Dr. Jennifer Buell
Analyst · William Blair. Please go ahead
Thank you very much, Garo, and hello everyone. As Garo mentioned, I’ll start by providing an update on AGEN1181, and there’s a summary of this program on slide 4 that we’ll review today. This molecule is familiar to many of you. As Garo said, it’s our multifunctional T-cell antibody, which also binds to CTLA-4. Now, importantly, this molecule is engineered -- the Fc region of this molecule is engineered. We did this because we knew of some key features this engineering could provide. Those features included increased immunogenicity, increased T-cell activation, beyond which we see with first-generation CTLA-4, superior combination with PD-1, as you see on slide 4 as well as important potential safety benefits such as a reduction in endocrinopathies for patients treated. And we expect to increase or broaden the patient population of responders, patients who will respond or unlikely to respond to a first generation CTLA-4 due to a genetic polymorphism, the impacts about 40% of the population. And what we’re going to talk to you about today, our data from this trial which will show that as the molecule has been designed to benefit patients who harbor this genetic polymorphism, patients are benefiting from AGEN1181. We have also seen no endocrinopathies, none of the safety-related side effects that we see with Yervoy related to hypophysitis or otherwise, a very important feature. Fc engineering is something that we know to be really quite important. We’ve published on this technology and our techniques on our AGEN1181 molecule in Can Cell last year. We’ve also -- as Dhan will speak to you today, we’ve the engineered our TIGIT molecule in order to bring similar enhancements. We’ve shown you data that supports the benefit of this engineering. And we’re also now seeing data from late-stage clinical trials with Fc engineered HER2 antibody called margetuximab. You may be aware of some of that data. So on slide 5, I’d like to summarize AGEN1181 is advancing in a Phase 1 dose-escalation trial. This next-generation antibody has shown profound activity in the form of objective responses, which are unusual to see this early in clinical development. We’re hopeful that based on the current trends and as patients continue on therapy, that we’ll continue to see more patients with more durable responses. Now, you may have heard that a number of hospitals have been converted to treat patients with COVID-19, and this could impact of course some clinical trials as well as patient access or patients with cancer getting access to their therapies. However, in spite of this reality, we continue to recruit to our trials without interruption. Our principal investigators have informed us that based on the data available to-date, AGEN1181 has lifesaving attributes that supports the continued enrollment of this trial. And today, we have a queue of patients waiting to be enrolled. Now, you may remember, as I mentioned earlier, that AGEN1181 was deliberately designed to improve the efficacy and safety of first generation CTLA-4. In addition, this antibody is expected to expand the patient population who will benefit. And now, I’m going to highlight some data that supports the design of this molecule and the activity that we’re seeing. In our dose escalation trial, AGEN1181 alone and in combination with balstilimab demonstrated clinical benefit rate of 70%. This includes complete responses, partial responses as well as disease stabilization of patients with late-stage cancer. Now, during our last call, we described a patient with refractory endometrial cancer. This patient had late-stage disease, checked out all prior therapies and importantly she had a very poor prognostic based on available biomarker that help us determine a patient’s likelihood to respond to therapy. These markers include the patient with negative for PDL-1, the patient had microsatellite stable disease, which is unlikely to respond to immune therapies, and this patient had a genetic polymorphism in her CD-16 allele that rendered her unlikely to respond to a first generation CTLA-4. In spite of these negative odds, we are thrilled to see that this patient is a confirmed a complete responder on AGEN1181 monotherapy at 1 mg/kg. Now, on slide 6, I want to highlight another very exciting case. This patient is a patient with refractory endometrial cancer, with a similarly poor prognostic profile with metastatic disease in multiple locations as you can see here. This patient is now also a confirmed partial response in her target lesions and a complete response in her non-target lesion. This patient responded to a very-low dose of AGEN1181 in combination with balstilimab, our PD-1 antibody. If I can turn your attention now to slide 7. Last week we convened with our Advisory Board. Now, this Advisory Board is comprised of top immuno-oncology experts, some of them are specialists in the CTLA-4 mechanism, some of whom were the first to dose patients with a first generation CTLA-4 over 20 years ago. After an extensive review session, our advisors endorsed our accelerated development path for AGEN1181, which we are now in the process of launching as we speak. For this phase of development, we will pursue a fast-to-market strategy. This means going after cancers, where there is limited or no effective treatment options available to these patients. These tumors are highly prevalent or said differently, large cancer market, like commercial market opportunities. These opportunities include PD-1 refractory non-small cell lung cancer, PD-1 refractory melanoma and microsatellite stable tumors like colorectal cancer as well as endometrial, which are the two cases that I shared with you just a few moments ago. We’ll continue to keep you updated as these programs progress and mature. I’ll now turn to our lead program, our PD-1 program balstilimab, which we call bali, and our CTLA-4 program zalifrelimab, which we call the zali. The results that you see on slide 8 show the evolution of cancer therapies for women with cervical cancer. Starting with chemotherapies on the left and VEGF inhibitors, which are still widely used despite their limited benefit. The data that we’ve presented now from our program, balstilimab and zalifrelimab are based on a large cohort of 55 patients, who had a median of 12 months of follow-up. Importantly, all responses were confirmed by an independent radiology review, which is a gold standard in assessing outcomes in cancer. We summarized our findings in a recent Agenus newsletter, which is available on our website. Notably, we have observed 14 objective responses. These include 4 complete responses and 10 partial responses in these 55 patients evaluated so far. This is a response rate of 26%. As a reference, Merck was granted accelerated approval for their PD-1 antibody based on 11 responses in 77 patients with a response rate of 14%. As you can see here, our combination has the potential to become the most effective treatment available to patients with metastatic cervical cancer. And a few comments regarding cervical cancer patients and our plan. Cervical cancer is a horrifying disease, particularly for young women who come from economically disadvantaged backgrounds and have limited access to healthcare. Patients are diagnosed and then treated with toxic chemotherapy, which has many difficult side effects and little clinical benefit. Their cancer ultimately progresses with a little to no effective treatment options available to them, as you can see here. We’re committed to changing this reality. Data from our cervical cancer clinical trials with the Agenus bali + zali, our PD-1 and CTLA-4 antibodies, has shown a near doubling of responses, as compared to currently available treatments. And importantly, most importantly for us is that these responses are durable. These patients are not converting or progressing once they’re responding, which is incredibly important to patients. And also importantly, we’re seeing patients with long-term disease stabilization who later convert to response. During our recent year-end call, we mentioned that we received Fast Track designation from the FDA for the investigation of balstilimab alone and in combination with zalifrelimab in relapsed/refractory or metastatic cervical cancer. We plan to submit our BLA filings this year and we’ll continue to keep you informed on our progress. Now, I’m going to wrap up with few very exciting programs. During our recent meeting with clinical experts, they noted that we have the most productive research engine in I-O. I agree. Today, I’m joined by two of our lead scientists responsible for our next innovation expected to enter the clinic very soon. Dr. Dhan Chand and Dr. [indiscernible] are leading our TIGIT and our iNKT programs respectively. They’re joining us here to talk about these programs today. As you know, TIGIT is shaping up as a powerful combination partner with PD-1 antibodies, especially in tumor expressing TIGIT. We’ve designed two different approaches to optimally target TIGIT. First, our Fc engineered anti-TIGIT antibody has outperformed all tested competitor antibodies and showed superior T-cell activation when combined with PD-1 or LAG-3 antagonists. And our TIGIT bispecific molecule AGEN1777, which has demonstrated potent tumor killing is a monotherapy in difficult-to-treat cancers where PD-1 antibodies alone are ineffective. In addition to these two TIGIT antibodies, we are rapidly advancing our allogeneic cell therapy to the clinic to treat patients with cancer and to treat patients with COVID-19. We expect both INDs to be cleared shortly. And as a matter of fact, one may clear as early as this week. I note that, like us, the FDA has been working through weekends to process applications, which is very heartening during this health crisis. [Indiscernible] will tell you more about T-cells. She is trained in molecular biology and immunology and she joined us from the Harvard Beth Israel Deaconess Medical Center.