index <12 mitoses per 10 hpf >12 mitoses per 10 hpf Chromatin and variation in size of nucleus Little Marked (nuclear size ratio ≥3) Mutation KRAS ++ BRAF + ER/PR +++ P53 +++ BRCA1/2 + Precursor Serous borderline tumor Tubal intraepithelial neoplasia LGSOC HGSOC Malpica et al., Am J. Surg Pathol 2007
Avutometinib Defactinib in Low - Grade Serous Ovarian Cancer RAMP 201: Topline Data Parts A + B + C
16 Topline RAMP 201 Data Support Rolling NDA Submission in Recurrent KRAS mt LGSOC • RAMP 201 topline data represent larger dataset of patients treated at the RP2D with a minimum follow up of 5 months at last data analysis (Parts A, B and C combined: n=115*; KRAS mt: n=58; KRAS wt : n=57) • Moving forward with rolling NDA submission for Accelerated Approval in adult patients with recurrent KRAS mt LGSOC who received at least one prior systemic therapy • RAMP 201 data with12 - months follow up is needed to complete the submission and drives timeline for final module • Path forward for KRAS wt to be discussed with FDA when mature RAMP 201 data available • Based on the longer median duration of treatment observed in RAMP 201 Part A, we believe KRAS mt represents >2/3 rds of the revenue opportunity, compared with combined KRAS mt and KRAS wt , without any differential pricing ** • Plan to present mature dataset from RAMP 201 at a medical conference in the second half of 2024 • Expect to complete NDA submission in the second half of 2024 *6 patients with no baseline measurable disease per independent review committee (IRC); KRAS wt: kirsten rat sarcoma virus; wt : wild type ** Based on internal revenue forecasts including potential market penetration of Verastem’s product candidates
17 RAMP 201 (ENGOTov60/GOG3052) Inclusion Criteria Recurrent LGSOC Prior chemotherapy Measurable disease (RECIST 1.1) Prior MEKi allowed Avutometinib + Defactinib KRAS mt (Total n=36) KRAS wt (Total n=36) N=72 (incl Part A+B) Avutometinib + Defactinib KRAS mt KRAS wt Expanded Enrollment +40 pts Avutometinib + Defactinib KRAS mt KRAS wt Expanded Enrollment + 20 - 30 pts Avutometinib + Defactinib KRAS mt (n=16) KRAS wt (n=16) N=32 Avutometinib Mono KRAS mt (n=36) KRAS wt (n=36) Avutometinib Mono KRAS mt (n=16) KRAS wt (n=16) N=32 Primary Endpoint: Objective Response Rate (blinded independent review) Evaluation of ORR in Combination Arm: 1) In KRAS mt patients 2) All patients (KRAS mt & wt ) Combination Arm: x Target Enrollment Reached For Parts A, B, C, and D x Actual Enrollment at RP2D: 115 treated patients n+20 n+20 n+20 n+20 Part A Selection Phase* Part B Expansion Phase* Part C Expansion Phase Combo* Part D Low - dose Avuto Combo* x x x x RAMP 201: Ongoing Registration - Directed Phase 2 Trial of Avutometinib ± Defactinib in Patients with Recurrent LGSOC * Dosing: Avutometinib + Defactinib combo: Avutometinib 3.2 mg PO 2x/ wk 21/28 days + Defactinib 200 mg PO BID: 21/28 days; Avutometinib monotherapy: Avutometinib 4.0 mg PO 2x/ wk 21/28 days ** Lower Dose: Avutometinib + Defactinib combo: Avutometinib 1.6 mg PO 2x/ wk 21/28 days + Defactinib 200 mg PO BID: 21/28 days; RECIST: Response Evaluation Criteria in Solid Tumors; PO: per oral; BID: twice daily: MEKi : Mitogen - activated extracellular signal - regulated kinase inhibitor;
18 Topline Data Pooled ORR RAMP 201 Parts A + B + C, Data cutoff: Feb. 2024 Minimum follow - up: 5 months Avutometinib 3.2 mg + Defactinib 200 mg IRC ORR Overall Population (Confirmed ORR by BICR) 27% (29/109)* 95% CI (19% - 36%) KRAS mt 37% (21/57) KRAS wt 15% (8/52) Clinical Benefit Rate (CR+PR+SD≥6 months): 60% (65/109) Discontinuations Due to AEs 9% (10/115) Topline Data: RAMP 201 Continues to Show Robust and Durable Benefit • Minimum follow - up of 5 months • 14 patients with stable disease or unconfirmed partial response remain on treatment • Potential for response rate to further improve with continued follow up • Potential responding patients: 29 - 43 (27% - 39%) • KRAS mt: 21 - 30 (37% - 53%) • KRAS wt : 8 - 13 (15% - 25%) • No new safety signals • Plan to present mature dataset at a medical meeting in 2H 2024 All information based on data cutoff as of Feb. 23, 2024; *6 patients with no baseline measurable disease per IRC
19 Initial Portion of RAMP 201, Part A, Response Rate Improved Through First Year of Follow Up Avutometinib + Defactinib Total (n=29) Minimum follow - up of 12 months ORR, % (n) 45% (13) 95% CI: (26%, 64%) KRAS mt 60% (9/15) KRAS wt 29% (4/14) Patients with reduction in tumor , % (n) 86% (25) Median Time to Response 5.5 months (range 1.6 - 14.7 months) Median Number of Prior Lines of Therapy 4 • Interim results from RAMP 201 Part A were presented at ASCO 2023 annual meeting • With a minimum of 12 months follow up in Part A at that time, time until objective response were reported • Approximately 1 year of follow up may be required to fully appreciate the optimal rate of response *As of 23Feb2024 data cutoff * M edian duration of therapy, at subsequent analysis, for patients enrolled to part A: Median duration of treatment (all patients Part A): 11 months KRAS mt median: 18 months KRAS wt median: 8 months
20 FRAME Study: High Rate of Durable Responses with the Combination of Avutometinib and Defactinib in Recurrent LGSOC (n=26) 28 - day cycles DoR: Duration of Response PFS: Progression free survival NR: Not reached • Overall response rate (ORR) = 42% (11 confirmed PRs/26) o KRAS mutant ORR = 58% (7 confirmed PRs/12) o KRAS wild - type ORR = 33% (4 confirmed PRs/12) • Median DoR 26.9 months (95% CI 8.5 - 47.3) across all LGSOC patients • Median PFS 20.0 months (95% CI 11.1 – 31.2) across all LGSOC per RECIST 1.1 • Median number of prior lines of therapy: 3.5 • Responses observed in patients previously treated with MEK inhibitor • No new safety findings with continued follow - up • 1 patient discontinued for adverse events as of July 2023 (skin AE) • Data confirmed via BICR Denis, 5 th Annual RAS - Targeted Drug Development Sept 2023; (Data cut off July 2023: Data on file); BICR: Blinded independent central review
21 Recent LGSOC Trials Provide Relevant SOC Comparator Trial Number of Prior Systemic Therapies Median (range) Prior MEK allowed Prior Bevacizuma b Therapy Response Rate ORR Image Assessment Median PFS Months (95% CI) Discontinuation Rate due to AEs GOG 281 1 2 (1 - 10) No * Low % SoC (n=130) 6% 95% CI: (3%, 12%) INV 7.2 (5.6 - 9.9) 30% MILO 2 2 (1 - 8) No * Low % SoC (n=101) 13% 95% CI: (7%, 21%) BICR 10.6 (9.2 - 14.5) 17% 1 Study GOG 281 trial Gershenson et al., Lancet 2022; 2 MILO Study Monk et al., J Clin Oncol 2020. SoC = Standard of Care (endocrine / chemotherapy). INV = Investigator, BICR = Blinded independent central review, PFS = Prog res sion free survival CI = confidence interval, NR = Not reached * Low historical use of bevacizumab during trial conduct. % not reported MILO: no more than 3 lines of prior chemotherapy
Avutometinib + Defactinib in Low - Grade Serous Ovarian Cancer Regulatory Update
23 Avutometinib + Defactinib for Recurrent LGSOC: Path to Accelerated Approval a Gershenson et al, Lancet 2022; Monk et al, JCO 2020 b Breakthrough Therapy Designation for combination of avutometinib and defactinib for treatment of recurrent LGSOC after one or m ore prior lines of therapy including platinum - based chemotherapy; FDA: Food and Drug Administration; CHMP: Committee for Medicinal Products for Human Use; PMDA: Pharmaceutical and Medical Devices Agency; EU: Eu rop ean Union Significant Unmet Medical Need x Initiating rolling NDA submission for recurrent KRAS mt LGSOC in Q2 2024 • Plan to share RAMP 201 mature dataset with FDA as part of rolling NDA submission • Expect to complete rolling submission H2 2024, priority review request • Potential for FDA accelerated approval in 2025 • Ongoing confirmatory study targeting full enrollment by end of 2025 Next Steps: Plans to discuss regulatory path with CHMP and PMDA (EU and Japan) x Breakthrough Therapy Designation granted b x Orphan Drug Designation granted for treatment of LGSOC as a distinct disease x FDA Pre - NDA meeting 1H 2024 Key Regulatory Achievements & Anticipated Milestones Standard of Care (chemo/hormonal therapy) a ORR: 6 - 13% D/C due to AE: 17 - 30% • No FDA approved therapies specifically for LGSOC • Urgent need for new treatment options that improve outcomes for patients with LGSOC • SOC therapy associated with low response rates and high discontinuation rate due to toxicity
Commercial Opportunity for Avutometinib + Defactinib in Low - Grade Serous Ovarian Cancer
25 Potential for Avutometinib + Defactinib to Rapidly Penetrate the Current Prevalent Patient Population, if Approved STAGE II - IV DISEASE 1 MOS: ∼ 10 YEARS 2 FRONTLINE TREATMENT INITIAL RECURRENCE SUBSEQUENT RECURRENCE ± Neoadjuvant platinum/ taxane Debulking surgery ± Platinum/ taxane chemotherapy ± Hormone therapy (Mx) or ± Endocrine therapy Target Product Profile (TPP) Based on Avutometinib + Defactinib Combination Treaters surveyed indicate that based upon approval of the target product profile of the combination, patients with LGSOC previously ineligible for continued treatment would now have a viable option at initial and subsequent recurrences, growing the treatable population 3 ~50% 1. NCCN: National Comprehensive Cancer Network; NCCN guidelines v1.2023 / 2. Gershenson Gynecol Oncol 2022/p1/Abstract/Results/ln1 - 2 / 3. VSTM DOF, ATU 2024 (n=96, Fielded December 2023 – January 2024): Mx: maintenance • 70% of Oncologists surveyed indicate they will initially plan to treat with prevalent patients at their next recurrence 3 • 49% of Oncologists surveyed indicate that initial recurrence is the ideal point in the patient journey to initiate treatment with the combination 3
26 Anticipate Concentrated Market Opportunity, Potential for Relatively Quick Adoption Given Limitations of SOC Plan for a focused commercial launch, if approved • Top 400 HCPs and top 100 HCOs collectively cover nearly half of the LGSOC population 1 ; focused sales force of 14 - 18 reps Substantial market preparation activities • Engaged with 1/3 of prevalent patient population 2 & ongoing engagement with HCPs 3 Excitement for avutometinib + defactinib underscores its potential to address the significant unmet need • Based on a TPP of avutometinib + defactinib combination: • 85% of treaters surveyed say they would adopt within 6 months of receiving FDA approval, suggesting swift uptake of the treatment for eligible patients 4 Opportunity for active switch to avutometinib + defactinib • Based on TPP of avutometinib + defactinib combination: • 28% of treaters surveyed say they would proactively reach out to switch half of their current LGSOC patients, if approved 4 Coverage and access support • Well - insured patient population will support widespread coverage • NCCN listing and Medicare protected class status could result in favorable coverage to label • Comprehensive suite of resources intended to support patients and physicians navigating payer barriers Ongoing engagement with plans for rapid uptake • Support of community practices through relationships with Oncology GPOs could facilitate education and adoption • Focused outreach with HCOs that cover majority of patients in key centers planned now Patient assistance • Financial and other insurance barriers, time to coverage, may be mitigated by robust patient service offerings • High touch Hub and limited distribution network could ensure patients start quickly and stay on therapy Ensuring Patients’ Ability to Start and Stay on Therapy Focused Commercial Launch *Based on internal revenue forecasts including potential market penetration of Verastem’s product candidates 1 Based on median duration of therapy from RAMP 201 Part A NCCN: National Comprehensive Cancer Network; HCP: healthcare professionals; HCO: healthcare organizations; GPO: group purchas ing organizations,: 1. VSTM DOF – Claims LGSOC Proxy 2. VSTM DOF. Self - identified LGSOC patients registered via DSE website. 3. VSTM CRM DOF 2024. 4. VSTM DOF, ATU 2024 (n=96, Fielded December 2023 – January 2024) Given the expected longer duration of therapy 1 , we believe KRAS mt represents approximately >2/3 rds of revenue opportunity compared with combined KRAS mt and KRAS wt , without any differential pricing*
Avutometinib + Defactinib in Low - Grade Serous Ovarian Cancer RAMP 301: Phase 3 Confirmatory Trial
28 • Confirmed LGSOC diagnosis • Recurrent disease after prior platinum therapy • Documented KRAS mutation status • Measurable disease per RECIST v1.1 • Prior MEKi allowed • Prior Bevacizumab allowed Inclusion Criteria 1:1 Randomization n = 270 Stratification Factors: KRAS mutation status ( wt vs. mt) Avutometinib 3.2 mg PO BIW Defactinib 200 mg BID 3 weeks on, 1 week off Avutometinib + Defactinib n = 135 Pegylated Liposomal Doxorubicin Paclitaxel Topotecan Letrozole Anastrozole Investigator’s Choice n = 135 Primary Endpoint: PFS (BICR by RECIST v1.1) Hierarchical Evaluation of PFS: KRAS mutant LGSOC only All recurrent LGSOC Secondary Endpoints a OS PFS by RECIST v1.1 per INV assessment ORR DoR DCR Safety Pharmacokinetics PROs a Unless otherwise specified, all tumor response - based endpoints will be analyzed using both BICR and INV assessments BICR : blinded independent central review ; BID : twice a day ; BIW : twice a week ; DCR : disease control rate ; DoR : duration of response ; INV : investigator ; KRAS : kirsten rat sarcoma virus ; MEKi : MEK inhibitor ; mt : mutant ; PO : per oral ; pts, patients ; ORR : objective response rate ; OS : overall survival ; PD : progressive disease ; PFS : progression - free survival ; PROs : patient - reported outcomes ; RECIST : response evaluation criteria in solid tumors ; wt : wild type . May crossover upon BICR - confirmed PD RAMP 301: International Phase 3 Confirmatory Trial Evaluating Avutometinib + Defactinib in Recurrent LGSOC RAMP 301 (GOG - 3907/ENGOT - ov81/NCRI): Ongoing Randomized Controlled Trial (RCT) NCT06072781
Topline Data from RAMP 205: Avutometinib + Defactinib + SOC in First - Line Metastatic Pancreatic Cancer
30 RAMP 205: Designed to Identify and Evaluate RP2D in C ombination with Chemotherapy for Tr eatment of Newly Diagnosed mPDAC Inclusion Criteria Part A: Dose Evaluation (3+3 DLT Assessment) Part B: Dose Expansion (Primary Endpoint: ORR) • Histologic or cytologic confirmed metastatic pancreatic ductal adenocarcinoma (PDAC) • Eligible for treatment in the first - line setting (no prior systemic therapy for advanced or metastatic disease) • Measurable by RECIST v1.1 by CT or MRI • ECOG Performance status of ≤1 • Part B only, adequate tissue sample to evaluate KRAS mutational status Avutometinib + Defactinib + Gemcitabine + Nab - paclitaxel Dose Finding Cohorts n=3 - 6 Avutometinib + Defactinib + Gemcitabine + Nab - paclitaxel DLT - Cleared Dose Level Expansion • Patients with PDAC treated at RP2D • Stage 1: 17 patients if ≥4 responders, then • Simon’s 2 - stage design: expand to 29 patients Collaboration with PanCAN , NCT05669482 DLT: dose - limiting toxicity; n: number of patients; ORR: overall response rate; RP2D: recommended phase 2 dose; CT: computed tom ography; ECOG: European Cooperative Oncology Group; MRI: magnetic resonance imaging RP2D Selection RAMP 205: Ongoing Phase 1/2 Evaluating Avutometinib + Defactinib with Gemcitabine and Nab - paclitaxel
31 RAMP 205: Initial Interim Safety and Efficacy Results • Encouraging early interim data from ongoing Phase 1/2 RAMP 205 study evaluating avutometinib + defactinib + gemcitabine + Nab - paclitaxel in first - line metastatic pancreatic cancer • As of data cutoff of May 14, 2024, Dose Level 1 mature with more than 6 months follow up o Confirmed ORR = 83% (5/6) o Cohort was DLT cleared, one DLT observed (neutropenic fever) • Evaluating additional dose/schedule combinations to optimize the dose for safety/tolerability and define RP2D for expansion cohort • 11 top academic sites currently enrolling and highly engaged • Presenting RAMP 205 initial interim data at ASCO on June 1, 2024 Dose Level Avuto Defactinib Gem Nab - Pac Day 1, 8, 15 chemo dosing: - 1 2.4 mg BIW 200 mg BID 800 mg/m 2 100 mg/m 2 1 2.4 mg BIW 200 mg BID 800 mg/m 2 125 mg/m 2 Day 1 and 15 chemo dosing: 1a 3.2 mg BIW 200 mg BID 800 mg/m 2 125 mg/m 2 2a 3.2 mg BIW 200 mg BID 1000 mg/m 2 125 mg/m 2 DLT: dose - limiting toxicity; ASCO: American Society of Clinical Oncology
32 Landmark Trials in First - Line Metastatic Pancreatic Cancer Trial/PI/Reported (# Patients) Intervention Comparator ORR by Investigator (95% CI) mPFS (95% CI) mOS (95% CI) MPACT Von Hoff 2013 (N=861) Gem/NabP * (n=431) Gem (n=430) Gem/NabP 5.5 months (4.5 - 5.9) 8.5 months (7.89 - 9.53) 29% (25 - 34) 23% (19 - 17) IRR** NAPOLI 3 O’Reilly 2023 (N=770) Nalirifox (n=383) Gem/NabP* (n=387) Gem/NabP 36.2% (31.4 - 41.2) 5.6 Months (5.3 - 5.8) 9.2 months (8.3 - 10.6) Nalirifox 41.8% (36.8 - 46.9) 7.4 months (6.0 - 7.7) 11.1 months (10 - 12.1) PRODIGE Conroy 2011 (N=342) Folfirinox (n=171) Gem (n=171) Folfirinox 31.6% (24.7 - 39.1) 6.4 months 11.1 months For Reference only: No cross - trial comparison made.*Dosing schedule in Gem/ NabP arms above= 1000 / 125 ሺ ‰ Ȁ ଶ ) D1,8,15 q 4w, **Secondary endpoint of ORR based on IRR (Independent Radiology Review), ***NR: Not Reported. SOC Treatment Landscape: • ORR is between 23% - 36% for Gem/ NabP • Median overall survival reported between 8.5 – 9.2 months
33 RAMP 205: Evaluating Multiple Regimens in Parallel to Efficiently Identify RP2D in First - Line mPC Duration of Treatment for All Patients; Safety Population (n=41) Data Cutoff Date:14 MAY 2024 Source: Program: F_TR_SWIMMER.sas In Dose Level 1: • 1 of 6 patients achieved objective response by month 2 • 2 of 6 patients achieved objective response by month 4 • 5 of 6 patients achieved objective response by month 6 Dose Level - 1 1 1a 2a
34 RAMP 205: Best Percent Change in Target Lesion Sum of Diameters Includes Patients Who Have Had At Least First Scan (n=26) Data Cutoff Date:14 MAY 2024 Source: Program: F_TR_WATERFALL_BYDOSE2 Threshold for PR
Avutometinib with KRAS G12C Inhibitors in Non - Small Cell Lung Cancer
36 High Unmet Need in Refractory NSCLC Adenocarcinoma Advanced or Metastatic NSCL Cancer Recommend Histologic and Molecular Subtyping 5 Appropriate targeted agent Chemotherapy Docetaxel Gemcitabine Pemetrexed Prior PD - (L)1 No Prior PD - (L)1 PD - (L)1 Chemo PD - (L)1 PD - (L)1 single agent or PD - (L)1 + chemo Chemotherapy or clinical trials EGFR/ALK/ROS1/BRAF/ KRAS G12C (targeted) Non - targeted PD - (L)1 1% Non - Targeted PD - (L)1 1% ▪ SOC in recurrent disease is chemotherapy ▪ Pre - PD - (L)1 era, chemotherapy response rate ~10% in recurrent disease; 12w PFS of 30 – 45% Recurrence Recurrence Verastem Clinical Trials: • RAMP 203: Avutometinib ± defactinib + sotorasib in KRAS G12C NSCLC • RAMP 204: Avutometinib + adagrasib in KRAS G12C NSCLC NSCLC Adenocarcinoma 3 0 5 10 15 % of Patients KRAS Mutation BRAF Mutation US Annual Incidence 7,8 : 114K WW Annual Incidence 1,2 : 882K 1 Globocan , 2020; 2 https://www.ncbi.nlm.nih.gov/books/NBK519578/ ; 3 TCGA PanCancer Atlas ( cBioPortal analysis); 4 www.thelancet.com Vol 389 January 21, 2017 ; 5 Adapted from NCCN Non - small cell lung cancer guidelines Version 3.2020; 6 Clinical Cancer Research DOI 10.1158/1078 - 0432.CCR - 18 - 2062; 7 50% of NSCLC is adenocarcinoma ( Pakkala and Ramalingam JCI Insight 2018) ; 8 Cancer Statistics 2020, Siegel et. al. CA Cancer J Clin 2020;70:7 - 30 KRAS Mutations Represent 25% of Lung Adenocarcinoma & BRAF Mutations Represent 4% (EGFR 17%, ALK 7%) 4,6 BRAF V600E BRAF non - V600E
37 0 10 20 30 0 500 1000 1500 2000 Tumor growth Days after first dose T u m o r v o l u m e ( m m 3 + / - S E M ) vehicle sotorasib sotorasib + avutometinib sotorasib + avutometinib + FAKi avutometinib trametinib **** **** **** Preclinical Synergy of Avutometinib + G12C Inhibitors in KRAS G12C Models Synergy of avutometinib + G12C inhibitors across G12C mutant NSCLC, CRC & Pancreatic cancer cell lines Doses Tested Sotorasib: 30 mg/kg PO QD Avutometinib: 0.3 mg/kg PO QD FAKi: 50 mg/kg PO BID Trametinib: 0.3 mg/kg PO QD Avutometinib & FAKi potentiate sotorasib efficacy in KRAS G12C NSCLC in vivo; Tumor regression in all mice with triple combination Avutometinib + sotorasib yields deeper and more sustained inhibition of ERK signaling pathway H2122 KRAS G12C NSCLC Sotorasib Avutometinib 4h 48h p - ERK Actin Total ERK ND: not determined - - + - - + + + - - + - - + + + H2122 KRAS G12C NSCLC Concentrations Tested Sotorasib: 100 nM Avutometinib: 100 nM Coma et al., AACR 2021 Combined Synergy Score Cell line Indication Sensitivity to G12C inhibitors Avutometinib + sotorasib Avutometinib + adagrasib H2122 NSCLC Moderately sensitive 44.7 44.6 H1373 NSCLC Sensitive 10.0 3.4 SW1573 NSCLC Insensitive 8.6 12.0 H358 NSCLC Sensitive 6.9 5.4 H2030 NSCLC Moderately sensitive 5.1 ND SW837 CRC Sensitive 16.1 18.5 MIAPACA2 Panc Sensitive 2.3 5.3 -100 0 100 200 300 400 Response at Day 10 R e s p o n s e @ D a y 1 0 ( % c h a n g e f r o m b a s e l i n e ) Vehicle VS-6766 0.3mg/kg QD AMG 510 30mg/kg QD VS-6766 + AMG 510 VS-4718 50mg/kg BID VS-6766 + VS-4718 AMG 510 + VS-4718 VS-6766 + AMG 510 + VS-4718 Trametinib 0.3mg/kg QD Trametinib + AMG 510 v e h i c l e t r a m e t i n i b 10 PR a v u t o m e t i n i b F A K i s o t o r a s i b s o t o r a s i b + t r a m e t i n i b s o t o r a s i b + a v u t o m e t i n i b s o t o r a s i b + F A K i V S - 6 7 6 6 + F A K i s o t o r a s i b + a v u t o m e t i n i b + F A K i -30 20 1 SD 2 SD 1 SD 1 SD 1 SD 1 PR 8 SD 2 PR 4 SD 3 PR 2 SD 4 PR
38 Avutometinib FAKi Restores Anti - Tumor Activity of Sotorasib in G12Ci - Resistant KRAS G12C Models Avutometinib inhibits proliferation of cells harboring acquired KRAS mutations that occur clinically upon progression on G 1 2C inhibitors Addition of avutometinib + FAKi restores anti - tumor activity after progression on sotorasib monotherapy in a KRAS G12C NSCLC GEMM model 0 50 100 150 0 5 10 15 20 Days after first sotorasib dose T u m o r v o l u m e ( m m 3 ) Sotorasib + Avutometinib + FAKiSotorasib Reference: Coma et al., AACR RAS meeting 2023 Addition of avutometinib + FAK inhibitor to sotorasib increases tumor growth inhibition in a sotorasib - resistant KRAS G12C/Y96D model 0 5 10 15 20 25 30 35 0 200 400 600 800 1000 Tumor growth Days after first dose T u m o r v o l u m e ( m m 3 S E M ) Vehicle Sotorasib Avutometinib Sotorasib + avutometinib Sotorasib + avutometinib + FAKi Avutometinib + FAKi Collaboration with Mariano Barbacid, CNIO (Spain) Collaboration with Chiara Ambrogio, U Turin (Italy) Collaboration with Andy Aguirre, DFCI
39 Inclusion Criteria Part A: Dose Evaluation (3+3 DLT Assessment) Part B: Dose Expansion (Primary endpoint: ORR) Cohort 1 Patients without Prior KRAS G12C Inhibitor Treatment Stage 1 : ~20 patients Stage 2 : expand • Documented KRAS G12C mutation determined using validated test • Treatment with 1 but no more than 3 prior systemic regimens for Stage 3B - C or 4 NSCLC* • May have received adjuvant chemotherapy for earlier - stage disease • Measurable disease per RECIST v1.1 • ECOG performance status ≤ 1 Avutometinib + Sotorasib Dose Finding Cohorts Doublet RP2D Selected: 4 mg a vutometinib / 960 mg sotorasib Avutometinib + Sotorasib + Defactinib in patients who have received prior G12Ci Dose Finding Cohorts Triplet RP2D Selection RAMP 203: Phase 1/2 Trial of Avutometinib + LUMAKRAS TM (Sotorasib) Defactinib in KRAS G12C Advanced NSCLC DLT, dose - limiting toxicity ; KRAS, kristen rat sarcoma virus ; NSCLC, non - small cell lung cancer ; ORR, objective response rate ; RECIST v 1 . 1 , response evaluation criteria in solid tumours version 1 . 1 ; RP 2 D, recommended phase 2 dose . Completed enrollment Enrollment ongoing Now enrolling expansion phase Cohort 2 Patients who Progressed on KRAS G12C Inhibitor Treatment Stage 1 : ~20 patients Stage 2 : expand Collaboration with Amgen, NCT05074810 *may include patients with or without prior G12C therapy
40 *On treatment at time of data cutoff; + Patient with - 38.4% tumor reduction classified as SD due to disease progression prior to confirmatory scan. Awad et al., EORTC - NCI – AACR Conference Oct 2023 Avutometinib + Sotorasib Percentage Change in Target Lesion Sum with time on treatment RAMP 203: Objective Responses in KRAS G12C NSCLC Sotorasib + Avutometinib Combination
41 • Documented KRAS G12C mutation determined using validated test • Treatment with >1 but no more than 3 prior systemic regimens, for Stage 3B - C or 4 NSCLC • Must have received prior therapy with a KRAS G12C inhibitor and experienced progressive disease • Measurable disease per RECIST v1.1 • ECOG performance status ≤ 1 Inclusion Criteria Avutometinib + Adagrasib Dose Finding Cohorts (n=3 - 6) Part A: Dose Evaluation ( DLT Assessment) Part B: Dose Expansion (Primary endpoint: ORR) RP2D Selection Stage 1: 19 patients (including Part A patients) treated with RP2D Stage 2: expand to 55 patients RAMP 204: Phase 1/2 Trial of Avutometinib + KRAZATI TM ( Adagrasib ) in KRAS G12C Advanced NSCLC Collaboration with Mirati (BMS) NCT05375994 DLT, dose - limiting toxicity ; KRAS, kristen rat sarcoma virus ; NSCLC, non - small cell lung cancer ; ORR, objective response rate ; RECIST v 1 . 1 , response evaluation criteria in solid tumours version 1 . 1 ; RP 2 D, recommended phase 2 dose .
RAS Pathway - Driven Cancers and Rational Avutometinib Combinations
43 Indication Incidence/ Prevalence Biomarker % Regimen Setting Phase Institution Gynecologic Cancers LGSOC Prevalence 6k 1 70% Avutometinib + defactinib + letrozole Low - grade serous ovarian cancer without prior systemic treatment Phase 1/2 Memorial Sloan Kettering Cancer Center Gynecologic Basket Incidence 4 - 8 : 85K 25% Avutometinib + defactinib Recurrent RAS Pathway - driven (RAS/RAF/NF1) endometrioid cancer, mucinous ovarian cancer, high - grade serous ovarian cancer or cervical cancer Phase 2 University of Oklahoma Mesonephric Incidence: 9 ~680 96% Avutometinib + defactinib Advanced or recurrent mesonephric gynecologic cancer Phase 2 Memorial Sloan Kettering Cancer Center CRC KRAS mt Incidence 2 : 148K 45% Avutometinib + cetuximab Recurrent metastatic KRAS mt Phase 1/2 University of Chicago RAS/RAF wt CRC Incidence 2 : 148K 50% 12 Avutometinib + defactinib + cetuximab Unresectable, Anti - EGFR - Refractory Advanced Colorectal Cancer Phase 1/2 M.D. Anderson Cancer Center Breast Cancer ER+/Her2 - Incidence 2 : 279K 22.5% Avutometinib + abemaciclib + fulvestrant Recurrent ER+/HER2 - breast cancer following progression on CDK4/6i + aromatase inhibitor Phase 1/2 Dana - Farber Cancer Institute Melanoma MAPK alterations or wt Incidence 2 : 100K 100% Avutometinib + defactinib ± encorafenib Patients with brain metastases from cutaneous melanoma with RAS, RAF or NF1 alterations or RAS/RAF/NF1 wt Phase 1/2 University of Utah Thyroid MAPK alterations + Incidence 3 : 44K 35% Avutometinib + defactinib Differentiated & anaplastic thyroid cancer Phase 2 Memorial Sloan Kettering Cancer Center Investigator - Sponsored Trials Provide Ongoing Comprehensive Approach to Establish More Complete Blockade of RAS Pathway & Resistance Pathways + excluding BRAFV600E 1 Monk, Randall, Grisham, The Evolving Landscape of Chemotherapy in Newly Diagnosed Advanced Epithelial Ovarian Cancer, Am Soc Cl in Oncol Educ Book; 2019; Slomovitz , Gourley, Carey, Malpica , Shih, Huntsman, Fader., Grisham et al, Low - Grade serous ovarian cancer: State of the Science; Gynecol Oncol; 2020. Grisham, Iyer, Low - Grade Serous Ovarian Cancer: Current Treatment Paradigms and Future Directions; Curr Treat Opti ons Oncology; 2018; Globocan 2020; 2 Cancer Statistics 2020, Siegel et. al. CA Cancer J Clin 2020;70:7 - 30 ; 3 Cancer Statistics 2020, Siegel et. al. CA Cancer J Clin 2020;70:7 - 30 4 Uterine cancer is one of the leading gynecologic neoplastic disorders in the US, of which over 80% are endometrioid adenocarc ino mas (EA); 5 Endometrioid OC ( EnOC ) accounts for approximately 10% of all OC, with the majority of cases diagnosed as low grade, early stage disease with excel len t clinical; 6 ucinous ovarian cancer: 3 - 11% of ovarian cancer ( Hada et al., 2021); 7 90% of Ovarian Cancer is Epithelial Ovarian Cancer (https://www.cancer.org/content/dam/cancer - org/research/cancer - facts - and - statistics/annual - c ancer - facts - and - figures/2018/cancer - facts - and - figures - 2018.pdf); 8 HGSOC the most common type of ovarian cancer, accounting for approximately 75% of epithelial ovarian cancers. ( https://ocrahope.org/news/high - grade - serous - carcinoma/ ) 9 Ji Son (David Hong) ASCO 2023
Discovery Efforts
45 Discovery and Development Collaboration with GenFleet Strengthens Pipeline Targeting RAS Pathway - Driven Cancers • Increases the breadth of Verastem’s oncology pipeline with strategically - aligned RAS pathway focus o Exclusive options for Verastem to exclusively license up to 3 programs with development and commercialization rights outside of the GenFleet markets of mainland China, Hong Kong, Macau, and Taiwan o Potential development in combination with Verastem’s current pipeline o Selected GFH375 (VS - 7375), an oral KRAS G12D (ON/OFF) inhibitor as lead program; programs 2 & 3 in discovery phase o Small molecule programs focused on anti - cancer targets related to the RAS/MAPK pathway or surrounding cancer cell signaling • Strategic collaboration builds on Verastem Oncology and GenFleet’s experience in RAS pathway - driven cancers o Collective worldwide strengths in RAS pathway discovery and development o Established network of collaborators, including leading scientific and clinical experts o Leverages experience from GenFleet’s KRAS G12C inhibitor program and Verastem’s avutometinib/defactinib program • Risk - sharing structure of the collaboration with milestone - based options provides capital efficient approach o At execution, Verastem paid GenFleet an upfront payment for options to obtain exclusive right to 3 programs on a program by program basis o Combined with the upfront amount, payments for future annual R&D support, development milestones and option payment for first program through completion of Phase I trial could equal up to $11.5 million o Potential total deal size across all 3 programs up to $625.5 million excluding royalties if Verastem exercises its in - license op tions o Includes exclusive rights for Verastem to obtain a license to each of the compounds after successful completion of pre - determined milestones in Phase 1 trials
46 GEF GTP GDP GTP GDP KRAS G12D (ON/OFF) inhibitor RAS/MAPK pathway signaling GEF: Guanine nucleotide exchange factor GAP: GTPase - activating protein GAP P KRAS OFF (inactive) KRAS ON (active) Rationale for Designing a Potent and Selective Orally Bioavailable Inhibitor of KRAS G12D (ON/OFF) for the Treatment of Patients with KRAS G12D Cancers KRAS G12D is the most frequent KRAS mutation in human cancer Ideal to inhibit both the active (ON) & inactive (OFF) states of KRAS for deep and durable inhibition of tumor growth Reference: Adapted from Hofmann et al., Cancer Discovery 2022 Pancreatic 37% Colorectal 12.5% Endometrial 8% NSCLC 4.9% Pancreatic 1.1% Colorectal 2.7% Endometrial 1.7% NSCLC 13.6% G12D 26.0% G12V 20.7% G12C 13.0% G13D G12R G12A Others
47 GFH375 (VS - 7375) is an Oral KRAS G12D (ON/OFF) Inhibitor • GFH375 (VS - 7375) is a potent and selective orally bioavailable inhibitor of KRAS G12D (ON/OFF) with potent anti - tumor efficacy demonstrated across preclinical models • Dual inhibitor of ON (GTP) and OFF (GDP) states of KRAS G12D • Orally bioavailable across preclinical species • Potent against intracranial tumor models suggesting potential to treat brain metastases • Avutometinib enhances anti - tumor efficacy of GFH375 (VS - 7375) in preclinical models • IND - enabling GLP toxicology studies complete • IND application filed in China and accepted for review; upon clearance expect to initiate Phase 1 trial in China in H2 2024 KRAS G12D State GFH375 IC50 ( nM ) (KRAS G12D binding) GppNp - bound (ON/active) 2 1 GDP - bound (OFF/inactive) 6 1 0 2 4 6 8 10 12 14 0 100 200 300 400 Days after first dose T u m o r v o l u m e ( m m 3 , m e a n ± S E M ) GP2D CRC Panc 04.03 PDAC Zhou et al., AACR 2024 Potent anti - tumor efficacy demonstrated across preclinical models Dual inhibitor of ON (GTP) and OFF (GDP) states of KRAS G12D First program from the GenFleet collaboration
Financials
49 Key Financial Statistics Cash, cash equivalents & investments $110.1M GAAP Operating Expenses $28.1M Non - GAAP Operating Expenses* $26.6M Shares Outstanding 25.3M** As of and for the quarter ended March 31, 2024 • Oxford Finance LLC Credit Facility • Up to $150M available in a series of term loans • $40M term loans outstanding • Remaining $110M available upon achievement of pre - defined milestones or at lender’s discretion • $25M tranche available upon FDA approval of avutometinib for treatment of LGSOC • Floating interest rate, subject to a floor and a cap; 5% final payment charge, and loan subject to 1 - 3% early payment fee • Interest only payments through April 2025 • No financial covenants Sources of Non - Dilutive Capital * Q1 2024 GAAP operating expenses of $28.06M less Q1 2024 stock - based compensation expense of $1.48M = $26.58M Q1 2024 non - GAAP operating expenses **Excludes Series A Preferred (0.8M Shares on as - converted basis), Series B Preferred (4.2M Shares on as - converted basis), and o utstanding unexercised pre - funded warrants (1.5M Shares).
50 Avutometinib + Defactinib: Recurrent LGSOC Avutometinib + Defactinib: Metastatic Pancreatic Cancer Avutometinib + KRAS G12C Inhibitors: NSCLC GFH375/VS - 7375: Oral G12D (ON/OFF) Inhibitor Recent Corporate Achievements x Initiating rolling NDA submission in recurrent KRAS mt LGSOC x Received FDA Orphan Drug Designation x Initiated Phase 3 confirmatory study in Q4’23 x Presented planned subgroup analysis of Part A RAMP 201 trial x Received FDA Fast Track Designation for avutometinib in combination with Mirati’s (BMS) G12C inhibitor adagrasib x Received FDA Fast Track Designation and for avutometinib plus defactinib with Amgen’s G12C inhibitor sotorasib x Received FDA Fast Track Designation for avutometinib in combo with Amgen’s G12C inhibitor sotorasib x Presented initial interim results from Phase 1/2 RAMP 203 trial of avutometinib + sotorasib x Initial interim safety and efficacy results from RAMP 205 to be presented at ASCO 2024 x Initiated RAMP 205 combo avutometinib + gemcitabine/nab - paclitaxel + defactinib x Established discovery and development collaboration with GenFleet x Presented preclinical data of GFH375/VS - 7375, a potential best - in - class oral KRAS G12D (ON/OFF) inhibitor, at AACR 2024 x IND application was filed in China and accepted for review in Q1’24
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Addendum
53 Recurrent LGSOC: High Medical Need 1 NCCN guidelines v1.2023 No Category 1 recommendations (high - level evidence). Category 2a (lower - level evidence with uniform NCCN consensus) unless otherwise indicated f: There is no standard sequencing of drugs for recurrent disease. Considerations include prior therapies, disease burden, relative efficacy, and relative toxicity profile. t: An aromatase inhibitor (i.e., letrozole, anastrozole, exemestane) is preferred if not used previously. Fulvestrant, tamoxifen, or leuprolide acetate is recommended if an aromatase inhibitor was given previously. Recurrent Low - Grade Ovarian Cancer – Treatment Guidelines 1 No Approved Treatment Options – Limited Benefit from Available Therapies
54 Avutometinib Patent Exclusivity Composition of Matter Method of Making Sept 2032 Dosing Protocol May 2038 Combination w/ Defactinib Dec 2042 Feb 2027 + 5 yrs (PTE) = 2032 Sept 2040 Solid Form PTE 2041 - 2042 if issued Methods or Treating; Combinations
55 Experienced Senior Management Team Previous experience: • CEO, The DNA Repair Co. (now On - Q - ity ) • PharMetrics (now IMS) • Axion Daniel Paterson President and Chief Executive Officer Dan Calkins Chief Financial Officer Cathy Carew Chief Organizational Effectiveness Officer Mike Crowther Chief Commercial and Business Strategy Officer John Hayslip, M.D. Chief Medical Officer Jonathan Pachter, Ph.D. Chief Scientific Officer Previous experience: • Technical Accounting Consultant - CFGI • PwC LLP Previous experience: • Principal – HR Collaborative • Ironwood • ActiveBiotics • Dynogen • Tufts Health Plan Previous experience: • CBO, Minerva Biotechnologies • Interim US lead and VP of US Marketing, Kite Pharma • Celgene Previous experience: • Head of Cancer Biology – OSI (now Astellas) • Schering - Plough Previous experience: • Chief Development Officer & SVP of Regulatory, OncXerna • Head of Global Regulatory, Lilly Oncology Colleen Mockbee Global Head of Regulatory Affairs and Development Previous experience: • CMO, I - MAB • Nektar Therapeutics, AbbVie • Director of clinical research and data management, University of Kentucky’s Markey Cancer Center