Q4 2022 Agenus Inc Earnings Call

Speaker 2: Thank you for holding and welcome everyone to the age and fourth quarter and full year 2022 financial results conference call. All lines have been placed on mute to prevent any background noise. After the speakers remarks there will be a question and answer session. If you'd like to ask a question during this time.

Speaker 2: Simply press star followed by the number one on your telephone keypad. If you'd like to withdraw your question again, press the star one. Thank you. I will now turn the call over to Zach, Head of Investor Relations. Zach, please go ahead.

Speaker 3: Thank you Jack, and thank you all for joining us today. Today's call is being webcast and will be available on our website for replay.

Speaker 3: I'd like to remind you that this call will include forward-looking statements, including statements regarding our clinical development, regulatory and commercial plans and timelines, as well as timelines for data release and partnership opportunities.

Speaker 3: These statements are subject to risks and uncertainties, and we refer you to our SEC filings for more details on these risks.

Speaker 3: Joining me today are Dr. Gato Arman, Chairman and Chief Executive Officer, Dr. Sivan O'Day, Chief Medical Officer, and Christine Klaskin, Vice President of Finance.

Speaker 3: Now, let's turn the call over to Garrow to highlight our progress and speak to our outlook for the remainder of the year.

Speaker 4: Good morning, everyone.

Speaker 5: And thank you for joining us this morning.

Speaker 5: We are absolutely thrilled to share the progress we've made at Agenas in advancing our deep immuno-oncology pipeline.

Speaker 5: Our portfolio is designed to address areas of high patient need.

Speaker 5: and to unlock the large untapped market opportunity in cold and treatment-resistant cancers.

Speaker 5: And on top of that, to provide benefit beyond what is currently available with IO treatments,

Speaker 5: in other tumors, including hot tumors.

Speaker 5: At the forefront of our pipeline is botanosilamab.

Speaker 5: a clinical stage multifunctional

Speaker 5: EFSI enhanced CTLA for anybody.

Speaker 5: with potentially blockbuster capabilities.

Speaker 5: Over the last 12 months, we've made substantive progress advancing the ongoing Potentially Map Development Program.

Speaker 5: including having endorsed over 300...

Speaker 5: heavily pretreated patients with advanced solid tumors as part of our phase 1b trial. That's a very large trial by any account.

Speaker 5: And we've done this with Ez Manotapian in combination with our PDL1, I'm sorry, PD1 anybody, false philomax.

Speaker 5: Well, Tacilumab has produced durable objective responses in nine cold and or treatment resistant cancers including...

Speaker 5: MS is colorectal cancer.

Speaker 5: And MSS stands for microsatellite stable cancers that are particularly challenging to treat with immunotherapy. So we've seen results in MSS colorectal cancer, MSS endometrial cancer, MSS endometrial cancer,

Speaker 5: Platinum resistant, refractory, ovarian cancer.

Speaker 5: PD-1 and CTLA-4 resistant refractory melanoma, a particularly challenging patient population.

Speaker 5: of melanoma, P1-resistant refractory cervical cancer.

Speaker 5: and your sarcoma

Speaker 5: list of difficult to treat cancers that have been treated and failed prior treatments.

Speaker 5: Based on the unprecedented clinical responses in these patients...

Speaker 5: We have initiated three global randomized research trials evaluating the efficacy and safety of botanilumab monotherapy or combination therapy with botanilumab in MSS cholorectal cancer. We have initiated three global randomized research trials evaluating the efficacy and safety of botanilumab monotherapy or combination therapy with botanilumab monotherapy or combination

Speaker 5: melanoma, and pancreatic cancer.

Speaker 5: We aim to initiate a phase 3 study in MSS colorectal cancer later on this year in the hope that the cumulative data that we've generated between phase 1

Speaker 5: The Phase II randomized trials and the initiation of our Phase III trials will lead to a rapid approval path for the benefit of the patients.

Speaker 5: We are thrilled by the clinical results we have seen with Potentium App and are excited about its potential to positively impact the treatment landscape for patients, obviously.

Speaker 5: suffering from cancer, all kinds of cancers.

Speaker 5: We remain committed to advancing our pipeline of innovative therapeutics and believe that our portfolio of programs in the immuno-oncology space is robust with multiple programs in development, including

Speaker 5: Very importantly, our ILT-2 program.

Speaker 5: which is codename Adrian 1571.

Speaker 5: and our CD137 program, otherwise also known as 41BB.

Speaker 5: which is codenamed AGEN-2373. Both of these molecules are progressing in the clinic.

Speaker 5: We look forward to sharing more updates on our progress during various conferences throughout this year and our other communication means as well again throughout this year.

Speaker 5: Thank you for your attention, and now I will turn the call over to Steven Odey to highlight the recent clinical data presented on botansilamab. Dr. Odey has a very extensive section today because there's a lot to talk about, and so we'll ask him to go through it very, very orderly, slowly.

Speaker 5: because I think the content is something that is not to be rushed. Dr. Odeh.

Speaker 5: content is something that is not to be rushed. Dr. O'Day. Thank you, Gero.

Speaker 2: Together with our investigators, we were pleased to have had the opportunity to present data updates.

Speaker 6: from the Botanilumab and Balsillimab Development Program.

Speaker 6: at five medical meetings over a nine month period.

Speaker 6: including plenary sessions at ESMO World Congress on Gastrointestinal Cancer.

Speaker 6: the Society for Immunotherapy of Cancer, otherwise known as CIPSI, the Connective Tissue Oncology Society known as CTOS, and the Center for Immunotherapy of Cancer.

Speaker 6: along with a late-breaking oral session at the American Society of Clinical Oncology Gastrointestinal Cancer Symposium this past January . And finally, an oral plenary session at the upcoming Society of Gynecologic Oncology annual meeting. Let's find out.

Speaker 6: These presentations highlighted the durable responses and meaningful clinical benefit of the bone-cyllimab-phalcillimab combination.

Speaker 6: compared to what has been reported to Standard of Care and other investigational therapies.

Speaker 6: in patients with MS stable colorectal cancer.

Speaker 6: Non-small cell lung cancer.

Speaker 6: ovarian cancer, and sarcoma.

Speaker 6: I'll now briefly describe these data updates, beginning with our MS Stable Colorectal Cancer Program.

Speaker 6: In metastatic MS stable colorectal cancer

Speaker 6: after failure of first and second line therapies.

Speaker 6: The current standard of care is a 12 month overall survival rate of approximately 25%.

Speaker 6: and an overall response rate of only 1 to 2 percent.

Speaker 6: Other PD-1 or PD-L1 CTLA-4 combinations evaluated in this comparable patient population have reported response rates of only 1 to 5 percent. Our latest update of Boat's Solvab program is...

Speaker 6: USC, Norris Comprehensive Cancer Center, and the Keck School of Medicine at USC.

Speaker 6: This presentation showed that treatment with Botanilumab-Balstilumab combination resulted in a 12-month survival rate of 63%.

Speaker 6: including a 12-month survival rate of 81% in patients with no active liver metastasis.

Speaker 6: and a 40% 12-month survival rate in patients with active liver metastasis.

Speaker 6: suggesting a favorable overall survival in each of these patients subpopulations. Median overall survival in the overall population and the subset without active liver met disease has not yet been reached.

Speaker 6: The overall response rate of the 70 evaluable patients was 23 percent, and 69 percent of these objective responses were still ongoing at the time of the data cut.

Speaker 6: The disease control rate, which is inclusive of complete responses, partial responses, and stable disease was 76%.

Speaker 6: These patients had a median number of four prior lives of therapy.

Speaker 6: Turning to anti-PD-1, PEL-1 relapse for factory non-small cell lung cancer.

Speaker 6: At CITC we reported our first four evaluable patients.

Speaker 6: with two objective responses or 50% response rate.

Speaker 6: And three out of the four responses with disease control for a 75% disease control rate.

Speaker 6: Since CITC, we have four responders out of a total of eight patients now with four additional patients treated.

Speaker 6: Confirming the response rate reported at CIPC in a larger patient population. Other PD-1 or PD-1-CTLA-4 combinations in this second or third line PD-1 refractory non-small cell lung cancer population.

Speaker 6: have reported response rates of 6 to 13%. Based on these early clinical signals, we are aggressively expanding enrollment in this non-small cell lung cancer cohort and plan additional non-small cell lung cancer studies.

Speaker 6: In 19 evaluable patients with platinum relapsed refractory ovarian cancer

Speaker 6: We observed five responses for an overall response rate of 26% and a disease control rate of 63%.

Speaker 6: Other PD-1 or PD-L1-CTLA-4 combinations have reported response rates of 3 to 10 percent in comparable patient populations.

Speaker 6: An update of this cohort will be presented at an Oral Plenary Session at the Society of Gynecologic Oncology 2023 Annual Meeting in Women's Cancer.

Speaker 6: on March 27th in just a couple weeks.

Speaker 6: At CTAS last November and presented by Dr. Bree Wilke at the University of Colorado, data was presented...

Speaker 6: on a cohort of heavily pretreated metastatic sarcoma patients of mixed histology.

Speaker 6: of the 13 evaluable patients.

The 12-month overall survival rate was 77%, and the median overall survival had not yet been reached. The 12-month overall survival rate was 77%, and the median overall survival rate was 77%.

The overall response rate was 46%.

with 67% of the objective responses still ongoing at the time of the data cutoff.

Other PDV1, PDL1, CTLA4 combinations have reported response rates of 12 to 16 percent in comparable patient populations. Reflecting the high unmet patient need in each of these cancer types, we have been encouraged by the consistently positive feedback we received from the

activities starting with MS stable colorectal cancer.

We have launched a randomized phase two trial of Botanilimab and the Botanilimab-Balcilimab combination therapy.

in patients without active liver metastasis who have received one or two prior lines of standard of care therapy.

This study is actively enrolling at sites around the world.

Importantly, we have designed this study to satisfy key regulatory requirements, including exploration of two known active fixed doses of Botanilab.

In addition, we are evaluating both boat and syllabus monotherapy.

and as combination with balfilamab.

and to establish the contribution of respective components in this study.

Finally, we have randomized to a fifth...

control arm that is a standard of care, either regressive...

or Long-Serve at their approved doses and schedules.

We intend to submit for regulatory review of MS stable colorectal cancer in 2024 a data package with this randomized phase 2 study along with data for more than 300 patients in the phase 1b study.

This package will include overall response rate, duration of response,

progression-free survival and overall survival.

We also expect to launch a phase three confirmatory study at MS stable colorectal cancer in 2023 that will be powered to demonstrate statistically significant and clinically meaningful overall survival.

We expect this study to be considerably or fully enrolled by the time of our potential regulatory submission in 2024.

Now let's turn to melanoma.

in melanoma as part of the phase 1b expansion. We reported responses with Botanilumab model therapy in patients who are refractory to PD-1 and

patients refractory to both PD-1 and C-2A4. This is an area of significant unmet need.

We currently have an active

A phase 2 study evaluating both silhouette monotherapy

in these cohorts of PD-1 refractory and PD-1 CTLA-4 refractory disease and plan to explore a rapid registration path if the observed signal remains robust.

In metastatic pancreas cancer, we are evaluating a second line to patients in a phase two randomized study comparing standard of care, Gemabraxane to Gemabraxane in combination with Bodzilumab UNT strangely successfulSh realizing there has always been a kind of dent in our stroke

therapy. We continue to enroll patients in our ongoing Phase 1B expansion cohorts with a focus on PD-1 or PD-L1 refractory non-small cell lung cancer patients.

Like our approach with melanoma.

We plan to explore a rapid registration path in non-small cell lung cancer if the observed signal continues to remain robust.

Oat filaments clinical activity in late stage or refractory cancers has generated substantial interest from leaders in the field worldwide, including requests for cooperative and investigator sponsored trials.

As we progress trials to support potential registration in colorectal cancer, melanoma, and lung cancer, we plan to leverage these important partnerships to expand development in indications such as sarcoma and ovarian cancer.

as well as other areas where Botanilumab has already demonstrated promising potential clinical benefit.

While advancing the clinical development of Botanilumab and Bostilumab remains our top priority,

We also continue, as Gero said, to progress a focused number of additional programs combining Botanilab with other agents in our pipeline to further expand the therapeutic potential of Botanilab and unlock the full potential of our portfolio.

Let me tell you a little bit about those programs.

We expect to complete enrollment of our phase 1 study of boat and still map.

in combination with AGEN 2373.

a CD137 agonist in PD-1 relapsed refractory melanoma in the first half of 2023.

HN-2373 is a conditionally active CD137 agonist.

designed to stimulate the activation of cytotoxic T and NK cells while mitigating the liver toxicities common to this...

target class. The advancement of this study triggered a $5 million payment.

from our partner Gilead last year. We also dose the first patient in the phase 1 study.

of AGEN 1571 at the end of last year as a model therapy.

and continued dose escalation of model therapy this year.

In addition, we will be combining our agent 1571 in combination with both Filamab and Filamab in advanced solid tumors this year.

Agent 1571 is an ILT2 agonist antibody designed to modulate tumor-associated macrophages.

T cells, NK cells, and NK T cells to overcome resistance to checkpoint blockade.

This clinical study was initiated based on preclinical data we reported at the 2022 American Association for Cancer Research annual meeting, which showed superior potency and functional activity of HN1571 compared to the only otherwise known clinical stage asset.

as well as enhanced immune cell activation when combined with both boudin-silamab or bause-silamab. Now I'll turn the call back over to Gaurav to discuss our strategic partnerships.

Thank you, Stephen. As you can see, it has been a very, very busy year with a lot of impressive data that has been generated.

and the validation that we have received in making presentations, putting presentations, planning presentations, four of them within a six month window.

at major conferences and a substantial number of KOLs that have been engaged in discussions about the data and about our next steps.

with the data for expansion of our trials and a potential registration pathway.

So, progress with me.

I will surely differentiate it out in the end.

and through student partnerships has been impressive by all accounts.

And as you know, we have generated $825 million in cash already received.

to our partnerships with the potential to deliver an additional $2.7 billion in future milestone payments.

And on top of that, royalties when these products are commercialized.

So that's the side of our business which doesn't drain any resources, including cash resources, from the company. This is in addition to us advancing our own portfolio which may result in a significant upside, a financial upside, for the company.

And of course this is a testament to the strength of my pipeline.

and the innovative capabilities of our R&D platforms.

And thank you for that team at Genesee Research.

In 2022 alone, our partnership with Merck

VMS Insight Eurogen

have resulted in the launch of nine new additional clinical trials of our partner DASX.

What's even more impressive is that these trials are all evaluating molecules discovered here by a genus.

including some exciting ones like MK4830, an ILT4 antagonist.

now led by Merck and BMS 986442

Etygous by specific antibody now led by BMS. We're also seeing very great progress with molecules targeting Gitter, LAC3, Chem3, and oxygen in the

Now led by InSight. Looking ahead at 2023, that's this year.

We have some major clinical milestones inside.

As Dr. Audé mentioned.

We're expecting to complete enrollment of our global randomized face-to-activate studies on potential MAP in MSS cholorectal cancer, melanoma, and pancreatic cancer.

Plus, we expect to initiate a phase 3 study of botanilumab with botanilumab in MSS colorectal cancer, complete enrollment of our phase 1 beat study of botanilumab and HM2373. That's our CD137 molecule.

melanoma and initiate motensilumab and balsillumab combination cohorts in a phase 1 study of Agen 1571, a very exciting molecule that targets the myeloid arm of the immune system.

We're also advancing seven clinical collaborations evaluating combinations of external agents with RPD-1 and CTLA-4 antibodies sponsored and executed by our partners. All in all, we are incredibly excited about the future potential of our pipeline.

and our partnerships. We're thrilled, of course, to share these updates with you all. With that, I'll turn the call over to Christine for a financial update and I'll come back for closing remarks. Christine.

Thank you, Garrow. As we head into 2023, we remain financially strong and well positioned for continued growth and success.

We ended the year with a cash, cash equivalent, and short-term investment balance of $193 million, demonstrating our ability to manage our resources effectively and efficiently.

In the fourth quarter of 2022, we recognized revenue of $28 million, bringing our total revenue for the year to $98 million.

We incurred a net loss of $74 million in the fourth quarter and $231 million for the full year of 2022.

This includes non-cash expenses of $33 million and $96 million, respectively.

It is important to note that we have made significant investments in our pipeline, which we believe will drive our future success.

We remain committed to our mission of discovering and developing innovative therapies for patients, and we are confident that our investments will yield great benefits for patients in the long run.

Overall, we are pleased with our financial position and remain optimistic about the future.

As we continue to make progress across our pipeline and with our strategic partnerships, we look forward to the continued progress towards our goal of improving patient outcomes.

I'll now turn the call back to Gareth. Thank you very much Christine and Dr. O'Day.

the call back to Gareth. Thank you very much, Christine and Dr. O'Day, for that wonderful summary.

And of course, it's been quite a year for us. The clinical data generated in 2022 has been robust, and the results of Potensilomab-Nafsilomab combination therapy have shown superior benefit compared to what's been reported so far for standard of care and other investigational therapies.

This demonstrates the potential of this combination.

And it's a proxy potentially for our future combinations.

to provide significant benefit to patients and address the large medical need that exists in cold and treatment resistant cancers and added to that improved benefit provided by other iotherapies in hot tumors.

Looking ahead to 2023, we anticipate achieving important clinical milestones on top of a year that has already demonstrated very impressive outcomes.

that will set the foundation for potential regulatory filing.

or potential botesculinum plus pelsulfilumab within a period of time that will be in the best interest of patients based on robust data that can be justified.

So this is the promising next steps for our combination therapies.

Of course, none of these progress would be possible without the hard work and dedication of our Genesis team members, as well as the support of our physicians, caregivers, participants in our clinical development program, as well as our partners.

We're committed to our mission of bringing curative, and I want to underline curative therapies to cancer patients, and are excited to continue our dedication to this mission with our partners and stakeholders. Curative is very important and the Genesys is well positioned, we believe, to be able to accomplish this.

because we have a very unique, strong armamentarium of compounds that we have the flexibility to combine for the best outcome for patients with a curative therapy.

So let's open up the call for questions and continue the conversation. Please feel free to come up with any questions you'd like.

Yes. Jack?

Jack, back to you.

Certainly. Again, if you'd like to ask a question, please press star 1 on your telephone keypad. Matt Fipp, Blair, your line is open. Good morning, guys. Congrats on the update in the non-smaltz-alone cancer cohort.

I was wondering how many patients do you want to enroll in that cohort before deciding on a phase two trial? And you know also would you still need a model therapy arm or could the kind of model therapy data from colorectal and other indications kind of satisfy any contribution of the product?

So I answered the first question, if that's okay, and then turn it over to Dr. O'Day. With regard to non-small cell lung cancer, when we observe the kind of...

sustainable, robust patient outcomes in the form of response rates. We made a decision just about a month ago to expand that cohort significantly so that we can justify starting the absolute large even at phase 3 trials.

or a phase two trial, randomized phase two trial, that would be expendable. So in the interest of that, we made a decision to expand our cohort to at least 30 patients.

perhaps more, to at least 30 patients. And we expect that that will be accomplished within the next several months.

And with that information, we will take it to the next steps. If we can sustain the kind of impressive results we've seen in a very small patient population.

If that could be sustainable, then it will justify our next steps for an expanded trial. And as you know, lung cancer is a very large indication. And even though there are some, and it's a hot cancer for the most part, but there are a number of patients that fail current.

therapies including IO regimens in combination with other agents.

And that's the patient population that we've targeted in our phase 1 trial. That would be the patient population targeted in our expanded cohorts. And that's the patient population that we will go after in our registration strategy. Dr. O'Day, if you want to answer the colorectal question. Thanks, Matt. For the colorectal question, I think the question was the monotherapy arms in the colorectal trial.

as contribution of components. So our phase two trial is designed to look at contribution of components with motin-silamab in addition to the combination. We don't feel that PD-1 monotherapy is required for contribution given its lack of essentially zero response rate in this setting. And so, yeah, so thank you very much everybody. Thank you.

We will be looking at the contribution of votes. It wouldn't be ethical to treat with a PD-1 only arm in that disease setting.

Thanks. Just another kind of follow-up. Do you expect any milestones this year from your numerous collaborations, and just how much of a priority is additional business development for you this year?

Yes, there is the potential of several milestones this year. I don't want to quantify them or identify the source of them, but these will be, when they come through, they'll be significant milestones, not five or ten million dollars.

My arm, I'm untied.

With B. Reilly, your line is open. Good morning, team. Thanks for taking our questions and appreciate the level of detail. So on the two phase three trials that you're talking about initiating in 2023, can you just talk a little bit about the differences in kind of what you're trying to achieve? Like, for example, for the...

PRC complementary study, you know, how that differs from the ongoing randomized phase two data in terms of, you know, target patient population study objectives. And then on the phase three lung cancer study that, you know, you just touched on, like, what are sort of the key goals there? You know, is it late line patients? Is it…

So, obviously the phase 3 CRC population that we're targeting.

is going to be along the same lines as our phase 2 population.

so that we can show the kind of robust responses.

that we've seen already so far, which will be repeated in a randomized setting, as Dr. O'Day said, in the phase 2 randomized trial. And will we use valve or a proof 51 in non-small cell lung cancer? Well, right now, the plan is to use valve.

right now, but it's also a function of potential partnerships that we may engage in. Because as you know, there are companies out there with their own PD-1 or PD-L1 agents.

and they're eager to become more competitive.

with something that will offer superior performance. And so with those partnerships, we may engage in some creative structures that allows them to also have a head start with their own 51 that may have had exposure in lung cancer.

That remains to be determined. Got it. Specifically to the data that is coming up, on the lung cancer cohort, did you say how you might be tracking on things like BOR and OS? No.

PROC data at SEO would be great to hear what sort of incremental updates you may look to present relative to SPSI and you know as you know in a variant there's a few ways you segment your population, BRCA, FR-alpha status, so is there sort of a biomarker driven development in a way in your thinking as the next step.

targeting anybody. Our own CTLA for targeting anybody is not just the CTLA for binders, but it does four additional things.

and that's why we call it a multifunctional CTLA-4. It is not an improved CTLA-4. It really is a multifunctional CTLA-4. And the attributes of this molecule are responsible for a number of things beyond just achieving response rates, but duration of responses.

driven by this molecule, the back end of the molecule, the FC engineered portion, that has imparted a number of other capacities including recruiting immune cells and imparting, for example, down regulation of regulatory T cells.

stimulation of memory T-cells. These are all very important elements, as you know, my aunt, for the extension of responses or even achieving curative treatments in combination with an agent, for example, like hour 2371. So we really want to give these individuals a level of discern tension to find ways in which tooug Alam being saxophone

So, but to cut to the chase, our ambition here is, number one, overall responses that are correlatable with overall survival that will translate potentially to cures for these patients. In fact, as you know.

Using the word cure was a taboo in this field because it was not deemed that cancers or stage four cancers could be curable until Dr. O'Day injected the very first patient with CTLA-4. 1

that started a trend of course with CTLA-4 Yeroy, we addressed a very narrow slice of otherwise incurable melanoma patients with curative outcomes and because of the attributes of our molecule potential map

We hope that that narrow slice effect will be broadened and not just be in melanoma, but many more cancers than melanoma. That is our ambition. And of course having the other elements of our portfolio gives us a high level of confidence that by combining these agents, we can make a difference.

we may be able to achieve some remarkable outcomes for patients.

Great. And maybe just my final question, Gero, at that sort of high level about the portfolio, are you able to comment your sort of perception of how, you know, big pharma or strategic side evaluating next gen IO programs as you know, PCV and ADCs are sort of the modalities getting popularity.

I'm curious if you take your pipeline in that direction and then, you know, as big companies trying to assess value at the program level, for example, for BOT, you know, can you comment on if it happens at the indication level and if there's one or more tumor types that, you know, get more value and how development stage and depth of data kind of play in that. Thanks again.

And that's a great outcome for them. Now that money needs to be put to work.

And the way they're putting that money to work rightfully, this is not a criticism, this is a very practical comment, the right way of doing that is to purchase immediate income. And so the transaction, for example, that you heard yesterday was a major step that is driven by a concern about a patent cliff.

to work. And that's an immediate acquisition of a company that has immediate sales and cash flow.

And so that's their game plan. Now we think highly of ABCs.

But it's not our business model. Our business model is use the body's immune system. The power within the body.

to be able to overcome this miserable disease. That's our business model. And that's what we've been doing for the last 29 years and unwavering we're pursuing this. And that's what we will continue to do. Now, do we think, do we rule out the possibility of, for example,Image

immuno-oncology agents to be used along with targeted therapies, VEGF and so on and so forth. No, including ABCs. We don't rule that out, but we look at those agents as adjunctive agents to perhaps to accentuate the immune response.

to achieve the kind of cures that we're looking for. So that's our model.

Hi, good morning. Thanks for taking the questions. Is there anything that you can share about the two new patients who responded in the lung cancer cohort in terms of like background characteristics? And maybe if you could just comment like what level of response rate that you'd want to see in the phase 1b in order to be confident to move into phase 3.

you know, how, you know, the base, you know, taxes here in this setting and other molecules are really in the 10 to 15 percent response rate, which is very short-lived, as you know. So, obviously, we need to have meaningful differentiation from that to move forward. So that makes sense. Maybe also...

In your phase two study for MSS-CRC, since you're focusing on patients without liver mess, could you kind of comment on how you expect the control arm to perform in this setting, since, like, most of these studies have been more broadly evaluated? Thanks. Solight for aouple of people

Right now, we've reported obviously all patients with a 23% response rate and we've also shown survival data in the non-active liver meds. And so obviously, patients without active liver meds have higher response rates and better survival.

This is the subgroup that we think is a significant subgroup in colorectal cancer and will drive our earliest path to registration. So we're focusing the phase two and the phase three, as Garrett just said, in that patient population for response, the duration of response, PFS, and most importantly, overall survival.

And I think you asked a question about the control group and control group responses, Dr. Obe. So in this setting, in the second, third line setting in MS stable colorectal cancer, the response rates to Gregorath or Long-Serve have been in the single digits, very low single digits. Their major impact, if you can call it that.

is really in their PFS and OS, not their response rate, and that's even limited to several months.

Thanks. Maybe last question. Are you planning to share any melanoma or pancreatic data either from the Phase I or Phase II studies this year? I think the...

I think it's premature to really declare when we will be able to share that data, but we're hoping that at least internally we'll have a very good glimpse at how those trials are progressing by the end of this year. And depending on the nature of the data, meaning how many patients we've seen responded, how many patients.

had reportable outcomes, we may be able to report that in the first quarter at a major conference, first quarter of next year at a major conference.

Great. Thank you. Mike King with EF Hutton. Your line is open. Good morning, guys. Thanks for taking the question. Congrats on the updated non-small cell lung cancer data. I wanted just to see if we could get any just maybe housekeeping questions first on financial guidance. Good morning.

You know what I don't know if you want to say anything about how far the cash runway will take you what cash use or what? Expenses are the SPA might look like this year. I would imagine given the ramp up in File activity that are these spenders going to increase but I don't know if you want to quantify any of that Okay. Thank you Mike Not withstanding the little excitement we had over the weekend

Of course, even though we didn't have a majority exposure, and all of that is resolved now, at least from our perspective. And so, without any additional milestones.

course, even though we didn't have a majority exposure and all of that is resolved now, at least from our perspective. And so without any additional milestones, which is unlikely.

and without any additional cash infusion into the company.

partnerships and other means. We believe our cash runway will take us to the second quarter of next year. And of course, realistically, even our track record, it's not...

to be expected that we're not going to be able to bring in additional cash from sources that I outlined. Can you say how much you have left on the ATM?

As you know Mike, we have a very comfort zone with the ATM. As I've said publicly, we don't use ATMs day in and day out. Some companies do that. We don't do that. We use ATMs opportunistically to manage our cash based on our spending patterns and the prospect of near-

ATM executions for us have been not just going out and selling in the market, we've also had a reasonable amount of ATMs come in as a result of inbound inquiries from institutions. So instead of waiting for a transaction, sometimes institutions will come to us.

as they have as recently as the last few months, and said, would you consider giving us X amount of shares through the ATM? Sometimes we comply, and sometimes we don't, depending on the price of the stock and the timing of things. Okay, great. Thanks for the clarity.

Just again, to come back to the lung cancer data, the question we get a lot obviously is, what defines refractory? What definition do you guys use? Because there's always that concern about, you know, whether patients are truly refractory or not, you know, pseudo progression comes into play, et cetera.

Steve, I don't know how much you can add to that.

These are not pseudo-progressions. These are refractory patients who have come off PD-1 chemo combinations and then were on PD-1 maintenance and progressed on that therapy. So these are what we would consider refractory PD-1 patients.

So, I don't know why they... Okay, so they must have come off of maintenance? Sorry, what was that? I heard you. I thought I heard you say they must have come off of maintenance with PD-1? Well, so the standard first line treatment is combination chemo and Petruda. That's one example of a triplet combination that's most commonly used. Those patients get a limited amount of chemotherapy over four to six months.

responses are all confirmed responses, yes? So out of the eight patients we have four responses, three are confirmed and a fourth is waiting for confirmation with the next scan.

So just to clarify, by the way, the way it works with our reports, the definition of a confirmed response is the outcome of the second scan, not whether or not first is a real response or a not real response. I would electrician Woodson

We've confirmed that the first response is a bona fide response, but by definition, you have to wait for the next scan to just check if it's confirmed. So none of the four patients have not confirmed with a second scan.

I.

Okay, great. Thanks very much.

David Dye with SMBC your line is open.

Great. Thanks for taking my questions. So, first question is just around the first active trial in MS SCRC. As soon as you will be looking to submit BLA in 2024, is it fair to assume that we'll see some top-line data in early 2024? And then, I guess, you know, similar to that question that we had earlier, just to confirm that you could be rolling down liver map patients in that trial. Is that correct?

Just to confirm, we're going to be seeing the top-line data in content 4, would that be correct?

That is our expectation, but we'll have to follow the data and the approval. Got it. That's helpful, Steve. Another question just around the expectation for the upcoming Society of Gynecology on collageninium eating. So,

How many patients should we be expecting and what's the length that follows for these patients, the ovarian cancer patients? So we're not gonna give you the details, but stay tuned for the oral plenary presentation on the 27th. What I will say though is, you know, we've obviously had multiple conferences in front of GI community with our MS stable colorectal.

The real only opportunity for expanded other diseases was at CITC last year where we highlighted Lyme and ovarian and sarcoma. We did have the opportunity to present the sarcoma data, as I said, at a disease-specific sarcoma meeting last year with CTOS. And this is our first opportunity to really present this data.

the GYN data, the ovarian data in front of a large GYN community. So we're looking forward to that, and there will be additional data and follow-up presented. And remember, we're producing follow-up that's mature too, so the number of patients presented is less than what we are currently enrolled. So we feel that this is very important.

data that will be presented in a couple of weeks. Got it. And then just one last question around the safety side of Bonacilamab-Alcilamab combo. We did see some instance of immuno-relatoxes including GRAVE3 plus diarrhea and colitis in MSCRC.

So what are the latest thinking around mitigation strategies around that? And then how has been the receptivity of the physician with respect to balancing the efficacy and safety side of the equation? So that's a great question. You know, toxicity related, immune related toxicity correlates with clinical benefit. The important thing is early intervention and it's highly reversible.

with effective treatments. We've come a long way in the management of IRAEs. In terms of the diarrhea colitis, you know, it's a spectrum. It's now, diarrhea and colitis are the same immune-related phenomenon in the gut. And we have reported this toxicity in anywhere from

30 to 50% of patients at different doses and schedules, dose and schedule dependent. The important thing is that it's manageable with early interventions with steroids and TNF inhibitors. And we have a very targeted program in our phase two trials to early recognition of this toxicity and early intervention and subsequent prophylaxis with the combination of steroids and TNF inhibitors. And it's been quite effective.

And most of the toxicity is sort of evenly split between grade one, two versus grade three, four. We expect that to improve substantially in terms of grade three, four with our mitigation strategy. When physicians and patients understand that toxicity can be associated with clinical benefit...

They will report the symptoms earlier and they can be managed more quickly and we think this is an important lesson learned from the first generation of biotherapies.

All right, thank you so much.

Thank you for taking my questions. The first question is for the 23% ORR in microsatellite of stable colorectal cancer you have reported. Is there an update on if all the responses are confirmed responses? And secondly, for the projected regulatory submission,

In this occasion, in 2024, you mentioned ORR, DOR, medium PFS, all included as efficacy signals. I'm curious, have you discussed this regular path with FDA, what has been the feedback on the accelerated path and what is the...

question, the continuation of what we have reported as response rates.

Okay, so we have reported in colon cancer as of the ASCO GI meeting 23% ORR.

So we have reported in colon cancer as of the ASCO GI meeting 23% ORR and that hasn't changed.

In other words, we don't have additional information that disputes what we have reported as not continuing to be the trend in the range of, let's say, 20 to 25 percent overall response rates.

in colon cancer. I mean, as you know, we started reporting this with Esmo GI last June , and then we reported again at CITESY, and again at ASCO, and with the confirmed responses, the responses have been in the range of 20 to 25%. And as more data develops, of course, we're going to report to CITESY.

subsequent conferences.

conferences.

Thank you.

Any other questions? There are no further questions at this time. I would now like to turn the call back over to our presenters for final comments. Thank you very much everyone. It's been a long conference call.

surprise trials that will be announced both in the form of investigator sponsored trials that may be the focus of attention here including for example trials that will address the toxicity issue preemptively and these are being done at leading institutions. So stay tuned and we will keep you rest of our clinical data.

and what is happening with our potential discussions with prospective partners. Thank you very much. This concludes today's conference call. We thank you for your participation. You may now disconnect.

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