Sanjay Shukla
Analyst · Jones Trading
Thank you, Ashlee. Good afternoon everyone and thank you for joining us for our second quarter 2021 results conference call. As we make our way through 2021. We continue to make significant progress in our mission to translate novel biological pathways into innovative therapeutics for improved outcomes for patients. Notably, we recently completed the last subject visit in our Phase 1b/2a proof-of-concept study of our lead therapeutic candidate ATYR1923 or 1923 in pulmonary sarcoidosis, our lead interstitial lung disease or ILD indication. We expect to report results from this important study in mid September of this year. This is a significant milestone for ATYR and the upcoming readout represents a key inflection point for 1923 clinical program and tRNA synthetase biology platform. The clinical proof of mechanism for 1923 established from our Phase 2 study in COVID-19 patients and the favorable safety profile demonstrated to-date, along with the preclinical efficacy observed in multiple translational ILD models support the potential for 1923 as a new therapeutic approach for pulmonary sarcoidosis and possibly other forms of ILD. We believe 1923 could potentially offer an alternate to current treatments, such as steroids with improved efficacy and fewer side effects. In addition to finishing up the important work for our 1923 clinical program, we've continued to generate new data and publish research related to our preclinical program further strengthening our pipeline. As we begin today, I'll summarize a few additional highlights. Since we last spoke in May. We hosted a key opinion leader or KOL event on current treatment options for pulmonary sarcoidosis, featuring Dr. Daniel Culver, Chair of Pulmonary Medicine and Director of Diffuse Parenchymal Lung Disease at the Cleveland Clinic. Kyorin Pharmaceutical Company, our partner for the development and commercialization of 1923 for ILD in Japan completed a Phase 1 study in healthy Japanese volunteers. We have two abstracts for 1923 accepted for presentation at the upcoming European respiratory society or ERS International Congress. We expanded our research collaboration with the Iowa State University or OSU to deepen the understanding of the immune mechanisms of sarcoid granuloma formation and identify potential biomarkers of efficacy for 1923 for pulmonary sarcoidosis. Dr. Elliot Krauser, professor of pulmonology critical care and sleep medicine at OSU will serve as principal investigator. We received a patent grant from the U.S. Patent and Trademark Office covering methods for the use of histidyl tRNA synthetase or HRS, FC fusion proteins, which includes the use of 1923 for reducing inflammatory response in the lung. We appointed Dr. Sara Zaknoen, a highly accomplished drug development and clinical research executive to our board of directors. Dr. Zaknoen is a hematologist oncologist, who has previously held Chief Medical Officer positions at several biotech company. We presented a poster at the Keystone symposia, cancer stem cells, advances in biology and clinical translation meeting related to preclinical research highlighting mechanistic insights into the tumor inhibitory effects of ATYR2810 or 2810, our lead anti-Neuropilin-2 or NRP 2, VEGF antibody candidate in preclinical development for cancer. And finally, we presented a poster at the antibody engineering and therapeutics euro virtual conference related to a second anti NRP 2 antibody, which demonstrated the selective blocking of that antibody to Semaphorin 3F signaling. We made significant progress during the first half of this year and we see the second half of this year shaping up to be as equally productive. Let's begin with our clinical program for 1923. We're developing 1923 as a potential treatment for patients with ILD, a group of rare immune mediated disorders that can cause progressive fibrosis of the lung. There are more than 200 types of ILD, but roughly 80% of these patients fall into four main disease categories, pulmonary sarcoidosis, chronic hypersensitivity pneumonitis, connective tissue disease, ILD, and idiopathic pulmonary fibrosis. All of these diseases have limited standard of care with substantial morbidity and mortality. 1923 has the potential to address this unmet need by targeting the aberrant immune responses central to ILD pathology and preventing progression of fibrosis, the key driver of poor outcomes in these patients. We estimate there are over 500,000 ILD patients in the U.S. alone and over 3 million patients globally. While our initial focus for 1923 is only sarcoidosis, the mechanism of action or MoA data from preclinical models and demonstrated effects on key inflammatory biomarkers in patients with COVID-19 pneumonia suggests that 1923 could have potential in other ILD indications as well. Our initial ILD indication for 1923 is pulmonary sarcoidosis, a hallmark disease characteristic of pulmonary sarcoidosis is the formation of granulomas or clumps of immune cells in the lungs. The formation of these granulomas is driven by persistent aberrant inflammation. If left untreated, it can lead to irreversible scarring or fibrosis and diminished lung function, which may lead to respiratory failure or the need for a lung transplant. We estimate the patient population for pulmonary sarcoidosis to be approximately 200,000 patients in the U.S., although estimates do vary. About half of all patients will require some form of systemic therapy. And unfortunately, 30% of all patients will have chronic progressive disease despite available treatments. The current standard of care for pulmonary sarcoidosis typically includes treating the inflammation with corticosteroids and other immunosuppressive therapies. While these treatments can help manage inflammation and alleviate symptoms, such as cough and shortness of breath, they have no demonstrated efficacy on disease progression and can result in serious long-term toxicity. Additionally, many patients do not respond to currently available treatments. So there is a substantial need for a safer, more effective treatment that could reduce or replace the requirement for chronic corticosteroids or other immunosuppressive therapy. This need was recently reinforced by one of the leading experts in the field Dr. Daniel Culver at the Cleveland Clinic. In June, we hosted a KOL event with Dr. Culver, who discussed limitations with the current standard of care and unmet medical need for treating patients with pulmonary sarcoidosis, including the toxicity burden of chronic steroid use and the need for better steroid sparing agents. Through this event, we heard firsthand from Dr. Culver about some of the side effects related to steroid use in sarcoidosis, including some staggering statistics related to metabolic complications, quality of life, economic burden and risk of mortality, leading him to believe that there is no safe maintenance dose of corticosteroids in patients with sarcoidosis. If you're unable to attend the event, I encourage you to listen to the replay, which can be found on our website. Now let's talk a bit more about 1923 and why we believe it is a potential first-in-class immunomodulator. For some of the inflammatory lung diseases we've been discussing, including pulmonary sarcoidosis. 1923 is a novel FC fusion protein based on the naturally occurring splice variant of the lung enriched tRNA synthetase HARs fragment that down regulates average immune responses in inflammatory disease states. 1923 has been shown pre-clinically to downregulate, inflammatory cytokine and chemokine signaling and reduce inflammation and fibrosis. NRP 2 is upregulated on key immune cells known to play a role in inflammation and is enriched in inflamed lung tissue. 1923 selectively binds NRP 2 and therefore has the potential to normalize the immune system, serving to resolve inflammation and prevent progressive fibrosis, thereby stabilizing lung function and alleviating morbidity and mortality. As a reminder, our ongoing trial in pulmonary sarcoidosis is a Phase 1ba, 1b/2a randomized, double blind, placebo controlled multiple ascending dose clinical trial in 37 pulmonary sarcoidosis patients. Trial consists of three cohorts testing doses of one, three and five milligrams per kilogram of 1923 or placebo dose intravenously every month for six months. The primary objective of this study is to evaluate the safety and tolerability of multiple ascending doses of 1923. Secondary objectives include assessment of the potential steroid sparing effects of 1923, in addition to other exploratory assessments of efficacy, such as lung imaging, lung function assessed by pulmonary function tests and relevant serum biomarkers. Based on our trial design, which includes a four steroid taper, an integral element of this study is to assess steroid burden in the 1923 treatment groups compared to placebo. As we have discussed here a bit today and reinforced by Dr. Culver, there is a crucial need for alternatives to existing treatment options, including steroids. We look forward to the results of this study, which we expect to report in mid-September this year. While we have advanced our clinical program for 1923, we continue to conduct research to deepen our understanding of 1923s MoA and advanced our understanding of sarcoidosis disease pathology. We are pleased to have announced that we have two abstracts for 1923 that have been accepted for presentation at ERS in September. One of these abstracts will present the biomarker data from our Phase 2 study in patients with COVID-19 pneumonia. Earlier this year, we released some findings from this data, which showed substantial anti-inflammatory effects in patients consistent with findings from our animal models. This data provides the first inpatient mechanistic proof of concept for 1923 and we look forward to sharing more details about the data at ERS. A second abstract will present data from a pilot proof-of-concept study conducted in collaboration with Dr. Elliott Crouser, a leader in sarcoidosis research and treatment at OSU which demonstrated the ability of a splice variant f HARs, the active component and portion of 1923 to disrupt sarcoid granuloma formation in vitro. Based on these successful pilot study findings, we announced just earlier today that we are expanding our research collaboration with OSU and Dr. Crouser to continue this important work. The collaboration is intended to deepen our understanding of the immune mechanisms of sarcoid granuloma formation and identify potential biomarkers of efficacy for 1923. The study will assess the effect of 1923 on sarcoid granuloma formation in vitro using blood samples taken from sarcoidosis patients. We will also focus on identifying the relevant immune mechanisms triggered in granuloma formation and analyze promising biomarkers predictive of strong granuloma formation in order to assess whether they could be used as a predictive biomarker for treatment selection or treatment response to 1923. We're very excited to continue our work with Dr. Crouser and his lab at OSU. The research generated from this collaboration may help direct us to biomarkers indicative of a population that may be sensitive to treatment with 1923 which could present the opportunity to take a much needed step forward in managing this disease and lead to improved patient outcomes. To wrap up our discussion on 1923, we're pleased to inform you that Kyorin Pharmaceutical our partner for the development and commercialization of 1923 for ILD in Japan has completed its Phase 1 study, which investigated the safety pharmacokinetics or PK, and immunogenicity of 1923 known as KRP-R120 in Japan and 32 healthy Japanese volunteers. In this study, 1923 was observed to be generally safe and well tolerated with no drug related serious adverse events and PK findings were consistent with previous studies of 1923. Before we turn to our pre-clinical program, I want to take a minute to highlight an important business update that occurred in the second quarter. In May, we announced the appointment of Dr. Sara Zaknoen to aTyr's Board of Directors. Dr. Zaknoen a hematology oncologist by training is an experienced pharmaceutical drug development and clinical research executive was previously held Chief Medical Officer positions at several biotech company. She also has a wealth of experience working at large pharmaceutical companies, including Novartis and Schering-Plough now Merck, where she was involved in supporting the development of a number of important marketed therapies, including Gleevec, Tasigna Exiade and Temodar. We believe Dr. Zaknoen's experience in advancing programs at both biotech and large pharma companies is ideally situated to support and guide aTyr as we prepare for the next clinical stage program to emerge from our tRNA synthase biology platform. I'd like to take a few minutes to discuss our preclinical program, which includes the development of anti NRP 2 antibodies for cancer and inflammation. NRP 2 is a compelling therapeutic target in a number of disease areas, including oncology and inflammation. When it comes to cancer NRP 2 is upregulated on a variety of solid tumors and is particularly enriched in highly aggressive tumors, with expression linked to worsen patient outcomes in several cancers, which may include drug resistance to current therapies such as chemotherapy or targeted agents. NRP 2 is also highly expressed on key immune cells implicated in regulating cancer progression, including tumor associated macrophages and myeloid derived suppressor cells, among others. Antibodies that can selectively block different aspects of NRP two signaling pathways may have the therapeutic potential in these aggressive cancers where NRP 2 is implicated. Our lead anti-NRP 2 antibody and IND candidate is 2810, a fully humanized monoclonal antibody that specifically and functionally blocks the interaction between NRP 2 and VEGF. The role of NRP 2 and VEGF signaling in the tumor microenvironment and its potential importance in the progression of certain aggressive cancers is becoming increasingly validated. We have generated a body of compelling preclinical data in both human drive and animal models demonstrating 2810s blocking ability, and tumor inhibitory effects. Notably, we've continued to strengthen our mechanistic understanding of the link between NRP 2 and the critical process of epithelial mesenchymal transition or EMT, which is of great importance in regulating tumor growth, progression and metastatic cascade, as well as being implicated in tumor evasion of the immune system. At a recent Keystone symposia of cancer stem cells advances in biology and clinical translation, we presented a poster demonstrating that in preclinical study, 2810 sensitize certain patient-derived xenograft models of triple negative breast cancer to chemotherapy. We are actively working to understand the underlying gene signatures that confer responsiveness. These findings build upon our mechanistic understanding of 2810 and demonstrate the molecular basis for selectivity by directly obstructing the VEGF binding site of NRP 2. 2810s ability to affect EMT and cancer stem cell properties may be one mechanism by which it mediates the anti-tumor effects we have observed. This work moves us closer to identifying the underlying characteristics within a tumor that may confer responsiveness to treatment with 2810. IND enabling activities for 2810 to support advancements and clinical trials in cancer in the future are ongoing. I will now turn it over to our Chief Financial Officer, Jill Broadfoot to review our financial results.