David J. Mazzo
Analyst · Chardan. Your line is open
Thanks, Joe. As the Hitachi Chemical agreement has the potential to redefine Caladrius as a pure play cell therapy development company, let's turn now to a discussion of our business strategy. Our clinical strategy is to develop select assets and to advance them to the next development milestone representing a significant increase in value, most often to proof-of-concept demand. Our long-term goal will be to partner those assets for further clinical development and ultimately commercial sale. We believe this strategy will create value for our shareholders, first, by virtue of simply achieving development maturation and derisking and then through the ultimate economics associated with partnering them. As I noted earlier, last year we identified our immune modulation program based on T-regulatory cell technology and as one with significant competitive potential across multiple indications and we made CLBS03 our primary clinical focus. CLBS03 is a personalized autologous cell therapy consisting of each patient's own regulatory T-cells or T-Rex, which have been expanded in number and functionally enhanced by a proprietary method developed through the collaboration with renowned researchers at the University of California, San Francisco or UCSF. The program is supported by promising published early clinical work conducted by respected leaders in the area of T-regulatory cell science. In a Phase 1 open-label dose escalating study using a product analogous to CLBS03 and conducted at UCSF and Yale University evidence for safety and tolerability of autologous expanded polyclonal T-regulatory cell therapy in 14 adults with established Type 1 diabetes were shown. Supportive to the follow-up data from this study were published in November 2015 in the peer-reviewed journal Science Translational Medicine. Additionally, early evidence of utility of T-Rex for Type 1 diabetes was provided by a study of pediatric patients age 5 to 18 with new onset Type 1 diabetes as published in Clinical Immunology. In that open-label non-randomized study the authors reported that treatment with expanded autologous T-Rex preserved function of pancreatic beta cells and reduce the need for exogenous insulin in the majority of patients treated. Prominent clinicians and scientists on our Scientific Advisory Board and the T-Rex study executive steering committee such as Dr. Jeff Bluestone and Steve Gitelman of UCSF and Kevan Herold of Yale University are associated with the trial and provide us confidence in the clinical and scientific rationale underlying CLBS03. As to the specifics of the Phase 2 T-Rex study, the Sanford Project T-Rex study is a prospective randomized placebo-controlled double-blind Phase 2 clinical trial to evaluate the safety and efficacy of CLBS03 in adolescence with recent onset Type 1 diabetes. The allowable range for the study has been expanded from ages 12 to 17 to ages 8 to 17. The study will include 111 subjects across approximately 12 to 15 U.S sites. We have already completed the 19 patient first cohort and an interim safety review and following a favorable safety recommendation from the independent data safety monitoring board, we resumed enrollment of the second final cohort of the study in October of 2015. Patients are being randomized to placebo or one of two active arms receiving either 2.5 million or 20 million of their own T-Rex cells per kilogram of body weight, respectively. The study uses standard endpoints for diabetes study including C-peptide measurement which is an accepted measure of the preservation of beta cell function, insulin use, severe hypoglycemic episodes, and hemoglobin A-1 C levels. The study has a pre-specified interim analysis of early therapeutic effect that is scheduled when half of the subjects reached the six month post treatment follow-up visit. Given the high-level of interest in this study, we expect to reach the corresponding enrollment milestone by mid-2017 with the top line data from the interim analysis to be announced in late 2017 or in early 2018. Data from the 12-month follow-up of all subjects are expected in late 2018 to early 2019. In conjunction with our private placement from September 2016, enrollment of the 70th subject will trigger an additional infusion of capital, which was previously defined to occur in mid 2017. As the name study -- as the study name implies we are in partnership with Sanford Research for the conduct of this Phase 2 trial. Sanford Research is a non-profit research organization that is part of Sanford Health and supports an emerging translational research center focused on finding a cure for Type 1 diabetes. Through our partnership, Sanford is providing the operational resources to execute subject recruitment, enrollment, treatment and monitoring along with corresponding support services at their two clinical sites. In addition, Sanford agreed to make a $5 million equity investment in Caladrius in support of this very promising program in the September 2016 private placement, 60% of which has been received. The remaining 40% originally agreed to be received when the 70th patient has been enrolled in the study is now expected to be accelerated based on their enthusiasm for the study and should be received shortly. The potential of T-Rex as a therapeutic platform has applicability in many other autoimmune modulated diseases. Our redefined focus on cell therapy and the fund expected to be available through the agreement with Hitachi Chemical for the sale of our remaining interest in PCT will allow us to identify and pursue the most promising of these opportunities. Additionally, Dr. Jeff Bluestone, one of the originators of the technology at UCSF and an advisor to Caladrius is currently running clinical trials supported by the National Institutes of Health evaluating autologous T-Rex as a treatment for cutaneous lupus and to induce tolerance in post-kidney transplant patients, two indications for which Caladrius holds intellectual property rights. We look forward to the completion of those studies and the results of Dr. Bluestone's work, as that information will contribute to our decision to further pursue development to these indications. Let me now move to an update regarding our CD34 technology. CD34 plus cells have been shown to induce the development of new blood vessels preventing tissue death by improving blood flow. CD34 cells have been investigated in clinical studies encompassing over 700 patients with over 400 receiving CD34 cell therapy exposure. Notably, one potential application of this technology is in critical limb ischemia or CLI. Our program for CLI, CLBS12, is based on previous studies of autologous CD34 cell therapy for no option CLI patients in both Japan and the United States. From those previous studies, researchers found that CD34 cell injection was safe, lead to improvement in CLI free status and improved amputation free survival and other clinical parameters. We have constructed a development program for CLBS12 in Japan based on that country's new regenerative medicines law. Under their newly defined process, we worked with and reached an agreement with the Japanese regulators on a Phase 2 clinical development plan, that if successful, should qualify CLBS12 for early conditional commercial approval in Japan for the treatment of CLI. The agreed trial is a 35 patients Phase 2 prospective randomized controlled open-label multicenter study in patients with no option CLI to be conducted in Japan. Those patients randomized to treatment will be dosed with autologous, UCSF mobilized peripheral blood derived CD34 plus cells to CD [ph], which is CLBS12 through intramuscular injection in addition to standard of care. Patients randomized to the control arm will receive standard of care pharmacotherapy alone. The study is expected to cost between $7 million and $8 million over approximately three years including an initial investment of approximately $2.5 million in the first year. Our goal is to initiate this study in 2017 and to follow results closely, recall that it is open-label, not only to decide on timing and appropriateness of continued investment, but also to manage discussions with potential developments and commercial partners. CLI is just one entry point to explore the broader applicability of the CD34 cell therapy platform, a platform which could potentially be effective in the treatment of major conditions such as chronic heart failure or dilated cardiomyopathy. We have two grant applications pending and a third expected to be submitted later this year to support clinical work for our CD34 cell technology and coronary microvascular dysfunction and other cardiovascular indications. We expect to learn the results of these applications during 2017. Our plan is to initiate clinical studies of our CD34 cell therapy technology platform based on the results of these grant applications. We also continue to explore other means of collaborative support such as partnerships or licensing to contribute to any development programs on which we embark for this technology. In closing, we are excited by the opportunities unfolded by the proposed acquisition of our remaining interest in PCT by Hitachi Chemical. And we're thrilled with the significant opportunities for Caladrius as a cell therapy development only company if the acquisition is completed. And the expected new form Caladrius would be in a strong position to contribute to and capitalize on the clinical utility of cell therapy as a viable approach to disease treatment. We appreciate the continued support of our shareholders and look forward to sharing with you our successes in cell therapy product development. And now, operator, we’re ready to take questions.