On Target to Outsmart Cancer

May 8, 2024

© 2024 Revolution Medicines, Inc.

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Legal Disclaimer

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Mission: to revolutionize treatment for patients with RAS-addicted cancers through the discovery, development and delivery of innovative, targeted medicines.

  • Pioneering class of RAS(ON) inhibitor drug candidates targeting oncogenic drivers of common, life-threatening cancers
  • Unprecedented RAS(ON) multi-selectiveinhibitor (RMC-6236)and RAS(ON) G12C-selectiveinhibitor (RMC-6291) show promising and highly differentiated initial clinical profiles
  • On track toward late-stagedevelopment of RMC-6236 and advancement of mutant-selective inhibitors led by RMC-6291 and RMC-9805

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Portfolio of RAS(ON) Inhibitors Designed to Target 30% of Human Cancers

RAS-Mutant Cancers

Normal

Cell

Membrane

Tightly regulated

= RAS(OFF)RAS(ON) proteins control cell growth

  • RAS(ON)

RAS Cancer Mutations

Excessive

RAS(ON) signaling drives uncontrolled cell growth

Oncogenic mutations in KRAS, NRAS or HRAS are common at positions

G12, G13 and Q61

New patients per year (U.S.)(1)

>200,000

including

60,000

Lung cancer

(29% of NSCLC)

75,000

Colorectal cancer

(49% of CRC)

53,000

Pancreatic cancer

(92% of PDAC)

  1. Estimated using tumor mutation frequencies from Foundation Medicine Insights March 2022 and scaled to estimated patient numbers using cancer incidence from ACS Cancer Facts and Figures 2023 (see appendix for additional detail); NSCLC = non-small cell lung cancer; CRC = colorectal cancer; PDAC = pancreatic ductal adenocarcinoma

Pioneering Tri-complex RAS(ON) Inhibitors Designed to Deliver Robust and Durable Anti-tumor Activity

Oncogenic RAS(ON)

Inhibited RAS(ON)

RAS(ON)

Inhibitor

GTP

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  • Direct inhibition of RAS(ON) cancer drivers
  • Deep and durable suppression of RAS cancer signaling designed to defy common drug resistance mechanisms
  • Clinical validation of first two RAS(ON) Inhibitors studied as single agents

Cell

Cyclophilin A

Membrane

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Initial Clinical Profiles of RAS(ON) Inhibitors Support Broad Set of Potential Opportunities to Treat RAS-Addicted Cancers

Target

Multi-Selective

Genotypes

RMC-6236 Clinical validation in NSCLC and PDAC

G12X and

expansion(1)

Mutant-Selective

RMC-6291

Evidence of differentiated clinical

G12C

activity in NSCLC and CRC

RMC-9805 Dose escalation ongoing

G12D

  1. KRAS G12X initially defined as mutation at codon 12 which encodes glycine (G) to X where X = A, D, R, S, or V. RMC-6236-001 protocol amended in August 2023 to broaden enrollment, now allowing patients with tumors bearing mutations in any of the three hotspots (G12X/G13X/Q61X) in any of the three major RAS isoforms (KRAS/NRAS/HRAS); G12X broadened to include G12C.

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2024 Capital Allocation Priorities to Advance

Pioneering RAS(ON) Inhibitor Pipeline …

… driving to

Expand reach of RMC-6236

by clinically assessing

opportunities

(1L, types, mutations)

Propel RMC-6236

into first pivotal trial(s)

Qualify mutant-

selective inhibitors led by RMC-6291and RMC-9805for late-stagedevelopment

Industry-Leading

Targeted

Medicines

Franchise for RAS-Addicted Cancers

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RAS(ON) Multi-Selective Inhibitor

RMC-6236

RMC-6236-001 Phase 1 Study Design

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Key Eligibility Criteria

  • Advanced solid tumors with KRAS G12X mutations(1) (initially excluding KRAS G12C)
  • Received prior standard therapy appropriate for tumor type and stage
  • ECOG PS 0-1
  • No active brain metastases

Key Endpoints

  • Safety and tolerability
  • Pharmacokinetics
  • Anti-tumoractivity

Dose Escalation

RMC-6236 administered orally QD

400 mg

300 mg

220 mg(2)

160 mg

Lowest dose/exposure

120 mg

range projected to drive

80 mg

tumor regressions in

humans based on

40 mg

preclinical models

20 mg

10 mg

Additional patients with PDAC or NSCLC were enrolled at dose levels that cleared DLT evaluation

Dose Optimization

+

RAS Genotype and

Tumor Type Expansion

RMC-6236-001Clinical Trial: https://clinicaltrials.gov/study/NCT05379985

  1. KRAS G12X initially defined as mutation at codon 12 which encodes glycine (G) to X where X = A, D, R, S, or V.
  2. 220 mg cleared DLT evaluation and a dose of 200 mg was selected for further expansion/optimization.

DLT, dose-limiting toxicity; ECOG PS, Eastern Cooperative Oncology Group Performance Status; QD, once daily.

Data Extracted 11 Sep 2023.

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RMC-6236-001: Summary of Treatment-Related Adverse Events

Total (n=131)

Maximum severity of TRAEs

Grade 1

Grade 2

Grade 3

Grade 4

Any Grade

TRAEs occurring in ≥10% of patients, n (%)

Rash*

57 (44)

29

(22)

6

(5)

0

92 (70)

Nausea

41

(31)

14 (11)

0

0

55

(42)

Diarrhea

32

(24)

9

(7)

1

(1)

0

42

(32)

Vomiting

27 (21)

9

(7)

0

0

36

(28)

Stomatitis

10 (8)

9

(7)

2

(2)

0

21

(16)

Fatigue

12 (9)

4

(3)

0

0

16

(12)

Other select TRAEs, n (%)

ALT elevation

6

(5)

1

(1)

1 (1)

0

8

(6)

AST elevation

6

(5)

0

1 (1)

0

7

(5)

Electrocardiogram QT prolonged

1

(1)

0

0

0

1

(1)

TRAEs leading to dose reduction , n (%)

0

9

(7)

2

(2)

0

11 (8)

TRAEs leading to treatment discontinuation, n (%)

0

0

0

1 (1)

1 (1)

  • Median duration of treatment at the time of data extraction was 2.27 months (range: 0.2-14)
  • One Grade 4 TRAE occurred in a patient with PDAC treated at 80 mg who had a large intestine perforation at the site of an invasive tumor that reduced in size while on treatment (TRAE leading to treatment discontinuation)
  • No fatal TRAEs were observed. Two patients discontinued study treatment due to death: one patient with PDAC (120 mg) died

due to PD; one patient with NSCLC (200 mg) died due to unknown cause reported as unrelated to RMC-6236

  • Post-dataextraction, the Grade 3 ALT and AST elevations were associated with biliary obstruction and reported as unrelated to RMC-6236

*Includes preferred terms of dermatitis acneiform, rash maculopapular, rash, rash pustular, dermatitis psoriasiform, erythema, rash erythematous; multiple types of rash may have occurred in the same patient; The most common TRAE leading to dose reduction was rash (acneiform or maculopapular); there were no reductions at doses ≤80 mg. AE, adverse event; ALT, alanine transaminase; AST, aspartate transferase; PD, progressive disease; TRAEs, treatment-related adverse events.

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Revolution Medicines Inc. published this content on 08 May 2024 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 08 May 2024 20:30:38 UTC.