Ali Fattaey
Analyst · Ted Tenthoff with Piper Jaffray
Thank you, Dan, and good morning, everyone. I'd like to begin by providing an update on our proprietary drug candidate, CUDC-907. By its nature, CUDC-907 has a number of different properties and we believe these are very advantageous properties for the drug. Let me begin by reviewing briefly how we expect these properties to translate into activity in patients in the chronic stage. CUDC-907 is designed as a targeted agent with potent PI3 kinase and HDAC inhibitory activities, both of which have been shown to be effective at killing cancer cells. As a PI3 kinase targeted agent, CUDC-907 potently inhibits PI3 kinase alpha and delta isoforms and to a lesser extent PI3 kinase beta and spares PI3 kinase gamma inhibitions. This is an attractive target profile since PI3 kinase delta inhibitors have recently shown good clinical activity against lymphomas and PI3 kinase alpha has recently been shown to also play an important role in several hematologic cancers. We believe that targeting both the delta and alpha isoforms of PI3 kinase should result in improved clinical benefit. For example, as recently reported in mantle cell lymphoma patient samples especially after the first relapse, PI3 kinase alpha expressions and signaling may provide a resistance mechanism to PI3 kinase delta inhibition. Therefore, by inhibiting both PI3 kinase alpha and delta isoforms, treatment with CUDC-907 may overcome this type of potential resistance mechanism. Beyond that inhibition of PI3 kinase alpha and delta may extend the activity of CUDC-907 to other cancer types such as multiple myeloma or both PI3 kinase delta and alpha isoforms are shown to be important for the survival of multiple myeloma cells. Our current Phase I clinical trial ongoing is enrolling both lymphoma and multiple myeloma patients, and we look forward to the results of these drugs in this patient population. Next as an HDAC targeted agent, CUDC-907 potently inhibits the HDAC enzymes designated HDAC 1, 2, 3, 6 and 10. Currently, HDAC inhibitors are approved for the treatment of specifically T-cell lymphomas and next generation inhibitors of HDAC are in clinical development for the treatment of multiple myeloma. We believe that the combined inhibition of PI3 kinase alpha and delta concurrent with HDAC inhibition provides additional cell killing potential and should extend the effective use of CUDC-907 in additional hematologic cancer patient population such as multiple myeloma. Now as Dan indicated earlier, we began the Phase I clinical testing for CUDC-907 in advanced lymphoma and multiple myeloma patients in January of this year. This Phase I clinical trial is designed as a standard dose escalation study where CUDC-907 is orally administrated in patients on a once daily dosing schedule on a continuous basis. The trial is currently recruiting patients at the Sarah Cannon Cancer Center and at the Memorial Sloan-Kettering Cancer Center with M.D. Anderson Cancer Center expected to begin patient recruitment in May of this year. Now, enrollment in the 30 milligram dose initial cohort is now complete with 3 patients. 2 multiple myeloma patients and 1 lymphoma patient was enrolled in the first cohort and all 3 patients received 2 cycles of treatment and continued to cycle 3 assessment of their disease. Patients are continuing in this current cohort with treatment of CUDC-907. We are tracking CUDC-907's exposure in pharmacokinetic properties in our Phase I trial as well and we are pleased to see a similar pattern as what we observed in preclinical animal model observation emerging from analysis of patient plasma samples in that the dual PI3 kinase in HDAC active CUDC-907 drug is metabolized to have formed the retained PI3 kinase activity. We have characterized this metabolic life form of CUDC-907 and appears to have a similar PI3 kinase isoform selectivity and potency, and a similar potency as the parent CUDC-907 drug. This metabolite also appears to be relatively long-lived in animals and in patient plasma samples, and we view this as an attractive profile for the drug since sustained suppression of PI3 kinase seems to be important for activity while HDAC inhibitory activity can be administered with short-term exposure and based upon the analysis of the currently available clinical data, we are encouraged by the initial PK results observed. Also we note that the adverse events observed in this first cohort of patients are consistent with the expected target related side effects in these patients. Although still anecdotal and very early, these observations may represent encouraging evidence of target engagement activity by the drug in patients. I would just like to caution here that these clinical results are from the first cohort of 3 patients only and although similar in the 3 patients, they require much further analysis and we look forward to disclosing and describing those for you in the coming months. CUDC-907 is being developed in collaboration with the Leukemia & Lymphoma Society or LLS, under which, LLS will support our ongoing clinical development of CUDC-907. Under the agreement, LLS will fund approximately 50% of our direct clinical cost of the development of CUDC-907 through Phase Ib or Phase IIa clinical testing stage for a total potential funding of up to $4 million. To date, we have recognized $1.1 million in milestone payments from LLS in recent months as a result of advancing CUDC-907 2 IND filing and beginning the Phase I clinical trial. This represents important capital to support our continued development of this molecule and we thank the Leukemia & Lymphoma Society for this commitment to this drug candidate. Finally, we are planning to pay for a trial in which we will examine the use of CUDC-907 in solid tumor patients. We expect to initiate this trial in the second half of this year, and we look forward to providing updates on the current Phase I trial and plans for further testing of CUDC-907 in patients in the coming months. I now would like to turn to our fully owned IP EBT inhibitor CUDC-427 designation, which target mechanism of evasion from apoptosis. CUDC-427 does this by an agonizing inhibitors of apoptosis or IAP protein, which functions to regulate intercellular signals for apoptosis induction. In addition, some of the IAP proteins are also components of extracellular pathway signaling of the tumor necrosis factor or TNF found in receptors. CUDC-427 in effect switches prosurvival TNF signaling into a potent pro-apoptotic pathway. In this respect, CUDC-427 is an attractive drug candidate, particularly in combination with other anti-cancer agents that have been shown to stimulate TNF expression such as gemcitabine and taxing drugs. As a reminder, in 2012, Genentech completed the Phase I clinical trial in which 42 patients received daily dose -- daily oral doses of CUDC-427 at a single agent for the first 2 weeks in a 21 day cycle. The results of this Phase I study will be presented next month at ASCO but overall, CUDC-427 was well tolerated and single agent clinical benefit was observed for some patients in this study. We are currently working on a Phase II clinical study designed to administer CUDC-427 in combination with some of the -- in metastatic cancer patients. Preclinical studies have shown that low doses of CUDC-427 synergize well with the standard doses of Xeloda and Five-FU in breast cancer xenograft preclinical models in the projected clinical trial, we look to determine the optimal and safe dose of CUDC-427 to administer with Xeloda in this patient population, as well as to determine the level of clinical benefit that CUDC-427 can provide beyond Xeloda alone in this breast cancer population. We're also planning to initiate at least 1 additional trial in the second -- in the second cancer indication later this year. Now in addition to these combination studies, we are actively exploring treatment of distinct patient populations whose tumors may have genetic alterations that rendered them responsive to single agent CUDC-427 and we expect to make a determination on a single agent development path in the coming months for this drug as well. All of our trials with CUDC-427 will incorporate plans to evaluate each patient that is enrolled in the study to help us identify subpopulations that may be particularly sensitive to CUDC-427 effects. We look forward to providing updates to our study, design and trial start date close to the time that the results of the Genentech Cancer Phase I study will be disclosed by ASCO. Lastly, regarding our ETFR and HDAC inhibitor program CUDC-101, we have determined that IV administration of the drug is impractical and have therefore discontinued enrolling patients in the Phase I IV trial in head and neck cancer patients. We are directing our resources to the preclinical testing of oral formulation of CUDC-101 and importantly to further development of our proprietary drug candidates CUDC-907 and CUDC-427. I'd like now to turn the call back to Dan, to provide an update on our partner program.