Rachel King
Analyst · ROTH Capital Partners
Thank you, Shari. Throughout 2020, GlycoMimetics' primary operational focus was on advancing uproleselan registration program in AML. Despite the challenges of COVID uproleselan continues to garner significant attention and interest from leading clinicians, academic centers, collaborative networks and regulatory agencies working with us here in the U.S. and abroad. GlycoMimetics' pivotal Phase 3 trial in relapsed/refractory AML continued to enroll patients in U.S., Australia and in Europe at a steady and predictable pace in the second half of 2020. While the pandemic slowed enrollment during March and April of 2002, site activation continued to extend the global reach of the trial and by year-end the company's interim target for enrollment had been achieved. With momentum from the second half of 2020 carrying into 2021, we can confirm that we anticipate completion of enrollment of all 380 patients in the second half of this year. This demonstrates the high level of enthusiasm and scientific interest of investigators and it is a very significant accomplishment in the context of a global pandemic. In addition, we've had productive interactions with the FDA under our breakthrough therapy designation. These are the kinds of conversations that a company would have in the normal course of moving towards a specific regulatory filing plan. To complement our regulatory activities, we completed certain other critical development work, such as release of the NDA batches, initiation of the commercial batch manufacturing and completion of human ADME work. That is studies that evaluate the absorption, distribution, metabolism and excretion of a drug in development. These are all measures of steady progress toward filing a New Drug Application or NDA should our read out be positive. In parallel, the NCI-sponsored Phase 2/3 registration trial that's evaluating uproleselan in newly diagnosed older adults with AML who are fit for chemotherapy continues to accrue at a steady pace. Based on the NCI's enrollment projection, we anticipate the trial will complete enrollment of the initial 262 patients necessary for the interim Phase 2 event-free survival or EFS analysis before yearend. Assuming the EFS trigger would occur within 6 months of enrollment completion, we would then expect to see the readout from this analysis to occur sometime in the first half of 2022. Together, the GlycoMimetics and NCI sponsored programs will constitute a large dataset of patients treated with uproleselan and intensive chemotherapy. The data for our Phase 3 trial and the NCI Phase 2 EFS analysis are likely to read out around the same timeframe. If both are positive, we would anticipate filing for approval for treatment of patients in both settings. Further underscoring the global interest in uproleselan is our collaboration with Apollomics announced last year. In January of this year, uproleselan was designated as a breakthrough therapy in China for treatment of AML, complementing a prior designation by the FDA. In addition, Apollomics announced the filing of an IND to begin clinical development of uproleselan in China. Our plan is to announce when the first patient is treated in Greater China, which is anticipated late this year. Beyond the NCI's prestigious consortium and our partnership with Apollomics, we're also receiving significant interest from clinicians at key centers of excellence, who would like to pair uproleselan with other AML therapies. In a few minutes, I'll describe some preclinical work that validates this, in particular, the research that combine uproleselan, venetoclax and a hypomethylating agent or HMA. Working in collaboration with clinical investigators consortia, partners and regulatory agencies around the globe, we have 1 goal in mind, namely to establish Upro as a foundational therapy across the entire spectrum of AML. Whereas most other AML therapies in development are focusing on narrow patient populations as defined by certain genetic markers, Uproleselan targets the bone-marrow microenvironment by inhibiting those prosurvival pathways that render cancer cells protected from the effects of chemotherapy. This is a novel approach that would be broadly applicable across the spectrum and range of therapies used for relapsed/refractory or newly diagnosed patients fit for chemotherapy. We soon hope to treat those not fit for a rigorous chemo regimen as well. Scientific rationale for targeting E-selectin and the role it plays within the bone-marrow microenvironment as a driver for AML resistance has always been robust. I'd still like to spend a few moments highlighting some of the new data our research teams generated that were presented in with oral and poster presentations at multiple scientific and medical meetings this past year. Of note, throughout 2020 preclinical data on uproleselan's mechanism of action were published in numerous scientific publications, including Nature Communications in April and an independent review paper in the journal Cancers in January of this year, 2021. These papers detailed the various mechanisms by which uproleselan dampens AML blast regeneration and strongly synergizes with chemotherapy. Importantly, they support the role and importance of targeting the tumor microenvironment, the key novel approach in cancer, where GlycoMimetics has a leadership position. Uproleselan was also featured at several major medical meetings, including the June 2020 AACR Meeting. There investigators presented preclinical data supporting the potential use of uproleselan in the treatment of AML as well as in the setting of stem-cell transplantation. Additionally, new information demonstrated the ability of transcriptome profiling to identify additional tumor types, most likely to benefit from targeted E-selectin antagonism, a key mechanism of both uproleselan and GMI-1359. And finally in September, at the meeting of the Society of Hematologic Oncology, and again at the annual ASH meeting, investigators from the MD Anderson Cancer Center Department of Leukemia, presented preclinical data and an oral presentation, showing how antagonizing E-selectin with uproleselan overcomes microenvironment-mediated resistance to venetoclax/HMA therapy. Just to elaborate on the model. This experiment was conducted using a cell line from a patient who had acquired resistance to venetoclax/HMA. In this setting, the addition of uproleselan not only prolonged survival of these mice, but also promoted normal HSC pro-survival signaling. The data were striking, and we were pleased that it was selected as an oral presentation at ASH. It's here in this last setting that we look forward to initiating an investigator-sponsored trial in the near future. As you know, uptake on venetoclax/HMA in the frontline, unfit AML setting has been strong. And while 60% to 70% of patients achieve a response, the responses are incomplete and approximately half the patients reducing durability and leading to relapse. Thus, they remained a significant unmet need. We're hearing from investigators eager to evaluate the triple combination to explore the potential of the uproleselan and overcoming some of the limitations related to the depth and durability of response with Ven/HMA alone. Turning now to sickle cell disease, I'd like to comment the 2020 gave us an opportunity to further explore opportunities for treating this disease, which we had previously been precluded from doing under our agreement with Pfizer. By April, Pfizer had completed its transfer to us of all rights and licenses originally granted in our 2011 agreement as well as the rivipansel IND and the datasets from both the Phase 3 research study and the Open Label Extension study. We committed to a detailed assessment of the full clinical data set for rivipansel and presentation of the full results at a scientific congress. Our analyses were presented at several key sickle cell meetings, the last of which was a December ASH meeting. The data highlighted the importance of early intervention, and validated E-selectin as a critical target for treating vaso-occlusive crisis or VOC for adults as well as pediatric patients. In parallel, we were invited to make oral presentations on GMI-1687 that those key meetings as well. I remind you that GMI-1687 is a significantly more potent E-selectin antagonist than rivipansel, and we've shown in animal models that it is fully bioavailable following subcutaneous dosing. Specifically in each of these congresses, we highlighted data demonstrating the compound's ability to prevent sickle red blood cells adherence to inflamed vasculature, inhibit vessel occlusion and restore normal blood flow within 90 minutes of administration. It is not a surprise given the strength of this preclinical data each of the abstracts was selected for oral presentation. The data supports development of GMI-1687 as the best-in-class E-selectin antagonist for self-administration at the time of VOC onset, potentially reducing the need for opioids, acute care visits and inpatient hospitalization. I'd like to highlight that the GMI-1687 program leverages all the clinical safety, efficacy and biomarker information gained with rivipansel, it can potentially be self-administered outside the hospital setting at the earliest stage of VOC onset, which we now know is critical for clinical benefit. This is particularly important, since the care of individuals with sickle cell disease has continued to shift to the outpatient setting, a trend which has accelerated during the pandemic. Based on input from the FDA with respect to rivipansel as well as KOLs from sickle cell disease, we will now focus development in this setting on GMI-1687. We are moving forward to complete the required IND-enabling activities with treatment of acute VOC is the potential lead indication. We believe that GMI-1687 may be ideally suited for this indication to ensure that patients can receive treatment early in their VOC crisis. Since it potentially can be self-administered, GMI-1687 also commands a much greater value proposition than rivipansel. Therefore, we have decided to discontinue development of rivipansel. We will keep you updated as to progress with the GMI-1687 program as we get closer to filing the IND, which we anticipate will occur in 2022. The last clinical program, I'd like to touch on is the ongoing Phase 1b study of GMI-1359, or dual-function E-selectin and CXCR4 antagonists, being conducted by Duke University Medical Center in patients with advanced breast cancer with bone metastases. This proof-of-concept study is evaluating pharmacodynamic or PD markers, such as CD34 mobilization. Mobilization of circulating cancer cells into the periphery down-regulation of soluble E-selectin and other biomarkers of biological activity, following both single ascending and multiple doses within the same patient. Our goal has been to use these PD markers to study dose response to inform our next trial, while also establishing the safety profile on PK of GMI-1359 in patients with advanced disease. While study enrollment has been impacted by COVID-19, I'm pleased to report that we have observed clear biologic - clear evidence of biologic activity in the first patients treated in this trial. We intend to present the interim findings from this trial at an upcoming scientific conference. Lastly, I'd like to highlight our specialized GlycoMimetics chemistry platform that continues to generate novel drug candidates. As you may be aware, our chemists have been focusing their efforts on galectin-3, a carbohydrate-binding protein whose expression has been shown to play a central role in fibrosis and cancer. Over the past year, our chemists have rationally designed several highly potent galectin-3 antagonists that have shown activity in preclinical models of fibrotic disease, including NASH, IPF, retinal degeneration and thrombosis, as well as the pancreatic cancer model where our galectin-3 inhibitor was combined with an anti-PD-L1 agent. In fibrosis models administration of our galectin-3 antagonists resulted in robust, statistically significant reductions in fibrosis, when given as a single agent. In the pancreatic cancer model, the addition of galectin-3 optimized anti-PD-L1 therapeutic activity through shifts in fibrotic response and cellular infiltration leading to a robust anti-tumor response. We plan to share more details regarding these galectin-3 inhibitors, and upcoming scientific conferences, while we consider strategic options for this novel class of compound. I hope you'll agree that the challenges of the pandemic notwithstanding, our team has been incredibly productive. While most of us worked almost exclusively out of our homes, we succeeded in continuing to advance both development and discovery. We have a diversified portfolio while remaining a lean organization is only about 55 full time individuals and an executive team that's been working together for many years. In 2020, we were pleased to add veteran regulatory leader Dr. Myra Rosario Herrle to the management team as Vice President, Regulatory Affairs. Myra came to us from AbbVie, a leader in AML and the developer of venetoclax. And this just last month, we promoted Dr. Eric Feldman, who will join our Q&A today to Senior Vice President and Chief Medical Officer. Eric is internationally recognized for his work in the development of new therapies for the treatment of leukemias and related bone marrow disorders. Eric has spent the last 2 years at the company running our Phase 3 registration trial, and he has dedicated his career to patients with hematologic malignancies. He is especially well positioned to lead our uproleselan program as it advances through registration trials. As you know, Dr. Helen Thackray, our outgoing CMO and Senior Vice President of Clinical Development, has accepted another position giving her an expanded role. We wish her well in that endeavor. Her contributions to us have been substantial, and this has been a pleasure working with her as a valued colleague. Importantly, our cash position provides runway through key milestones in the uproleselan program. I've asked Brian now to comment in greater detail on our financial results. Brian?