Sean McCarthy
Analyst · Christopher Marai with Nomura
Thanks, Chris, and good afternoon, everyone. I'm very pleased to be here with you today to briefly review another very productive quarter for CytomX. At CytomX, we are reinventing therapeutic antibodies for the treatments of cancer. We see a major opportunity to more effectively target therapeutic antibodies into diseased tissue, generating new classes of differentiated anticancer therapies as these are best-in-class molecules against validated targets or for first-in-class molecules against novel targets that we believe our technology can uniquely address. Our innovative approach to antibody localization into diseased tissue is called the Probody platform. Probodies are fully recombinant antibody prodrugs comprised of a therapeutic antibody, a linker and a mask designed in a way that the antibody can't see its target until the mask is removed. Mask removal occurs specifically and selectively within cancer tissue as a function of disease-associated proteases, which clip off the mask in the tumor allowing the underlying antibody to bind target and elicit its biological effect. Probody therapeutics are designed to offer localized target binding in diseased tissue while maintaining potency, reducing side effects and enabling new targets of mechanisms to be translated into novel product opportunities. We see this as a really big idea backed by decades of research by our deep knowledge of the biology of the tumor microenvironment, innovative protein engineering and a robust intellectual property portfolio. We are the leader in this emerging field of therapeutic antibody localization with four clinical stage programs, strong partnerships and recent clinical proof-of-concept. The first quarter saw excellent progress by the CytomX team in developing our differentiated technology platform and our lead product candidates as we continue to build on the first Probody clinical data we presented for our lead program, the anti-PD-L1 probody, CX-072, at ASCO last year. Since then, we presented additional clinical and translational data, including from our second program, CX-2009, at ESMO, SITC, at our R&D Day in February and most recently at AACR. It's been an exciting year for us, and we've learned a tremendous amount about how our unique antibody technology functions in cancer patients having checked key boxes to support proof-of-concept for the Probody platform. We've demonstrated encouraging antitumor activity and safety profiles for both of our lead wholly owned programs, and we are now intensely focused on the development of next steps for the further development and advancement of these assets. I'd like to take the opportunity here to briefly recap what we've disclosed to-date about the clinical performance of these two lead molecules. Our most advanced program CX-072 is a PD-L1 targeting probody for which we have presented increasingly matured Phase I data for monotherapy and in combination with the anti-CTLA-4 antibody, ipilimumab, also known of course as Yervoy. Our vision for CX-072 is for the probody to become a differentiated centerpiece of combination anticancer therapy by enabling safer, more effective combinations. We also see opportunities for CX-072 to potentially expand beyond the existing market to settings where conventional PD pathway agents are not currently employed. Data presented on CX-072 as monotherapy at our Q1 R&D Day showed that CX-072 continues to demonstrate a favorable safety profile as well as durable anticancer activity in heavily pretreated patients with tumor types not typically expected to respond to PD pathway inhibitors. Data from the completed dose escalation phase of PROCLAIM-CX-072 showed that of 24 efficacy evaluable patients, all with generally weakly immunogenic tumors and treated with doses greater than or equal to 3 mg/kg of CX-072, 12 or 50% of patients demonstrated tumor shrinkage, including 4 partial responses. CX-072 was generally well tolerated with maximum tolerated dose not reached. Preliminary results from dose escalation informed our ongoing monotherapy dose expansion cohorts studying the dose of 10 mg/kg of CX-072 in multiple tumor types. As reported during our Q1 R&D Day, CX-072 is showing activity in several tumor types at this dose and updated data from these expansion cohorts will be presented in a poster and also as part of a poster discussion session at ASCO 2019. Turning now to CX-072 in combination with ipilimumab. As reported previously from our dose escalation phase, we've defined the maximum tolerated dose of this combination as 10 mg/kg of CX-072 and 3 mg/kg of ipi, which is the full label dose of ipilimumab. Our preliminary efficacy data is encouraging with antitumor activity, including complete and durable responses seen in advanced stage cancer patients, again, with tumors not generally regarded to be responsive to PD pathway inhibitors. As of our most recently reported data cutoff, of 19 patients evaluable for efficacy, 4 or 21% experienced confirmed responses, including one complete response. Furthermore, among the 27 patients treated with the 072 plus ipi combination of 3 mg -- with ipi at 3 mg/kg or above, the combination was generally well tolerated with 7 or 26% of patients reporting a Grade 3/4 treatment-related adverse event and this compares very well to historical controls, which, of course, have shown incidence of Grade 3/4 TRAEs in excess of 50%, typically for the combination of a PD inhibitor and ipi at full dose. So these data suggest that the combination of CX-072 plus ipilimumab could allow for the safe and effective treatment of patients in multiple indications with full dose and schedule of ipi with the goal of reaching longer and more durable responses. Based on these important clinical data for CX-072, we are excited about the prospects of the program to make a difference to cancer patients, and we're busy developing our next steps for this unique asset and we'll be laying out our plans in the near future. Now I would like to turn to CX-2009, a potentially first-in-class probody drug conjugate targeting a unique and broadly expressed tumor antigen CD166. Now because probody therapeutics are designed to minimize binding of drug to normal tissues, we're in a very unique position to address a new class of targets with attractive molecular features that were previously thought undruggable because of their high expression on normal tissues. CD166 is an example of this kind of target. The target is highly and homogeneously expressed in multiple solid tumor types and might be considered an attractive target for a conventional antibody drug conjugate were it not for the fact that is also present on most normal epithelial tissues. We think it's a great target for a probody drug conjugate, however, since probodies allow us to more selectively target tumor tissue This is a really exciting program since it combines probody technology with drug conjugate technology with the goal of making a transformative difference for patients across a wide range of cancer types. During Q1 ,we presented preliminary clinical data from the Phase I dose escalation portion of the ongoing PROCLAIM clinical trial of CX-2009 monotherapy in a subset of CD166 expressing cancer types, including certain patients that were selected for high-level expression of CD166. The intent and design of this Phase I dose escalation trial was firstly, of course, to evaluate the safety of this very novel drug candidate, safety being a particularly critical question given the widespread expression of CD166 on normal tissues. We also wanted to understand as much as we could in Phase I about the contribution of the drug conjugate payload to the overall safety profile of the molecule in order to give us the maximum information with which to design our Phase II strategy. And lastly, we were looking for any initial signs of anticancer activity in a late stage, very heavily pretreated patient population that is, of course, typical for such highly experimental Phase I studies. We've been very encouraged with the preliminary data for CX-2009 that we've shared previously. At the time of data cutoff for our AACR presentation, 71 patients across all doses were evaluable for efficacy. Of the 39 patients who received greater than or equal to 4 mg/kg of CX-2009 and had at least 1 post-baseline on-study tumor assessment, 38% of these patients achieved tumor shrinkage, including 7 unconfirmed partial responses observed in breast cancer, ovarian cancer and also in head and neck cancer. In addition, 74% of patients achieved stable disease or better at the time of their first on-treatment scan. This single-agent activity is the first validation of CD166 as an anticancer target, and we believe holds much promise. CX-2009 was generally well tolerated. The maximum tolerated dose was not reached at the highest dose level tested at 10 mg/kg, the most common treatment-related adverse events were Grade 1 and Grade 2 and they included nausea, fatigue and decreased appetite. The most common Grade 3/4 treatment-related adverse event was keratitis. And so it's worth taking a moment or two to just reflect on the safety profile given just how broadly expressed this target is on normal tissue. We believe these data are strong evidence that probody masking technology can really allow us to target first-in-class tumor antigens regardless of their broad normal tissue expression, and we see this actually as an important advance in the field of antibody therapeutics generally. The keratitis that we observed principally at high doses of CX-2009 is a well-established side effect of DM4, the drug conjugate payload that we're employing in this drug candidate. We are now engaged in further dose refinement, while taking steps to manage keratitis with ocular prophylaxis, which has been shown to be affected by others. This ongoing work will enable us to finalize our strategy for Phase II studies, which we'll be communicating in due course. Taken together, we are very pleased with how our wholly owned CX-072 and CX-2009 programs have progressed to date, and we look forward to providing a more detailed road map for these two assets in the coming months. I'd like to comment briefly now on our pharma alliances. Firstly on our BMS alliance. This partnership was entered into in 2014 and was expanded in 2017. In total, the alliance provides BMS with access to up to 12 discovery targets from the CytomX platform. To date, CytomX has received a total of $287 million in upfront and milestone payments from BMS. The lead program in the alliance is the anti-CTLA-4 Probody, BMS-986249, which is based on ipilimumab and continues to progress through a Phase I/II clinical trial being run by BMS. Our shared vision with BMS is that the CTLA-4 Probody has the potential to be a safer, more effective version of Yervoy allowing the full realization of CTLA-4 as a powerful and highly validated cancer immunotherapy target. Additional research work continues under this alliance, and we look forward to additional targets that BMS may select in the future. Now I'd like to return to the drug conjugate space for just a moment where our alliances with AbbVie and ImmunoGen also continue to advance. In collaboration with AbbVie, CytomX is advancing a second clinical stage probody drug conjugate, CX-2029 directed against CD71, which is also known as the transferrin receptor. This program has the potential to turn CD71 a widely expressed receptor on normal tissues into a druggable target. CytomX continues to enroll patients in PROCLAIM-CX-2029, a Phase I/II clinical trial evaluating this molecule as monotherapy in patients with solid tumors or with lymphomas. With ImmunoGen, we continue to make progress on our probody drug conjugate targeting the highly expressed tumor antigen, EpCAM. And last but certainly not least with regard to our collaborations, research work continues on multiple targets in our broad alliance with Amgen focused on T-cell engaging bispecific probodies. The goal of this research is to use probody technology to more effectively target T-cell engaging bispecifics into sold tumors, an area where toxicity is proven to be a real challenge for the field due to the very high potency of these agents. The leading edge of this alliance is an EGFR-CD3 probody bispecific. With these updates on the company, I'll now turn the call over to Robin for a brief review of financial highlights from Q1.