Howard Robin
Analyst · Cowen. Your line is open
Thank you Jennifer, and thank you to everyone for joining us today for our year end 2017 conference call. On today’s call we will review the many upcoming milestones for Nektar's pipeline over the next 12 months, including our planned submission of an NDA for NKTR-181 in the second quarter and the continued advancement of our I-O portfolio with NKTR-214, NKTR-262, and NKTR-255. We will also provide our financial guidance for 2018. 2017 was a truly transformational year for our company. We achieved major successes on multiple fronts with Nektar invented medicines across three therapeutic areas; pain, immuno-oncology and immunology. This is a singular set of achievements that is truly remarkable and is the culmination of many years of hard work and scientific innovation by the Nektar team. In the area of chronic pain, all Phase 3 trials of NKTR-181 were successful. The efficacy study in patients, the long term safety study in patients and the pivotal human abuse liability study conducted in recreational drug users. This successful and comprehensive Phase 3 development program will enable us to submit an NDA package for NKTR-181 in the second quarter of this year. In the immuno oncology we developed a highly valuable and highly focused strategy, which resulted in a pipeline of new potential medicines that address the key components of the immune cycle in order to restore immune surveillance and properly harness the body’s immune system to fight cancer. We now have a strong pipeline in immuno oncology, NKTR-214, NKTR-262 and NKTR-255. We’ve had compelling results with our lead I-O program NKTR-214 in terms of clinical efficacy, safety and supporting translational science, which led to our recent strategic collaboration with Bristol-Myers Squibb. The collaboration enables us to develop NKTR-214 broadly and rapidly in order to establish it as a backbone of cancer care across multiple indications. And in immunology we opened the IND and began clinical development with NKTR-358, a first in class T reg, targeting resolution therapeutic to treat autoimmune disease. Our preclinical success with NKTR-358 led to an extensive partnership with Eli Lilly to develop NKTR-358 for a wide range of autoimmune diseases. Based upon the proof-of-mechanism results observed to-date in the single ascending dose first in human trail, NKTR-358 is now advancing into lupus patients in a multiple-ascending dose study which we plan to begin in the second quarter of this year. I don’t know of any other company at our stage of development to have this number of substantial and successful achievements in a single year, and I am very proud of our employees. First let’s review the substantial progress we’ve made with NKTR-181. In the past two months, we’ve had two highly productive, pre-NDA meetings with the agency to discuss our clinical, non-clinical, and CMC data packages that will go into our NDA submission. As you know, our NDA data package includes an extensive amount of efficacy and safety data in over 2,100 patients and healthy subjects. This includes our 600 patient Phase 3 efficacy trial, our two human abuse potential studies and our 630 patient Phase 3 long term safety study, which also included long term measurements of pain control, as well as a wide range of PK and PD studies of therapeutic and supra therapeutic doses of NKTR-181 in over 450 healthy subjects. The FDA staff gave us clear and collaborative guidance on the expectations for completion of our NDA submission. An agreement was reached to file the package in the second quarter of this year. The agency further confirmed that Nektar has an adequate abuse potential assessment data package and that together with the safety population the data appeared to be adequate to warrant a discussion of a less restrictive scheduling than schedule two. As I said earlier, we are on track to submit the NDA for filing in the second quarter of this year. NKTR-181 has emerged not only as a critically important new potential medicine to treat patients with moderate-to-severe chronic pain, but also as an important component of a solution to address the opioid public health emergency. This afternoon Steve and I were invited to and participated in the opioid summit at the White House, which focused on the treatment of addiction in our country and the education, prevention and treatment of pain patients in light of the current opioid epidemic we are facing. A key theme of this event was the importance of providing pain relief to patients without the high risks of abuse and addiction found with today’s opioid drugs. As the first new full mu-opioid agonist molecule to be developed in over 50 years, NKTR-181’s unique inherent properties position the drug to not only help stem the rate of new addiction to conventional opioids, but also to reduce diversion of prescription pain medications for abuse. We strongly believe that we could add more value to NKTR-181 through the continuing regulatory process. We believe NKTR-181 is a major building block in the fight against opioid addiction and we are highly focused on the best way to bring this important new medicine to patients quickly following approval. We are actively evaluating potential licensing to commercial partners or other strategic, structural alternatives while we advance the regulatory process. Finally we are very pleased to announce today that two NKTR-181 abstracts were accepted for oral presentation at the upcoming 2018 Annual Scientific Meeting for the College of Problems of Drug Dependence, which will be held in San Diego the week of June 9. The first presentation will feature results from our dopamine microdialysis animal models which show that NKTR-181 does not create the same dopamine surge in the brain’s reward center as is observed with standard opioids. The second presentation will review new positive data from our Phase 3 efficacy study from an important exploratory end point related to assessing the abuse potential of the medicine. The end point used in new measurement tool called MADDERS, which was developed with the FDA Action Public Private Partnership Initiative in order to quantify potential abuse related events in clinical trials. The MADDERS tool was specifically developed to generate evidence to support approval, labeling and scheduling decisions for new medicines. Now let’s talk about NKTR-214. As you know, we recently entered into a transformative collaboration with Bristol-Myers Squibb, the global leader in immuno-oncology. This new collaboration is a major strategic step forward for our company in order to establish Nektar as a new leader in the immuno-oncology field. The collaboration’s broad clinical development program ensures that we could advance this new potential medicine to as many patients as possible as quickly as possible. As you know Nektar will book all global revenue and we will keep 65% of global profits for NKTR-214. We will also receive an upfront payment of $1 billion and a premium equity investment of $850 million at $102.60 per share. We expect the collaboration to commence in the second quarter once the HSR review period ends. Since we have the flexibility to pursue other combination possibilities, we maintain pricing and distribution control for NKTR-214 and our partner has committed to pay two-thirds of the collaborations development costs. We now have the right foundation in place to maximize the value of NKTR-214. Onto the framework of the new collaboration, Bristol-Myers Squibb and Nektar will be initiating over 20 registration enabling studies that will enroll approximately 15,000 patients in nine tumor types. These trials will start within the first 14 months of the collaboration and the first two Phase 3 studies which Bristol will start in the middle of this year will be conducted in patients with first line melanoma and first line renal cell carcinoma. We plan to share the design of these trails later this year at ASCO. At ASCO we will also share our first presentation of data from the second part of the ongoing PIVOT study of NKTR-214 plus Opdivo knows as the expansion stage. At JP Morgan I provided an update on the patients from the first part of the ongoing PIVOT study, the 38 patients from the dose escalation stage. To remind you, the response rates we reported at JP Morgan were 75% response in second line I-O naïve non-small cell lung cancer, a 64% response rate in first line I-O naïve melanoma patients, and a 57% response rate in first-line I-O naïve renal cell carcinoma patients. Further, all of the partial and complete responses observed in the dose escalation stage of the trail has been confirmed and we see ongoing tumor shrinkage and all patients with responses from dose escalation continue on treatment. Importantly, there have been no patients with responses who relapsed in any of the tumor types. This highlights that the length of time patients spend on treatment with the combination of NKTR-214 plus nivolumab is correlated with further tumor shrinkage and improved and continued response. Specifically I want to take a moment to focus on the improvement and response over time for the 14 patients with first line renal cell carcinoma. When we initially presented the first line RCC dose escalation data as the SITC Conference in November of last year, the response rate was 46%. As I just said two months later at the time of JP Morgan the response rate was 57%. Today we are pleased to report that we have additional patients with stable disease that converted to responders, which means we now have a 71% response rate in first line RCC with all patients with responses confirmed in ongoing treatment. There is also one additional patient in first line RCC with stable disease who is still on treatment as well. That patient had experienced tumor reduction and also has a potential to convert to responder. Across the entire 38 patients in dose escalation in all tumor types, we now see a confirmed 60% overall response rate in the 20 patients with base line PD-L1 Negative Status. In addition, our safety profile across the entire PIVOT population continues to be encouraging with no patients discontinuing because of treatment related AEs and a low 11% G3 adverse event rate in over 150 patients treated to-date. As I just stated, at ASCO we will present the first data from the second expansion study. The PIVOT study continues to enroll patients into the second expansion stage. As you’ll recall we plan to enroll 330 patients into 13 different expansion cohorts that’s been in five different tumor types. We expect to complete enrolment for the first five tumor types by the end of the third quarter of 2018. In the second quarter we will add three new expansion cohorts to PIVOT, gastric, colorectal and small cell lung cancer. It will begin enrolment very shortly after the HSR review period. As we retain the ability to develop NKTR-214 in combination with other anti-cancer agents, we plan to initiate additional development collaborations this year. This will ensure that we maximize our potential to rapidly establish NKTR-214 as the future backbone of immuno-oncology therapy. Today, we have several NKTR-214 combination programs underway in non-clinical tumor models, including a collaboration with Takeds with five different targets, as well as vaccine and other small molecule programs. Based on the positive results from multiple pre-clinical studies, we expect to advance several new combinations into the clinic this year. At the upcoming AACR conference in April, we will present four separate non-clinical datasets for NKTR-214, including a combination of NKTR-214 with an HDAC inhibitor in models of renal and colon cancer, and a combination of NKTR-214 with an adoptive T-cell transplant approach conducted in collaboration with Dr. Anthony Revis. It’s important note that the Bristol-Myers Squibb collaboration puts us in a very strong financial position and allows us to execute on our vision for Nektar’s portfolio in immune-oncology. Our pipeline of I-O candidates beyond NKTR-214 includes NKTR-262, a TOR 78 Agonist, and NKTR-255 and IL-15 candidate that can stimulate both NK cells and memory T cells. The preclinical data for the NKTR-214, 262 combination are particularly compelling and we are on track to dose the first patient in the novel-novel combination trail of NKTR-262 with NKTR-214 this month. The trial will enroll up to 400 patients with eight different tumor types in first and second line as well as refractory settings. The first stage of the trial will assess the doublet to NKTR-262 and NKTR-214 and the second stage of the trail we have the option to evaluate a triplet of NKTR-262 and NKTR-214 plus Opdivo. We expect to have the initial data from this trail sometime in the fourth quarter of this year. Now let me give you an update on the advancement of Nektar-358 with our partner Eli Lilly. As I stated earlier, with success in the Phase 1 singe-ascending dose trial of Nektar-358 in healthy volunteers, Nektar-358 is now slated to enter Phase 1b multiple ascending dose trial in patients with lupus in the second quarter of this year. This Phase 1b study will enroll approximately 50 patients and will evaluate safety and biomarkers of Nektar-358. With a 12-week retreatment period we expect the trail duration to be 18 to 24 months with initial data sometime in 2019. And with that, I’ll hand the call over to Gil to provide financial guidance for 2018.