Jeevan Shetty
Analyst · Brian Abrahams from RBC Capital Markets. Please go ahead
I now turn to our important study focusing on high-risk CLL and Richter's transformation, the EUPLAGIA study. The design of our EUPLAGIA study incorporates all the unique components of the Galapagos platform, i.e., concurrent conditioning, seamless CAR-T production and innovative IT and QC technology, ensuring release at the day of harvest and infusion. This is truly transformational. As you can see, the study population treats patients with relapsed/refractory CLL with more than or equal to two prior lines of therapy, CD19-positive CLL patients. Significantly, the trial allows patients with Richter's transformation and also transplant-eligible patients. The study was designed to explore three dose levels. Looking now at the baseline characteristics of the EUPLAGIA study population, we see that they are really consistent with the population of risk of unfavorable outcome, shown here by age and by gender. Furthermore, the advanced nature of the disease in our study is evidenced by, number one, the prior lines of treatment, prior BTK inhibitors and venetoclax and prior hematopoietic stem cell transplant and also the disease characteristics; number two, TP53 mutation and the high rate of unmutated IGHV that you see. Turning now to safety. We see a good safety profile with our product. It is well tolerated. There is no Grade 3 CRS. Only six patients experienced low-grade CRS, Grade 1 and Grade 2. There were no ICANS reported, no deaths occurred. Most treatment-emergent adverse events were Grade 1 and Grade 2. And most observed Grade 3 and 4 adverse events were all huge origin and all well managed with standard point-of-care. I turn now to the efficacy. We have observed excellent efficacy with our drug in patients with relapsed/refractory CLL with or without Richter's transformation. Objective response was assessed as per iwCLL for patients with CLL, and Richter's transformation was observed as per the Lugano classification. 11 out of the 12 patients, including patients responding to the treatment, resulted in an objective response of 92%. 75% of patients reached a complete response as their best response. A further clear observation is the 83% complete response at dose level 2. This compelling data has transformed our decision on our recommended Phase II dose RP2D of 100 million cells. At the time of analysis, nine out of 11 patients, 82% of the responders, had an ongoing response. The duration was up to nine months post infusion, which is the latest available response assessment at the time of the abstract submission. Further follow-up is clearly ongoing. Focusing on the Richter's transformation subset, seven of the 12 enrolled patients in the EUPLAGIA study were diagnosed with Richter's transformation. All but one patient with Richter's transformation responded to treatment, a rate of 86%. And five out of the sox responding patients achieved a complete response, 83%. So to conclude, though a small patient number, the efficacy, together with the safety, has excited experts in the field and confirms our desire to accelerate this program to bring this therapy to patients as soon as possible. The next steps for EUPLAGIA are genuinely exciting. As I alluded to earlier, with the 83% CRR at a rate of dose level 2, the class-leading safety and the ratification by experts, both internally and externally, we will proceed with dose level 2. We will initiate the Phase II expansion cohort for the two populations we have described. Critically, we have initiated the tech transfer to the first U.S. site, Landmark Bio, in Boston, as mentioned by Paul. Do remember our poster at ASH on the 9th of December. Turning now to the NHL program. With our decentralized manufacturing and short wait time, we strongly believe accessibility and efficacy of CAR-T therapy can be improved and serve the sickest NHL patients with the most aggressive disease. This has informed our thinking on future NHL subgroups that we will pursue. Disease is currently underserved by the approved CD19 CAR-T therapies. Additionally, even with approved products available, we identify persistent unmet need in indications where less CAR-T products are actually available as a result of manufacturing slot shortages through the centralized model that exists. This is the design of our ATALANTA study based on our unique Galapagos platform, a Phase I/II trial in patients with non-Hodgkin lymphoma, consisting of diffuse large B-cell lymphoma, mantle cell lymphoma, marginal zone lymphoma and follicular lymphoma. The study population requires patients with relapsed or refractory disease after two or more prior lines of therapy with the inclusion of transplant ineligible patients in addition to primary refractory diffuse large B-cell patients also being included. With regard to prior lines of therapy, we allowed the same patient population that would be eligible in the improved CAR-T products. However, as a consequence of our seven day vein-to-vein time, our study allows a patient with potentially more aggressive disease to be included in our trial. Here, too, we will appraise three dose levels. Baseline characteristics of the ATALANTA study is typical of the patient population and representative of the heavily pretreated patients in the study. We see encouraging safety data for our product in the ATALANTA study. With ICANS, there were six patients who experienced a Grade 1 ICANS and only one case of Grade 3 CRS. All others were Grade 1 to Grade 2. There were two deaths in the study. One was with the patient experiencing intra-abdominal hemorrhage. This patient has been previously diagnosed with only thromboembolic disease and was already on low-molecular-weight heparin. The second was a patient who has urosepsis and have come to this six months after infusion. We observed very encouraging efficacy in our therapy in patients with multiple subtypes of relapsed or refractory disease. In our data set, 13 patients were evaluable for response at the time of analysis and 11 patients responded to treatment, resulting in an objective response of 85%. One can also observe complete response rate of 83% at dose level 2. 69% of our patients reached a complete response and the best response in the all patient population. This is the data at the time of abstract submission. The study is clearly ongoing, and we'll continue to collect more data with longer follow-up times. We now have the first patient in the ongoing response for over a year, and we will be presenting more of these patients at ASH. As with EUPLAGIA, the next steps for ATALANTA are similarly exciting. We will expand an indication with the benefit of -- in indications that will benefit from the short vein-to-vein time. We will implement dose level 3. And as mentioned previously by Paul, we will complete the tech transfer to the first U.S. site, Landmark Bio in Boston. Given the encouraging safety and efficacy we are presented in CLL and NHL using our innovative and reliable platform, we're moving ahead with addressing the unmet need in multiple myeloma in the PAPILIO study. Whilst, of course, there are commercially available BCMA therapies, there is limited access to these products, and this population remains severely underserved. Here is the study design and the patient population we are proceeding with. We expect our first patient to enroll any time certainly this month. The data from the 26 patients that were enrolled in the EUPLAGIA and the ATALANTA studies that we've shared with you today demonstrate that the point-of-care CAR-T manufacturing with short vein-to-vein time is feasible. Our CAR-T therapies are administered as fresh products with a median base wait time of seven days. We've shown 100% manufacturing success. All patients that underwent leukapheresis were dosed and they all received fresh CAR-T products. In our trials, the clinical responses were supported by high in vivo expansion of the CAR-T cells and durable persistence post-infusion. This was observed across the dose levels that we tested. Furthermore, our novel point-of-care manufacturing models and early phenotype of the less-differentiated CAR-T cells is preserved in the CAR-T product. This really strengthens our belief that our manufacturing process contributes to better CAR-T product. And that leads us to believe it is not so much the number of cells that are infused, but more of the quality of the cells. We believe we have a very innovative platform for the future of CAR-T therapies that could serve patients around the world, patients with little time and a few options. Thank you. I hand back to Paul.