Kristen Buck
Analyst · H.C. Wainwright. Your line is open
Thank you, James, and good afternoon, everyone. I realize that we just reviewed our programs a few weeks ago during our full year 2022 results call, but I believe it's important to keep our stakeholders up to date on the continuous progress being made by the Lisata team. Lisata's pipeline is built on a portfolio of proprietary and patented technology that is grounded in strong scientific rationale and a body of published preclinical and early clinical data. Our technologies are designed to address major impediments to successful treatment of solid tumors in the context of increasing pharmacoeconomic pressures on the health care system. We appreciate the critical importance of generating meaningful clinical data to advance our platform technology, and I can assure you that our entire organization has this goal top of mind in everything we do. With that, I will now provide a summary and status update for each of Lisata's active clinical development programs. Kicking off with our lead product candidate, LSTA or LSTA1, for the treatment of advanced solid tumors in combination with other anticancer agents. Despite advances in cancer therapy today, many solid tumors remain difficult to treat effectively. Cancers such as pancreatic cancer, gastric cancer and other solid tumors are surrounded by dense fibrotic tissue known as stroma, which limits access of most pharmacotherapies to the tumor. Many tumors also exhibit a hostile tumor microenvironment, or TME, which suppresses a patient's immune system and makes it less effective in fighting cancer. The combination of a dense stroma and a hostile TME negatively impacts the ability of many cytotoxic agents and immunotherapies to effectively treat these cancers. This, coupled with the fact that most anticancer therapies are not efficient in targeting only cancer tissue, defines the major challenge in maximizing effectiveness and safety in the treatment of solid tumors. To combat this, Lisata's approach is to activate the C-end Rule or CendR system, a naturally occurring active transport system to selectively deliver anticancer drugs through the stroma and into the tumor. Lisata's lead product candidate, LSTA1, is an investigational drug that actuates the CendR active transport mechanism while also having the potential to modify the tumor microenvironment and make it less immunosuppressive. LSTA1 targets tumor vascular endothelial cells as well as tumor cells themselves based on its affinity for alpha-v beta 3 and beta 5 integrins that are operated later on these cells but not necessarily healthy tissue. LSTA1 is a 9-amino acid cyclic internalizing RGD peptide that, once bound to these integrins, is cleaved by proteases expressed in the tumor microenvironment to release a peptide fragment called the CendR fragment. The CendR fragment then has high affinity for and binds to an adjacent receptor called neuropilin-1, also upregulated on tumor vascular endothelial and tumor cells to activate the C-end Rule active transport pathway and ferry anticancer drugs more efficiently into solid tumors. Additionally, LSTA1 has been shown in a range of preclinical models to modify the tumor microenvironment, making it less hostile to immune cells and adding to the efficacy of anticancer drugs used against solid tumors. These results come internally from Lisata and from collaborators and research groups around the world and have been the subject of over 200 scientific publications. Along with our collaborators, we have amassed significant non-clinical data demonstrating enhanced delivery of a range of emerging anticancer therapies, including immunotherapies and RNA-based therapeutics. Clinically, LSTA1 has demonstrated favorable safety, tolerability and activity to enhance the delivery of standard-of-care chemotherapy for patients with metastatic pancreatic cancer. Our development programs are designed to exploit the potential of LSTA1 to enhance a variety of anticancer treatment modalities in a range of solid tumors. Currently, LSTA1 is the subject of about a dozen planned or active clinical trials globally for the treatment of various solid tumors. Let me touch on a few of these individually. Firstly, the ASCEND trial is a 155-patient double-blind, randomized, placebo-controlled clinical trial evaluating LSTA1 in combination with gemcitabine and nab-paclitaxel in patients with metastatic pancreatic ductal adenocarcinoma. The trial is being conducted at up to 40 sites in Australia and New Zealand led by the Australasian Gastro-Intestinal Cancer Trials Group or AGITG. In collaboration with the NHMRC Clinical Trials Centre at The University of Sydney. We are very pleased with the work of AGITG. To date, an enrollment is progressing quite well. We originally projected enrollment completion by the second quarter of 2024. But if current enrollment rates continue, we could complete enrollment sooner than that. Just recently, along with our clinical research partner WARPNINE, we treated two of our first patients in the iLSTA Trial in Australia, evaluating LSTA1 in combination with standard of care, gemcitabine and nab-paclitaxel chemotherapy; and immunotherapy that is durvalumab, as a first-line treatment in locally advanced nonresectable pancreatic ductal adenocarcinoma. This is the first of several planned trials in which we are expanding the study of LSTA1's impact on existing therapies to include immunotherapies. We also expect enrollment completion in this trial by the second quarter of 2024. Next is CENDIFOX. CENDIFOX, the Phase Ib/IIa open-label trial of LSTA1 in combination with neoadjuvant FOLFIRINOX-based therapies in pancreatic, colon and appendiceal cancers, continues to make steady progress. And we expect enrollment completion by the fourth quarter of this year with data readouts in 2024. This trial will provide us with post-treatment biopsy immunoprofiling data as well as long-term outcome data. LSTA1 is also currently being evaluated in combination with gemcitabine and nab-paclitaxel in a Phase Ib/IIa open-label trial in China led by our licensee in that territory, Qilu Pharmaceutical. Preliminary progression-free survival data are expected to be presented at the upcoming ASCO Meeting in June. The company's BOLSTER Trial of LSTA1 is a Phase II placebo-controlled basket trial evaluating LSTA1 in combination with standards of care in advanced solid tumors, including head and neck, esophageal and cholangiocarcinoma. This trial will include both cytotoxic and immunotherapy standards of care. We're excited to announce this trial is now up and running, and we hope to announce enrollment of the first patient by the end of the second quarter. Lastly, iGoLSTA, a Phase Ib/IIa proof-of-concept safety and early efficacy study evaluating LSTA1 in combination with nivolumab and FOLFIRINOX as a first-line treatment in locally advanced nonresectable gastroesophageal adenocarcinoma, is on track to initiate by the third quarter of this year. In addition to the clinical trials I just mentioned, we also plan to have other studies up and running in the next few months, including LSTA1 in combination with temozolomide in glioblastoma multiforme, or GBM, as well as LSTA1 in combination with HIPEC, intraoperative intraperitoneal lavage in patients with peritoneal carcinomatosis. For those who are interested, a more complete description of each of our trials is available in the appendix of the corporate presentation available on our website. Additionally, in the body of the presentation, there are two slides that depict the anticipated timing of all data readouts from our trials. Turning now to LSTA12, also known as HONEDRA in Japan, our product candidate for the treatment of critical limb ischemia, or CLI, and Buerger’s disease. HONEDRA is the company's SAKIGAKE-designated product candidate for the treatment of CLI and Buerger's’ disease in Japan. As we have reported for several quarters, we have completed a registration-eligible study of HONEDRA in Japan, and those data from that study formed the basis of a pre-consultation and, ultimately, a consultation process with the Japanese regulatory authorities to determine the next step of development for the program. To date, the PMDA has provided an advice on how to proceed -- excuse me, how to prepare for the formal consultation meeting and has indicated their preference for additional clinical information to accompany the filing of a JNDA. As a result, we are considering our options for next steps and have engaged a specialized boutique firm to assist in our efforts to secure a Japanese partner to complete the remaining steps of development and registration as well as eventual commercialization in Japan. Lastly, LSTA201 for the treatment of diabetic kidney disease, or DKD. In 2022, the company initiated a Phase Ib open-label, proof-of-concept trial evaluating LSTA201, a CD34+ regenerative cell therapy investigational product for intrarenal artery administration in patients with diabetic kidney disease. Our proof-of-concept protocol had the objective of determining the tolerance of intrarenal cell therapy injection in DKD patients as well as the ability of LSTA201 to regenerate kidney function. As we reported on 6 February 2023, the top line results from the study showed that LSTA201 was safe and well tolerated by patients with no serious adverse events related to the therapy. However, the study did not demonstrate a consistent improvement in kidney function among all patients. That said, encouragement received from the study's principal investigator and key opinion leaders led us to conclude that there still may be potential for use of CD34+ cell therapy for the treatment of diabetic kidney disease. Further development of LSTA201 though will certainly require significantly larger studies and capital investment, and thus, development by Lisata would only be continued if a strategic partner that can contribute the necessary capital for future development is identified. With that, I will now turn the call back to Dave.