David Young
Analyst · Oppenheimer. Your line is live
Thank you, Jim. Good evening. Thank you for joining us. During my time with you today, I plan to highlight what we’ve accomplished in 2021 in our drug development programs and briefly share what you should be expecting over the next 12 months. I will not be covering all the details on each slide, but the slides are posted on our website if you want to study them more. Let’s go to our first slide, Slide 3. This slide provides you with a snapshot of the Processa highlights. As you know, Processa is a drug development company, focused on improving the quality of life and/or survival of patients who have an unmet medical need condition. These are patients who either have no treatment option or need a better treatment option. Each of our five drugs within our pipeline addresses a different unmet medical need with a potential market size for each drug being greater than $1 billion. This means that Processa is giving each of our investors, which includes the Processa staff, five independent opportunities or shots on goal to have a blockbuster drug. In addition, we not only have five potential blockbusters, but we are simultaneously developing all five drugs, all at different stages, but all are now going through our development process. This process is the regulatory science approach that we started to develop 30 years ago when we worked on two FDA contracts, determining the best way to answer a number of FDA clinical and scientific regulatory questions. Our contracts led to the development of a number of FDA guidances. We now have multiple near-term milestones on our five drugs that we expect to achieve from March to August and at the end of the year. I’ll discuss these milestones as I briefly review each drug within our pipeline. Next slide. To remind everyone, Slide 4 describes the criteria that we have used to select the five drugs in our pipeline. Since I’ve already spoken to some of these slides, I would only like to point out one other key item on this slide. The second criteria in the red box states efficacy evidence, this means that there is some clinical evidence of efficacy in the targeted population for each of the five drugs or for a drug with very similar pharmacology. If you look at other biotech companies, how many of the companies can say that they have five potential $1 billion drug in the pipeline and all five have some positive evidence of efficacy in the targeted population. Next slide. Now let’s look at a summary of our pipeline. The status of each drug and the key milestones we expect to achieve in 2022 are presented on the slide. Instead of going into the details of each drug using this slide, I’d like to point out that we have three drugs in clinical development, 6422, 6422 which we are now rebranding the next-generation capecitabine, 499 and 12852. And the fourth drug, 3117, that will be ready for clinical development by the end of the year. In 2022, we should hit key milestones for all four of these drugs. Although in later slides that do provide some background information on each of the five drugs, I will be emphasizing the 2021 achievements and the 2022 value-added milestones for each drug. Next slide. Let’s first review the next-generation capecitabine, which should have some data readout mid-2022. Next slide. Next-generation capcitabine, which we previously designated at 6422, is a chemotherapy treatment that includes 6422 chemotherapy modifier to capecitabine, administered with cepcitabine. Capecitabine one of the cornerstone chemotherapy drugs used in cancer and the oral prodrug form of 5-FU. As you can see from the diagram looking at the right side of the metabolic scheme for 5-FU, 5-FU is metabolized through DPD and line to a metabolite called FBAL, which has no therapeutic effect that can cause side effects, and these side effects can be dose limiting. 6422 irreversibly inhibits existing DPD in the body, shutting down the right side of to the metabolite to FBAL. The shutdown of the side results in 5-FU metabolism shifting to the left side, the side that forms 5-FU nucleotide, which kills cancer cells but also kills normal cells being synthesized like neutrophils. This shift, however, does not last forever because they know DPD is formed over time. And if no 6422 is present, the new de novo DPD can metabolize 5-FU to FBAL. We demonstrated into 2021, the next-generation capecitabine with a single dose of 6422 inhibited DPD activity for 24 to 48 hours after 6422 administration, resulting in capecitabine potency being 50x greater than the present FDA-approved capecitabine. However, the increased potency appeared to only last for 24 to 48 hours and did not last for all seven days of capecitabine dosing. Next slide. We have clinical and preclinical evidence that if we can decrease the metabolism of 5-FU to FBAL for less than 10% compared to the typical 80% for all seven days of capecitabine dosing, while still minimizing the exposure to 6422. The efficacy safety profile for next-generation capecitabine should be much better than presently approved capecitabine. To achieve this, we need to better understand the timeline of DPD inhibition and de novo formation to determine a regimen of 6422 that would provide minimal exposure and still maintain less than 10% metabolized to FBAL. Next slide. Given the DPD activity findings after a single dose of 6422, we’ve modified the Phase 1b protocol to also, one, better understand the time line of DPD inhibition and de novo formation. And two, evaluate the possibility of using an individualized, personalized treatment approach for next-generation Capecitabine. The modified protocol was submitted to FDA in February, and we are working to restart the modified Phase 1b trial. Sites are being reactivated, and we are adding one to two more sites. Sites with IRB approval have begun to identify patients. We expect to restart dosing patients in the second quarter of 2022. We expect that preliminary results on the DPD timeline by mid-2022, and have the preliminary determination of an MTD for next-generation capcitabine by the end of the year. The overall timeline for initiation of a pivotal registration trial is still 2023 to 2024 and an NDA submission in 2027 to 2028. Next slide. Let me quickly review PCS499, our Phase 2b drug, for which we have FDA orphan designation for the treatment of necrobiosis lipoidica. And there is presently no approved treatment or even a standard of care for this condition. Next slide. As seen as these two pictures, necrobiosis lipoidica or NL, presents in patients as non-ulcerated NL and ulcerated NL. The literature reports approximately 22,000 to 55,000 in ulcerative NL patients in the U.S. with painful ulcers occurring naturally or from contract from to the lesion. However, the numbers may be significantly less, but this should not alter the potential $1 billion market. It is important to note that natural complete healing or wound closure of moderate-to-severe ulcers during the first one to two years after onset incurs in less than 5% of these patients. Next slide. Currently, there is no FDA-approved treatment for NL or ulcerative NL. There’s no standard of care, and all drugs used off-label are inadequate because of dose-limiting side effects, which prevents the drugs to be given at a high enough dose to see significant efficacy in a trial. This includes a drug called pentoxifylline or as I often call it PTX. PTX does work in closing the ulcers of some patients, but side effects limit the dose that can be administered, which then limits the efficacy. PCS499 is the duterated analog of a metabolite of PTX. PCS499 qualitatively has the same metabolites as PTX, but quantitatively has different amounts of the metabolites, resulting in a better safety profile. Next slide. In addition, in our Phase 2a NL trial, complete wound closure was achieved in the only two patients who presented with ulcers. Next slide. So what have we accomplished in 2021 for PCS499? We’ve enrolled three patients in our blinded Phase 2b randomized placebo-controlled trial, with the preliminary findings in some of these patients showing complete wound closure and improvement in the NL lesion overall. At this time, we do not know if these patients receive PCS499 or a placebo, and the results are only preliminary. We have had a number of patients interested in enrolling but not willing to travel because of COVID. Many ulcerative NL patients have other medical conditions such as diabetes and having lived with ulcers for years that we don’t want to travel. The combined risk, these patients are willing to continue tolerating the ulcer even a little longer rather than potentially be exposed to COVID in the travel sites. In fact, a couple of patients who expressed interest in the study, actually died from COVID before they came into the screening process. To improve the enrollment, we have also initiated a number of remedial efforts at the end of last year. We’ve closed four sites in Europe that were not recruiting well, and we are replacing these sites with new sites in the U.S. or possibly ex-U.S. Since the purpose of this Phase 2b trial is to obtain additional information on the response to PCS499 and placebo, we are also evaluating if these questions can be answered with fewer patients in the interim and final analysis. The interim analysis group of patients should be enrolled by 6/30/2022, with the interim results expected in December of 2022. Complete enrollment of the trial is expected by the end of the year. We still plan to meet with the FDA after the study is completed and began a Phase 3 trial at the end of 2023. Next slide. The next drug to discuss is PCS12852. Next slide. Let me remind you that the drug increases the gastric emptying rate, which can have a significant effect on the symptoms of gastroparesis. PCS12852 has already been shown to have a significant effect on gastric emptying in patients with constipation. In our Phase 2a trial, we expect to see the same type of improvement in the gastric emptying rate in gastroparesis patients. Next slide. At the present time, there is only one FDA-approved drug for the treatment of gastroparesis. And that drug has serious side effects, a black box warning and can only be used for 12 weeks, even though most patients have chronic constipation. Next slide. We are presently activating clinical sites for this trial and expect our first patient to be dosed in the second quarter of 2022. We expect the trial to complete enrollment in 2022 with top line final results available December of 2022 or January 2023 and the Phase 2b trial to begin in 2023. Next slide. The last two drugs are cancer drugs, and they are PCS3117 and PCS11T. Next slide. The next three slides briefly describe the status of these programs and the next milestones. A summary of these drugs is, one, both are cancer drugs with the market potential each of over $1 billion; two, for both drugs, the active media already been shown to be clinically efficacious in cancer patients; three, the potential benefit risk associated with these drugs allows us to target a population of cancer patients who need alternative treatments; and lastly, we are presently defining the development program and the road map to approval for both of these drugs. The last group of slides are the pipeline background slides that have been presented before in some form. I’ll not discuss these slides, but they are in the deck to provide more information on each drug. This concludes my remarks. I will now ask the operator to open the phone lines for Q&A. Operator, can you please poll for questions?