Thomas Heineman
Analyst · Canaccord Genuity. Please go ahead
Thanks, Matt. I’d like to kick off my portion of the call by setting the stage for what to expect from BRACELET-1’s anticipated readout next quarter. As a reminder, BRACELET-1 is a randomized Phase 2 trial to be conducted in collaboration with Pfizer and Merck KGaA. It enrolled patients with HR-positive HER2-negative metastatic breast cancer into three distinct cohorts. The first two cohorts mirror the ND-213 study that Matt referenced earlier with one cohort evaluating paclitaxel monotherapy and the other evaluating the combination of paclitaxel and pela. In addition, the third cohort evaluates a combination of paclitaxel, pela and the checkpoint inhibitor, avelumab. At a medical meeting next quarter, we anticipate reporting progression-free survival and tumor response results from this trial, which was designed to enroll a total of 48 patients. While enrollment into BRACELET-1 is complete, it should be noted that many patients continue to be followed for critical endpoints. Accordingly, some key results of the study, including overall survival will only come into focus as the data mature. Given its size, BRACELET-1 is not powered to demonstrate statistical significance between the study groups. A successful result from the trial would therefore B2C one or both of the cohorts that include pela numerically outperformed the paclitaxel monotherapy arm. Achieving this result would result in a second randomized dataset supporting pela’s ability to deliver meaningful clinical benefit to HR-positive HER2-negative breast cancer patients further derisking our program as we move towards a registrational study. As we look ahead for our breast cancer program, we are also highly encouraged by recent data presented by our partner, Adlai Nortye at last year’s San Antonio Breast Cancer Symposium. 0These data were from Adlai’s single-arm bridging trial evaluating pela plus paclitaxel in Chinese patients with HR-positive HER2-negative metastatic breast cancer. As you just heard, pela plus paclitaxel is the same combination being studied in BRACELET-1’s second cohort. Results from Adlai’s bridging trial demonstrated this combination’s favorable safety profile in Chinese patients and showed tumor shrinkage in 12 of 14 evaluable trial participants with 7 achieving a partial response. Of the 7 patients with partial responses, three had the responses confirmed by subsequent scans, while two others had potentially confirmatory scans pending. Notably, one patient continued to maintain a partial response after nearly a year following the presentation’s cutoff date. And although they are still evolving, I would like to also note that the trial’s progression-free survival results presented at San Antonio Breast Cancer Symposium showed a median PFS of 9.1 months. These interim results from Adlai’s bridging trial further demonstrate the ability of pela plus paclitaxel to drive durable clinical responses in HR-positive HER2-negative breast cancer patients. We believe this promising finding bodes well for BRACELET-1’s upcoming readout. I will now speak about our recent results in pancreatic cancer and what they mean for the program moving forward. These data were presented at the SITC meeting last year and came from our GOBLET study, which is a Phase 1/2 multi-indication trial being conducted in collaboration with Roche and AIO. The trial was designed in two stages so that any cohort that achieves a pre-specified response rate in Stage 1 maybe expanded to enroll additional patients in Stage 2. As Matt previewed, GOBLET’s pancreatic cancer cohort evaluated the combination of pela, the PD-L1 checkpoint inhibitor, atezolizumab and the chemotherapeutic agents, gemcitabine and nab-paclitaxel in first line patients with advanced or metastatic disease. We reported an objective response rate of 69% in 13 evaluable patients with 8 patients achieving a partial response and 1 achieving a confirmed complete response, which is a quite rare finding in this indication. The study combination was also shown to be well tolerated. To help provide a full understanding of these results, I’ll emphasize some key points made during the recent key opinion leader webinar, a replay of which can be found on our website. This webinar featured GOBLET’s principal investigator along with two additional pancreatic cancer experts. First, I’ll emphasize that achieving a 69% response rate in GOBLETs pancreatic cancer cohort far surpassed our expectations going into the trial. As Matt mentioned, the average response rate for pancreatic cancer trials of gemcitabine plus nab-paclitaxel is only about 25% or roughly third of what was observed when we added pela and a checkpoint inhibitor to this regimen. Moreover, a number of trials have shown that checkpoint inhibitors only improve outcomes in pancreatic cancer patients classified as MSI high who represent only about 1% of all pancreatic cancer patients. This helps explain why older chemotherapeutic regimens such as gemcitabine plus nab-paclitaxel remain the standard of care in pancreatic cancer despite providing a median overall survival of less than a year. The next point from our KOL webinar that I’ll emphasize is that goblet’s pancreatic cancer cohort included patients that are quite typical and similar to what would be expected in a randomized registrational trial. Of the evaluable patients, 13 had metastatic disease with nine having liver metastases and the average age of the patients was just over 62 years. Having achieved these very encouraging results in a representative population increases our confidence as we move our program towards a registrational study. And the last point I will emphasize is that we have a robust set of mechanistic data prior trials supporting GOBLET’s results, which suggests pela synergistic reacts with checkpoint inhibition and chemotherapy to drive tumor responses in pancreatic cancer. These data have demonstrated pela’s ability to activate and expand anticancer immune cells while simultaneously reversing immunosuppressive tumor microenvironments. Immunologic effects such as these are known to enhance the efficacy of checkpoint inhibition, highlighting the scientific rationale for the GOBLET study. Based on GOBLET’s compelling results, as well as the unmet need and current treatment landscape in pancreatic cancer, we have chosen to forego Stage 2 expansion phase for the trial’s pancreatic cancer cohort so that we can move directly towards a registrational pathway. Given the clear signal of activity we’ve seen in GOBLET’s pancreatic as or cohort to date, we believe this is the most clinically appropriate next step for the program and one that is in the best interest of patients. To enable the advancement of our pancreatic cancer program to a randomized trial, we are gathering input from regulators and other key stakeholders on the optimal design for its next trial. As we work to do this, we will benefit from our pancreatic cancer program’s recent Fast Track designation from the FDA. This designation will provide us with the opportunity to communicate more frequently with the agency about our data and planned development pathway. It also provides a degree of validation for GOBLET’s interim results since receiving Fast Track designation requires that a therapy show some advantage over available treatments such as superior effectiveness. While it’s too early to share the specifics of what pela’s next pancreatic cancer trial will look like, what I can say now is that we are envisioning a randomized Phase 2 study with an adaptive design. Ideally, this design would allow seamless progression from an interim analysis to an expansion phase designed to support a regulatory file. We look forward to our continued work designing this trial and to sharing more details once they are finalized. Lastly, before handing off the call to Andrew, I would like to remind all listening that in addition to its pancreatic cancer cohort, GOBLET also includes cohorts evaluating pela atezolizumab combinations in metastatic colorectal and advanced anal cancer. We expect to have additional updates from these cohorts over the course of the year and have been pleased with the overall enrollment to date. With that, I’ll ask Andrew to speak about our business development efforts. Andrew?