Helen Sabzevari
Analyst · JMP Securities
Thank you, Steve. I'm extremely pleased to be here today to highlight the significant progress Precigen has made since our official company debut during the JPMorgan Healthcare Conference in January.
As we have communicated previously, we believe we hold a unique position in the biotech landscape, having all of the required technology platforms for advancing precision medicine. This technology platform are designed to enable us to construct powerful multi-gene program for optimized gene expression, deliver these multi-gene programs using viral and nonviral vectors with high-payload capacity and controller gene expression and regulate therapeutic performance, utilizing clinically advanced switches. The breadth and the versatility of these platforms, coupled with our expertise in immunology, has positioned us to have an unparalleled holistic approach with the potential to deliver the core promise of precision medicine.
Next slide, please. These platforms have allowed us to lay the foundation to build a comprehensive pipeline in immuno-oncology, infectious diseases and autoimmune disorders. In 2019, we have successfully progressed 2 first-in-class UltraCAR-T programs into the clinic; advanced PRGN-2009 towards potential IND; advanced 2 discovery programs into preclinical testing; optimized our UltraCAR-T manufacturing process and built an in-house GMP manufacturing facility to support our off-the-shelf AdenoVerse immunotherapy program.
Precigen now sits at an inflection point, as our achievements during this year positioned Precigen to deliver on important data readouts in the coming quarters.
Given the breadth of our pipeline, business development and product prioritization remain key components of Precigen's business model. We remain disciplined in our R&D spending and while we plan to develop select programs on our own, we will also seek a strategic partnership to advance other pipeline programs in an efficient and cost-effective manner.
On today's call, I will highlight the significant strides we have made since the beginning of the year, particularly in regard to our UltraCAR-T therapeutic platform and associated ongoing trials.
Next slide, please. Our UltraCAR-T program is fundamentally differentiated from the competition and addresses major challenges associated with the current generation CAR-T therapy.
One key differentiator with UltraCAR-T platform is the use of our nonviral sleeping beauty gene delivery system. We have optimized the sleeping beauty system using our UltraVector DNA construction platform to produce multi-genic UltraCAR-T cells. This optimization produces a homogeneous population of UltraCAR-T cells, where multiple genes are expressed [ on all ] modified T cells. Our UltraCAR-T co-express an antigen-specific CAR, a kill switch and a membrane-bound IL-15 simultaneously.
Precigen's proprietary membrane-bound IL-15 enhances persistence, in-vivo expansion and maintains a stem like memory phenotype of UltraCAR-T cell. This leads to longer-lasting antitumor response compared to conventional CAR-T cells, which is essential for successful targeting of solid tumors.
Another key differentiator with the UltraCAR-T therapeutic platform is our decentralized, rapid manufacturing process, which allows us to manufacture overnight at the medical center cGMP facility and reinfuse the patients the next day. We have evolved our manufacturing platform to advance rapidly through the clinic towards commercialization. We are the first company to implement nonviral, decentralized, rapid manufacturing of CAR-T cells in the clinic. We have demonstrated our ability to infuse patients the day after gene transfer at 2 different sites in our ongoing clinical trials. And I'm pleased to announce today that we have experienced 100% success in manufacturing of UltraCAR-T cells for both the PRGN-3005 and PRGN-3006 clinical trials to date. We consider this a very significant milestone in demonstrating the potential of our UltraCAR-T platform. We believe that Precigen is poised to disrupt the current CAR-T treatment landscape.
Next slide, please. Now moving to the first program, I'll detail PRGN-3005 UltraCAR-T. This is an investigational therapy using autologous CAR-T cells targeting the Mucin 16 or MUC16 protein. MUC16 is an attractive CAR-T target for ovarian cancer since it is overexpressed on more than 80% of ovarian tumors with limited expression in normal tissue and that is important. This UltraCAR-T is multigenic and designed to co-express membrane-bound IL-15, a kill switch and antigen-specific CAR that targets MUC16. We have designed our MUC16 CAR to preferentially target PRGN-3005 to tumor cells.
Furthermore, our team has optimized the affinity of our anti-MUC16 binding domain for optimal signaling by our CAR. These genes are delivered via our nonviral system, which enables homogeneous expression of these 3 genes in all modified T cells. These CAR-T cells homogeneity is an important factor for future commercialization.
We choose ovarian cancer as one of our first tumor targets as these patients still have significant unmet need. There are few treatment options and survival rates remain low. It is also a large patient population, with approximately 300,000 patients diagnosed worldwide annually, including 22,000 in the U.S. alone.
Next slide, please. We are currently testing PRGN-3005 in a Phase I study in collaboration with the University of Washington and Fred Hutchinson Cancer Center, leaders in immunotherapy and CAR treatment. This is an investigator-initiated dose escalation study to evaluate the safety and maximum tolerated dose of PRGN-3005, delivered by either intraperitoneal or intravenous infusion. This study population includes advanced stage 3 or 4 recurrent ovarian, fallopian tube and primary peritoneal cancer patients who are platinum resistant and have progressed after receiving a standard of care therapy. For both routes of administration, PRGN-3005 will follow a 3 x 3 dose escalation pattern. We expect to enroll up to 41 patients total in this study.
In August, we communicated that we had dosed the first patient in this Phase I trial, and I am very pleased to announce that we recently completed dosing the first cohort in the intraperitoneal, or IP arm of this trial. We are incredibly pleased with the progress of this trial. Its execution to date demonstrates ability to enroll patients and rapidly manufacture UltraCAR-T. While the Phase I trial is obviously focused on safety, we are also evaluating the maximum tolerated dose and the ability of PRGN-3005 to expand in-vivo, a key factor for future success.
We are excited to continue the dose escalation and look forward to updating you on our progress. We expect to provide an initial data readout from IP arm of this trial in the second half of 2020.
Next slide, please. I'll now move to PRGN-3006 UltraCAR-T. PRGN-3006 is an autologous CAR-T therapy, targeting patients with relapsed or refractory acute myeloid leukemia, or AML, and higher-risk myelodysplastic syndrome, or MDS. There are approximately 20,000 AML patients diagnosed in the U.S. annually. This UltraCAR-T is multigenic and designed to co-express membrane-bound IL-15, a kill switch, an antigen-specific CAR that targets CD33. CD33 is an attractive target for immunotherapy because it is overexpressed on AML blast and leukemic stem cells, but is not expressed on normal hematopoietic stem cells. 85% to 90% of AML patients express CD33 under tumor cell. AML is a heterogeneous disease with very high relapse rates and rapid progression. Time is of the essence for these patients, and long manufacturing delays of viral-based CAR-T therapies can be an obstacle for successful treatment intervention.
Our UltraCAR-T approach represents a significant advantage for the time-critical treatment of these patients.
Next slide, please. PRGN-3006 is being evaluated in a Phase I/Ib study of the treatment of patients with relapsed or refractory AML and higher-risk MDS. This is a nonrandomized investigator-initiated safety and tolerability study of the PRGN-3006 UltraCAR-T following intravenous administration of escalating dose. The trial is being run in collaboration with the Moffitt Cancer Center, a pioneer in CAR-T clinical development. In the 3x3 dose escalation phase, patients will be treated in 1 of 2 arms. Arm 1 will receive CAR-T cell infusion without prior lymphodepletion and arm 2 will receive lymphodepleting chemotherapy. The dose escalation phase of each arm will be followed by a dose expansion phase at a maximum tolerated dose. Since our UltraCAR-T cells have potential for enhanced in-vivo expansion and persistence without additional cytokine requirement, we are very excited to evaluate PRGN-3006 in patients without prior lymphodepletion. In July, we announced that we had completed dosing of the first patient in the PRGN-3006 trial. I'm happy to announce that we recently completed treatment of patients at the first dose level in arm 1 without prior lymphodepletion.
As with PRGN-3005, we are incredibly pleased with the progress of PRGN-3006 and see it as another validation of our ability to execute.
For comparison, I would like to discuss PRGN-3006 versus INXN-3004, both targeting CD33, but with very different manufacturing process. INXN-3004 is a discontinued legacy investigational product that was in a Phase I safety study of autologous T-cell, transfused with lentivirus to express CD33 specific CAR in patients with relapsed or refractory AML. This study was conducted in collaboration with MD Anderson Cancer Center.
Unfortunately, after nearly 2 years, only 3 patients were infused with the product. This was due to failures of viral-based ex vivo manufacturing that did not generate therapy fast enough for some patients whose disease progressed before the therapeutic CAR-T cells were available. This is why we spent so much energy developing a state-of-the-art nonviral manufacturing process to deliver UltraCAR-T therapy to patients overnight. We continue to believe that CD33 is an attractive target for treatment of AML and PRGN-3006 represents a viable treatment option for this patient population.
We are extremely excited about the PRGN-3006 clinical trial and evaluation of our platform with or without lymphodepletion in AML patients. We expect to provide an initial data readout from the ongoing trial in the second half of 2020. Additionally, we will present preclinical data at the upcoming American Society of Hematology Annual Meeting and Exposition in December.
Next slide, please. I'll now move to PRGN-2009. PRGN-2009 is an off-the-shelf immunotherapy product candidate utilizing AdenoVerse platform, designed to activate immune system to recognize and target HPV positive solid tumors. HPV positive cancers represent a significant health burden in indications such as head and neck, cervical, vaginal and anal cancer. Multiple approaches to targeting HPV positive cancers have recently been of great interest in immuno-oncology, of which TCR-T cell therapies are applicable to only a small subset of HPV positive cancer patients due to the HLA polymorphism and are further restricted by manufacturing and high cost. And [ critical ] cancer vaccines approaches have lacked efficacy due to the combination of a limited immune response and narrow antigen coverage. PRGN-2009 leverages our UltraVector platform to optimize HPV antigen design and coverage and our Gorilla adenovector, which has low to no seroprevalence in humans. This allows for durable immune response and the ability for repeat administration.
Preclinical testing of PRGN-2009 has demonstrated robust antigen-specific immune response and potent antitumor activity in humanized mouse model. Based on results from in-vivo mouse model, PRGN-2009 also represents a target opportunity for combination with treatment, both within and outside of our pipeline. This program is currently under development through CRADA with Dr. Jeffrey Schlom, a world-renowned investigator in immuno-oncology at the NCI. This CRADA has been valuable to Precigen as it allowed us to complete the preclinical work and the forthcoming Phase I clinical trial in a cost-effective way and at a very rapid pace. It also provides for the potential for expansion to other targets and combinations. We are working very closely with the NCI team on an IND submission for PRGN-2009. We expect NCI to begin dosing patients in 2020, and are looking forward to providing additional details on this program in the near future.
Furthermore, the opening of our manufacturing facility in Germantown, Maryland, which we announced in April is designed to support our AdenoVerse platform-based therapeutics, including PRGN-2009. The opening of this facility is a strategic long-term decision that will put Precigen firmly in control of our early phase clinical manufacturing needs for gene therapies, and future product development.
Next slide, please. Lastly, I'll move to our multifunctional therapeutic platform, targeting solid tumors. While checkpoint inhibitors have had a significant impact on oncology treatment, a large percentage of patients fail to respond and among those that do, approximately 1/3 relapse. Our multifunctional therapeutics platform is designed to address multiple immunosuppressive pathways in the tumor microenvironment. We have taken a strategic approach to developing this platform with 2 preclinical assets, PRGN-5001 and PRGN-5002 with significant market opportunity.
Our first multifunctional therapeutic candidate PRGN-5001 has demonstrated the ability to enhance T-cell activation and antitumor effect in mouse models of tumors that do not respond well to anti-PD-1 checkpoint inhibitor antibodies.
As shown in the last section of this slide, we highlight that in a humanized mouse model of head and neck cancer, PRGN-5001 showed an ability to overcome tumor microenvironment immunosuppression and significantly improved T-cell function as compared to a stand-alone anti-PD-1 treatment, leading to superior antitumor response.
Our team has generated a strong preclinical data package, demonstrating the effectiveness of PRGN-5001 in multiple cancer models where anti-PD-1 treatment is not very effective.
Our second multifunctional therapeutic candidate, PRGN-5002, is advancing rapidly through preclinical development, targeting a different pathway to address tumor microenvironment driven immunosuppression, to enhance efficacy over checkpoint inhibitor. In a preclinical study, PRGN-5002 exhibited enhanced infiltration of cytotoxic T-cells into tumor and superior antitumor effect in humanized mouse model of cervical cancer compared to anti-PD-1 therapy. Our multifunctional therapeutics platform, including PRGN-5001 and PRGN-5002, has tremendous potential in multiple cancer indications, and we continue to evaluate the optimal path forward for their development, including partnership opportunities.
Next slide, please. To conclude, I like to again highlight that Precigen is highly differentiated from other immuno-oncology companies. We have made significant progress in advancing our pipeline, and we expect several data readouts in the coming quarters. The current slide shows the objectives we outlined during the JPMorgan Conference in January. We have already achieved these objectives as we have initiated a Phase I/Ib trial in AML and MDS for PRGN-3006 UltraCAR-T and completed dosing of the first cohort; initiated a Phase I trial for ovarian cancer for PRGN-3005 UltraCAR-T and completed dosing of the first cohort; we have advanced the PRGN-2009 for solid tumors; we have advanced one infectious disease candidate; and finally, we have also advanced multiple preclinical candidates.
We look forward to providing our key objectives for 2020 at the JPMorgan conference in January. We will now open the call up for questions.