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Crescent Biopharma, Inc. (CBIO)

Q1 2017 Earnings Call· Thu, May 18, 2017

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Transcript

Operator

Operator

Good morning. And thank you all for joining GlycoMimetics Corporate Update Conference Call. At this time, all participants are in a listen- only mode. Following management's remarks, we'll hold a brief question-and-answer session. And at that time the lines will be opened for you. [Operator Instructions] I'd now like to turn the call over to Ms. Shari Annes of the Investor Relations group at GlycoMimetics. Please go ahead.

Shari Annes

Analyst

Good morning. And welcome to GlycoMimetics' first corporate conference call. Today's call will focus on the just published data contained in the abstract accepted for presentation to both the upcoming ASCO and EHA meetings in June. As you know, we issued our first quarter financial results press release on May 8. Should you have some questions about that topic, we'll be happy to respond in the Q&A session. Copies of our press releases are available in the news section of the company's website at www.glycomimetics.com. Today's call is being recorded and will be available in the Investor Relations section of the company website for 30 days. Joining me on the call today from GlycoMimetics is Rachel King, Chief Executive Officer; Brian Hahn, Chief Financial Officer and Helen Thackray, Senior VP and Chief Medical Officer. Before we start, I'd like to remind you that today's call will include forward looking statements based on current expectations. Forward looking statements contained on this call include but are not limited to statements about the timing of clinical results and presentation of data from our GMI-1271 clinical development program, as well as the development plans for rivipansel, our product candidate license to our collaborator Pfizer. Such statement represents management's judgment and intention as of today and involves assumptions, risks and uncertainty. GlycoMimetics undertakes no obligation to update or revise any forward looking statement. Please refer to GlycoMimetics' filings with the SEC which are available from the SEC or on the GlycoMimetics website for information concerning the risks factors that could affect the company. I'll now turn the call over to Rachel King, our CEO who will provide an overview of the highlights and discuss the GMI-1271 clinical program. Following Rachel, Dr. Helen Thackray, our CMO will discuss in greater detail the data contained in the GMI-1271 abstract. After some additional remarks from Rachel, we'll then ask the operator to open up the call for your questions. Rachel?

Rachel King

Analyst

Thank you, Shari. Good morning and welcome to our corporate update call. And thank you all for joining us today. Yesterday, we were very please to announce that FDA has granted Breakthrough Therapy designation to GMI-1271 for the treatment of adult with relapsed/refractory AML. In addition, with yesterday's online publication of abstract by ASCO and this morning's publication of abstract by EHA, the European Hematology Association, I'm delighted to be in a position today to provide you with clinical data update on our GMI-1271 program and offer our perspective on the data. Importantly, my goal today is to share our growing confidence to what we believe could very well be a novel and distinctly differentiated therapeutic approach to AML. To step back just a bit and there is perhaps many of you know GMI-1271 is a potent E-selectin antagonist. It's currently being evaluated in the Phase 2 clinical trial in AML in combination with standard of care chemotherapy. The Phase 2 trial is comprised of two arms. One, treating newly diagnosed AML patients 60 years and older and one treating patients with relapsed/refractory disease. Both arms are evaluating treatment with GMI-1271 and chemotherapy. The enrollment of the cohort of newly diagnosed patients has been completed and we are on track to complete enrollment of the other cohort of patients with relapsed/refractory AML by mid-year. In total and including AML patients enrolled in the Phase 1 dose escalation portion, we expect to evaluate approximately 90 patients consisting of approximately 25 with newly diagnosed disease and approximately 65 with relapsed/ refractory disease. This is a significant sample size and enrollment into this Phase 2 study been brisk. We think the pace of enrollment is indicative of the strong interest that our clinical investigators have for this novel agent. We began reporting the…

Helen Thackray

Analyst

Thank you, Rachel. Two GlycoMimetics abstracts have been selected for presentation at ASCO and two have been accepted for presentation at EHA. At both of the meetings in June we will provide updated data. To be clear, the results we are discussing this morning are the results of a late January data cut and are what is reported in the abstracts. The first abstract selected for poster with discussion at ASCO, updates data we provided at ASH for the relapsed/refractory arm of the study. The second selected for poster presentation reports on results seen in a newly diagnosed population of elderly patients. To step back a bit, GMI-1271 is a novel antagonist E-selectin that down regulate cell survival pathway and in animal model disrupts blast appearance in the bone marrow and enhance its survival when added to chemotherapy. In addition, in preclinical studies, reductions in chemotherapy induced mucositis were also observed following the administration of GMI-1271. Let's first turn to the relapsed/refractory findings that will be part of the poster with discussion at ASCO on Monday June 5. This is abstract 2520.We assessed GMI-1271 for salvage chemotherapy with mitoxantrone, etoposide and cytarabine or MEC for the treatment of patients studied. In the Phase 1 portion of the study, we dose escalated GMI-1271 across the pharmacologically active dose range from 5-20 mg/ kg combined with MEC induction. Treatment was well tolerated at all dose levels. In the Phase 2 portion, we've added the option for responders to receive consolidation with GMI-1271 and MEC. Safety, tolerability and anti-leukemia activity were evaluated and a prespecified analysis also included assessment of expression at the E-selectin ligand biomarker. The recommended Phase 2 dose of GMI-1271 used in the Phase 2 portion of the study was 10 mg/kg. As also shown in our prior published research…

Rachel King

Analyst

Thank you, Helen. To close, I'd like to reiterate that our plan with GMI-1271 going forward is to continue to report data as it matures at key oncology conferences, the next of which will be ASCO and EHA in June. We anticipate that this would then be followed by a more complete report at ASH in December based of course on our submission and their acceptance of an abstract. Our clinical program with GMI-1271 also includes a GlycoMimetics sponsored Phase 1 study in patients with multiple myeloma disease has become resistant to bortezomib or carfilzomib. In this study, GMI-1271 is added to their chemotherapy treatment regimen to evaluate whether sensitivity to the produced inhibitors can be restored. This is a multi center open label dose escalation trial being conducted in Europe. It's important to note that the finding of the importance of E-selectin ligand is not limited to AML and myeloma. I referred earlier to a large body of publication in addition to our own work that speaks to the relevance of E-selectin ligand poor prognosis. We prepared to background or summarizing this data which you can find on our website and which hope will be helpful to you as you think about how to consider the observations about the biomarker published today in the abstract. On another note, we can report that the Phase 3 program to evaluate rivipansel for vaso-occlusive crisis of sickle cell disease. According to our parter Pfizer remains on track and is a cool target for completion in the second half of 2018. I remind you that our partner Pfizer is managing that trial and that under special protocol assessment agreement with the FDA, the plan is to evaluate data from 350 patients. Given our own Phase 2 data with rivipansel that was selected for best of ASH and the recent positive Phase 2 results with the selectin P-select and antibody that was presented at ASH last year, we are increasingly confident in our approach to treat vaso-occlusive crisis or VOC. Through our own work and others, selectin have been shown to play an important role in the path of physiology at VOC. Based on the inherent challenges of compliance with prophylactic regimens, we believe our pan selectin approach in the acute setting is uniquely and well positioned to address key unmet needs in this underserved patient population. To conclude, going forward we will be developing a clinical and regulatory strategy taking into account these recent observations with GMI-1271 and taking advantage of the opportunity provided by the breakthrough therapy designation granted yesterday. We'll do this while continuing to generate longer-term follow up data on patients in our Phase 2 study including looking at effects of multiple cycles of therapy. As we do this, we also move towards the read out from the rivipansel Phase 3 study. I'll turn the call over now to the operator to address your questions. Operator?

Operator

Operator

[Operator Instructions] Our first question comes from Yatin Suneja with SunTrust. Your line is open.

Yatin Suneja

Analyst

Good morning, guys. Congrats on the data and breakthrough designation, it's really great. Just a couple questions I have starting with biomarker data. I think the first time you are talking about this data especially in patient. So is there any threshold at which you are seeing maybe better response 1271? I mean I know the median binding was about 35% but the range seems to be up to 75%. So is there any correlation that you are seeing or is there a particular threshold beyond which you are seeing higher responses?

Rachel King

Analyst

We haven't announced anything about the threshold. The announcement I have to -- the information we disclosed today I think has to be limited to what was disclosed in the abstract in which we indicated that it was predictive of response. And the higher levels of the biomarker were associated with more likely remission. We will be disclosing additional data around that at ASCO and at EHA.

Yatin Suneja

Analyst

Okay. And then in frontline patient, are there any differences in terms of level for the frontline AML patient relative to relapsed/refractory?

Rachel King

Analyst

Again, I am afraid I have to limit myself to the data that's in the abstract but we will be sharing more when we know about that at ASCO and at the EHA as well.

Yatin Suneja

Analyst

Okay. And then in terms of the future development plans, I mean since you now have a breakthrough designation, are you planning to prioritize one indication versus the other? And at what point you will be meeting with the FDA? And what is your expectation for -- like how do you think the registration programs going to look like?

Rachel King

Analyst

Well, as I indicated we received the breakthrough therapy designation just yesterday which we are of course thrilled about and so we haven't yet had conversation with the FDA in that context. We've been doing a lot of thinking about plans for the program and so that puts us a in a good position to have those conversations with the agency which we anticipate doing later this year. And once we have a clear path described and outlined together with the agency we will be sharing them.

Yatin Suneja

Analyst

Okay. Maybe just one more then again going back on the biomarker, I mean how are you doing that? Are you using flow cytometry and then let's say if you do a future trial or future trials would you prescreen patients for high E-selectin ligand bindings?

Rachel King

Analyst

The assay that's currently being run in the Phase 2 study is being done by flow. And we are looking at flow and other ways that the assay could be done going forward. As far as whether we would use that or how would you use that in future studies, again I am afraid I am going to have to defer that comment. Importantly though the breakthrough therapy designation as we announced, it is not limited to patients with high levels of expression of the biomarker. The breakthrough therapy designation is for patients with adult or adult with relapsed/refractory disease. So we are in the process of evaluating of how we can incorporate the biomarker into the development plans. Again, we'll share that information when we know more.

Operator

Operator

Thank you. Our next question comes from Stephen Willey with Stifel. Your line is open.

Stephen Willey

Analyst · Stifel. Your line is open.

Yes, good morning. Congratulation on the updates and on the breakthrough. I know so in the abstract last night you showed I guess for the first time leukemia free survival and overall survival in the phase of one portion of the relapsed/refractory study. Can you just remind us whether or not 1271 was allowed during consolidation in the Phase 1 portion? Because I know that the trial protocol was amended at some point to allow for 1271 beyond induction. I am just trying to think about those data points in the context of dosing.

Rachel King

Analyst · Stifel. Your line is open.

Yes. That's a very important point actually and a distinction between the Phase 1 and Phase 2 portion of the study. So let me turn that to Helen to address that more specifically.

Helen Thackray

Analyst · Stifel. Your line is open.

Thank you. So in the Phase 1 portion of the study we administered GMI-1271 with induction chemotherapy, it was not available with consolidation for responders. In the Phase 2 portion of the study we had added then the opportunity for responders to receive GMI-1271 with consolidation MEC chemotherapy in relapsed/refractory and with consolidation intermediate dose Ara -C in the newly diagnosed older population. So we treated for one cycle of chemotherapy with GMI-1271 in the Phase 1 and those of the data that are reported. And we anticipate reporting at a later time the data from Phase 2 when treatment with multiple cycles with an option.

Stephen Willey

Analyst · Stifel. Your line is open.

Okay. That's helpful. Thank you. And then I guess with the discussion around E-selectin as a biomarker. It's obviously some telling to be identified predictive of response in this disease but I guess just given the mitigation of the chemo induced toxicity, do you think that there is an even need to pre-select patients on the basis of E-selectin ligand expression specifically in the relapsed/refractory setting?

Rachel King

Analyst · Stifel. Your line is open.

I think that raises a very interesting point and I am glad that you mentioned it because while we do see this relationship with respect to remission, we have not said anything about whether that -- in fact one wouldn't expect that it would be the case that patients will have to have higher level of E-selectin ligand on their tumors in order to see a potentially beneficial effect during the induction chemotherapy. I am just saying that based on our preclinical data. In our preclinical data, we showed reductions in chemotherapy induced mucositis which were quite pronounced in the animal model. We haven't disclosed data yet on that in the abstract but we will report on it when we know it at ASCO and EHA. But I think you are correct that one not might necessarily need to select for patients to see that benefit in the induction phase. So that's a very and certainly an interesting observation we've seen pre-clinically and we are excited to follow that in the clinical setting as well.

Stephen Willey

Analyst · Stifel. Your line is open.

Okay. And maybe just one more if I may. So I guess as you think about the Phase 3 trial design or some advanced trial design here in relapsed/refractory setting, would you think that you would have to specify NEC as a control arm or would you expect that to be kind of more of physicians' choice type of decision? And then maybe if you Rachel whether expect to just broader strategic question is the Phase 3 something that you would like to take on by yourselves or would you prefer to maybe pursue some kind of cost and risk sharing arrangement? Thanks.

Rachel King

Analyst · Stifel. Your line is open.

Sure. Let me turn it first to Helen to address the control arm in the Phase 3 in the current topic.

Helen Thackray

Analyst · Stifel. Your line is open.

So we know from this trial the effects that we are seeing with MEC chemotherapy; we know also from our preclinical data that survival benefit over chemotherapy is seen with multiple different times of chemotherapy. And so we would want to discuss with the agency about the program going forward whether it's appropriate to treat as we have with MEC chemotherapy or perhaps broaden to other chemotherapy options available to the physicians. But the preclinical data would be supportive of a broader approach.

Rachel King

Analyst · Stifel. Your line is open.

And then to your question about our strategic options and plus the partnering, I think it's premature to make any comments about any specific partnering plans but I'd say that it would certainly be our goal to preserve significant value within the company if we do engage in any partnership around this program.

Operator

Operator

Thank you. Our next question comes from John Newman with Canaccord. Your line is open.

John Newman

Analyst · Canaccord. Your line is open.

Hi, guys, good morning. Congrats on breakthrough and the interesting data here. Thank you for giving us an update. I have two questions. The first one is just wondering if you could discuss at all the percentage of patients in the relapsed/refractory portion of the study that we are able to go on to receive a transplant given your very high rates of early response? And the second question I had was also on E-selectin and obviously understand that you can't talk about things that haven't yet been disclosed but can you say with E-selectin whether there was a trend towards higher response with higher E-selectin levels or was there a level above which the majority patients had a response? Thank you.

Rachel King

Analyst · Canaccord. Your line is open.

So let me answer the second question first and then I'll turn it over to Helen for the question about transplant. As far as the specific data on E-selectin, again I am afraid I am going to have to defer that to ASCO. We'll be sharing everything that we know as of that data cut in the context of ASCO and EHA. So I encourage you to tune back and then we'll be able to say more that way. And let me turn it to Helen for the question about transplant.

Helen Thackray

Analyst · Canaccord. Your line is open.

So in the context of relapsed/refractory group, one of the things that we are interested and evaluating is the durability of remission and the ability to sustain remission therefore long enough to get through the complicated process of preparing for an identifying a transplant. We have seen some patients go on to the transplant, we reported that in the Phase 1 portion of the report at ASH and we will update that with the further information available at the ASCO and EHA presentation.

Operator

Operator

Our next question comes from Ritu Baral with Cowen and Company. Your line is open.

Ritu Baral

Analyst · Cowen and Company. Your line is open.

Good morning, guys. Thanks for taking the question. I wanted to ask just few more specific from the two subsist test that you did. That you did disclose in the relapsed/refractory population. Given E-selectin's role in immune response, was there anything unusual about these two subsist tests out of the ordinary from a normal chemo toxicity?

Rachel King

Analyst · Cowen and Company. Your line is open.

I'll let Helen answer that too.

Helen Thackray

Analyst · Cowen and Company. Your line is open.

So we did report in the newly diagnosed population and older population, we had two test of subsist within the first 60 days on study. It is actually unfortunately a population that has a very high rate of death subsists and so two deaths in that group are not at all unusual. And we've had no indication in the preclinical data or the clinical trial data reported publicly so far that there will be any increased risk of infection with this mechanism. We'll certainly discuss further with the other safety details that are reported at ASCO and EHA.

Ritu Baral

Analyst · Cowen and Company. Your line is open.

Got it. And then turning to Europe, now that you have breakthrough therapy and all the allowances with FDA as part of that program. What is the European strategy going forward with EMA? Are you going to apply for a prime designation? Is that a possibility and how do you look at that regulatory strategy as well as the business strategy over there? Is that a territory that you'd be interested in keeping or potentially a separate partnership?

Rachel King

Analyst · Cowen and Company. Your line is open.

We certainly are exploring the options in Europe as well as possible with our designation that could be helpful there from -- so answer that from a strategic standpoint. As far as clinical issues, Helen could you comment on our path for year.

Helen Thackray

Analyst · Cowen and Company. Your line is open.

So as the program looks forward we would expect to engage with regulatory agencies. We will as you know engage with the FDA with the breakthrough therapy designation opportunity. We would also expect to engage with the European agency through scientific advice process and seek their guidance on the appropriate path to take in Europe from a regulatory standpoint.

Ritu Baral

Analyst · Cowen and Company. Your line is open.

Got it. And then last question just about your multiple myeloma trial. Can you talk about how that's enrolling and potential timeline around that -- those dataset?

Rachel King

Analyst · Cowen and Company. Your line is open.

We are enrolling in that study now in Europe. We have decided to add additional sites and additional countries. That study was initiated in Ireland. So we are currently in the process of expanding that and adding some larger additional sites. And as we get those other sites online we get a better handle on the accrue on that study and then at that point we will able to give some more tangible guide as to when we expect to get top line readout. The study is continuing to accrue though and we are actively adding sites.

Operator

Operator

I am showing no further questions at this time. I'd like to turn the conference back over to Rachel King for closing remarks.

Rachel King

Analyst

Thank you and thanks everyone for your questions and for taking the time to listen to the call. In closing, we believe that 2017 is an important year for the company. Data from the pipeline of investigational new drug products will continue to be submitted to key cancer meetings and we hope that this should -- hope and believe that this should further validate both our pipeline and our platform. So thank you very much for your interest and for your support.

Operator

Operator

Ladies and gentlemen, thank you for participation in today's conference. This does conclude the program. And you may now disconnect. Everyone have a great day.