Pascal Touchon
Analyst · JPMorgan. Your line is now open
Thank you, John, and thank you, everyone, for joining us this morning. Before we begin our discussion on our recent progress, I want to reinforce how proud I am of the advances we’ve made toward our vision of delivering an off-the-shelf allogeneic T-cell immunotherapy to every patient in need at any time. We know that lives depend on us achieving this vision and our team is strongly motivated every day to deliver meaningful results for patients and the company. During today’s call, we’ll provide context surrounding our new strategic priorities, recent clinical and operational progress, and upcoming milestones. First, I would like to update you on Atara’s strategic objective and priority, following the extensive review of technologies, assets, resources and organization that I have conducted during my first month as CEO. Objective moving forward is to become the leading off-the-shelf allogeneic T-cell immunotherapy company, transforming the life of patients with cancer, autoimmune and viral diseases. We are planning to accomplish this objective over the next three years by executing resiliently on four strategic priorities. First and foremost, file and launch tabelecleucel or tab-cel for patients with relapsed/refractory EBV+ PTLD in the U.S. and Europe as well as develop tab-cel for other indications. Second, achieve clinical proof of concept with ATA188 or allogeneic MS-specific EBV T-cell immunotherapy. Third, advance of mesothelin programs with autologous ATA2271 and allogeneic ATA3271. And fourth, develop ATA3219 or allogeneic CD19 therapy to clinical proof of concept in B-cell malignancies. In parallel, we’ll continue to leverage the capabilities and expertise of external partners for autologous CAR T immunotherapy development. Starting with tab-cel, we are very pleased to share exciting long-term outcome data, from a multicenter expanded access program following acceptance of an abstract of presentation at ASH 2019. I would like to ask only to highlight the long-term outcomes in a subgroup of 22 stem cell and 13 organ transplantations with relapsed/refractory EBV+ PTLD treated with tab-cel. We would likely had been eligible for our ongoing Phase III study. These results demonstrates tab-cel was generally well-tolerated with overall response rate of 55% in HCT and 82% in SOT patients. Estimated two-year overall survival lasts 79% for HCT and 81% for SOT. With such large amount of patients and longer duration follow-up, these data are consistent with previous studies showing a well-tolerated safety profile, high response rates and durable overall survival of two years, that to reinforce our clinical development and regulatory strategy for patients with relapsed/refractory EBV+ PTLD. These new data also confirm that tab-cel is potentially the transformative off-the-shelf allogeneic T-cell immunotherapy with compelling value for patient, physician interest in this often deadly ultra-rare cancer. Turning to our pivotal clinical development program for tab-cel, we remain on track to initiate tab-cel BLA submissions for patients with EBV+ PTLD in the second half of 2020. We now have 35 sites available for enrollment in the U.S. and Australia, and plan to continue to open additional sites at transplant centers in the U.S. and Canada over the coming months. We also plan to file a clinical trial application or CTA in several European countries by the end of this year, and to open study sites there next year. Meanwhile, we engage in discussions with the EMA and the outcome of these discussions will determine the timing of the tab-cel EU conditional marketing authorization application for patients with EBV+ PTLD. Our BLA submission guidance takes into account the recruitment constraints inherent in our pivotal study due to the nature of PTLD as an ultra-rare and rapidly progressing disease. Our Phase III study are also only open at about 10% of transplant site in the U.S. And there are a number of competing, although less advanced, clinical trials. Since July, we have upgraded the way we are addressing these constraints. And importantly, we believe these development constraints should have limited impact on the tab-cel business case for PTLD. Indeed, the value to individual patients will be high with such a potentially transformative T-cell immunotherapy. Also tab-cel could be delivered within three days of order to any center to an appropriate patient’s need. And if tab-cel becomes the first approved treatment for PTSD, it will likely be supported by patients and physicians based on proven efficacy and safety. The potential U.S. market sites where we serve tab-cel indication is several 100 patients per year. Taken together with the potential tab-cel opportunity in Europe, we believe there is a strong and profitable business case for Atara to commercialize that sale in the relapsed/refractory EBV+ PTLD in these geographies. We’re also advancing studies in potential additional indication for tab-cel. We continue to enroll patients in our Phase I/II clinical study of tab-cel in combination with anti-PD-1 therapy in patients with platinum-resistant or recurrent EBV-associated NPC. We also expect to start enrollment in the Phase II multi-cohort study targeting other EBV+ cancer in the second half of 2020 to continue expanding the value proposition of tab-cel. Overall, these value studies show the potential opportunity for tab-cel as an ultra-rare disease pipeline in a product. Now turning to our second corporate priority, ATA188. We reported encouraging data taken since September in patients living with progressive MS. Recently we reviewed the six months follow-up data for cohort 3 dose. Based on this data, we are pleased to share that we have selected this cohort 3 dose to initiate the Phase Ib portion of the study. The decision to initiate the Phase Ib was based on achieving in cohort 3 our pre-determined criteria of a continued well-tolerated safety profile and at least 50% of patients experiencing clinical improvement based on the multi-scale assessment defined at ECTRIMS with improving patient coming from more than one clinical study site. Recognizing these are early data and incorporating input from external experts, we believe these results merit the acceleration of ATA188 development for progressive MS patients who have limited treatment options and in whom continuous decline is expected. In addition, enrolment in the fourth and final client Phase I dose escalation cohort is complete. Six months data from cohort 4 will be mature in April 2020. We plan to present then all cohort data in detail at an appropriate congress in 2020. Following such encouraging ATA188 results and in line with our strategic focus on allogeneic T-cell therapy, we have decided not to move forward with the Phase II study for ATA190 or autologous product in MS. This decision will allow us to focus our resources on ATA188 to ensure efficient study execution as well as reduced autologous operating complexity and associated manufacturing cost. We’ll continue to evaluate strategic options for ATA190. Our first strategic priority is around the mesothelin CAR T programs, ATA2271 and ATA3271. ATA2271 is an autologous CAR T for mesothelin-associated solid tumors for which an IND is planned in 2020. ATA2271 will enter the clinic first, while we work to advance development of ATA3271, our allogeneic mesothelin-targeted CAR T, leveraging our EBV T cell platform. Both of these programs have great potential due to the incorporation of a novel 1XX co-stimulatory domain and a PD-1 dominant negative receptor. Finally, Atara’s first strategic priority is ATA3219 or internal allogeneic CD19 CAR T. This asset is currently in preclinical study and will later evolve to IND with the goal to demonstrate clinical proof-of-concept for our EBV CAR T cell platform. Here we intend to show that allogeneic EBV CAR Ts are safe, expand in vivo traffic to more sites and persist efficiency to obtain high response rate and durability of responses. Turning to a few operational updates. Facility commissioning and qualification activities to support clinical development at our operations and manufacturing facility ATOM are complete. Commercial production qualification activities are progressing well and aligned with our commercial strategy. Additionally, and will be expected by a new CEO, Operations, maximizing at a rather operational efficiency, I am now in a process of adapting my leadership team to a new strategic priority. This effort includes active searches for a new Global Head of Research and Development, a Head of Commercial and a General Counsel. Before opening the call to – for the questions, I would like to comment on our third quarter 2019 financial results. We ended the quarter with cash balance of $282.9 million, reflecting proceeds from a recent secondary follow-on financing. We continue to expect to have cash to fund and growing operations in 2021. I would like now to turn the call back over to the operator, so we can go ahead and take your questions. Operator?