Bicara Therapeutics (NASDAQ:BCAX) Q1 2026 Earnings Call

0:00 Good day and thank you for standing by. Welcome to the Bicara Therapeutics First Quarter twenty twenty six Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during the session, you will need to press 11 on your telephone. You will then hear an automated message advising your hand is raised. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Rachel Frank, Vice President of Investor Relations and Corporate Communications. Please go ahead. Thank you, and good morning, everyone. It's a pleasure to welcome you to Bicara Therapeutics First Quarter twenty twenty six Earnings Call. Earlier this morning, we issued a press release highlighting results from the quarter and recent business progress.

0:59 You can access the press release as well as the slides that we'll be reviewing today by going to the Investors section of our website. Before we begin, please note that this call will include forward looking statements under the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Please refer to our most recent SEC filings for important risk factors that could cause our actual performance and results to materially differ from those expressed or implied in these forward looking statements. Any forward looking statement made on this call represents our views only as of today, and we disclaim any obligation to update any forward looking statements. Joining us on the call today are Claire Mazumdar, Chief Executive Officer Bill Shellman, Chief Medical Officer Ryan Kohlheep, President and Chief Operating Officer and Ivan Hayab, Chief Financial Officer.

1:46 I'll now turn the call over to Claire. Good morning, thank you for joining us today. The first quarter of twenty twenty six set a strong foundation for the year ahead. We made measurable progress on the strategy we outlined earlier this year, with continued momentum behind our lead asset, Fisera Fispha, or Fisera, which we believe is a potentially best and first in class bifunctional EGFR directed antibody combined with a TGF beta ligand trap for the treatment of HPV negative first line head and neck cancer. Our priorities remain focused on executing a strategic development plan for Fysara, preparing for commercial success by laying the foundation to capture a large and growing global market in head and neck cancer, and expanding Fiscera's potential beyond our lead indication while maintaining financial discipline.

2:38 To deliver on those priorities, we are building the team to match our ambitions as we transition from a clinical stage to a commercial stage organization. With that in mind, I want to share a few updates this morning. After several years as our Chief Medical Officer, Dave Rabin has transitioned to a senior executive advisor role, And Bill Shellman, previously executive vice president of clinical development, has stepped into the CMO role. Dave has been instrumental in shaping Bicara into the company it is today, guiding Ficara into pivotal phase three development and building the foundation of our clinical and medical organization. We are deeply grateful for his contributions and look forward to his continued partnership in his advisory capacity. Bill is well positioned to build on that foundation.

3:26 He joined us last fall as an experienced development and commercial stage leader and has quickly made an impact across our development programs. And as we build toward commercial launch, we are thrilled to have brought on a proven leader to guide that work. Chris Sarkey joined last week as our Chief Commercial Officer, bringing extensive oncology, commercialization, and leadership experience. Chris will continue building out the team with additional hires across market access and commercial operations in the months ahead. In addition, we made a number of key updates in the first quarter. First, our continued execution has us on track to achieve substantial enrollment in FORTIFY ATN-one by the end of the year, positioning us for an interim analysis in mid-twenty twenty seven for potential accelerated approval.

4:15 With that progress, our belief in Fiscera's potential to be both best and first in class in frontline recurrent and metastatic HPV negative head and neck cancer has only strengthened. That conviction is grounded in Fiscera's differentiated mechanism, the depth and durability of response we have observed, and our development approach. Recent developments in the competitive landscape are reinforcing this view. While the market has at times viewed peer timelines as ahead of ours, that picture is changing, driven by our own continued progress, as well as the significant upsizing of a PIERCE pivotal trial. Together, these dynamics support our potential path to first in class. They also validate the strategic choice we made to develop FISARA specifically for HPV negative patients, where the science, the unmet need, and the commercial opportunity align.

5:10 Second, and Bill will speak to this in more detail, based on discussions with the FDA, we plan to initiate a study that will evaluate Ficara in combination with pembrolizumab as a loading and every three week maintenance dosing regimen. This is an advancement that we believe has the potential to expand optionality for patients and providers, and enhances the long term commercial profile of Fiscera. Third, just last Friday, a peer reviewed manuscript was published in the Journal of Clinical Oncology, detailing results from our phase 1b expansion cohort, evaluating fifteen hundred milligrams of Fysara weekly in combination with pembrolizumab in frontline recurrent and metastatic head and neck cancer. Data most recently presented at ASCO twenty twenty five.

5:58 This publication is an important milestone that validates and adds to the growing body of scientific evidence supporting Ficara's differentiated mechanism of action and clinical benefit. It also provides the broader oncology community with a peer reviewed view of the data underpinning our pivotal program. And lastly, with the completion of the Novo Subscribed public offering in February, built on an already strong cash position, we are well positioned to invest in the opportunities ahead of us. As we look ahead to the next quarter and the remainder of the year, we're excited to share meaningful long term follow-up data at ASCO in a few weeks. The data will further characterize Bicara's safety profile, along with the depth and durability of response driven by TGF beta inhibition.

6:45 These data span all three clinical doses tested in expansion cohorts, including the dose we're advancing in our pivotal trial. We are also continuing to enroll multiple phase 1b expansion cohorts to identify early proof of concept signals and inform Fiscera's development strategy, both within head and neck cancer and across solid tumors. With that, I'll turn it to Bill to walk through our recent clinical updates and what to expect from us at ASCO this year. Thanks, Claire, and good morning, everyone. We have taken a deliberate and thoughtful approach to evaluating Fiscera in patient populations with high unmet need and with the strongest biological rationale. Has included development in head and neck cancer, as well as other solid tumors, including metastatic colorectal cancer, cutaneous squamous cell carcinoma, and anal cancer.

7:35 In that context, our recent disclosures have focused on clinical data from approximately 90 patients across three cohorts from our Phase 1b study evaluating Bicara in combination with pembrolizumab in frontline recurrent or metastatic HPV negative head and neck cancer. This patient population has particularly poor outcomes with limited treatment options and represents the vast majority of patients in this setting. The fifteen hundred milligram weekly plus pembrolizumab cohort, which is the dose we are currently evaluating the phase three portion of the FORTIFY HML1 pivotal trial was presented at ASCO last year and represents our most mature dataset. With two years of follow-up, deep and durable responses were observed with a median duration of response of twenty one point seven months and a median overall survival of twenty one point three months, more than doubling the overall survival observed with the standard of care Pembrolizumab in HPV negative patients.

8:31 The seven fifty milligram weekly plus Pembrolizumab cohort supported the evaluation of the optimal biological dose of in the phase two portion of our ongoing FORTIFY trial, and helped to inform selection of the fifteen hundred milligram weekly as the OBD that is currently being evaluated in the phase three portion of the study. The data from these cohorts also reinforces our confidence in the interim analysis of overall response rate as the foundation for pursuing accelerated approval. The cohort evaluating two thousand milligrams every other week plus pembrolizumab demonstrated that even at a less frequent dose, we see rapid and deep responses that are the hallmark of the Bicara clinical profile. The data from this cohort also helped inform our alternative dosing regimen study.

9:20 Across all three phase 1b cohorts, the depth and durability of response observed underscore the central role of TGF beta inhibition in Fysara's mechanism. By enabling tumor penetration, TGF beta inhibition drives the kind of deep and durable responses that translate to long term survival benefit. Taken together, the data presented to date affirm that Vysara has the potential to be a well tolerated chemotherapy free treatment option across the spectrum of disease burden, including in patients with large bulky tumors and low CPS scores, where rapid and deep responses are particularly critical. As we look towards ASCO 2026, we will be presenting updated data across all three of these cohorts from the phase 1b study. We will provide three year follow-up data from the fifteen hundred milligram cohort, which will allow us to characterize the long term efficacy from this dose compared to the standard of care.

10:15 We will also share long term endpoints from the seven fifty milligram weekly and the two thousand milligram every other week datasets. These data will provide the most comprehensive look at Bicara and frontline recurrent and metastatic HPV negative head and neck cancer to date, including durability of outcomes not seen with other investigational agents targeting EGFR in this setting, a key differentiator and a signal of VICERRA's best in class potential. Additionally, the strength and consistency of these results across cohorts further derisk our pivotal FORTIFY HN01 trial. Another key aspect of our ASCO update is that we'll further characterize the role of TGF beta in head and neck cancer. TGF beta inhibition is the defining feature of Fysara and what sets it apart from other EGFR directed therapies.

11:06 Our translational data has shown consistent TGF beta inhibition across all Fysara doses confirming the mechanism behind tumor penetration and immune activation with the strongest inhibition at the fifteen hundred milligram weekly dose and the two thousand milligram every other week dose. We'll also look to show how tumor penetration driven by TGF beta inhibition translates into depth and durability of response that leads to long term outcomes for patients. Alongside the clinical story, we'll continue to build at ASCO. We're also focused on optimizing how FICERRA is delivered to patients. As previously mentioned, based on discussions with the FDA, we plan to initiate an alternative dosing study in the third quarter of this year. This study will enroll approximately 150 to 200 patients and will evaluate the efficacy of FICERRA on a twelve week loading phase, followed by an every three week maintenance phase regimen.

12:00 All patients will receive fifteen hundred milligrams weekly of Fiscera plus pembrolizumab for twelve weeks, and will then be randomized to either continue fifteen hundred milligrams weekly of Fiscera plus pembrolizumab, or transition to two thousand two and fifty milligrams every three weeks plus pembrolizumab. The primary endpoint will evaluate progression free survival. In designing an alternative dosing regimen, our priority is to preserve FICERRA's potential best in class profile while creating practical options for patients and providers. Since we expect to seek accelerated approval for FICERRA with the fifteen hundred milligram weekly dose from the FORTIFY HN01 study. Running this randomized study in parallel will allow us to potentially have results from this study in time for a potential approval, creating a compelling path for early adoption of the streamline regimen.

12:53 Additionally, this addresses an important need for patients, providers and payers, specifically by providing treatment options that will reduce clinic burden, improve quality of life and support long term adherence. And critically, this dosing strategy is shaping how we are thinking about lifecycle management and FICERRA's opportunity beyond frontline recurrent or metastatic head and neck cancer. With that, I'll turn it over to Ryan to discuss the potential market opportunity and what's ahead for the rest of the year. Thank you, Bill. Turning to the broader opportunity, we have strong conviction in the differentiated profile Bicara has shown across our clinical program compared to other investigational agents in head and neck. And the development strategy we built around that profile is designed to deliver against the full opportunity ahead.

13:41 Head and neck cancer is a significant and fast growing global market projected to reach more than $5,000,000,000 in global sales into the 2030s. HPV negative patients represent a large majority of patients in the frontline or current metastatic setting, and HPV status is known at the time of diagnosis, which means that HPV testing is not a barrier to care. Across major markets, there are roughly fifty thousand annually incident patients, including approximately eighteen thousand in The US where we plan to launch initially. The unmet need in this population for a therapy that drives deep, durable, and clinically significant benefit while sparing chemotherapy and improving quality of life is what makes the rigor of our clinical data and the discipline of our development strategy matter.

14:29 It is also why we continue to invest the medical and commercial infrastructure required to deliver Bicara to patients. This includes the commercial leadership team we have been building, with Chris now leading our commercial efforts, including the prelaunch evidence generation and field readiness work required for a successful oncology launch. And we look forward to having him on the road with us at ASCO and beyond. While the frontline recurrent metastatic setting is our initial focus, the opportunity for Ficara in head and neck cancer is much larger, Given our conviction in Ficara's potential to be both first and best in class, we see clear space to own and lead a broader segment of the head and neck cancer landscape. The locally advanced setting, in particular, represents another large market with clear biologic rationale for Fiscera and a meaningful opportunity for expansion.

15:21 As we think about that opportunity, we have initiated two investigator initiated sponsored studies in the locally advanced setting and continue to enroll additional cohorts that will inform our expansion strategy, including a cohort of patients in frontline recurrent metastatic HPV negative head and neck cancer with CPS less than or equal to one, as well as a cohort of patients with frontline recurrent metastatic HPV positive head and neck cancer with heavy history of smoking. Beyond head and neck, we believe there is a strong biological rationale to expand Bicara's pipeline and a potential into a solid tumor types with significant unmet need. We have already shown proof of concept in indications such as cutaneous squamous cell carcinoma and anal canal cancer, reinforcing our conviction in Bicara's broad applicability across TGF beta driven tumors.

16:13 Building on that foundation, we are currently enrolling patients in a phase 1b expansion cohort evaluating Ficara, both as a monotherapy and in combination with pembrolizumab in patients with third line plus metastatic colorectal cancer. TGF beta is implicated in metastatic disease and resistance to current treatments, providing a biologic rationale for evaluating Ficara in this setting. This is also a challenging setting. Patients are very sick, often progressing rapidly through prior lines of therapy. And with the treatment landscape and CRC continuing to evolve, we are taking a measured approach with a high bar for what would warrant further investment. As the data mature across these cohorts, we will continue to make thoughtful decisions about where Bicara can deliver the most differentiated value and how we allocate our resources accordingly.

17:05 With that, I'll turn it to Ivan to review the financials. Thanks, Ryan. Earlier this morning, we reported detailed first quarter twenty twenty six financial results in our press release, and I'll summarize a few highlights here. Our total operating expenses for the first quarter of twenty twenty six increased compared to our first quarter of twenty twenty five, driven by clinical operations and development expenses associated with our ongoing pivotal FORTIFY HN-one study, including increased manufacturing and development costs. We also saw an increase in personnel related costs, including stock based compensation, as we have grown our workforce, primarily in support of clinical operations and development functions. Consistent with the first quarter, we anticipate continued increases in operating expenses for 2026, reflecting increased investment in our clinical operations, particularly for the pivotal FORTIFY HN1 study with the interim analysis expected in mid-twenty twenty seven and parallel study, as well as an increase in SG and A as we invest in early commercial and medical infrastructure to support the potential launch of Bicara.

18:13 We ended the first quarter of twenty twenty six with $539,800,000 in cash, cash equivalents and marketable securities, bolstered by an oversubscribed public offering in February that generated $161,800,000 net proceeds and meaningfully strengthened our balance sheet, which provides cash runway into the first half of twenty twenty nine and allows us to invest thoughtfully in areas we believe will deliver future clinical and commercial success. With that, I'll now turn the call back over to the operator for questions. Operator? Thank you. Press 11 on your telephone and wait for your name to be announced. To withdraw your question, please press 11 again. In the interest of time, we do ask that you please limit yourself to one question.

19:02 Please stand by while we compile the Q and A roster. And our first question comes from Eric Schmidt of Cantor. Your line is open. Good morning and thanks for taking my question. Maybe one in terms of what to expect ASCO in a couple of weeks' time. Can you provide us with any benchmarks for three year outcomes data, landmark data in HPV negative head and neck? And then you mentioned looking at the role of TGF beta as well. Does that mean that we're going to see some correlations between PD and response rates? Thank you. Thank you for your question, Eric. So, the question was relating to a preview of the ASCO 2026 datasets.

19:48 So as we highlighted during the call, there are two separate abstracts that were accepted as behalf of ASCO. One is focused on long term follow-up in terms of the three expansion cohorts in frontline recurrent and metastatic HPV negative head and neck, with the most mature data set being the fifteen hundred milligram one you were alluding to, which will have three years worth of median follow-up. In that one, we really hope to speak to the so called immunotherapy tail driven by the TGF beta durability. And so in there, if you look at prior precedence, pembrolizumab in all comers delivers about a twenty percent to twenty five percent three year overall survival, while it's believed to be about fifteen to twenty percent in the HPV negative subset from real world data sets.

20:41 The other abstract is focused on looking at depth and durability of response from the TGF beta inhibition. And we'll continue to speak to what we believe is Ficara's defining hallmark that TGF beta inhibition is driving this depth of response that's ultimately leading to far superior durability than other investigational agents and leading to outsized overall survival benefit. Thank you. Thank you very much. Thank you. And our next question comes from Tyler Van Buren of TD Cowen. Your line is open. Hey guys, good morning. Congrats on the progress. Thanks for taking the question. Just want to ask a quick follow-up before my question, if you don't mind.

21:30 A follow-up on Eric's question related to the ASCO data. I guess it's clear that we'll have three years to follow-up with the fifteen hundred mg dose. But since investors are asking, it would be helpful if you could just clarify how much follow-up we should expect with the two thousand and seven fifty dose cohorts. We can obviously guess, but just clarity there would be helpful. And then I guess my main question is related to the alternate dosing regimen of the fifteen hundred mg induction with the two thousand two and fifty mg maintenance. Do you think it's possible that that regimen could have improved durability than either fifteen hundred or two thousand two and fifty alone based upon exposure and the data you've produced to date?

22:18 Thanks for your questions, Tyler. So I'll answer the first question first, which is a question around the other two cohorts being presented at ASCO, which are the seven fifty milligram weekly cohort, as well as the two thousand milligram every two week cohort. Both of those have approximately twelve to eighteen months worth of median follow-up. And so we do plan to share longer term follow-up data sets for both of those at ASCO in a few weeks. And to help answer your question around durability of response in the maintenance setting, I'll pass that question over to Ryan. Thanks, Tyler, for the question. In terms of the regimen, again, the overall approach that we are taking there, as you mentioned, is we're initiating it with the fifteen hundred milligrams weekly and then transitioning to a maintenance phase at 2,250.

23:07 A couple, I think, key tenets of that approach. One, as you recognize from the data that we presented thus far, we see deep rapid responses, which are enabled by the fifteen hundred milligram dose. And really being able to get a depth of response, more than 80 of our patients are getting depth of response of 80% or greater, which we really believe is contributing to that durability. One of the things that the two thousand two hundred fifty every three weeks enables is an exposure profile that allows us to, I think, maintain that durability after we receive or achieve very meaningful reductions in tumor reductions. And keeping patients on from a tolerability perspective, I think being able to bring people into clinic every three weeks rather than every week while maintaining exposures to maintain that durable response.

24:00 We absolutely believe that this regimen potentially enables both a more durable as well as a better, more tolerable profile. Thank you. And our next question comes from Steven Willey of Stifel. Your line is open. Yeah, good morning. Thanks for taking the questions. Maybe just some color around the use of PFS as a primary endpoint in the dose optimization trial, just given that this is obviously an event driven endpoint, there's no control arm? And then is there a formal non inferiority margin that you need to hit? Guess just any color you can provide around kind of this formal notion of comparability would be helpful. Thanks.

24:55 Thanks for your question, Steve. So, I'll actually answer the second part of your question first around non inferiority. This is actually not designed as a non inferiority study. We got positive feedback from the FDA based off of our discussions, based off of the sizing of the study, which we alluded to being approximately one hundred and fifty two hundred patients, it would have required far more patients as a non inferiority study. The other focus, again, back to Tyler's question, the other focus of looking at this dosing regimen is really again to ensure that we're maintaining the efficacy profile focused on depth and durability of response with the induction into maintenance dosing.

25:43 And so the focus of the PFS endpoint was really to look at that, ensuring the durability is consistent between the two arms. And the FDA was comfortable with PFS being that endpoint for that reason. Great, thanks. Thank you. And our next question comes from Kelsey Goodwin of Piper Sandler. Your line is open. Hey, good morning. Thanks for taking my questions. I think you alluded to it in the prepared remarks, but for your competitors' frontline trial where they increased target enrollment by about 200 patients, I just first wanted to confirm, is there any read through to FORTIFY and its trial size? And then secondly, how do you think about the gap and timing now between Ficara and PEDO? Thanks so much.

26:33 Thank you for your question, Kelsey. So just to highlight, we were alluding to the LIGR one study and you may have seen on clinicaltrials.gov that the page was updated to reflect enrollment of 700 patients up from the original 500 in an all comers study. I think that's consistent with feedback we've been hearing from investigators that they were planning to add additional HPV negative patients. From what we have heard today, was potentially an imbalance in terms of HPV positive versus HPV negative patients in that particular study, given that there are no other HPV positive studies in phase three. We haven't seen any read through other than the fact that it continues to highlight what we've always highlighted that FICERRA has the potential to be both best and first in class.

27:25 We've seen very strong execution of the FORTIFY HN-one study, and those dynamics continue to speak to what we believe is a significant narrowing of the perception around Ficara and FORTIFY being second to market. In fact, we continue to believe in our potential first in class. That's great. Thank you so much. Thank you. And our next question comes from Brad Camino of Guggenheim. Your line is open. Hey, good morning. Thanks, team. It's nice to be on the call. At ASCO, maybe just to drill into one of the doses, the lower seven fifty mg, which wasn't selected for the Phase III. So how do you look at that as really being able to support the TGF beta hypothesis given the exposure and coverage that it provides?

28:15 And will that view only be in a subset of patients such as the responders? And then just a quick second, given we're talking about the competitor trial and the upsize, where do you sit with expected timing of OS analysis for your Phase III study today? Thank you. Thanks, Brad, for your question and welcome to the team. So to the first question around the seven fifty milligram dose, so that was as you highlighted a dose that we did not take forward in the pivotal phase three study. However, we do see significant TGF beta inhibition and we know that from EGFR receptor occupancy we are fully saturating the EGFR locus.

29:02 So we've always thought of it as still superior than EGFR monoclonal antibody, while showing slightly less TGF beta inhibition. What you will continue to see at ASCO is that even in this patient population, the hypothesis that TGF beta inhibition is driving improved depth and durability will continue to speak to another strong data set that will reinforce the notion now in a total of ninety patients that we have strong depth and durability data that will speak to outside overall survival benefit. And your second question was related? Timing of OS I apologize. Timing of OS analysis. So as we continue to guide to the interim analysis for potential accelerated approval is slated for mid-twenty twenty seven, which is a look at overall response rates with six months of durability and likely a look at qualitative overall survival at that time. We do anticipate being focused on HPV negative patients only, that our event rates will happen more rapidly than those of our peers, and that the OS endpoint will come again more rapidly than anticipated.

30:22 Great, thank you. Thank you. And our next question comes from Judah Frommer of Morgan Stanley. Your line is open. Yes. Hi, good morning. Thanks for taking the question, guys. Maybe just broadening out the competitor conversation a bit, we saw some data from an OX40 targeting asset this morning, but I believe in CPS greater than 20. So maybe can you just remind us of kind of the breakdown of the epidemiology by CPS score and kind of what the advantages of a broader targeting asset in FICERRA could be and again, what timelines could look like versus this asset? Thanks. Thanks for your question Judah. I do believe you're referring to an Inhibrix presentation that actually I believe is happening at the same time as our call. While we haven't had a chance to significantly look at the dataset, I can speak at a high level to those results.

31:22 So as you alluded to, the data set from I believe a randomized Phase two is focused on CPS greater than or equal to 20. So these are considered the CPS high patients who typically do respond to pembro monotherapy. What we do know is that FICERRA is being the FORTIFY study is being looked at in the CPS greater than or equal to one, as well we have shown some strong results from our late line patients in CPS zero and are currently looking at an open label CPS zero cohort. In the CPS one to 19 category, we see strong response rates across all three of our cohorts between fifty to seventy percent, really speaking to the TGF beta inhibition going after the more immune, so called immunosuppressive patients where the CPS flow. From an epidemiological standpoint, it's believed to be about 50 CPS one to 19 versus CPS 20 to greater and 15% of the frontline market being the CPS zero.

32:31 I think your other question was around just the competitive threat. What we believe we're hearing is that they're slating to start enrollment in the pivotal study later this year with full enrollment scheduled to be 2029. So significantly later than our interim analysis for potential accelerated approval coming mid twenty twenty seven. We do not see this as a competitive threat in terms of timing. Thanks. Thank you. And our next question comes from Randy Benjamin of Citizens. Your line is open. Hey, great. Thanks for taking the questions and congrats on the progress. As my question is mainly focused around the Phase 1b expansion cohorts and the early proof of concept signals, can you just maybe provide more color on each of those expansion cohorts, kind of why we're going after CPS less than one and those patients with heavy smoking?

33:34 And then same thing with the CRC, what is that high bar that you're hoping to achieve when those results come out in the second half? Thank you. Thank you for the question. I'll start with the other cohorts. You had mentioned CPS less than one, and also the heavy smokers. I think what we have saw in dose escalation is we actually saw some pretty significant responses in those patients who had CPS0. In fact, one patient in particular had a complete response there. As you go back to kind of the fundamental biology of our molecule EGFR and TGF beta, there's a lot of biological support for the synergy associated with those two mechanisms being given together and also in combination with a PD-one.

34:27 And so that was biology that we wanted to probe and again exploring a population. As Clara had alluded to in the last response, in terms of the epidemiological perspective, about fifteen percent of patients are CPS less than one, so it's a meaningful population. And again, biology that's supported by our molecule. In the heavy smokers, I think it goes back to our view. When we looked at our dose escalation data retrospectively, there was a responder population with an HPV positive. All of those patients who responded were heavy smokers. In that case, we saw people who had a history of smoking of twenty pack years or greater who responded. And again, of our three responders there, two out of the three of them were complete responses.

35:15 So our view is that there's likely a component of smoking that's driving the biology there, even more so than the HPV positive infection. And again, an area that we wanted to probe as we think about those expansion opportunities within the head and neck population. CRC, I think honestly it's an evolving target. We continue to look at the landscape. We've seen data sets out from other agents of recent. And I think the other thing, not only is relative to the competitive landscape, but also our own internal. Had mentioned activity in cutaneous anal canal. There's good opportunities for this molecule on the locally advanced setting of head and neck. So as we evaluate the various opportunities, there are, I think, ample opportunities to develop Ficara across a range of different tumors and more broadly in head and neck cancer. And that really is the bar, is where we think we're going have the most meaningful impact, and that's where we're going to end up investing our capital.

36:20 And can I just follow-up with when we might see some of the data for we know when the CRC data is coming out, but maybe from these other cohorts? When might we see those data? Again, we've not provided specific guidance on that. And again, we'll provide greater clarity in terms of timing for that in future updates. Great. Thank you very much for taking the questions. Thank you. And our next question comes from Jeet Mukherjee of BTIG. Your line is open. Great. Thanks for taking the question. Just looking ahead to your loading and maintenance regimen, Just as you talk to your investigators, how do they think about a twelve week weekly regimen followed by once every three weeks versus just a pure once every two week regimen from Pito there?

37:15 Is there any preference that they have generally between one or the other? Obviously, safety and efficacy being, the primary point there, but just was curious if there's any preference there between the two regimens. And then just coming back to ASCO, are we looking to have updated data be a part of the abstracts, or will they be reserved for the conference presentation? Thank you. I'll take your first question there. As we have talked with investigators and the broader community, I think there's a real focus on that initial therapy and the rapidity and the depth of that initial therapy. I think even if you look at the historical treatment paradigm, we continue to see a fair amount of chemotherapy used.

38:05 And that is largely being driven by the desire to have very rapid responses. And so in terms of that trade off of being able to go to every two weeks at the outset versus being able to get rapid deep responses, the preference continues to be that rapid deep response, which the weekly regimen gives. Again, I think as you think about the overall administration schedule transitioning to every three weeks at the twelve week mark, I think the view there is a willingness to get faster, better efficacy quick, and then be able to go to a more convenient maintenance regimen over time. And to your second question, Jeet, which I believe was about whether the abstracts whether the data presentation will have more mature data than the abstracts. That is correct. There will be more data provided during our presentation than what was provided in the abstracts.

39:06 Thank you for your question. Thank you. And our next question comes from Boris Peaker of Jones Trading. Your line is open. Great. Thanks for squeezing me in. Just to follow-up on a prior question, and we're talking about every two week dosing, every three week maintenance dosing. In addition to potentially satisfying FDA's Project OPTIMACE requirements, how important do you see this dosing from the commercial perspective and kind of competitive perspective? I'll answer your first question around Project OPTIMAIS and then pass it over to Ryan. So just to highlight, Boris, we have satisfied Project OPTIMAIS by choosing the 1,500 as opposed to the seven fifty milligram dose weekly within the FORTIFY HN01 study. So this is a separate parallel clinical study that is looking at moving this new alternative dosing regimen into a potential ultimate label.

40:13 To your second question around the commercial uptake, I'll pass it over to Ryan. Yeah, in terms of from a differentiation perspective, efficacy remains the key parameter for differentiation, consistent I think with most oncology molecules. Again, that's why we continue to initiate with twelve weeks of weekly therapy to maximize efficacy, deep, durable, rapid responses. And again, we think that that will be the key that's going to drive differentiation and the initial share uptake between ourselves and competitor molecules. Being able to then also maximize and optimize for schedule once you get out to that twelve week maintenance phase, we believe that we will be creating a regimen that has the ability to not only compete, but to differentiate and be best in class from an efficacy, tolerability, and from a convenience perspective, really being able to fully optimize the profile across all three dimensions.

41:18 Great, thanks for taking my question. Thank you. And our next question comes from Joe Catanzaro of Mizuho. Your line is open. Hey, everybody. Thanks so much for taking my questions. I actually had one as well on this maintenance trial that you've sort of, I think, touched on. But wondering if you could speak to the quantitative difference in exposure at steady state, if any, between 1,500 weekly and 2,250 every three weeks. It sounds like you need those longer term efficacy metrics, but wondering if the argument could be made on sort of equivalent PK and safety between those two regimens. Thanks. Yes, I mean, again, from an overall exposure perspective, what we are looking to accomplish there, the 2,250, essentially we're looking for exposures that are comparable to what you've seen at seven fifty. And again, why we look across the various data sets to really get, I think the regimen that we have gotten to. We're looking at the strength of the data across all of our various cohorts.

42:32 So again, I mean, I think the key here is starting the fifteen hundred milligrams, getting that rapid deep response then being able to maintain the exposure levels to maintain the durability of response. Okay, great. Thanks so much. Thank you. And our next question comes from Richard Law of Goldman Sachs. Your line is open. Hey, guys. Good morning. So based on that accelerated approval timeline, I believe you mentioned in the past that only a small clinical team will be unblinded to review the interim Phase III results and management will still be blinded. So when will management team become unblinded and when should we expect to see the data as well? And also does it mean that the unblinded clinical team will file the BLA with Dell management seeing what's in there initially when filed?

43:32 Richard, I think you're just to understand your question, the study is a blinded study. We have an interim for potential accelerated approval in mid-twenty twenty seven that will be based on response rates with six months worth of follow-up as well as qualitative overall survival. Like any company, there will be, the data cut will be done, the data lock will be done, and then our team within Bicara will submit the BLA. There are no oddities to that process. So there's no separate unblinding with a different team and then where I I thought that was the case before. It's not not that No. So there is an IDMC, like like, in many cases, that will allow us to submit, and then we will move to the Bicara team.

44:26 Okay. Thanks. Thank you. I'm showing no further questions at this time. I'd like to turn it back to Claire Mazumdar for closing remarks. Thank you for joining us today and for your continued support of Bicara. We're focused on the work ahead for the program and most importantly for the patients we're working to serve, and we look forward to seeing many of you at ASCO in a couple of weeks. This concludes today's conference call. Thank you for participating, and you may now disconnect.